Term
| What are the different classes of medications used as antidepressants? |
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Definition
Selective serotonin reuptake inhibitors (SSRIs)
Tricyclic antidepressants
Monoamine oxidase inhibitors |
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Term
| What classes of drugs are antianxiety drugs? |
|
Definition
Antideprssants
Benzodiazepines
Buspirone |
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Term
| What receptors do the benzodiazepines target? |
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Definition
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Term
| What are the physiologic effects of the benzodiazepines? |
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Definition
Anxiety relief
Drowsiness, sedation
Skeletal muscle relaxation
Anticonvulsive activity
Anterograde amnesia |
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Term
| What kind of a channel is the GABA channel? |
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Definition
| Ligand gated chloride channel |
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Term
What are the effects of the following on the GABAa receptor?
BZDs?
Z-drugs?
Alcohol?
Anesthetics?
Neurosteroids? |
|
Definition
All increase the activity
Causes inhibitory firing of the nerrons |
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Term
| What is the effect of giving more BZD? |
|
Definition
More severe effects.
Here's the continuum, from least depression to the most;
Anticonvulsive
Anxiolyrix
Sedation
Hypnosis
Anesthesia
Medullary depression
Death |
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Term
| What is the advantage of BZDs over barbiturates? |
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Definition
| BZDs can't cause higher level CNS depressionsuch as anasthesia or medullar depression |
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Term
| What property of BZDs leads to greater absorption and more rapid onset of action? |
|
Definition
Lipid solubility
The greater the lipid solubility, the more able they are to cross the BBB and act |
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Term
| What enzymes are responsible for the metabolism of BZDs? |
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Definition
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Term
| What BZD isn't metabolized by the P450's but is conjugated? |
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Definition
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Term
| How long does diazepam take to get to a maximal plasma concentration? |
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Definition
|
|
Term
| What's the half-life of diazepam? |
|
Definition
|
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Term
| How long does lorazepam take to get to a maximal plasma concentration? |
|
Definition
|
|
Term
| What's the half-life of lorazepam? |
|
Definition
|
|
Term
| Which is more water soluble: diazepm or lorazepam? |
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Definition
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Term
| What is the administration route of midazolam? |
|
Definition
|
|
Term
| What is the use of midazolam? |
|
Definition
|
|
Term
| What is the use of temazepam? |
|
Definition
Hypnotic/sedative
Commonly in sleeping pills |
|
|
Term
| What is the effect of BZDs on sleep? |
|
Definition
Decrease sleep latency, especially when you first use them
Increase total sleep time in stage 2
Increase the total amount of REM episodes |
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Term
| What is the problems with taking BDZ as a sleeping medication? |
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Definition
| The effects decline after a time |
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|
Term
| What other drugs should you be careful about prescribing BZDs with? |
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Definition
|
|
Term
| What are the side effects of BZDs? |
|
Definition
Lightheadedness
increased reaction time
Hangovers - drowsy
Rebound anxiety/wakefulness
Ataxia, nystagmus
Anterograde amnesia
Paradoxical excitement |
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|
Term
| What are contraindications to BZD use? |
|
Definition
COPD, obstructive sleep apnea (decrease muscular tone in upper airway)
Liver problems |
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|
Term
| What are the therapeutic uses of BZDs? |
|
Definition
Anxiety
Sleep disorders
Seizures
Skeletal muscle spasms (anticonvulsant)
Alcohol withdrawal
Preanesthetic medication |
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Term
| What is flumazenil? When should you use it? |
|
Definition
Benzodizepine receptor antagonists
Use it when you want to bring someone out of BZD sedation/anasthesia |
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|
Term
| How is flumazenil administered? |
|
Definition
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Term
| What is the function of the GABAa alpha 1 receptor? |
|
Definition
Sedation
Amnesia
Seizure protection |
|
|
Term
| Where is the GABAa alpha 1 receptor located? |
|
Definition
|
|
Term
| What is the function of the GABAa alpha 2 receptor? |
|
Definition
|
|
Term
| Where is the GABAa alpha 2 receptor located? |
|
Definition
Limbic region
Striatum
Cortex |
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|
Term
| What are the Z drugs? Where do they act? |
|
Definition
| Non BZDs that act at the BZD receptor: GABAa alpha-1 receptor |
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Term
| What are the advantages of Z drugs over the BZDs? |
|
Definition
Less day-after psychomotor depression
Less amnesic effects
No tolerance develops to the therapeutic effects |
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Term
| What should you not use Z drugs for? |
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Definition
| Anti-anxiety: they only act at the GABAa alpha 1 receptor |
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Term
| What enzymes metabolize the Z drugs? |
|
Definition
|
|
Term
| What are the adverse effects of the Z drugs? |
|
Definition
Wakeful behavior and amnesia
Risk of abuse |
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|
Term
| What is buspirone? Where does it act? |
|
Definition
Antianxiety drug
Partial agonist of serotonin receptors |
|
|
Term
| What is the onset of action for buspirone? |
|
Definition
|
|
Term
| What condition should you use buspirone for? |
|
Definition
|
|
Term
| What is an advantage of using buspirone? |
|
Definition
|
|
Term
| What is the use of chloral hydrate? |
|
Definition
| For sedation in kids, elderly |
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