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10 Cards in this Set

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What is primary use of barbiturates?
Mostly sedative. Poor anxiolytics. Good anticonvulsants (phenobarbital). Good for induction of anesthesia (thiopental)
What is phenobarbital good for?
ANTICONVULSANT...80-120 hr half-life!!!
Mechanism of action of barbiturates?
ENHANCED BINDING OF GABA TO GABA RECEPTOR. Hyperpolarization of cell. Inotropic effects (decreases current through cardio calcium channels)
What are effects of barbiturates on respiratory and cardiovascular rates?
Depression of cardio-respiratory centers in brainstem. Depression of CO2 response curve. Depression of hypoxic drive.

Blood Pressure drop because decreased contractile force (inotropy) and decreased preload (inhibited homeostatic reflexes)
What is danger with barbiturates?
MAINLY SEDATIVES...NARROW THERAPEUTIC RANGE
Mechanism of action of benzodiazapenes?
DIRECTLY BINDS TO GABA RECEPTOR/CL CHANNEL COMPLEX. Different receptor subtypes.
Cardiovascular and respiratory effects of benzo's
Decreased blood pressure, causes barroreceptor increase in heart rate. May have effect on initiation of respiration.
Problems with benzo's...
POTENTIAL FOR ADDICTION. NEGATIVELY IMPACT SLEEP ARCHITECTURE! NOT RECOMMENDED FOR LONG-TERM SLEEP AID. (use non-benzo sedative/hypnotics)
TREATMENT OF SLEEP DISORDERS
1) Look for underlying medical conditions (hyperthyroidism, apnea, stimulant use, chronic pain)

2) Underlying psychological conditions (mania, depression, schizophrenia, anxiety disorder)

3) Exercise, sleep hygiene, stimulant NONUSE, LESS ALCOHOL

4) Benzos bad because fuck with sleep architecture...less REM.
How do you treat alcohol withdrawal?
Benzo's! Cross-tolerance.