Anxiolytic and Hypnotic Drugs Overview
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Questions and Answers

Which of the following medications is classified as a benzodiazepine?

  • Paracetamol
  • Triazolam (correct)
  • Ibuprofen
  • Sertraline

What is the primary use of midazolam?

  • Antidepressant
  • Pain reliever
  • Sedative and anxiolytic (correct)
  • Antipyretic

Which drug among the following is least likely to be used for anxiety management?

  • Lithium (correct)
  • Oxazepam
  • Diazepam
  • Alprazolam

Which benzodiazepine is often administered for short procedures due to its rapid onset?

<p>Midazolam (B)</p> Signup and view all the answers

What common side effect should be monitored when administering benzodiazepines?

<p>Drowsiness (D)</p> Signup and view all the answers

What effect do chloride ions have on neuronal activity?

<p>They cause hyperpolarization of the neuron. (C)</p> Signup and view all the answers

How does the influx of chloride ions impact neurotransmission?

<p>It inhibits the formation of action potentials. (B)</p> Signup and view all the answers

Which of the following best describes the result of hyperpolarization in a neuron?

<p>It reduces the neuron's ability to transmit signals. (B)</p> Signup and view all the answers

What is the primary function of chloride ion influx in relation to neuron action?

<p>To decrease neuronal excitability. (A)</p> Signup and view all the answers

What is the consequence of decreased action potentials in a neuron?

<p>Decreased neurotransmission. (C)</p> Signup and view all the answers

Which barbiturate is classified as ultra short acting and primarily used for inducing anesthesia?

<p>Thiopental (C)</p> Signup and view all the answers

What is the primary therapeutic use of Phenobarbitone?

<p>Treating eclampsia (B), Managing tonic clonic convulsions (D)</p> Signup and view all the answers

Which statement correctly describes the action of barbiturates on glutamate receptors?

<p>They block excitatory glutamate receptors. (A)</p> Signup and view all the answers

Which conditions are specifically treated with Phenobarbitone?

<p>Tonic clonic convulsions and febrile convulsion (A)</p> Signup and view all the answers

In what scenario would Thiopental be most appropriately used?

<p>As an anesthetic induction agent (C)</p> Signup and view all the answers

Which of the following side effects is considered the most common when experiencing adverse effects?

<p>Drowsiness and Confusion (A)</p> Signup and view all the answers

What is a potential effect of ataxia at high doses that can impact daily activities?

<p>Loss of full control of body movements (B)</p> Signup and view all the answers

Which of the following describes a cognitive effect related to this medication's adverse effects?

<p>Decreased long-term recall (A)</p> Signup and view all the answers

What phenomenon does Triazolam exhibit that affects its long-term use?

<p>Fast tolerance build-up (B)</p> Signup and view all the answers

Which adverse effect would most likely preclude activities requiring fine motor coordination?

<p>Ataxia (C)</p> Signup and view all the answers

Which of the following statements is true about long-acting benzodiazepines?

<p>They have a prolonged duration of effect compared to short-acting variants. (D)</p> Signup and view all the answers

What is a potential drawback of using long-acting benzodiazepines?

<p>Greater likelihood of prolonged sedation and cognitive impairment. (C)</p> Signup and view all the answers

In what situation would long-acting benzodiazepines be least appropriate?

<p>Short-term management of panic attacks. (D)</p> Signup and view all the answers

Which long-acting benzodiazepine is often utilized for treating generalized anxiety disorder?

<p>Clonazepam (C)</p> Signup and view all the answers

How does the pharmacokinetic profile of long-acting benzodiazepines differ from that of short-acting benzodiazepines?

<p>They have a longer half-life. (A)</p> Signup and view all the answers

Which of the following is NOT a characteristic of long-acting benzodiazepines?

<p>They handle sudden acute anxiety effectively. (C)</p> Signup and view all the answers

What primary mechanism do long-acting benzodiazepines rely on to exert their effects?

<p>Enhancement of GABA activity. (C)</p> Signup and view all the answers

Which patient population might need to avoid long-acting benzodiazepines due to potential risks?

<p>Elderly patients with cognitive decline. (A)</p> Signup and view all the answers

What potential interaction should be considered when prescribing long-acting benzodiazepines?

<p>Additive sedation with alcohol. (C)</p> Signup and view all the answers

What is a common reason clinicians might choose long-acting benzodiazepines over short-acting ones?

<p>Reduced frequency of dosing. (A)</p> Signup and view all the answers

What psychological effect can result from short-acting dependence?

<p>Confusion (A)</p> Signup and view all the answers

Which of the following is NOT a typical withdrawal symptom associated with short-acting dependence?

<p>Withdrawal tranquility (A)</p> Signup and view all the answers

In the context of short-acting dependence, how is anxiety categorized?

<p>A psychological effect (D)</p> Signup and view all the answers

Which of the following effects is associated with short-acting dependence?

<p>Rapid heartbeat (B)</p> Signup and view all the answers

Which underlying issue can short-acting dependence heighten?

<p>Agitated states (D)</p> Signup and view all the answers

What term best describes the physical aspects of withdrawal from short-acting substances?

<p>Physical dependence (B)</p> Signup and view all the answers

Which of the following best describes agitation in the context of short-acting dependence?

<p>A result of withdrawal symptoms (C)</p> Signup and view all the answers

What kind of symptoms might characterize the withdrawal from substances associated with short-acting dependence?

<p>Severe anxiety and confusion (D)</p> Signup and view all the answers

Which condition could worsen due to short-acting dependence?

<p>Intense anxiety (C)</p> Signup and view all the answers

Which physiological response is commonly noted during withdrawal from short-acting substances?

<p>Increased perspiration (A)</p> Signup and view all the answers

What might withdrawal symptoms indicate regarding short-acting substance use?

<p>The onset of tolerance (B)</p> Signup and view all the answers

What psychological effect can elevated levels of agitation contribute to?

<p>Decreased emotional regulation (B)</p> Signup and view all the answers

Why might confusion occur as a withdrawal symptom for short-acting substances?

<p>It reflects a disruption in mental processes (B)</p> Signup and view all the answers

What can a significant psychological disturbance during withdrawal indicate?

<p>Deepening psychological dependence (B)</p> Signup and view all the answers

What is an example of a withdrawal symptom?

<p>Confusion, anxiety, agitation, prolonged time.</p> Signup and view all the answers

Which of the following are withdrawal symptoms? (Select all that apply)

<p>Agitation (A), Confusion (B), Anxiety (D)</p> Signup and view all the answers

Withdrawal symptoms can include physical dependence.

<p>True (A)</p> Signup and view all the answers

What are some common adverse effects of benzodiazepines?

<p>Drowsiness and confusion (A), Ataxia at high doses (D)</p> Signup and view all the answers

Triazolam shows rapid tolerance.

<p>True (A)</p> Signup and view all the answers

What are benzodiazepines primarily used for?

<p>Anxiolytic drugs</p> Signup and view all the answers

Which of the following precautions should be taken when using benzodiazepines?

<p>Not for use in acute narrow-angle glaucoma (A), Avoid in liver disease (B)</p> Signup and view all the answers

What is Flumazenil?

<p>A GABA receptor antagonist that can rapidly reverse the effects of benzodiazepines.</p> Signup and view all the answers

What neurotransmitter do benzodiazepines act on?

<p>GABA (D)</p> Signup and view all the answers

GABA receptors are composed of four subunits.

<p>False (B)</p> Signup and view all the answers

Which of the following statements about barbiturates is true?

<p>They induce enzyme activity. (D)</p> Signup and view all the answers

What effect does the influx of chloride ions have on neurons?

<p>Hyperpolarization and decreased neurotransmission</p> Signup and view all the answers

What are the effects of chronic ethanol consumption?

<p>Severe liver disease, gastritis, nutritional deficiency, and cardiotoxicity.</p> Signup and view all the answers

Chloral hydrate is effective as a __________ and hypnotic.

<p>sedative</p> Signup and view all the answers

Which of the following are therapeutic uses of benzodiazepines? (Select all that apply)

<p>Muscular disorders (A), Anxiety disorders (B), Seizures (D)</p> Signup and view all the answers

Benzodiazepines should be used for long periods without risk of tolerance.

<p>False (B)</p> Signup and view all the answers

What role does Melatonin play in sleep?

<p>It helps regulate sleep, secreting from the pineal gland.</p> Signup and view all the answers

What is Diazepam commonly used for?

<p>Muscle spasms and seizures</p> Signup and view all the answers

What is the mechanism of action for barbiturates?

<p>They enhance GABAergic transmission. (B)</p> Signup and view all the answers

Which benzodiazepine is used for absent epilepsy?

<p>Clonazepam (A)</p> Signup and view all the answers

What are the effects of benzodiazepines on sleep disorders?

<p>Sedative and calming effects</p> Signup and view all the answers

Benzodiazepines are primarily used for ______ disorders.

<p>anxiety</p> Signup and view all the answers

Match the following benzodiazepines with their classification:

<p>Flurazepam = Long-acting Lorazepam = Intermediate acting Alprazolam = Intermediate acting Triazolam = Short-acting</p> Signup and view all the answers

Flashcards

Chloride influx

The movement of chloride ions into a neuron.

Hyperpolarization

An increase in the negative charge inside a neuron.

Neurotransmission

The communication between neurons.

Action potential

The electrical signal that travels down a neuron.

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Inhibit neurotransmission

To reduce or prevent communication between neurons.

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Triazolam

A type of medication.

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Midazolam

Another type of medication.

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Oxazepam

Benzodiazepine medication.

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Alprazolam

Medication for anxiety.

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Benzodiazepines

Medication family

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Adverse effects of Triazolam

Side effects, like drowsiness, confusion, and impaired memory, especially at high doses.

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Drowsiness and Confusion

Common side effects of some medications that can affect cognitive function and motor skills.

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Ataxia

Loss of full control of body movements, especially at high doses of some drugs.

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Cognitive impairment

A decrease in thinking skills, including memory and learning, that can be a reaction to some drugs.

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Rapid tolerance to Triazolam

The body adapts quickly to the drug so that it becomes less effective.

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Chlordiazepoxide

A long-acting benzodiazepine (anti-anxiety medicine)

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Chlordiazepoxide use

Treats anxiety and/or seizures

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Benzodiazepine

A class of drugs that help with anxiety and seizures.

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Long-acting drug

Medications that provide relief for a longer time compared to short-acting drugs.

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Chlordiazepoxide (brand name)

A specific type of long-acting anti-anxiety drug.

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Anti-anxiety drug

Medication used to manage anxiety.

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Anti-seizure medication

Medicine that helps prevent seizures.

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Medication class

Drugs categorized based on similar properties and actions

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Treatment of Seizures

Medical approach to managing seizures

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Seizure

Abrupt episode of uncontrolled electrical activity in the brain

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Thiopental use

Ultra-short-acting barbiturate for inducing anesthesia.

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Phenobarbital's use

Long-acting barbiturate for seizures and eclampsia.

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Barbiturate action

Blocks glutamate receptors, impacting nerve signals.

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Barbiturate type: Thiopental

Ultra-short acting barbiturate, used for short-term anesthesia.

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Barbiturate type: Phenobarbital

Long-acting barbiturate, used to relieve seizures and eclampsia.

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Withdrawal symptoms

Physical and psychological reactions to stopping a substance or behavior.

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Confusion

A state of mental disorder, marked by difficulty thinking clearly.

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Anxiety

A feeling of worry, nervousness, or unease.

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Agitation

A state of restlessness or anxiety that prompts physical movement.

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Psychological Dependence

A condition where the body adapts to and requires a drug or behavior.

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Physical Dependence

When the body has physically adapted to a substance or behavior.

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Stopping a Substance

Ceasing use of a substance or behavior.

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Psychological reactions

Emotional responses to a change in substance or behavior.

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Physical reactions

Bodily responses to a change in substance or behavior.

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Withdrawal

Symptoms felt upon quitting or reducing a dependence on a substance or habit.

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Substance Use

Consumption of a controlled substance or participating in a behavior that causes dependence.

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Behavior

Actions a person performs habitually. Examples include overeating or gambling.

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Dependency

A condition in which an individual has a compulsive need for a habit, substance or activity.

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Stopping a behavior

Ceasing a specific pattern of actions.

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Benzodiazepines

A group of drugs used as anti-anxiety medications, acting on GABA receptors.

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GABA receptors

Brain receptors that are targeted by Benzodiazepines to reduce anxiety. GABA is the primary inhibitory neurotransmitter.

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Anxiety disorders

Mental conditions involving excessive worry, nervousness, or unease.

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Muscle spasm

Involuntary contractions of muscle groups.

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Multiple sclerosis

Chronic autoimmune disease affecting the central nervous system.

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Amnesia

Loss of memory, often temporary.

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Seizures

Sudden episodes of uncontrolled electrical activity in the brain.

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Sleep disorders

Conditions affecting a person's ability to sleep soundly or regularly.

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Tolerance

Decreased responsiveness to a drug after repeated use.

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Withdrawal

Unpleasant physical and psychological reactions when a drug is stopped.

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Long-acting benzodiazepines

These medications provide relief for a longer period comparative to short-acting benzodiazepines.

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Short-acting benzodiazepines

Used for short-term relief, primarily in procedures, like pre-surgical preparation.

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Sedative

Medicines that calm a person down, creating a soothing effect.

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Drowsiness and Confusion

Common side effects of some medications, especially affecting cognitive function and motor skills.

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Benzodiazepines

A class of drugs used for anxiety and seizures, working by enhancing GABAergic transmission.

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Ataxia

Loss of full control of body movements, often a side effect of medications at high doses.

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Cognitive impairment

A decrease in thinking skills, such as memory and learning, sometimes due to medications.

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Triazolam tolerance

The body adapting quickly to triazolam, so it becomes less effective.

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Withdrawal symptoms

Reactions from stopping a substance or behavior, may be physical or psychological.

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Thiopental

Ultra-short-acting barbiturate used to induce anesthesia.

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Phenobarbital

Long-acting barbiturate used for seizures and eclampsia.

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Barbiturate action

Mechanism involves blocking glutamate receptors, which affects nerve signals.

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Zolpidem

A non-benzodiazepine hypnotic with a short duration of action.

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Hydroxyzine

An antihistamine with antiemetic (anti-vomiting) and sedative properties.

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Flumazenil

A benzodiazepine antagonist, used to reverse the effects of benzodiazepines.

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Disulfiram

A medication used to deter alcohol consumption by causing unpleasant reactions to alcohol.

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Buspirone

An anti-anxiety medication that acts on serotonin receptors, with minimal dependence potential.

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Melatonin

A hormone secreted by the pineal gland that regulates sleep-wake cycles.

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Withdrawal Symptoms

Physical and psychological reactions to stopping a substance or behavior.

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Confusion (Withdrawal)

Difficulty thinking clearly, a symptom of withdrawal.

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Anxiety (Withdrawal)

A feeling of worry or unease, a symptom of withdrawal.

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Agitation (Withdrawal)

Restlessness or anxiety prompting physical movement, a symptom of withdrawal.

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Psychological Dependence

Adaptation of the body requiring a drug or behavior.

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Physical Dependence

Body adapting to a substance or behavior.

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Withdrawal

Symptoms felt when stopping a substance or behaviour.

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Stopping a Substance

Ceasing the use of a drug or behaviour.

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Psychological Reactions (Withdrawal)

Emotional responses to ending a substance or behavior use.

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Physical Reactions (Withdrawal)

Physical responses to ending a substance or behavior use.

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Short-acting

Drugs providing relief for a shorter time compared to long-acting drugs.

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Long-acting

Drugs providing relief for longer time compared to short-acting drugs.

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Dependency

Compulsive need for a substance, behaviour or activity.

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Stopping a behavior

Ceasing specific actions or patterns.

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Substance use

Consumption of a controlled, habit-forming substance or involvement in a habit.

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Study Notes

Anxiolytic and Hypnotic Drugs

  • Benzodiazepines are widely used anxiolytics, safe and effective drugs.
  • Mechanism of action: Benzodiazepines act on GABA receptors.
  • GABA is the major inhibitory neurotransmitter in the central nervous system (CNS).
  • GABA receptors are composed of five subunits (α, β, and γ) that span the postsynaptic membrane.
  • GABA binding opens the chloride channel, allowing chloride ions to enter.
  • Chloride influx causes hyperpolarization, decreasing neurotransmission and inhibiting action potentials.

Therapeutic Uses

  • Anxiety disorders, anxiety with depression, schizophrenia: Should not be used for normal stress, reserved for severe anxiety, short-term use (tolerance develops within 1-2 weeks). Long-acting agents are preferred over short-acting ones.
  • Muscular disorders: Useful in muscle spasms (e.g., muscle strain), muscle spasticity (e.g., multiple sclerosis, cerebral palsy).
  • Premedication for endoscopic and bronchoscopy procedures and angioplasty: Short-acting agents are used.
  • Seizures: Clonazepam for absence epilepsy, Diazepam for grand mal seizures, status epilepticus, and acute alcohol withdrawal. Reduces withdrawal-related seizures.
  • Sleep disorders: All benzodiazepines have sedative and calming effects; some have hypnotic effects. Decrease latency to sleep onset, increase stage 2 of Non-REM sleep.

Classification

  • Long-acting: Diazepam, clonazepam, chlordiazepoxide, clorazepate, flurazepam.
  • Intermediate-acting: Lorazepam, alprazolam, temazepam.
  • Short-acting: Triazolam, midazolam, oxazepam

Dependence

  • Psychological and physical dependence can occur with high doses.
  • Withdrawal symptoms include confusion, anxiety, agitation, restlessness, insomnia, and tension.

Adverse Effects

  • Drowsiness and confusion: Most common, ataxia at high doses, cognitive impairment.
  • Precautions: Liver disease, acute narrow-angle glaucoma, alcohol and other CNS depressants enhance benzodiazepine effects. Not used during pregnancy or breastfeeding.

Other Anxiolytics and Hypnotics

  • Zolpidem: Not a benzodiazepine, acts on BZ receptors, short duration of action, minimal rebound withdrawal effects.
  • Hydroxyzine: Antihistamine with antiemetic activity, sedation prior to surgery.

Benzodiazepine Antagonist

  • Flumazenil: GABA receptor antagonist, rapidly reverses benzodiazepine effects, short half-life, repeated doses needed to maintain reversal of long-acting benzodiazepine IV administration.

Barbiturates

  • Formerly used for sedation and sleep maintenance.
  • Now largely replaced by benzodiazepines due to enzyme induction, tolerance, physical dependence, and narrow safety margin.
  • Mechanism of action: Interaction with GABA receptors, enhancing GABAergic transmission, binding site distinct from benzodiazepines and can block excitatory glutamate receptors, potentially causing epigastric distress and gastrointestinal tract irritation.
  • Individual drugs: Thiopental (ultra-short acting), phenobarbital (long-acting).

Non-barbiturate sedatives

  • Chloral hydrate: Pro-drug converted to trichloro ethanol; sedative and hypnotic effects; irritating to the gastrointestinal tract.

Antihistamines

  • Diphenhydramine: Sedating properties, used in mild insomnia.
  • Other antihistamines: Chlorpheniramine.

Ethanol

  • Anti-anxiety and sedative effects; toxic potential outweighs benefits.
  • Chronic consumption: Severe liver disease, gastritis, nutritional deficiency, cardiotoxicity.
  • Benzodiazepines are often the treatment of choice for alcohol withdrawal.

Disulfiram

  • Blocks acetaldehyde oxidation; causes flushing, tachycardia, hyperventilation, nausea; used to discourage alcohol ingestion.

Buspirone

  • Anti-anxiety partial agonist; acts on serotonin receptors, does not cause dependence, suitable for older adults.

Melatonin

  • Secreted by the pineal gland, promotes sleep; ramelteon acts on MT1 and MT2 receptors.
  • Side effects: Gastrointestinal tract (GIT) disturbances.

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Anxiolytic and Hypnotic Drugs Lec 1 PDF

Description

This quiz covers the mechanisms of action, therapeutic uses, and specific details related to benzodiazepines as anxiolytic and hypnotic drugs. It emphasizes the pharmacological properties of GABA receptors and the clinical applications in treating various disorders. Test your knowledge on these essential medications and their implications in mental health and muscle disorders.

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