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Pharmacology > Sedatives & Hypnotics > Flashcards

Sedatives & Hypnotics Flashcards

1
Q

Ok, so what’s the difference between a sedative, a hypnotic, and a general anesthetic?

A

Sedative: Anxiolytic (“inhibit anxiety) – but ideally with minimal effect on motor or mental functions. Hypnotic: Induce sleep (with a much more pronounced CNS depression than sedatives). General Anesthetic: Induce reversible coma – Hypnosis, Amnesia, Analgesia, Muscle relaxation, Attenuation of autonomic reflexes.

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2
Q

Benzodiazepines?

A

Diazepam, Chordiazepoxide, Lorazepam, Flurazepam, Alprazolam, Midrazolam, Triazolam

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3
Q

Diazepam class?

A

Benzodiazepine

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4
Q

Chlordiazepoxide class?

A

Benzodiazepine

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5
Q

Lorazepam class?

A

Benzodiazepine

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6
Q

Flurazepam class?

A

Benzodiazepine

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7
Q

Alprazolam class?

A

Benzodiazepine

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8
Q

Midrazolam class?

A

Benzodiazepine

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9
Q

Triazolam class?

A

Benzodiazepine

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10
Q

Benzodiazepine mxn?

A

GABAa agonist: bind between a1 & y2 subunits.

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11
Q

Diazepam half-life? Active mets for?

A

43 hrs, 100 hrs

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12
Q

Diazepam for?

A

Depression, Bipolar, Anticonvulsant, Muscle relaxant

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13
Q

Chlordiazepoxide half life? Active mets for?

A

10 hrs, 100 hrs

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14
Q

Chlordiazepoxide for?

A

Depression, Bipolar

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15
Q

Lorazepam half life?

A

14 hrs

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16
Q

Lorazepam for?

A

Depression, Bipolar, Sedation, Anticonvulsant, Prevent w/drawal in alcoholics

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17
Q

Flurazepam half life? Active mets for?

A

74 hrs, 100 hrs

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18
Q

Flurazepam for?

A

Depression, Bipolar

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19
Q

Alprazolam half life?

A

12 hrs

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20
Q

Alprazolam for?

A

Depression, Bipolar Sedation

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21
Q

Midazolam half life?

A

1.9 hours

22
Q

Midazolam for?

A

Anesthesia (calms, anterograde amnesia)

23
Q

Triazolam half life?

A

2.9 hours

24
Q

Triazolam for?

A

Depression, Bipolar, Sleep

25
Q

Benzodiazepine side effects?

A

Daytime sedation, drowsiness, anterograde amnesia, synergistic/additive CNS depression with other drugs (but remember the “ceiling effect”), psychologic & physiologic dependence with chronic use

26
Q

Use of sedative-hypnotics?

A

Induce sleep, anxiolysis (GAD, panic disorders, OCD, phobias), muscle relaxation, anticonculsant, pre-anesthetic, recreation

27
Q

Zolpidem class?

A

Non-benzodiazepine receptor agonist – BDZ-1 selective agonist

28
Q

Zolpidem for?

A

Sedation and hypnosis WITHOUT muscle relaxation or anticonvulsant activity

29
Q

Zolpidem side effects?

A

Sleep-walking, next morning impairment (still, generally short half-life, so little hang over)

30
Q

Flumazenil class?

A

Benzodiazepine antagonist: Competitive non-selective antagonist

31
Q

Flumazenil use?

A

Benzodiazepine overdose

32
Q

Flumazenil side effect?

A

Withdrawal (may be life threatening), seizures in mixed overdoses

33
Q

Barbiturates?

A

Thiopental & Phenobarbital

34
Q

Barbiturate mxn?

A

GABAa agonists

35
Q

Thiopentinal for?

A

Induce anasthesia

36
Q

Phenobarbital for?

A

Antiepileptic, anticonvulsant

37
Q

Barbiturate side effects?

A

Daytime sedation and drowsiness, dose-dependent depression of CNS, psychologic and physiologic dependence (chronic use), significant P450 enzyme induction,

38
Q

Why cant other barbiturates be used for hypnosis?

A

Half-lifes are too long: they will accumulate during repetitive administration (hence the preferred use of benzodiazepienes)

39
Q

Buspirone mxn?

A

Partial agonist at 5HT1A receptors, NO interaction with GABAa

40
Q

Buspirone for?

A

Anxiolytic WITHOUT marked sedation (euphoric, hypnotic, anticonvulsant, muscle relaxant)

41
Q

Benzos for sedation?

A

Lorazepam, Alprazolam

42
Q

Benzos for sleep?

A

Triazolam, Zolpidem (pseudo-benzo)

43
Q

Benzos for anesthesia? What else can be used?

A

Midazolam (+ calming, anterograde amnesia). For induction, thiopental (barbiturate) is used.

44
Q

Benzos for anticonvulsion? What else can be used?

A

Lorazepam, Diazepam. Phenobarbital (barbiturate) can also be used.

45
Q

Benzo for muscle relaxation?

A

Diazepam

46
Q

Depression tx?

A

Antidepressants for long term, Benzos for short term immediacy if needed

47
Q

Acute anxiety tx?

A

Benzos

48
Q

GAD?

A

SSRIs are first line, then buspirone & benzos

49
Q

Panic disorder tx?

A

SSRIs, benzos

50
Q

OCD tx?

A

SSRIs

51
Q

PTSD tx?

A

Various antidepressants

Pharmacology (46 decks)

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