Sedatives-Hypnotics

Question 1

What accounts for the long acting ability of some benzos vs others?

Answer 1

the long acting benzos are metabolized to nordiazapem which has a longer half-life

the short acting benzos undergo conjugation or CYP met

Question 2

what are the long acting benzos?

Short acting?

Answer 2

long: Clorazepate, diazepem, chlordiazepoxide, prazem, halazepm
short: alprazolam, oxazepam, lorazepam

Question 3

which benzos are CYP met

Answer 3

lorazepam and oxazepam

Question 4

what are the IV benzos

Answer 4

diazepam and lorazepam

Question 5

what preg category are the BNZ

Answer 5

D (contraindicated)

Question 6

diff in withdrawal of BNZ vs barbituates

Answer 6

barbituates = delerium and CV collapes

BNZ: sleep probs, depression, rebound anziety, seizures. systolic HTN, photo/audio sensitivity

Question 7

BNZ used to treat anxiety

Answer 7

alprazolam, lorazepam, clonazepam

Question 8

BNZ to treat panic attacks

Answer 8

alprazolam

Question 9

BNZ used for muscle relatxation/inhibits monosynaptic reflex in spinal cord

Answer 9

diazepam

Question 10

BNZ used in alcohol withdrawal

Answer 10

Chlordiazepam and diazepam

**Lorazepam if liver impairment

Question 11

describe the progression of tolerance that develops with BNZ

Answer 11

1st tolerate sedation
then anti-convulsant effects
rarely antiiolytic effects

Question 12

what is the mechanism

Answer 12

1. receptor uncoupling
2. receptor subunit down regulation
3. sensitization of glutamate system
4. cross talk from other GPCR systems (DA, Ach, 5HT)

Question 13

non-BNZ anxiolytics

Answer 13

busprione and propranolol

Question 14

MOA buspirone

Answer 14

supress 5HT while inc DA and NE activities

Question 15

suppresses somatic and autonomic symptoms of anxiety but does not alter emotional symptosm

Answer 15

propranolol