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24 Cards in this Set
- Front
- Back
the sedative -hypnotics are drugs that
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depress CNS function.
used mainly to treat anxiety and insomnia. |
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anxiolytics
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drugs used to relieve anxiety
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hypnotics
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drugs used to promote sleep.
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the three major groups of sedative-hypnotics are
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barbiturates ex: secobarbital
benzodiazepines ex: diazepam benzodiazepine-like ex: zolpidem |
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Drugs of choice for anxiety and insomnia are the
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benzodiazepines.
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Benzodiazepines work by
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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. |
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barbiturates work by
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mimicking the the actions of of GABA.
profound CNS depression can occur if the dose is great enough. |
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the high lipid solubility of benzodiazepines readily
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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. |
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benzodiazepines metabolites are
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pharmacologically active and may have a long duration.
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benzodiazepines are contraindicated in
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pregnancy and those suffering from sleep apnea.
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GABA
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the principle inhibitory neurotransmitter in the CNS.
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benzodiazepines cause minimal respiratory depression except when
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combined with other CNS depressants like barbiturates, opioids and alcohol.
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the principle adverse effects of benzodiazepines are
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daytime sedation, anterograde amnesia
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the principle indications for benzodiazepines are
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anxiety, imsomnia and seizure disorders.
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Flumazenil is
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a benzodiazepine receptor antagonist and is used to treat a benzodiazepine overdose.
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hypnotic agents, in general, are contraindicated in
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pregancy
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benzodiazepines
Halcion-triazolam |
rapid onset
short duration good choice for patients having trouble falling asleep |
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benzodiazepines
Dalmane-flurazepam |
delayed onset
prolonged duration good choice for patients having difficulty maintaining sleep. |
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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. |
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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. |
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melatonin
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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. |
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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. |
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benzodiazepines and benzodiazepine-like drugs
side effects |
may cause drowsiness, excitement, dry mouth, nightmares and nausea.
for short term use, avoid alcohol |
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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. |