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24 Cards in this Set

  • Front
  • Back
the sedative -hypnotics are drugs that
depress CNS function.
used mainly to treat anxiety and insomnia.
anxiolytics
drugs used to relieve anxiety
hypnotics
drugs used to promote sleep.
the three major groups of sedative-hypnotics are
barbiturates ex: secobarbital
benzodiazepines ex: diazepam
benzodiazepine-like ex: zolpidem
Drugs of choice for anxiety and insomnia are the
benzodiazepines.
Benzodiazepines work by
potentiating the inhibitory actions of GABA.
they are safer than barbiturates since ther is a finite amount of endogenous GABA., thus limiting the depth of CNS depression.
barbiturates work by
mimicking the the actions of of GABA.
profound CNS depression can occur if the dose is great enough.
the high lipid solubility of benzodiazepines readily
allow crossing of the blood-brain barrier of the CNS.
readily cross the placental barrier and are contraindicated, especially during the first trimester increasing the risk of congenital defects.
they are pregnancy risk category D and some are category X.
benzodiazepines metabolites are
pharmacologically active and may have a long duration.
benzodiazepines are contraindicated in
pregnancy and those suffering from sleep apnea.
GABA
the principle inhibitory neurotransmitter in the CNS.
benzodiazepines cause minimal respiratory depression except when
combined with other CNS depressants like barbiturates, opioids and alcohol.
the principle adverse effects of benzodiazepines are
daytime sedation, anterograde amnesia
the principle indications for benzodiazepines are
anxiety, imsomnia and seizure disorders.
Flumazenil is
a benzodiazepine receptor antagonist and is used to treat a benzodiazepine overdose.
hypnotic agents, in general, are contraindicated in
pregancy
benzodiazepines
Halcion-triazolam
rapid onset
short duration
good choice for patients having trouble falling asleep
benzodiazepines
Dalmane-flurazepam
delayed onset
prolonged duration
good choice for patients having difficulty maintaining sleep.
benzodiazepine-like drugs
Ambien-zolpidem
Sonata-zaleplon
Lunesta-eszopiclone
drugs of choice for insomnia
not anxiolytic
not contraindicated for pregnancy
rapid onset-help those having difficulty falling asleep.
Melatonin agonists
Rozerem-
approved for long term therapy of insomnia.
rapid onset
short duration
does not cause tolerance or dependence.
not regulated as a controlled substance.
melatonin
a hormone released by the pineal gland, which is located at the base of the brain.
secretion is suppressed by environmental light and stimulated by darkness.
secretion is greatest in children and declines with age.
secretion is signaled by neuronal pathway that connects the retina to the pineal gland.
Antihistamines
diphenhydramamine Hcl-Benadryl
side effects
may cause tachycardia, dry mouth, drowsiness and decreased blood pressure in the elderly.
increase fluid intake and avoid alcohol.
benzodiazepines and benzodiazepine-like drugs
side effects
may cause drowsiness, excitement, dry mouth, nightmares and nausea.
for short term use,
avoid alcohol
barbiturates
phenobarbital
seconol
dalmane
nembutal
side effects:
drowsiness
excitement
decreased respiratory rate
decrease REM sleep
for short term use
avoid alcohol and other CNS depressants.