Pharm 22 Sedative Hypnotics

Front 1

barbiturate with high lipid solubility, can be used for induction anesthesia d/t fast onset of CNS action

Back 1

thiopental

Front 2

how are actions of thiopental terminated?

Back 2

rapid redistribution to other highly perfused tissues

Front 3

several days of therapy with which drugs can lead to accumulation of active metabolites and excessive sedation?

Back 3

diazepam, flurazepam

Front 4

these benzos undergo extrahepatic conjugation and do not form active metabolites

Back 4

lorazepam, oxazepam

Front 5

benzos used for GAD?

Back 5

chlordiazepoxide, clonazepam, clorazepate (long-acting)

Front 6

MOA of benzodiazepines

Back 6

bind to GABA-A chloride channel and increase frequency of opening

Front 7

antidote for benzodiazepine OD

Back 7

flumazenil

Front 8

MOA of barbiturates

Back 8

facilitate and prolong GABA and glycine inhibition in reticular formation;
also binds to GABA-A receptor chloride channel and increase duration of its opening

Front 9

aside from their normal MOA, what effects to barbiturates have, esp at high doses?

Back 9

block glutamate and sodium channels

Front 10

sedatives that are not benzos but bind to the same receptor (with more selectivity)?

Back 10

zolpidem, zaleplon, eszopiclone

Front 11

when 2 or more sedative-hypnotics are given together, depressant effects are _____

Back 11

additive

Front 12

which of the sed-hyp drugs has a linear dose-response curve?

implication?

Back 12

barbiturates

dose too high = anesthesia -> medullary depression -> coma

Front 13

which sed-hyp's can produce anesthesia?

Back 13

midazolam, diazepam, and most barbiturates

Front 14

which drugs, at doses that suppress convulsions, do not produce marked sedation?

Back 14

phenobarbital, clonazepam

Front 15

which sed-hyp drugs are used in status epilepticus?

Back 15

high doses of IV diazepam, lorazepam, phenobarbital

Front 16

which drug is useful for spasticity states at sedative doses?

Back 16

diazepam

Front 17

which drugs have fewer withdrawal sxs after discontinuance?

Back 17

zolpidem, zaleplon, eszopiclone

Front 18

which sed-hyp are favored in tx of acute anxiety states?

Back 18

benzos

Front 19

drugs used in primary insomnia and other sleep disorders?

which have the least hangover?

Back 19

benzos (estazolam, flurazepam, triazolam)

zolpidem, zaleplon, eszopiclone (least hangover)

Front 20

sed-hyp used in tx of bipolar disorder?

Back 20

clonazepam

Front 21

drugs used to tx W/D from alcohol or other sedative hypnotics?

Back 21

long acting benzos (chlordiazepoxide, diazepam)

Front 22

most common drug interaction with sed-hyp's?

Back 22

additive CNS depression when used with etOH, antihistamines, antipsychotics, opioids, and TCAs

Front 23

sed-hyp's that induce CYP enzymes

Back 23

barbiturates and carbamates

Front 24

class of sed-hyp that can cause AIP

Back 24

barbiturates

Front 25

sed-hyp that increases anticoag effects of warfarin

Back 25

chloral hydrate

Front 26

atypical sed-hyp that is anxiolytic but has no anticonvulsant or muscle relaxant properties; partial agonist of 5HT-1A receptors

Back 26

Buspirone

Front 27

sed-hyp that activates melatonin receptors to decrease sleep latency

Back 27

ramelteon

Front 28

sxs of withdrawal from sed-hyp's, esp shorter-acting ones?

Back 28

anxiety, tremors, hyperreflexia, seizures

Front 29

half life of secobarbital is _____ than that of phenobarbital

Back 29

shorter

Front 30

anxiolytic with >1 week onset of action?

Back 30

buspirone