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32 Cards in this Set
- Front
- Back
What are the CNS depressants? |
1. Benzodiazepines 2. Barbiturates 3. Hypnotics 4. Ethanol 5. General anesthetics |
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What are the effects of barbiturates and other hypnotics at higher doses? |
1. Depress respiratory and vasomotor centers 2. Induce anesthesia 3. Coma 4. Death |
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Are benzodiazepines or barbiturates abused more often? |
1. Barbiturates |
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What is the MOA of benzodiazepines? |
1. Potentiate actions of GABA in CNS 2. Via GABA A receptors 3. Positive allosteric modulators |
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What type of GABA receptor has underlying hypnotic effects? |
1. Those with a1 subunit |
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What is the MOA of barbiturates? |
1. Potentiate action of GABA 2. GABA agonist at high concentrations 3. Inhibit AMPA receptors 4. Inhibit Na/K channels |
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What is the MOA of flumazenil? |
1. Competitive benzodiazepine antagonist |
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How do you tx barbiturate toxicity? |
1. Respiratory/CV support 2. Alkalization of urine for phenobarbital and thiopental |
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What are the indications for benzodiazepines? |
1. Anxiety 2. Insomnia 3. Seizure disorders 4. Muscle spasm 5. Alcohol withdrawal |
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What are the side effects of benzodiazepines? |
1. Decreased motor skills and confusion 2. Anterograde amnesia |
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What is the effect of benzodiazepines on the P450 system? |
1. Induction |
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What can inhibit benzodiazepine metabolism? |
1. Cimetidine 2. OCs 3. Isoniazid |
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What is the pregnancy category for benzodiazepines? |
1. D (most) 2. X |
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When are benzodiazepines contraindicated? |
1. Pregnancy 2. L/D 3. Breastfeeding |
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What are the benzodiazepine-like drugs? |
1. Zolpidem (ambien) 2. Zaleplon 3. Eszopiclone |
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What is the MOA of benzodiazepine-like drugs? |
1. Bind to benzodiazepine binding site 2. Selectively bind a1 subunit-containing GABA receptors |
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What is the effect of zolpidem? |
1. Minimal muscle relaxation and anticonvulsant effects |
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What are the adverse effects of zolpidem? |
1. Drowsiness 2. Drugged feeling 3. Mild rebound insomnia after d/c |
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What metabolizes zolpidem? |
1. Cytochrome P450 and cyp3A4 in liver |
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What are the side effects of zaleplon? |
1. Next-day amnesia 2. Psychomotor impairment |
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What is the MOA of doxepin? |
1. H1 antagonist |
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What is the indication of doxepin? |
1. Tx of insomnia with difficulty in sleep maintenance |
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What are the adverse effects of doxepin? |
1. Somnolence 2. Sedation 3. Nausea 4. URI |
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What is the MOA of ramelteon? |
1. Melatonin agonist (MT1 and MT2) |
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What is the use of ramelteon |
1. Induce sleep 2. Decrease awakening 3. Not very powerful |
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What are the side effects of ramelteon? |
1. Increase prolactin level |
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What are the DOCs for narcolepsy/ |
1. Modafinil 2. Armodafinil 3. MOA unknown |
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What is the MOA of amphetamines? |
1. Reverse dopamine transporters and VMAT2 2. Elicits release of catecholamines into the synapse 3. Phosphorylates transporters |
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What is the MOA of cocaine? |
1. Block monoamine reuptake |
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What is the DOC for cataplexy? |
1. Protriptyline 2. Venlaxafine |
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What is the MOA of protriptyline? |
1. TCA--- inhibits NE reuptake |
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What are the DOC for RSBD? |
1. Clonazepam |