Sedatives and Hypnotics
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Questions and Answers

What is the primary difference between sedative and hypnotic effects?

  • Sedative effects are seen at higher doses, while hypnotic effects are seen at lower doses
  • Sedative effects reduce anxiety, while hypnotic effects induce drowsiness (correct)
  • Sedative effects are seen in the daytime, while hypnotic effects are seen at night
  • Sedative effects are short-term, while hypnotic effects are long-term

    • Which of the following drugs is classified as a non-sedating anxiolytic?

  • Alprazolam (Xanax)
  • Diphenhydramine (Benadryl)
  • Pentobarbital (Nembutal)
  • Buspirone (BuSpar) (correct)

    • What is the characteristic of acute anxiety?

  • Recurring episodes of severe anxiety
  • Severe anxiety with marked psychological and physiologic symptoms (correct)
  • Chronic anxiety with no symptoms
  • Mild anxiety with minimal symptoms

    • What is the primary mechanism of action of benzodiazepines on consciousness and sleep?

    <p>Facilitating the activity of GABA at various sites</p> Signup and view all the answers

    Which of the following sleep stages is characterized by high-frequency, low-amplitude activity?

    <p>Stage 1 and 2</p> Signup and view all the answers

    Which of the following is NOT a type of anxiety disorder?

    <p>Obsessive-compulsive personality disorder</p> Signup and view all the answers

    Which of the following drugs is commonly used to treat OCD?

    <p>Antidepressant drug</p> Signup and view all the answers

    What is the primary symptom of panic disorder?

    <p>Acute episodes of severe anxiety with marked psychological and physiologic symptoms</p> Signup and view all the answers

    Which of the following benzodiazepines is commonly used to treat panic disorder?

    <p>Alprazolam (Xanax)</p> Signup and view all the answers

    What is the primary difference between benzodiazepines and barbiturates?

    <p>Benzodiazepines are safer in cases of overdose</p> Signup and view all the answers

    What is the primary difference between benzodiazepines and barbiturates?

    <p>Benzodiazepines are used for anxiety, while barbiturates are used for sleep</p> Signup and view all the answers

    What is the effect of long-term use of benzodiazepines?

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

    What is the primary effect of benzodiazepines on memory?

    <p>Produce anterograde amnesia</p> Signup and view all the answers

    Which of the following antihistamines is used as a sedative-hypnotic?

    <p>Diphenhydramine (Benadryl)</p> Signup and view all the answers

    What is the primary mechanism of action of buspirone?

    <p>Acts as a partial agonist at 5-HT1A receptors</p> Signup and view all the answers

    Which of the following is a non-sedating alternative to benzodiazepines?

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

    Which of the following barbiturates is used to induce anesthesia?

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

    What is the primary use of newer hypnotic drugs such as zolpidem and eszopiclone?

    <p>To treat insomnia</p> Signup and view all the answers

    Which of the following is NOT a type of sedative-hypnotic drug?

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

    Which antihistamine has been used to treat mild anxiety and is sometimes used as a sedative before surgery?

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

    What is the effect of benzodiazepines on the cardiovascular system?

    <p>They dilate coronary arteries</p> Signup and view all the answers

    What is the primary use of flumazenil?

    <p>To reverse the effects of benzodiazepines</p> Signup and view all the answers

    What is a characteristic of non-benzodiazepine sedative hypnotics?

    <p>They have a shorter duration of action</p> Signup and view all the answers

    What is a potential use of melatonin?

    <p>Accelerating 'resetting' the biologic clock</p> Signup and view all the answers

    What is a unique feature of buspirone?

    <p>It is a partial agonist at serotonin 5-HT1A receptors</p> Signup and view all the answers

    Which of the following is NOT a characteristic of buspirone?

    <p>It produces muscle relaxation</p> Signup and view all the answers

    What is a common use of diphenydramine?

    <p>Treating insomnia</p> Signup and view all the answers

    Which of the following barbiturates has been used to treat seizure disorders?

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

    What is the primary mechanism of action of benzodiazepines?

    <p>Increasing the affinity of the receptor for GABA and the duration of time the channel remains open</p> Signup and view all the answers

    What is a potential limitation of antihistamines?

    <p>Some tolerance can occur during long-term use</p> Signup and view all the answers

    What is the main advantage of using lorazepam over other benzodiazepines in elderly patients?

    <p>It can be administered orally or IV</p> Signup and view all the answers

    Which of the following non-benzodiazepine sedative hypnotics has a high affinity for H1 receptors?

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

    What is the primary indication for the use of midazolam?

    <p>Anesthesia for endoscopy or minor surgery</p> Signup and view all the answers

    What is the main difference between the mechanism of action of benzodiazepines and barbiturates?

    <p>Benzodiazepines bind to a different site on the GABA receptor</p> Signup and view all the answers

    What is the primary use of flumazenil?

    <p>Counteracting the adverse effects of benzodiazepines</p> Signup and view all the answers

    What is the primary advantage of using clonazepam over other benzodiazepines?

    <p>It doesn't have active metabolites</p> Signup and view all the answers

    What is the main characteristic of highly lipid-soluble barbiturates?

    <p>They are well absorbed from the gut and rapidly redistribute from brain to peripheral tissues</p> Signup and view all the answers

    What is the primary indication for the use of temazepam?

    <p>Treating insomnia</p> Signup and view all the answers

    What is the main difference between the duration of action of oxazepam and lorazepam?

    <p>Oxazepam has a shorter duration of action</p> Signup and view all the answers

    Why is it important to gradually taper doses of benzodiazepines?

    <p>To prevent seizure</p> Signup and view all the answers

    Study Notes

    Sedatives and Hypnotics

    • Sedative-hypnotic drugs are extremely common and can cause sedation at regular doses and hypnosis at higher doses.
    • They can be classified into different categories, including benzodiazepines, barbiturates, antihistamines, and non-benzodiazepine sedative hypnotics.

    Classification of Anxiety

    • Anxiety can be classified into different types, including:
      • Acute anxiety
      • Panic disorder
      • Phobic disorders
      • Obsessive-compulsive disorder (OCD)
      • Generalized anxiety disorder (GAD)
      • Post-traumatic stress disorder (PTSD)

    Panic Disorders

    • Panic disorders are characterized by acute episodes of severe anxiety with marked psychological and physiologic symptoms.
    • They may include feelings of impending doom, accompanied by sweating, tachycardia, and tremors.
    • Panic disorders often respond to treatment with benzodiazepines or antidepressants (SSRIs).
    • Alprazolam (Xanax) and clonazepam (Klonopin) are commonly used benzodiazepines, while fluoxetine (Prozac) is a commonly used SSRI.

    Obsessive-Compulsive Disorder (OCD)

    • OCD is characterized by obsessions, which are recurring or persistent thoughts and impulses, as well as compulsions, which are repetitive behaviors in response to obsessions.
    • OCD can be treated effectively with antidepressant drugs and psychotherapy.

    Generalized Anxiety Disorder (GAD)

    • GAD is characterized by chronic worry and apprehension concerning future events.
    • Benzodiazepines are used for short-term therapy, can be used intermittently, and SSRIs and SNRIs are often used as well.
    • Buspirone (BuSpar) provides a non-sedating alternative to benzodiazepines.

    Sleep Disorders

    • Sleep disorders can be classified into different types, including insomnia, hypersomnia, narcolepsy, enuresis, somnambulism, and nightmares.
    • Insomnia can be treated with benzodiazepines, such as zolpidem (Ambien), zaleplon (Sonata), and eszopiclone (Lunesta), which decrease sleep latency and increase sleep duration.

    Benzodiazepines

    • Benzodiazepines are a type of sedative-hypnotic drug that exerts their effect on consciousness and sleep by facilitating the activity of GABA at various sites.
    • They increase the affinity of GABA for its binding site and facilitate the opening of the chloride ion channel.
    • Benzodiazepines can produce anterograde amnesia, are useful for patients undergoing stressful procedures, and can cause physical dependence and withdrawal syndrome.
    • Flumazenil (Romazicon) is a competitive benzodiazepine receptor antagonist that can counteract the adverse effects of benzodiazepines.

    Barbiturates

    • Barbiturates are another type of sedative-hypnotic drug that binds to a distinct site on the GABA receptor chloride ion channel.
    • They increase the affinity of the receptor for GABA and the duration of time the channel remains open, but have a greater toxicity and smaller therapeutic index than benzodiazepines.
    • Barbiturates are used less frequently due to their toxicity and potential for abuse.

    Antihistamines

    • Antihistamines, such as diphenhydramine, are occasionally used to treat mild insomnia and anxiety, have less potential for abuse, and are available over-the-counter.
    • They can cause tolerance and have a ceiling effect, but are not associated with physical dependence or significant drug abuse.

    Non-Benzodiazepine Sedative Hypnotics

    • Non-benzodiazepine sedative hypnotics, such as zolpidem (Ambien), zaleplon (Sonata), and eszopiclone (Lunesta), have replaced older benzodiazepines for the treatment of insomnia.
    • They have fewer adverse effects, do not affect REM or slow-wave sleep, and have a shorter duration of action, precluding daytime sedation and hangover effects.

    Melatonin

    • Melatonin is a hormone that regulates the sleep-wake cycle and is available over-the-counter.
    • It may be effective in treating jet lag, insomnia in shift-change workers, delayed sleep-phase syndrome, and non-24-hour sleep-wake disorder.

    Non-Sedating Anxiolytic Drugs

    • Buspirone (BuSpar) is a unique anxiolytic drug that is not similar to any other drugs.
    • It is a partial agonist at serotonin 5-HT1A receptors, causing up-regulation of postsynaptic serotonin receptors.
    • Buspirone takes 3-4 weeks to produce an anxiolytic effect and is used to treat chronic anxiety without causing sedation, amnesia, tolerance, dependence, or muscle relaxation.

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    Description

    Learn about sedative-hypnotic drugs, their effects, and types including benzodiazepines and barbiturates. Understand their uses and differences.

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