Test 2 Hypnotics and Sedatives Flashcards
How do older sedatives/hypnotics/alcohol differ from Benzos and newer hypnotics?
Benzos and newer hypnotics have a higher margin of safety
What is the indicated use for Alprazolam?
Depression
What is the indicated use for chlordiazepoxide?
Alcohol withdraw syndrome
What is the indicated use for clonazapam?
Convusions, panic disorder, muscle relaxation
What is the indicated use for valium and lorazepam?
Status epilepticus
What is the indicated use for Triazolam?
Early morning insomnia
Which drugs are listed as anxiolytics?
Literally all of them except triazolam and flurazepam
What can make benzos dangerous?
When combined with other CNS depressants, but rarely fatal by themselves, even at high doses
What is the main mechanistical property of benzos?
Sedation and hypnosis, which increase as the dose increases
Decreases time to fall asleep, increases the time of Non rem sleep
Decreases the duration of Rem sleep
What type of amnesia can benzos cause? Differentiate if from the other type.
Anterograde amnesia, given pre operatively and makes them forget what’s about to happen
Retrograde is where their memory is lost of an event that already occurred
What are the three benzos listed as anticonvulsants?
Clonazepam, lorazapam, diazepam
CAD (ativan instead of L)
What does benzos bind to specifically? Causing what action?
GABA A, increases the frequency of channel opening events
What effect do benzos have on neuronal inhibition mediated by GABA?
It potentiates it!
What are the side effects of benzos?
Ataxia, discordination
Abuse/dependence
Withdrawal if using chronically then stopping
Drug to drug interactions with alcohol-increases the absorbtion of benzos
What effect does alcohol have on benzos?
Alcohol increases the absorption rate of BZDs
What are the half life’s of short, intermediate, and long acting benzos?
short- less than 6 hours
Intermediate- 6-24 hours
Long- Over 24 hours
What category is buspirone?
Partial 5-HT 1A agonist at the brain and affinity with D2 receptors
What drug class is zolpidem, zaleplon, and eszopiclone?
Non-benzo
What are the non benzos MOA?
Selectively bind to BZ1 (a1) subtype of GABA A receptor
What are the muscle relaxant and anticonvulsion properties of non benzos?
Minimal of either
When are doe adjustments needed with non benzos?
Hepatic issues, elderly, patients taking cimetidine and rifampin. Inhibitor and inducer, respectively
What is the benzo AND non benzo reversal?
Flumazenil
What drug category is flumazenil?
Competitive BZD antagonist
What are the downsides of barbituates, compared to benzos?
Barbituates are more dangerous overall, higher incidence of toxicity, abuse, and physical dependence
