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17 Cards in this Set
- Front
- Back
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GABA
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Inhibits norepinephrine (Depresses CNS)
Acts through GABA receptors (type A and B) Type A….Increases the influx Cl- ions |
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Benzodiazepines (BDZ)
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Increases the FREQUENCY of Cl- channel opening
Short-acting …. t1/2 <6hrs Triazolam, midazolam (versed) Intermediate-acting t1/2 = 6-20hrs Lorazepam(ativan), oxazepam, alprazolam (xanax) Long-acting t1/2 >20hrs Diazepam (Valium), Flurazepam |
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Q; drug, very addictive, withdrawal syndromes;
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looking for drug that is short-acting! (triazolam, midazolam)
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Q; drug for -anesthesia?
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short acting; will INDUCE sleep
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maintenance of anesthesia
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use long acting
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Q- old lady took drug to fall asleep; she fell down the stairs
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means she long acting sedation; long acting
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Benzodiazapems that are excreted in stool NOT kidney
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Lorazepam and oxazepam
-any kidney ptn needs these drugs (even for sedation) -INCL old ppl |
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Q-76 ptn comes in for surgery;
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Lorazepam and oxazepam
we need to assume old ppl have lower kidney exretion |
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Diazepam (valium)/ lorazepam(ativan) IV
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DOC for status epilepticus, muscle spasms, tetanus , IV General Anesthesia , febrile convulsions (per rectal route ), withdrawal symptoms treatment, eclampsia
-Diazepam DOC for status epilepticus (except in old people, give lorazepam even for status epilepticus) |
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eclampsia
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ONLY diazepam; AGE does not matter
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FLUMAZENIL
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Benzodiazapems TX of Overdose
A competitive benzodiazepine receptor antagonist (refering to GABA type A receptor) DATE RAPE |
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Zolpidem
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is its own class b/c it has no addictive traits (DOC for any type of ansomina); other wise it is the same as benzodiasapine
-overdose also use Flumazenil |
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Barbituates
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GABA type A receptor (different spot from the BDZ spot)
Increases the DURATION of Cl- channel opening AND Also mimic GABA – So …More CNS depression Also inhibits glutamate receptor Long –acting **Phenobarbital 80-120 Short-acting Secobarbital 15-14 Ultra-short-acting **Thiopental 08-14 ***Because of Rapid redistribution of the drug into brain, thiopental is ultra short acting |
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Barbituates uses
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used in grand mal and status epileptics
Thiopental (IV) for inducing general anesthesia (one of the induction agents) (Important question) |
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Barbituates drug interactions
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induced hepatic microsomal enzymes increases the metabolism of many drugs
-- anti-coagulants like Warfarin --Oral contraceptives 2. Some drugs increase the effect of barbiturates CNS depression: BDZ, Alcohol etc |
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Buspirone
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-GENERALIZED ANXIETY USE BUSPIRONE
-generalized anxiety; sleep disturbances , no relation with BDZ or barbitutrates, slow effects No rebound or withdrawal signs No hypnotic, anticonvulsant, muscle relaxant properties 5HT1 agonist |
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Zolpidem
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Used to treat insomnia
Actions antagonized by flumazenil Hypnotic but less muscle relaxing or anticonvulsant effects than BDZ |
