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CNS Depressants
CNS Depressants- nursing pharmacology
53
Pharmacology
Undergraduate 2
02/08/2011

Additional Pharmacology Flashcards

 


 

Cards

Term
GABA receptors
Definition
major inhibitory neurotransmitters of the brain
Term
change the structrue of the GABA protein
Definition
What do barbiturates do to the GABA receptor when they bind to it?
Term
positive allosteric modulator
Definition
Alcohol is a _____________ that makes it easier for GABA to bind to its site.
Term
as a pre-anaesthetic
Definition
What are ultra short-acting barbiturates used for?
Term
Thiopental
Definition
This ultra-short-acting barbiturate has a half life of 12 hr, but the effects last only 5-8 min.
Term
Ultra shor acting barbiturates
Definition

Thiopental

Thimylal

Methylhexital

Term
Short-to-intermedicate-acting barbiturates
Definition
These are too dangerous to prescribe for an outpatient indication and can produce super-additive effects if administered with other CNS depressants. 
Term
Short- to- intermediate- acting barbiturates
Definition

Secobarbital (seconal)- t 1/2= 15-40 hrs

Pentobarbital (Nembutal)- t 1/2= 15-50 hrs

Term
Long-acting barbiturates
Definition
these are used as an anticonvulsant, prescribed in a pt population that monitors meds carefully, #1 SE is sedation.
Term
Phenobarbital (Luminal)- t 1/2= 80-120 hr
Definition
Name an example of a long-acting barbiturate
Term
metabolic tolerance
Definition
With repeated administration, barbiturates actually enhance their own metabolism.  This is called __________
Term
lipid solubility
Definition
The rate of distribution of barbiturates depends on their _________
Term
hepatic enzymes
Definition
metabolism of barbiturates can be altered by induction of _________
Term
GABAα
Definition
Barbiturates bind to a specific site on_______ receptors.
Term
directly activate them
Definition
At large concentrations, what can barbiturates do to GABAα receptors?
Term

induction of anesthesia

treatment of some forms of epilepsy

Definition
Clinical uses of barbiturates
Term

- sedation

- Respiratory depression

- tolerance

- dependance

- abuse

Definition
Side effects of barbiturates
Term

- additive effects with other CNS depressants

- induction of hepatic enzymes can accelerate metabolism of other drugs

Definition
Interactions of barbiturates:
Term
benzodiazepines
Definition
allosteric modulators with their own binding sites on the gaba receptors.
Term
anterograde amnesia
Definition
a side effect of benzos where you can't remember things you did while on it
Term
Short-acting benzos
Definition

Midazolam (Versad)

Triazolam (Halcion)

Term
Midazolam (Versad) t1/2= 2hr
Definition
this short acting benzo has a pediactric version in the form of a lollipop. its a preanestetic.
Term
Triazolam (Halcion) t1/2= 3 hr
Definition
This short acting benzo is used for sleep onset disorder and off-label for third molar extraction.
Term
Intermediate- acting benzos
Definition

Lorazepam (ativan)

oxazepam (serax)

temazepam (restoril)

alprazolam (xanax)

Chlordiazepoxide (librium)

Term
Larazepam (Ativan) t 1/2= 14hr
Definition
this intermediate acting benzo is the most water soluable benzo. It's easiest to give by IV and used for grand mal seizures.
Term
Oxazepam (Serax)
Definition
this intermediate acting benzo is used for situational anxiety and has a t1/2 of 8 hr
Term
temazepam (restoril)
Definition
this intermediate acting benzo has a t 1/2 of 11 hours and is used for sleep maintenance
Term
alprazolam (xanax)
Definition
this intermediate acting benzo has a t1/2 of 12 hr and is aprroved for anxiety and depression
Term
Chlordiazepoxide (librium)
Definition
this intermediate acting benzo was the first one invented, and has a t 1/2 of 10 hours
Term
Long acting benzos
Definition

Flurazepam (dalmane)

Diazepam (valium)

Clonazepam (Klonopin)

Term
Flurazepam (Dalmane)
Definition
this long acting benzo has a t1/2 of 74 hours and isn't really used...
Term
diazepam (valium) 
Definition

this long acting benzo has a t 1/2 of 43hr. it is one of the first anxiolytics, and it is hard to inject

Term
Clonazepam (Klonopin)
Definition

this long acting benzo has a t 1/2 of 23 hr and is used for many psychiatric indications including schizophrenia.

Term
active metabolites
Definition
Metabolism of benzos can cause the formation of _________
Term

temazepam

oxazepam

lorazepam

Definition
Persons with liver problems should take benzos such as __________, ____________, and __________ that do not need to be extensively metabolized
Term
activate the GABAA  receptor directly
Definition
Benzos are safer than barbiturates because they can not ______
Term

anxiolytic

sedative

muscle relaxant

anticonvulsant

induction of anesthesia

Definition
Clinical uses of Benzos:
Term

CNS depression

anterograde amnesia

respiratory depression

tolerance

dependance

abuse potential

Definition
Adverse effects of Benzos:
Term
additive effects with other CNS depressants
Definition
Drug interactions of Benzos
Term
generalized anxiety disorder
Definition
persistent state of heightened anxiety with increased levels of motor tension and autonomic hyperactivity
Term
panic disorder
Definition
recurrent, discrete periods of sudden and intense fear or discomfort accompanied by autonomic arousal
Term
benzos
Definition
This treatment for an anxiety disorder has immediate anxiolytic effects
Term
alaprazolam (xanax)
Definition
the only benzo marked for panic disorder
Term
Buspirone
Definition
This treatment for an anxiety disorder is a serotonin type 1A agonist. it is not effective in treating panic disorder
Term
antidepressants- SSRIs, tricyclics, MAO inhibitors
Definition
first treatment of choice for panic disorder
Term
beta blockers
Definition
used to prevent performance anxiety
Term

stress

aging

illness

drugs/alcohol

sleep cycle disruption (jet lag)

Definition
Causes of insomina
Term

Tiazolam- t1/2=3 hr

Flurazepam- t1/2= 74 hr

Temazepam (Restoril)- t1/2= 11 hr

Definition
Benzos used to treat insomnia
Term
Non benzodiazepines
Definition
These phamacologically and mechanistically are benzos b/c they work at the benzo receptor on a particular confirmation of the GABA receptor that we believe responsible for sleep. 
Term
non-benzos
Definition

zolpidem (ambien)- t1/2= 2 hr

zaleplon (sonata)- t1/2= 1 hr

eszopiclone (lunesta)

Term
Chloral Hydrate
Definition
This treatment for insomnia should never be used, some older MDs still prescribe, but this drug is distrubited very unevenly. What Anna Nicole Smith OD'ed on
Term
antihistamines ex: hydroxyzine
Definition
This treatment for insomnia can be found in any over the counter sleep aid
Term
flumazenil/ (romazicon)
Definition
antagonist of benzos
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