Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pharm > antianxiety, relaxants, sedative hypnotics, etOH > Flashcards

antianxiety, relaxants, sedative hypnotics, etOH Flashcards

1
Q

Alprazolam (Xanax)

A

Benzo

intermediate acting

anxiolytic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Chlordiazepoxide (Librium)

A

Benzo

long acting

Anxiolytic, Anticonvulsant, Withdrawal suppressant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Diazepam (Valium)

A

Benzo, Centrally acting musc. relaxant

long acting

Anxiolytic, Anticonvulsant, Anesthesia supplement,
Withdrawal suppressant, Muscle relaxant (for spasms)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Lorazepam (Ativan)

A

Benzo, Centrally acting musc. relaxant

intermediate acting

Hypnotic, Anxiolytic, Anesthesia supplement, Withdrawal suppressant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Midazolam (Versed)

A

Benzo

short-acting

Induction or supplement to anesthesia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Temazepam (Restoril)

A

Benzo

intermediate-acting

hypnotic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Triazolam (Halcion)

A

Benzo

short acting (good to help fall asleep)

hypnotic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Flumazenil (Romazicon)

A

BENZODIAZEPINE ANTAGONIST

antag. at benzo receptor
not v. useful in emergencies: benzos don’t depr. resp that much, won’t reverse barb/opiate/etOH induced resp depr.

  • used in anesthesiology: post-op when given benzo, block effects, come out quicker
  • can trigger seizures in pts dependent on benzos/barbs/etOH
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Butalbital (Fiorinal)

A

BARBITURATE

for tension ha, centrally acting relaxant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Pentobarbital (Nembutal)

A

BARBITURATES

intermediate/short acting

sedative-hypnotics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Phenobarbital

A

BARBITURATES

long acting

tx for epilepsy, anticonvulsant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Thiopental (Pentothal)

A

BARBITURATES

ultra-short acting

not currently used
IV induction of sx anesthesia
used for execution, then pancuronium (NM blocker)–>then K to stop heart

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Balcofen (Lioresal)

A

CENTRALLY ACTING MUSCLE RELAXANT

analog of GABA, acts as agonist at GABAb

dec. skel. musc tone
tx spasticity (UMN probs)
rehab medicine

adverse: CNS depression, musc. wkness, dependence/abuse potential

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Cyclobenzaprine (Flexeril)

A

CENTRALLY ACTING MUSCLE RELAXANT

related to tricyclic antideps.
most widely prescribed muscle relaxant
doesn’t work as well as benzos
don’t operate machinery, drive

highly sedating

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Diazepam (Valium)

A

CENTRALLY ACTING MUSCLE RELAXANT

muscle spasms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Metaxalone (Skelaxin)

A

CENTRALLY ACTING MUSCLE RELAXANT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Tizanidine (Zanaflex)

A

CENTRALLY ACTING MUSCLE RELAXANT

alpha2 agonist (like Clonidine) 
CNS effects: dec. skel musc. tone

very sedating (take at night)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Alcohol

A

MISC. ANXIOLYTIC AND SEDATIVE-HYPNOTIC

anxiolytics, sedative, relaxant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Buspirone (Buspar)

A

MISC. ANXIOLYTIC AND SEDATIVE-HYPNOTIC

anti-anxiety, NO musc. relaxation, NOT sedating

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Gammahydroxybutyrate (GHB)

A

MISC. ANXIOLYTIC AND SEDATIVE-HYPNOTIC

abused: party/club, date rape

GABA analog, crosses BBB

ergogenic effect: body building

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Melatonin

A

MISC. ANXIOLYTIC AND SEDATIVE-HYPNOTIC

nutritional suppl, not prescription, OTC

can normalize sleep patterns- “shift-work disorder”, travel
no effect on REM sleep (good quality sleep!)

don’t work well for most

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Ramelteon (Rozerem)

A

MISC. ANXIOLYTIC AND SEDATIVE-HYPNOTIC

melatonin-rec agonist
jet-leg, etc.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Zolpidem (Ambien)

A

MISC. ANXIOLYTIC AND SEDATIVE-HYPNOTIC

longer acting (6-8 hrs)

widely presc. sleep med
newer, even less effect on REM sleep (good!)

non-benzos, but benzo agonist, bind receptors
enhance GABA-stim Cl- influx

less anxiolytic, less musc relaxant

should be prescribed short term

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Zaleplon (Sonata)

A

MISC. ANXIOLYTIC AND SEDATIVE-HYPNOTIC

short acting (2-4 hrs)
help getting to sleep initially
or take in middle of night

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Oxazepam (Serax)

A

Benzo

intermediate-acting
sleep aid
Hypnotic, Anxiolytic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Disulfiram (Antibuse)

A

etOH tx

inhibits of aldehyde dehydrogenase : blocks conversion of acetaldehyde to acetate
“acetaldehyde sickness”

*induces unpleasant rxn: flushing, ha, nausea, confusion
encourages abstinence

hepatotoxicity
also inhibits p450, drug interactions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Acamprosate (Campral)

A

etOH tx

decrease cravings for alcohol

may involve glutamate and GABA receptors, block NMDA receptors, stimulate GABA-A rec.

less potential for hepatoxicity than others

can use combo with naltrexone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Naltrexone (ReVIA)

A

etOH tx

long-acting opioid antagonist

reduce craving for alcohol in alcoholic

hepatotoxicity can make pain worse

other form: vivitrol: repo injection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Eszopiclone (Lunesta)

A

MISC. ANXIOLYTIC AND SEDATIVE-HYPNOTIC

longer acting (6-8 hrs)

act at benzo receptors (benzo agonist) but NOT benzos

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

action of these drugs

A

graded dose dep depression of CNS function

see graph

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

barbituate curve

A

steep curve, more potent than etOH

used to prescribe enough barb sleeping pills to kill someone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

etOH curve

A

not v. potent, but steep response curve!

33
Q

benzo curve

A

produce graded effects earlier, but plateau, so less likely to cause death
safer

34
Q

benzo generalities

A

safer than Barbs, less likely to depr. resp. in OD

anticonvulsant for seizures

anxiolytic, acute panic/phobia disorders
GAD more tx by antideps

centrally acting musc. relaxant

35
Q

benzos mech of action

A

(benzo binding enhances GABA) GABA A receptors

influx of Cl—>hyper polarized–>less likely to reach AP

36
Q

barb mech of action

A

barbs also enhance GABA-med opening of Cl- channels
CAN ALSO open Cl- themselves (benzos can’t)
*dangerous

37
Q

what else enhances GABA stim. Cl- influx

A

etOH

(why etOH/benzos/barbs share similar effects and exhibit cross-tolerance) and benzos (ativan) can be used to suppress etOH withdrawal (cross-dependence)

38
Q

higher dose SEs

A

sedation drowsiness, lightheadedness (lower doses)

mental clouding, psychomotor impairment, ataxia
(drunk-like)

memory impairment: anterograde amnesia (new mem.)- good in benzos for unpleasant procedures

disinhibitions
used for date-rape

euphoria, hangover, rebound anxiety, mild resp. depression, tolerance, dependence

*teratogen

39
Q

rohypnol vs valium for date rape

A

rohypnol more soluble in drinks

40
Q

CNS side effects may be especially pronounced in ??

A

elderly patients

or OD

41
Q

if take valium (longer acting benzos) to sleep…

A

have “hangover effect” in morning

42
Q

may experience rebound anxiety

A

especially with short acting drugs such as triazolam (HALCION) or etOH

-perpetrates cycle of dependence

43
Q

one benzo that is more likely to cause respiratory depression?

also ??

A

midazolam (VERSED)
powerful, state of anesthesia

enhanced resp. depression when taken with other resp. depressors (opioids: narco, etc)

44
Q

tolerance develops rapidly to

A

sedative - hypnotic effects
i.e. to help sleep
decreasing effects, use short term for insomnia

45
Q

tolerance does not dev. as rapidly to

A

anxiolytic effect (good!)

get anxiety relief w.out as much sedation

46
Q

benzo dependence?

A

physical and psychological

47
Q

w.drawal symptoms

A

agitation, anxiety, irritability, insomnia, abdominal cramps, sweating, and seizures

48
Q

to avoid benzo withdrawal

A

gradually wean pt off drug by dec. dose by 10% every 2-3 days for 2-3 wks

49
Q

very serious benzo w/drawal symptoms

A

delerium, tremors

grand mal seizures (may be status epilepticus)

life-threatening–>tx!

50
Q

if dependent on short acting drug

if dep. on longer acting drug

A

withdrawal syndrome will tend to be fairly intense, but of a short duration (e.g. 1-5 days)

less intense, but 5-30 days

51
Q

benzos and preggos

A

don’t use! possible teratogenicity

52
Q

benzo effect on sleep

A

decrease sleep latency (time needed to fall asleep)

increase time spent in stage 2 non-REM sleep

dec. time spent in REM sleep (but we need some!)–>so decreases quality of sleep

“REM rebound” when go off benzos: crazy dreams

53
Q

drug suppresses REM sleep the most

A

etOH (poor quality sleep)

then barbs

then benzos

54
Q

diazepam has to undergo

A

Phase 1 oxidative metabolism–>long lived active metabolites
longer acting drugs

then Phase 2: conjugated to glucuronide and excreted

*not easy for alcoholic (liver failure) pts to get rid of–>toxicity

55
Q

some benzo metabolites

A

are active!

may be even harder to get rid of

56
Q

lorazepam and oxazepam are directly

A

conjugated to glucuronide and excreted (no Phase 1: oxidation)
*better for liver failure pts

57
Q

drugs that can inhibit the oxidative metabolism of benzos–>prolong action

A

Cimetidine (Tagamet)
disulfiram (antabuse)
INH

58
Q

benzos can inc. serum levels of

A

digoxin, and possibly phenytoin

59
Q

barbs vs benzos

A

better anesthetic effect
anticonvulsants effects
more euphoric effect
respiration depression

60
Q

barbs are metabolized by

why drug interactions??

A

hepatic microsomal system

induction of microsomal enzymes–>potential for drug interactions

61
Q

barbs adverse effects

A

worse then benzos
GI upset, nausea
allergic reactions, skin

aggravation of acute intermittent porphyria–>induce hepatic enzymes involved in porphyrin synthesis
(vs. benzos: do not induce hepatic drug metabolizing enzymes)

62
Q

?? effects greatly reduced by phenobarbital

A

Warfarin

63
Q

barb abuse

A

?

64
Q

barb poisoning

A

suicide
CNS depression
tx symptomatically, no antidotes

65
Q

Buspirone (Buspar) 2

does not act thru ??

cannot be used for ??

A

newer drug, slower acting, 2-4 weeks!

does not act thru GABA mech, may be partial agonist at serotonin (5-HT)

WILL NOT suppress symps of etOH w.drawal, need to use benzos

better than benzos for long term alcoholic psych care
*don’t use benzos, too similar to etOH, trigger

66
Q

sedative/hypnotic SEs

A

CNS depression

REM rebound

67
Q

antihistamines sometimes used for

A

sedation

*Hydroxyzine (ATARAX, VISTARIL)
*promethazine (PHENERGAN)
diphenhydramine(benadryl)

68
Q

propranolol

A

B-blocker
used for anxiolytic affects
-dec. HR, HTN, etc
-helps “stage fright”

69
Q

etOH metabolism in liver

A

90%

zero order kinetics: constant rate, independent of concentration

metabolized @ 7-10 g/hour

alcohol dehydrogenase pathway
microsomal etOH oxidizing system (MEOS)

70
Q

alcohol dehydrogenase pathway

A

etOH + NAD–>acetaldehyde*

*excess accumulation may be toxic

71
Q

MEOS

A

etOH + NADPH–>acetaldehyde

low doses: most by etOH dehydrogenase pathway

  • this pathway used more @ higher doses and induced w. chronic consumption
  • tolerance and drug interactions
72
Q

aldehyde metabolism

A

acetaldehyde–>acetate–>H2O + CO2

via aldehyde dehydrogenase
*inhibited by disulfiram

some Asians have lower levels aldehyde dehydrogenase

73
Q

etOH probs

A

N/V, e-lyte abnormalities

sleep probe

resp. depression

CV: flushing, warmth, HTN, cardiomyopathies, arrhythmias

74
Q

hangovers from ??

A 
acetaldehyde buildup
alcohol analogs present in beverages
metabolic changes and dehydration resulting from acute alcohol
intoxication
pharmacodynamic changes in the brain
75
Q

benefits of drinking

A

mod use (1-2 drinks/day) shown to inc. conc. of HDL, dec. LDL

76
Q

etOH withdrawal: onset, duration

mild?

severe?

A

6-24 hrs after last drink, typ. resolve in 5 days

mild: anxiety, irritability, insomnia, nausea, sweating, tachycardia, palpitations, hypertension.
severe: anxiety, fear, hallucinations (alcohol hallucinosis), delirium, tremors (delirium tremens), grand mal seizures, hypertension, tachycardia, arrhythmias *emergency

77
Q

etOH withdrawal tx

antipsychotics?

A

benzos: diazepam, lorazepam, and oxazepam

phenytoin (dilantin) to control seizures

no anti psychs, make seizures worse

*clonidine for ANS/CV effects

vitamins

78
Q

goal etOH withdrawal tx

A

prevent seizures, delirium, arrythmias

79
Q

general use of benzos

A 
anxiety
sedative-hypnotics
acute etOH w.drawal
convulsive seizure, status epilepticus
skel musc spasms
preanesthetic med and supplement
induction of anesthesia

Pharm (45 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions