Questions and Answers
What is the primary distinction between sedatives and hypnotics?
Which drug is categorized as a non-sedating anxiolytic?
Which class of drugs is commonly used for treating panic disorders?
What is a common characteristic of panic disorder episodes?
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Which medication is a common benzodiazepine prescribed for anxiety?
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What effect does sedation at regular doses of sedative-hypnotics have?
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Which of the following disorders is classified under anxiety disorders?
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How do barbiturates function compared to sedatives?
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What common physical symptom is associated with panic disorder?
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Which of the following treatments is appropriate for panic disorders?
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What is the primary mechanism of action for benzodiazepines?
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Which class of medications is most commonly used in treating obsessive-compulsive disorder (OCD)?
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Which of the following describes a key characteristic of generalized anxiety disorder?
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How do newer agents for treating insomnia differ from traditional hypnotics?
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What is a potential consequence of long-term use of benzodiazepines?
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Which symptom is NOT typically associated with hypersomnia?
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What distinguishes the REM stage of sleep from other stages?
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Which medication can provide a non-sedating alternative to benzodiazepines for anxiety treatment?
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What type of memory impairment can occur with benzodiazepine use?
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Which of the following medications is used in cases where benzodiazepines are ineffective during sedation?
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What is the primary use of alprazolam (Xanax)?
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Which benzodiazepine is specifically noted for its suitability in elderly patients?
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What is a significant adverse effect associated with flumazenil?
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Which of the following statements about barbiturates is true?
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Which benzodiazepine is commonly administered intravenously as an anesthetic?
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What is the mechanism of action of barbiturates?
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Which benzodiazepine is specifically indicated for treating panic disorder?
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What characterizes the action of flumazenil?
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Which characteristic is true about phenobarbital among barbiturates?
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How should benzodiazepine doses be adjusted to prevent seizures during withdrawal?
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What is a primary therapeutic use for amobarbital?
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Which non-benzodiazepine sedative hypnotic is known for a rapid onset and fewer adverse effects?
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What does buspirone primarily act as?
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Which sedative hypnotic option has been associated with a risk of less tolerance and dependence?
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Hydroxyzine is primarily used to treat which condition?
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What is an effect of melatonin in individuals traveling across several time zones?
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Which of the following factors is true about long-term use of antihistamines?
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What distinguishes non-benzodiazepine sedative hypnotics from older benzodiazepines?
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Which of the following is a characteristic of thiopental?
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What differentiates Doxepin from other antihistamines in the context of sleep aid?
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Study Notes
Overview of Sedatives
- Sedative-hypnotic drugs include two main categories: sedatives (calm and reduce anxiety) and hypnotics (induce drowsiness and promote sleep).
- Regular doses cause sedation; higher doses can lead to hypnosis.
- Some agents, like buspirone (BuSpar), primarily have anxiolytic effects without sedation.
Drug Classes
- Benzodiazepines: e.g., alprazolam (Xanax).
- Barbiturates: e.g., pentobarbital (Nembutal).
- Antihistamines: e.g., diphenhydramine (Benadryl).
- Miscellaneous sedative-hypnotics: e.g., zolpidem (Ambien).
- Non-sedating anxiolytics: e.g., buspirone (BuSpar).
Classification of Anxiety Disorders
- Acute anxiety.
- Panic disorder: characterized by acute episodes with psychological and physiological symptoms, often responsive to benzodiazepines or SSRIs.
- Phobic disorders.
- Obsessive-compulsive disorder (OCD): involves obsessions and compulsions treated with antidepressants and psychotherapy.
- Generalized anxiety disorder (GAD): chronic worry, managed with benzodiazepines short-term, SSRIs, and SNRIs.
- Post-traumatic stress disorder (PTSD).
Panic Disorders
- Manifest severe anxiety with symptoms like sweating and tachycardia, treated commonly with alprazolam (Xanax) and fluoxetine (Prozac).
- Sense of impending doom is frequently reported.
Generalized Anxiety Disorder (GAD)
- Involves chronic worrying and fluctuating severity over time.
- Benzodiazepines serve for short-term management; buspirone offers a non-sedating alternative.
Sleep Disorders
- Sleep is comprised of distinct stages, including REM (rapid eye movement) and slow-wave sleep.
- Sleep latency refers to the time taken to fall asleep; decreased by benzodiazepines and sedative-hypnotics.
- Drugs like zolpidem, zaleplon, and eszopiclone are preferred for insomnia due to less impact on sleep architecture.
Other Sleep Disorders
- Hypersomnia, narcolepsy, enuresis (bedwetting), somnambulism (sleepwalking), nightmares/terrors.
Sedative-Hypnotic Drugs
- Benzodiazepines are generally safer than barbiturates regarding overdose risks, with fewer adverse reactions.
- Sedating antihistamines are less likely to be abused and are effective for mild insomnia and anxiety.
Benzodiazepines
- Examples include alprazolam (Xanax), clonazepam (Klonopin), lorazepam (Ativan), and midazolam (Versed).
- They enhance GABA activity in the brain, facilitating sleep and reducing anxiety.
- They can cause anterograde amnesia, affecting short-term memory formation without recalling past events.
- Long-term use may lead to physical dependence, with withdrawal symptoms typically being mild but potentially severe when abruptly discontinued.
Flumazenil (Romazicon)
- Acts as a competitive antagonist at benzodiazepine receptors, reversing sedative effects.
- Can cause seizures and other adverse effects; administered intravenously.
Specific Benzodiazepine Uses
- Alprazolam: mainly for anxiety and panic disorders.
- Lorazepam: IV use for seizures and anxiety in elderly patients; effective for outpatient procedures.
- Clonazepam: treats anxiety and seizures, has no active metabolites.
- Midazolam: used as an anesthetic in medical procedures.
Barbiturates
- Lipid solubility affects onset and duration; highly lipid-soluble drugs act swiftly.
- Bind to GABA receptors, increasing chloride influx; have a lower therapeutic index than benzodiazepines.
- Used for insomnia and seizures, thiopental is an anesthetic.
Antihistamines
- Cause some sedation; not associated with significant dependence.
- Common examples include diphenhydramine and hydroxyzine.
Non-Benzodiazepine Sedative Hypnotics
- Include zolpidem, zaleplon, and eszopiclone, noted for fewer side effects.
- Melatonin is an OTC option that helps regulate biological clocks and is beneficial for insomnia.
Non-Sedating Anxiolytics
- Buspirone (BuSpar) works as a partial agonist at serotonin receptors, offering effects without sedation and minimal dependence risks; onset of action may take weeks.
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Description
This quiz focuses on sedative-hypnotic drugs and their effects, including anxiety reduction and drowsiness induction. It covers various drug classes such as benzodiazepines and barbiturates, providing a clear understanding of their roles in sedation and hypnosis. Test your knowledge on the different agents and their specific uses.
