Benzodiazepines and Barbiturates Quiz

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Questions and Answers

What is a distinguishing feature of benzodiazepines compared to barbiturates?

  • They have a specific antagonist, Flumazenil. (correct)
  • They induce loss of consciousness.
  • They produce anesthesia in high doses.
  • They can cause respiratory depression.

Which of the following benzodiazepines is categorized as long-acting?

  • Alprazolam
  • Diazepam (correct)
  • Temazepam
  • Midazolam

How do barbiturates differ in their mechanism of action from benzodiazepines?

  • They bind only to the α subunit of GABA receptors.
  • They increase the frequency of channel opening.
  • They target serotonin receptors instead of GABA.
  • They bind at α and β subunits and affect channel duration. (correct)

What effect do benzodiazepines have on the respiratory system compared to barbiturates?

<p>They do not affect the respiratory system. (A)</p> Signup and view all the answers

Which statement accurately describes the duration of action of barbiturates?

<p>Phenobarbital is an example of a long-acting barbiturate. (A)</p> Signup and view all the answers

What characterizes the action of GABA in benzodiazepines?

<p>It increases the frequency of opening of GABA channels. (A)</p> Signup and view all the answers

Why are benzodiazepines preferred for daytime anxiety treatment?

<p>They can be aroused from in high doses. (B)</p> Signup and view all the answers

Which of the following substances is categorized as a miscellaneous anxiolytic?

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

What is the primary purpose of general anaesthesia during surgical procedures?

<p>To produce reversible loss of consciousness (A)</p> Signup and view all the answers

Which phase of general anaesthesia is characterized by increased muscle tone and vital sign excitement?

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

How do the IV agents Etomidate and Propofol primarily work in inducing unconsciousness?

<p>By hyperpolarizing neuronal membranes (A)</p> Signup and view all the answers

What is a common side effect of Propofol during anaesthesia?

<p>Hypotension and respiratory depression (C)</p> Signup and view all the answers

What is one primary use of CNS depressants?

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

Which of the following is NOT a potential effect of CNS depressants?

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

Which of the following statements about the second group of anaesthetics is correct?

<p>They produce analgesia but have a weaker ability to induce unconsciousness. (B)</p> Signup and view all the answers

Which class of drugs is considered safer due to less addiction potential?

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

What is the risk associated with the use of Etomidate as mentioned in the content?

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

Which anaesthetic agents are classified as having the weakest ability to produce unconsciousness?

<p>Nitrous Oxide and Xenon (B)</p> Signup and view all the answers

The primary mechanism of action of GABA in CNS depressants involves which ion influx?

<p>Chloride ion influx (D)</p> Signup and view all the answers

What are benzodiazepines typically used for?

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

What occurs during the medullary paralysis phase of general anaesthesia?

<p>Complete loss of reflexes and cardiovascular stability (A)</p> Signup and view all the answers

Which condition is a contraindication for barbiturate use?

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

What could occur as a result of the misuse of CNS depressants?

<p>Permanent brain damage (C)</p> Signup and view all the answers

Activation of which GABA receptor type leads to an increase in post-synaptic K+ permeability?

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

What is the primary mechanism by which an opioid antagonist works?

<p>Blocks the receptors in the brain to reverse opioid effects (A)</p> Signup and view all the answers

Which side effect of opioids is directly related to their action on the medulla?

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

How does acetaminophen primarily exert its effects?

<p>By inhibiting cyclooxygenase only in the CNS (C)</p> Signup and view all the answers

What is a significant side effect of opioids related to their effects on the urinary system?

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

Which of the following non-opioid analgesics is known to reduce the formation of blood clots?

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

What effect do opioids have on the immune system?

<p>Suppresses immune system activity (A)</p> Signup and view all the answers

Which opioid side effect is caused by the release of histamine?

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

What is a key consequence of opioid activation of Mu receptors in the brain?

<p>Increased dopamine activity (C)</p> Signup and view all the answers

What is the primary role of cyclooxygenase (COX) enzymes in the body?

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

Which of the following is a disadvantage of aspirin?

<p>Increased risk of bleeding (A)</p> Signup and view all the answers

What is the role of thromboxane A2 in the body?

<p>Facilitates platelet aggregation (C)</p> Signup and view all the answers

Which drug is known for both pain relief and anti-inflammatory properties?

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

What effect does ethanol have on the body’s coordination and responses?

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

Which of the following non-benzodiazepine hypnotics primarily affects GABA receptors?

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

What mechanism is primarily utilized by general anesthetics in Group 2 that includes Ketamine?

<p>Decrease in NMDA activity (C)</p> Signup and view all the answers

Which of the following is a local anesthetic that blocks voltage-gated sodium channels?

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

Which opioid is known for having a selective antagonistic effect?

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

Which of the following analgesics primarily decreases COX-1 and COX-2 enzyme activity?

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

What is a mechanism of action shared by halogenated volatile anesthetics?

<p>Increased GABA activity (C)</p> Signup and view all the answers

What kind of effect does Tramadol exhibit aside from being an opioid?

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

Which of the following substances acts as an analgesic by blocking NMDA channels?

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

Flashcards

CNS Depressants

Drugs that slow down the central nervous system, reducing activity and producing relaxation.

Effects of CNS Depressants

They cause relaxation, reduced anxiety, reduced pain, impaired coordination, impaired judgment, slurred speech, sedation, sleep induction, and potentially loss of consciousness.

Uses of CNS Depressants 1

Treatment for anxiety disorders, insomnia, pain, seizures, and muscle spasms, including alcohol withdrawal.

Uses of CNS Depressants 2

Can be misused recreationally leading to addiction, health risks, and overdose, including risk of impaired breathing and death.

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Hypnotic Sedative

A type of CNS depressant used for sleep problems (Insomnia) or Anxiety.

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Anxiety

Characterized by excessive worry, fear, difficulty concentrating and problems sleeping. It can cause physical symptoms such as tachycardia and muscle aches.

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Benzodiazepines

A class of hypnotic sedatives, ideal for oral sedation, relatively safer, less addictive with a larger therapeutic index.

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Barbiturates

A class of hypnotic sedatives that are contraindicated in certain conditions.

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GABA (Gamma-aminobutyric acid)

A neurotransmitter that inhibits nerve impulses in the central nervous system.

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GABA-A Receptor

A receptor that when activated allows chloride ions into the cell causing hyperpolarization and inhibiting nerve impulses

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GABA-B Receptor

A receptor that when activated, inhibits the release of excitatory neurotransmitters and increases potassium flow out of the cell, inhibiting nerve impulses.

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Hyperpolarization

An increase in the negativity of the inside of a neuron, making it less likely to fire an action potential.

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Benzodiazepines

A class of anxiolytic drugs that work by increasing the activity of GABA, a neurotransmitter that reduces brain neuron activity

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Barbiturates

A class of CNS depressants that work by affecting GABA receptors in the brain.

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Benzodiazepine antagonist

Flumazenil; a selective GABA-A receptor antagonist that reverses the effects of benzodiazepines.

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GABA

A neurotransmitter that helps reduce brain neuron activity, contributing to a calming effect.

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Anxiolytic drugs

Medications used to treat anxiety disorders by targeting the brain's mood and anxiety-regulating neurotransmitters.

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Benzodiazepine Duration - Long acting (BZ long)

Last 1 to 3 days; examples include Chlordiazepoxide, diazepam, flurazepam, clonazepam, and chlorazepate.

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Benzodiazepine Duration - Intermediate acting (BZ intermediate)

Last 10-20 hours; examples include temazepam, lorazepam, alprazolam, oxazepam, nitrazepam, and estrazolam

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Benzodiazepine Duration - Short acting (BZ short)

Last 2-8 hours; examples include midazolam, triazolam

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Barbiturate Duration - Long acting (Barbiturate long)

Last 1-2 days; example is Phenobarbital

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Barbiturate Duration - Short acting (Barbiturate short)

Last 3-8 hours; examples are Pentobarbital, secobarbital & amobarbital.

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Barbiturate Duration - Ultrashort acting

Last 20 mins; example is Thiopental

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Cyclooxygenase (COX) enzymes

Enzymes that produce prostaglandins and thromboxane A2.

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Prostaglandins (PGs)

Chemicals involved in pain, inflammation, fever, blood clotting, uterine contractions, and more.

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NSAIDs (Nonsteroidal anti-inflammatory drugs)

Drugs that inhibit COX enzymes.

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Aspirin effect on pain

Aspirin relieves pain by reducing prostaglandin and inflammation.

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Aspirin effect on blood clotting

Aspirin reduces blood clotting by inhibiting thromboxane A2 production.

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Acetaminophen vs. NSAIDs

Acetaminophen primarily reduces fever and pain, while NSAIDs reduce fever, pain, and inflammation.

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Alcohol's effect on the body

Alcohol affects many body systems, impacting coordination, responsiveness, body temperature, respiration, and sexual function.

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General Anaesthesia

A reversible condition induced by anaesthetic drugs, causing decreased or complete loss of pain and sensation, including consciousness and muscle movement, during surgery or invasive procedures.

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Local Anaesthesia

Numbing a specific area, preventing pain sensation without loss of consciousness.

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Stages of General Anaesthesia

A progression of four stages: Induction, Excitement, Surgical Anaesthesia, and Medullary Paralysis during general anesthesia.

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Induction (Anaesthesia)

The initial stage of general anesthesia, where the patient is brought into unconsciousness.

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Excitement (Anaesthesia)

The stage of general anesthesia marked by excitement of involuntary muscle movements, including increased heart rate, blood pressure, and respiration.

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Surgical Anaesthesia

The stage of general anesthesia where a patient is unconscious and ideal for surgery, with careful monitoring.

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Medullary Paralysis (Anaesthesia)

The final stage of general anesthesia, where respiratory and cardiovascular functions fail, leading to potential death.

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Analgesia

The state of being free from pain sensations during anesthesia.

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IV agents

Intravenous anesthetic drugs, including etomidate, propofol, and barbiturates, used in the induction phase of general anesthesia.

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Etomidate

An IV anesthetic drug that is potent in inducing unconsciousness. Caution advised due to its potential effects on the adrenal glands.

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Propofol

An IV anesthetic drug used in the induction phase known for rapid onset of unconsciousness.

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Barbiturates

IV anesthetic drugs used in the induction phase for profound unconsciousness, but also pose respiratory depression risks and hypotension.

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Ketamine

An IV anesthetic drug offering significant pain relief but less effective at inducing complete unconsciousness or immobility.

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Opioid Antagonist

A drug that reverses or reduces the effects of an opioid overdose.

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Opioid overdose reversal

Using an opioid antagonist to counteract the effects of an opioid overdose, such as restoring normal breathing.

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Opioid Side Effects

Unwanted physical effects caused by opioid use, impacting various bodily functions

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Nausea (opioid)

Opioid-induced nausea, triggered by stimulation of chemoreceptors in the medulla.

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Respiratory Depression (opioid)

Reduced ability to breathe caused by opioids decreasing the brainstem's response to CO2.

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Antitussive Effect (opioid)

Opioid's ability to suppress the cough reflex by affecting the cough center in the medulla.

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Immune Suppression (opioid)

Opioids weaken the body's immune response.

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Hypotension (opioid)

Low blood pressure induced by opioids stimulating histamine release which can lower blood pressure.

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Constipation (opioid)

Opioids slow down digestion, causing difficulty with bowel movements.

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Urinary Retention (opioid)

Opioids cause difficulty urinating by increasing sphincter tone affecting renal function.

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Opioid Addiction

Physical and psychological dependence on opioids.

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Opioid Withdrawal

Symptoms that occur when opioid use is stopped, because of desensitization of opioid receptors.

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Desensitization (opioid receptors)

The brain adapts to opioids by changing how opioid receptors function, making addiction more likely.

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Analgesic use (non-opioid)

Used to relieve mild-moderate pain

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Acetaminophen (Paracetamol)

Non-opioid pain reliever and fever reducer; only inhibits central nervous system prostaglandins.

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Nonsteroidal Anti-inflammatory Drugs (NSAIDs)

Class of drugs that reduce inflammation, pain, and fever, often used for mild to moderate pain.

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Aspirin (ASA)

NSAID; pain reliever and anti-blood clot medication.

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Non-benzodiazepine hypnotics

Drugs used to treat insomnia, not acting like benzodiazepines.

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Zolpidem

A non-benzodiazepine hypnotic drug

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Zaleplon

A non-benzodiazepine hypnotic drug

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Eszopiclone

A non-benzodiazepine hypnotic drug

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General Anesthetics (Group 1 IV agents)

Intravenous anesthetic drugs affecting GABA receptors.

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Etomidate

An IV anesthetic that increases GABAergic activity.

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Propofol

An IV anesthetic that increases GABAergic activity.

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Barbiturates

A class of IV anesthetics, increasing GABAergic activity.

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General Anesthetics (Group 2)

A class of anesthetic drugs affecting NMDA receptors, and/or 2-pore-domain potassium channels.

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Ketamine

An IV anesthetic affecting NMDA receptors.

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Nitrous Oxide

An inhaled anesthetic that increases 2-pore-domain potassium channel function.

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Local anesthetics

Drugs that block voltage-gated sodium channels.

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Bupivacaine

A local anesthetic drug.

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Opioids Analgesics (Endogenous)

Naturally occurring pain-relieving substances.

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Endogenous Opioids

Naturally occurring pain relievers in the body.

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Acetaminophen

A non-opioid pain reliever that doesn't affect COX enzymes.

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