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Anxiolytic and hypnotic drugs

memorize.ai (lvl 286)

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Whats a safer alternative to barbiturates?

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Last updated

6 years ago

Date created

Mar 14, 2020

Cards (22)

Section 1

(22 cards)

Whats a safer alternative to barbiturates?

Front

Benzodiazepines are a safer alternative to barbiturates

Back

What is benzodiazepines used as?

Front

Benzodiazepines are used as: - anxiolytic - hypnotic - anticonvulsant - myorelaxant - amnestic

Back

What is the sleep promoting system?

Front

GABAergic ventrolateral preoptic nucleus of the hypothalamus

Back

Where do barbiturates bind?

Front

Barbiturates bind to a different site on the GABA-A receptor (even in the absence of GABA)

Back

2 drug examples of barbiturates

Front

Phenobarbital - anti-epileptic drug Thiopental - general anaesthetic

Back

When are barbiturates used?

Front

Barbiturates are used in severe intractable insomnia in those already taking barbiturates.

Back

What type of drug is effective in all anxiety disorders?

Front

SSRIs are effective in all anxiety disorders

Back

Side effects of benzodiazepines

Front

- Sedation due to interactions with alpha 1 andrenonergic receptors - Dangerous when combined with alcohol, barbiturates - Memory disturbance - Impaired driving ability - Tolerance to hypnotic effect - Risk of psychological dependence

Back

What is the international classification of sleep disorders?

Front

1. Dyssomnias = disruption to timing, quality and amount of sleep - intrinsic sleep disorders e.g idiopathic insomnia - extrinsic sleep disorders e.g altitude insomnia - circadian rhythm sleep disorder e.g jet lag 2. Parasomnias = undesirable physical / behavioural abnormalities during sleep - arousal disorder e.g sleep walking - sleep wake transition disorder e.g sleep talking - parasomnias associated with REM sleep e.g nightmare - other parasomnias e.g sleep burxism

Back

Risks of barbiturates?

Front

- Highly dangerous in overdose or combined with alcohol or benzodiazepines - Considerable risk of tolerance, physical and psychological dependence - Many dangerous drug interactions - Withdrawal symptoms

Back

Outline the pharmacokinetics of benzodiazepine

Front

- Well absorbed orally - Hepatic metabolism - Metabolites can accumulate in prolong use - Anxiolysis with low dose of long acting compound - Sleep induction with high dose of short acting compound

Back

What may Z drugs cause?

Front

Z drugs may cause rebound of insomnia and discontinuation of symptoms. Can cause withdrawal symptoms when stopped. *expensive compared to benzodiazepines

Back

Which drug used in the treatment of anxiety disorder does not treat the psychological symptoms of anxiety?

Front

Beta blockers

Back

When do benzodiazepines bind to GABA - A receptors?

Front

Benzodiazepines only bind to GABA-A receptors when GABA is bound to the receptor. - it increases the frequency of Cl- channel opening

Back

What does the activation of GABA-A receptors lead to?

Front

Activation of GABA-A receptors lead to hyperpolarisation and decreased activity. - when GABA binds, channel opens allowing the influx of Cl- *benzodiazepines bind to a different region of the GABA-A complex

Back

Apart from treating epilepsy, what is pregabalin used to treat?

Front

Pregabalin is also used to treat general anxiety disorders and social anxiety disorders.

Back

What does the binding of barbiturates do?

Front

The binding of barbiturates increases duration of Cl- channel opening, prolonging hyperpolarisation.

Back

What type of drug used in the treatment of anxiety disorder, does not treat coexisting depression?

Front

Benzodiazepines do not treat coexisting depression.

Back

What GABA receptor is found on neurons involved with wakefulness and arousals?

Front

GABA-A receptors are found on neurons involved with wakefulness and arousals.

Back

Action of pregabalin

Front

Pregabalin is an anti-epileptic drug. It binds to alpha-2 delta subunit of the P / Q type voltage gated calcium channel in over-excited neurons. It reduces the release of excitatory neurotransmitters e.g glutamate.

Back

What are the Z drugs?

Front

Z drugs are another type of hypnotic drug. They are short acting drugs for short term relief of insomnia. - minimal to no anxiolytic effects - reduces adverse effects on memory

Back

In what type of patients can we not give pregabalin?

Front

We cannot give pregabalin to patients with kidney disease.

Back