Care Viii - Pharmacology - Cns Depressants/antianxiety Agents - Lecture 17

Front 1

What are the two classes of drugs used as CNS depressants?

Back 1

1. barbiturates
2. benzodiazepines

Front 2

Both barbiturates and benzodiazepines are classified according to their...

Back 2

rate of onset and duration of action

Front 3

What are the 3 catagories of barbiturates?

Back 3

1. ultrashort acting
2. short to intermediate acting
3. long acting

Front 4

What are the ultrashort acting barbiturates?

Back 4

1. thiopental
2. thiamylal
3. methylhexital

Front 5

What are the short to intermediate acting barbiturates?

Back 5

1. secobarbital
2. pentobarbital

Front 6

What is the long acting barbiturate?

Back 6

phenobarbitol

Front 7

What mechanisms of action are shared by both barbiturates and benzodiazepines?

Back 7

-They both bind to a specific site on GABAa receptors.
-They both faciliate the actions of GABA.

Front 8

What is the difference in the mechanisms of action in barbiturates and benzodiazepines?

Back 8

Barbiturates can activate the GABAa receptors directly in large concentrations.
Benzodiazepines can NOT directly activate the GABAa receptors.

Front 9

What are the clinical uses for barbiturates?

Back 9

1. induction of anesthesia
2. treatment of some forms of epilepsy

Front 10

What are the adverse effects of barbiturates?

Back 10

1. CNS depression (sedation)
2. respiratory depression
3. tolerance
4. dependence
5. abuse

Front 11

What are the drug interactions for barbiturates?

Back 11

-additive effects with other CNS depressants
-induction of hepatic enzymes can accelerate metabolism of other drugs

Front 12

Pharmacokinetics of barbiturates...

Back 12

-rate of distribution depends on their lipid solubility
-metabolism can be altered by induction of hepatic enzymes

Front 13

What are the catagories of benzodiazapines?

Back 13

1. short acting
2. intermediate acting
3. long acting

Front 14

What are the short acting benzodiazepines?

Back 14

1. midazolam
2. triazolam

Front 15

What are the intermediate acting benzodiazepines?

Back 15

1. lorazepam
2. oxazepam
3. temazepam
4. alprazolam
5. chlordiazepoxide

Front 16

What are the long acting benzodiazepines?

Back 16

1. flurazepam
2. diazepam
3. clonazepam

Front 17

Pharmacokinetics of benzodiazepines...

Back 17

metabolism can result in the formation of active metabolites

Front 18

What are the clinical uses of benzodiazepines?

Back 18

1. anxiolytic effects
2. sedative effects
3. muscle relaxant effects
4. anticonvulsant effects
5. induction of anesthesia

Front 19

What are the adverse effects of benzodiazepines?

Back 19

1. CNS depression (sedation)
2. anterograde amnesia
3. respiratory depression
4. tolerance
5. dependence
6. abuse potential

Front 20

What are the drug interactions of benzodiazepines?

Back 20

addictive effects with other CNS depressants

Front 21

Which anxiety disorder is described as... a persistant state of heightened anxiety with increased levels of motor tension and autonomic hyperactivity

Back 21

generalized anxiety disorder

Front 22

Which anxiety disorder is described as... recurrent, discrete periods of sudden and intense fear or discomfort accompanied by autonomic arousal

Back 22

panic disorder

Front 23

What are the 4 categories of treatment of anxiety disorders?

Back 23

1. benzodiazepines
2. buspirone
3. antidepressants
4. beta blockers

Front 24

Which anti-anxiety drug is the only benzodiazepine marketed for panic disorder?

Back 24

alprazolam (xanax)

Front 25

What is the first choice for treatment of panic disorder?

Back 25

antidepressants

Front 26

Which of the anti-anxiety drugs are used to prevent performance anxiety?

Back 26

beta blockers

Front 27

What are the adverse effects of buspirone?

Back 27

headache
nausea
dizziness

Front 28

What are the causes of insomnia?

Back 28

1. stress or emotional upset
2. aging
3. medical and psychiatric illness
4. drugs/alcohol
5. sleep cycle disruption (jet lag)

Front 29

What are the 5 catagories of drugs used to treat insomnia?

Back 29

1. benzodiazepines
2. non-benzodiazepines
3. chloral hydrate
4. antidepressants
5. antihistamines

Front 30

What drug should NOT be used for the treatment of insomnia?

Back 30

chloral hydrate

Front 31

What are the 3 benzodiazepines used to treat insomnia?

Back 31

1. triazolam
2. flurazepam
3. temazepam

Front 32

What are the 3 non-benzodiazepines used to treat insomnia?

Back 32

1. zolpidem (ambien)
2. zaleplon (sonata)
3. eszopiclone (lunesta)

Front 33

Which of the anti-anxiety drug classes have immediate anxiolytic effects?

Back 33

benzodiazepines

Front 34

Which of the anti-anxiety drugs is a serotonin agonist?

Back 34

buspirone

Front 35

Which of the anti-anxiety drugs has a long latency to obtain anxiolytic effects?

Back 35

buspirone

Front 36

true or false:
two CNS depressants given together will produce a synergistic effect

Back 36

true

Front 37

What are the two types of sleep disorders?

Back 37

1. sleep maintence disorder
2. sleep onset disorder

Front 38

Which anti-anxiety drug is the first choice for grand mal seizures?

Back 38

lorazepam

Front 39

Which anti-anxiety drug is used for sleep maintence disorder?

Back 39

temazepam

Front 40

Which of the anti-anxiety drugs don't have active metabolites? (so they are used for DT's and are easy on the liver)

Back 40

1. lorazepam
2. oxyazepam
3. tomazepam

Front 41

True or false:
You can become dependent on benzodiazepines given at the therapeutic level.

Back 41

true

Front 42

true or false:
A person must go through withdrawls to be considered physically dependent.

Back 42

true

Front 43

true or false:
In the case of CNS depressants, withdrawls can be life threatening.

Back 43

true

Front 44

If you give benzodiazepines through IV, respiratory depression....

Back 44

increases dramatically.

Front 45

Excitation of CNS may cause...

Back 45

seizures