SM_90b: Sedatives and Hypnotics Flashcards
Sedative reduces ___ and produces a ___ effect
Sedative reduces excitatory response to external stimuli and produces a calming effect
Hypnotic causes ____ and ____
Hypnotic causes drowsiness and sleep
Sedative hypnotics cause ____ in lower doses and ____ in higher doses
Sedative hypnotics cause sedation in lower doses and sleep in higher doses

Most sedative-hypnotics act on the ____ receptor
Most sedative-hypnotics act on the GABAA receptor
- Ligand gated Cl- channel
- Bind between alpha and gamma subunits

Benzodiazepines bind between the ____ and ____ subunits of the GABAA receptor at the ____ site
Benzodiazepines bind between the alpha and gamma subunits of the GABAA receptor at the BDZ site

Benzodiazepines ____ GABA channel openings and ____
Benzodiazepines increase the frequency of GABAA channel openings and require GABA to open channels before acting

General anesthetics (propofol, etomidate) act by ____
General anesthetics (propofol, etomidate) act by increasing the duration of GABAA channel openings
- Act on beta subunit
- Higher doses can open channel without GABA

Barbiturates act by ____
Barbiturates act by increasing the duration of GABAA channel opening
- Act on alpha subunit
- Higher doses can open channel without GABA

Picrotoxin is a ____
Picrotoxin is a non-competitive GABAA antagonist that binds to the channel part of all subunits
Convulsant

Bicuculline is a ___
Bicuculline is a competitive GABAA antagonist that binds to GABA binding site
Convulsant

Penicillin is an ____
Penicillin is an uncompetitive GABAA antagonist
Convulsant
(blocks open channels, so needs agonist to work)

Benzodiazepines max out at causing ____ due to a ____
Benzodiazepines max out at causing anesthesia due to a ceiling effect

-azepams and -azolams are ____
-azepams and -azolams are benzodiazepines

____ is used for immediate relief of anxiety or aggression
Diazepam is used for immediate relief of anxiety or aggression

____ or ____ are used for immediate relief of panic
Alprazolam or clonazepam are used for immediate relief of panic
(severe anxiety with strong autonomic overactivity)

____ is used to treat REM sleep behavior disorder in which muscle atonia is absent
Clonazepam is used to treat REM sleep behavior disorder in which muscle atonia is absent

____ or ____ are used for sedation/amnesia during medical procedures and in balanced anesthesia
Midazolam or diazepam are used for sedation/amnesia during medical procedures and in balanced anesthesia

____, ____, or ____ are used as anticonvulsants
Diazepam, lorazepam, and clonazepam are used as anticonvulsants

____ are ____ used for muscle spasms
Diazepam and clonazepam are used for muscle spasms

____ are used to treat ethanol withdrawal
Benzodiazepines are used to treat ethanol withdrawal
____ can create anterograde amnesia
All benzodiazepines can create anterograde amnesia
____ may cause breakthrough panic attacks, while ____ may prevent breakthrough panic attacks
Short-acting agents such as alprazolam may cause breakthrough panic attacks, while long-acting agents such as clonazepam may prevent breakthrough panic attacks
After several months, stopping benzodiazepines will cause ___
After several months, stopping benzodiazepines will cause withdrawal symptoms
- Low to moderate dose: anxiety, agitation, muscle cramps (myoclonic jerks), sleep disturbances, dizziness, increased sensitivity to light and sound, paresthesias and strange sensatiosn
- High dose: seizure and delirium





























