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27 Cards in this Set

  • Front
  • Back
- used to treat chronic anxiety
Barbituates, alcohol, Chloral hydrate, GHB
- "type A drugs"
- produce a nonselective, dose dependent depression of CNS.
- first order thing
- "type B drugs"
- have sedative-hypnotice and/or muscle relaxing effects
- less severe depression of CNS (safer!)
Type A drugs and Type B effects
- both do: sedation, relief of sedation, hypnosis
- only A does anesthesia
- B can only be used as ADJUNCT to anesthesia
Benzodiazepine mechanism
- does not stimulate GABA receptor by itself
- it is an agonist
- Causes GABA receptor to bind with a greater affinity
Barbiturates mechanism
- unlike benzodiazepine, these can actually directly activate GABA receptors
- also, they can inhibit excitatory receptors
Are barbiturates more or less POTENT than benzo's???
- they are LESS potent.
- You actually have to give more
- a barbiturate
- used at LOW dose to tx anxiety
- benzo that is an anti-anxiety, but also hhas special indication for panic disorders and agoraphobia
Benzo's used as Anti-anxiety drugs
- Alprazolam (panic disorders
- Diazepam (long term)
- Lorazepam (short term)
- Triazolam (brief half life)
- Midazolam (IV only)
- Oxazepam (short term)
Benzo's used as sedatives
- used well at low dose, but tolerance usually develops after a few days
benzo for anitconvulsants
- Diazepam used for status epilepticus, alcohol withdrawl, and reactions to local anesthetics
Drugs for hypnosis
- fast acting benzo's are the best
- often Triazolam - this drug also effective because it has less side effects on REM
Side effects of Benzo's
- respiration depression (but not as bad as bartbiturates)
- Euphoria - makes the short acting drugs likely to be abused
- Paradoxical excitement - release of punishment suppressed behavior
- Anterograde amnesia - often when used with anethetics
Interactions of benzo's with other drugs
- additive CNS depression with alcohol and other sedatives
- Cross tolerance
- Oral contraceptives reducediazepam elimination
- benzo antagonist!!
- used in emergency
- careful of withdrawl symptoms
Barbituates: theraputic uses
- IV anesthetic : short acting
- Sedatives
- Anticonvulsant: epilepsy
- barbit
- ultra short acting
- due to lipid solubility
- barbit
- primarily used as a anti-epileptic drug
- barbit
- hypnotic with high abuse potential
- Alternate drug
- anti-depressant
- very slow acting - takes weeks to see effects
- no sedative effects
- affects serotonin receptors
Beta blockers
- alternative
- Propranolol
- decreases sympathetic tone
- may give symptomatic relief of anxiety
Alpha 2 agonist
- alternative
- Clonidine
Tricyclic antidepressants
- alternative
- used to tx panic attacks
Zolipidem, Zaleplon
- sedative/hypnotic
- thought to have low abuse potential
- have unique structures
- Lunesta
Chloral hydrate
- other sedative/hypnotic
- inexpensive
- liquid form for children
- converted to trichloroethanol
- chronic use can be hepatotoxic
- laryngeal spasm
Hydroxzine, Diphenhydramine
- antihistamines used for sedative effects
- OTC's
- may synergize with morphine
- often have anticholinergic side effects (dry mouth)
- contraindicated for pregnant woman