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Questions and Answers
What effect do barbiturates have on blood pressure and heart rate at hypnotic doses?
What effect do barbiturates have on blood pressure and heart rate at hypnotic doses?
Which therapeutic use is appropriate for phenobarbital and mephobarbital?
Which therapeutic use is appropriate for phenobarbital and mephobarbital?
What is a common adverse effect of barbiturates linked to overdose?
What is a common adverse effect of barbiturates linked to overdose?
How do low-lipid soluble barbiturates differ from highly lipid-soluble agents in terms of pharmacokinetics?
How do low-lipid soluble barbiturates differ from highly lipid-soluble agents in terms of pharmacokinetics?
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Which of the following is a serious consequence of barbiturate toxicity?
Which of the following is a serious consequence of barbiturate toxicity?
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Which drug is commonly used for induction of anesthesia?
Which drug is commonly used for induction of anesthesia?
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What type of interactions do barbiturates commonly have with other medications?
What type of interactions do barbiturates commonly have with other medications?
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Which of the following is not an adverse effect commonly associated with barbiturates?
Which of the following is not an adverse effect commonly associated with barbiturates?
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What is the mechanism of action of ramelteon?
What is the mechanism of action of ramelteon?
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Which of the following is a side effect associated with tricyclic antidepressants?
Which of the following is a side effect associated with tricyclic antidepressants?
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Which of these medications may be used for performance anxiety?
Which of these medications may be used for performance anxiety?
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How do selective serotonin reuptake inhibitors (SSRIs) primarily function?
How do selective serotonin reuptake inhibitors (SSRIs) primarily function?
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What is a characteristic onset time for the effectiveness of tricyclic antidepressants?
What is a characteristic onset time for the effectiveness of tricyclic antidepressants?
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Which characteristic contributes to the popularity of benzodiazepine (BZP) over barbiturates?
Which characteristic contributes to the popularity of benzodiazepine (BZP) over barbiturates?
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What is a significant advantage of drugs like zolpidem, zaleplon, and eszopiclone compared to traditional benzodiazepines?
What is a significant advantage of drugs like zolpidem, zaleplon, and eszopiclone compared to traditional benzodiazepines?
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What is a primary clinical use of buspirone?
What is a primary clinical use of buspirone?
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What is a disadvantage associated with buspirone?
What is a disadvantage associated with buspirone?
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Which of the following side effects is commonly associated with buspirone?
Which of the following side effects is commonly associated with buspirone?
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How do 5-HT agonists like buspirone mainly exert their anxiolytic effects?
How do 5-HT agonists like buspirone mainly exert their anxiolytic effects?
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What is a consequence of chronic buspirone treatment on serotonin receptors?
What is a consequence of chronic buspirone treatment on serotonin receptors?
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What is a potential interaction effect noted when buspirone is taken with MAO inhibitors?
What is a potential interaction effect noted when buspirone is taken with MAO inhibitors?
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What is the primary difference in effect between low and high doses of a hypnotic drug?
What is the primary difference in effect between low and high doses of a hypnotic drug?
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Which of the following benzodiazepines is classified as short-acting?
Which of the following benzodiazepines is classified as short-acting?
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Which sedative-hypnotic medication has ultra-short acting properties?
Which sedative-hypnotic medication has ultra-short acting properties?
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Which class of medications is NOT considered an anxiolytic?
Which class of medications is NOT considered an anxiolytic?
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What is the duration of action for intermediate-acting benzodiazepines?
What is the duration of action for intermediate-acting benzodiazepines?
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What administration route is NOT recommended for chlordiazepoxide?
What administration route is NOT recommended for chlordiazepoxide?
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What is the role of lipophilicity in the pharmacokinetics of anxiolytic medications?
What is the role of lipophilicity in the pharmacokinetics of anxiolytic medications?
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Which of the following treatments is NOT typically part of managing anxiety?
Which of the following treatments is NOT typically part of managing anxiety?
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What is a primary clinical use of ultra short-acting barbiturates like thiopental?
What is a primary clinical use of ultra short-acting barbiturates like thiopental?
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What is the relationship between lipid solubility and duration of action in barbiturates?
What is the relationship between lipid solubility and duration of action in barbiturates?
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Which characteristic is common in all barbiturates regarding their effects on the CNS?
Which characteristic is common in all barbiturates regarding their effects on the CNS?
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What is a significant risk associated with barbiturate overdose?
What is a significant risk associated with barbiturate overdose?
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What is the primary reason barbiturates have been largely replaced by benzodiazepines?
What is the primary reason barbiturates have been largely replaced by benzodiazepines?
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Which barbiturate is commonly used in the treatment of insomnia?
Which barbiturate is commonly used in the treatment of insomnia?
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In terms of pharmacologic effects, which sequence represents the progression of responses to barbiturates?
In terms of pharmacologic effects, which sequence represents the progression of responses to barbiturates?
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What is the typical duration of action for long-acting barbiturates such as phenobarbital?
What is the typical duration of action for long-acting barbiturates such as phenobarbital?
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Study Notes
Sedative-Hypnotics Overview
- Hypnotics can act as sedatives at low doses and produce general anesthesia at high doses.
- The spectrum includes sedation, hypnosis, and anesthesia.
Classification of Sedative-Hypnotics
- Barbiturates: Divided into ultra-short acting, short-immediate, and long-acting.
- Benzodiazepines: Varied by duration: short, intermediate, and long-acting.
- Miscellaneous: Includes specific agents like chloral hydrate and meprobamate.
Benzodiazepines Classification
- Short-acting: Oxazepam, Triazolam (3-8 hours).
- Intermediate-acting: Alprazolam, Lorazepam (10-20 hours).
- Long-acting: Diazepam, Flurazepam (1-3 days).
Pharmacokinetics of Benzodiazepines
- Well absorbed orally; absorption rates vary based on lipophilicity.
- Can be administered parenterally (IV, IM); some are available only for IV use.
Barbiturates Overview
- Classified by duration of action and lipid solubility.
- Ultra-short (e.g., Thiopental) is used for induction of anesthesia.
- Short to intermediate acting (e.g., Secobarbital) treats insomnia.
- Long-acting (e.g., Phenobarbital) is effective for seizure control.
Barbiturates Pharmacological Effects
- CNS depression progresses from sedation to anesthesia.
- Cardiovascular effects lead to hypotension with toxic doses.
- Induce hepatic drug-metabolizing enzymes.
Therapeutic Uses of Barbiturates
- Effective for seizure disorders, anesthesia induction, and insomnia (largely replaced by benzodiazepines).
- Notable adverse effects include respiratory depression and potential for abuse.
Benzodiazepines vs. Barbiturates
- Benzodiazepines have a higher therapeutic index and less respiratory impact.
- They produce less physical dependence and do not alter drug disposition through enzyme inhibition.
Benzodiazepine-Like Drugs
- Include zolpidem and zaleplon, interacting selectively with GABAA receptors.
- Antagonized by flumazenil.
5-HT Agonists (Buspirone)
- Acts as a partial agonist at 5HT1A receptors, inhibiting serotonin release.
- Shows delayed anxiolytic effects; ineffective for severe anxiety or panic disorder.
- Minimal risk of dependence or cognitive dysfunction.
Melatonin Agonist (Ramelteon)
- Activates melatonin receptors, regulating sleep-wake cycles.
Tricyclic Antidepressants (TCAs)
- Reduce the uptake of serotonin and norepinephrine.
- Effective for anxiety, especially in co-occurrence with depression.
- Side effects include dry mouth, postural hypotension, and sexual dysfunction.
Selective Serotonin Reuptake Inhibitors (SSRIs)
- Fluoxetine is a commonly used SSRI, significant for anxiety and panic disorders.
- Acts by blocking serotonin reuptake with delayed onset of action.
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Description
Explore the various classes of sedative-hypnotics, including barbiturates and benzodiazepines. This quiz covers their pharmacological characteristics, duration of action, and mechanisms, providing a comprehensive understanding of these important medications in clinical practice.
