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Benzodiazepines and Barbiturates: Mechanism of Action, Effects, and Adverse Reactions, Quizzes of Health sciences

An overview of benzodiazepines and barbiturates, their mechanisms of action, effects, and adverse reactions. Benzodiazepines are highly soluble and easily cross the blood brain barrier, binding to cns receptors as agonists and enhancing the inhibitory neurotransmitter gaba. They are used to treat anxiety, panic attacks, insomnia, and alcohol withdrawal. Barbiturates, on the other hand, are original sedative-hypnotics with a narrow ti and high abuse rate, causing complete respiratory and cardiovascular depression. They are still used to treat seizure disorders and to induce general anesthesia. Both classes of drugs have various effects, adverse reactions, and interactions with other medications.

Typology: Quizzes

2010/2011

Uploaded on 04/28/2011

lmcclasky
lmcclasky 🇺🇸

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TERM 1
most common drugs to treat
anxiety
DEFINITION 1
benzodiazepines
TERM 2
Benzodiazepines are highly -soluble and have
a quick _
DEFINITION 2
lipid; onset
TERM 3
benzodiazepines easily cross
DEFINITION 3
the blood brain barrier
TERM 4
benzodiazepines They are metabolized in the
_ and excreted in the _
DEFINITION 4
liver; kidneys
TERM 5
benzodiazepine mechanism of action
DEFINITION 5
bind to CNS receptors as agonists, enhance inhibitory
neurotransmitter -aminobutyric acid (GABA), decreases
excitation in the limbic system
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most common drugs to treat

anxiety

benzodiazepines TERM 2

Benzodiazepines are highly -soluble and have

a quick _

DEFINITION 2 lipid; onset TERM 3

benzodiazepines easily cross

DEFINITION 3 the blood brain barrier TERM 4

benzodiazepines They are metabolized in the

_ and excreted in the _

DEFINITION 4 liver; kidneys TERM 5

benzodiazepine mechanism of action

DEFINITION 5 bind to CNS receptors as agonists, enhance inhibitory neurotransmitter -aminobutyric acid (GABA), decreases excitation in the limbic system

benzodiazepines effects

reduce anxiety, sedation, anticonvulsant, skeletal muscle relaxation TERM 7

benzodiazepines adverse reactions

DEFINITION 7 excessive CNS, anterograde amnesia, respiratory depression, diplopia, nystagmus, xerostomia, or increased salivation, swollen tongue, bitter taste TERM 8

benzodiadepines abuse, dependence,

TI

DEFINITION 8 can be abused or have dependence, high TI TERM 9

benzodiazepine antagonist flumazenil

DEFINITION 9 may be used to treat overdoses TERM 10

benzodiazepine uses

DEFINITION 10 treatment of anxiety, panic attacks, insomnia, and alcohol withdrawal; seizures (but not maintenance anticonvulsant)

barbiturates

original sedative-hypnotics TERM 17

barbiturates TI, abuse, results

DEFINITION 17 narrow TI, high abuse rate, complete respiratory and cardiovascular depression TERM 18

Barbiturates are still used to treat seizure

disorders and to induce general anesthesia

DEFINITION 18 Barbiturates are used to treat seizure disorders and to induce general anesthesia TERM 19

barbiturates are well-absorbed both_. They

are metabolized by the _ and excreted by the

_

DEFINITION 19 orally and rectally; liver; kidneys TERM 20

barbiturates produce effect

by

DEFINITION 20 enhancing GABA receptor binding

barbiturates Pharmacologic effects

CNS depression, analgesia, and anticonvulsant effects TERM 22

CNS depression can be exaggerated in _

patients and in those with _ or _ failure

DEFINITION 22 elderly; liver; renal TERM 23

barbiturates - dependence, contraindications,

drug interactment

DEFINITION 23 physical and psychologic dependence, intermittent porphyria, Barbiturates stimulate liver microsomal enzymes and interact with many different drugs TERM 24

barbiturate

examples

DEFINITION 24 secobarbital - phenobarbital - sodium thiopental TERM 25

Hypnotics

DEFINITION 25 Nonbenzodiazepine-Nonbarbiturate Sedative

Melatonin Receptor Agonists

ramelteon (Rozerem), highly selective = less side effects TERM 32

Centrally Acting Muscle Relaxants

DEFINITION 32 act on CNS, Common side effects include GI upset, sedation (CNS), and dizziness TERM 33

muscle relaxer

examples

DEFINITION 33

  • cyclobenzaprine (Flexeril) considered strongest of mucle relaxants - methocarbamol (Robaxin) - carisoprodol (Soma) TERM 34

Also _ can be used as a muscle relaxer as in

TMD and myofacial spasms

DEFINITION 34 diazepam (Valium) TERM 35

_% of top 200 drugs are related to CV

conditions

DEFINITION 35 25

Contraindications to dental treatment

Acute or recent myocardial infarction (3-6 months); Unstable/recent onset of angina pectoris; Uncontrolled CHF or arrhythmias; Significant uncontrolled BP TERM 37

epinephrine limited cardiac dose of _ may be

warranted in a few severe cardiac cases but

most of the cases should be okay

DEFINITION 37 0.04mg TERM 38

Congestive Heart Failure

(CHF)

DEFINITION 38 Left side failure= pulmonary edema; Right side failure= more systemic i.e. peripheral edema TERM 39

Cardiac/digitalis glycosides:

DEFINITION 39 digoxin (Lanoxin) most common/prototype TERM 40

Digoxin

DEFINITION 40 increases the force and strength of contractions. (positive inotropic). Reduces edema via more blood circulates thru kidneys. used in CHF, arrhythmias atrial fibrillation and atrial tachycardia. Adverse reactions: Narrow TI, GI, nausea/vomiting and copious salivation, Cardiac irregularities,Headache, visual disturbance, Increase gag reflex

Antiarrhythmic agents work by

depressing parts of the heart that are beating abnormally (low TI) TERM 47

nitroglycerin is a

DEFINITION 47 vasodilator TERM 48

nitroglycerin Adverse reactions:

DEFINITION 48 severe headache, flushing, hypotension and syncope. TERM 49

Calcium Channel Blockers:

DEFINITION 49 inhibition of movement of calcium during the contraction of cardiac and vascular smooth muscle TERM 50

Some CCBs also _ myocardial contraction

(negative inotropic effect) or _ coronary

vasodilation

DEFINITION 50 decrease; increase

CCBs are used

for

hypertension and cardiac arrhythmias TERM 52

CCB Examples:

DEFINITION 52 verapamil (Calan)** diltiazem ( Cardizem)* nifedipine ( Procardia)* TERM 53

BETA-Adrenergic Blockers

DEFINITION 53 block beta stimulation which net effect is to reduce myocardial oxygen demand, may be used for angina TERM 54

BETA-Adrenergic Blockers

examples

DEFINITION 54 propranolol (Inderal), metoprolol (Lopresor), atenolol (Tenormin TERM 55

hypertension affects

DEFINITION 55 heart, kidney, brain, retina

Loop Diuretics

Decrease sodium reabsorption in kidneys with more loss of fluids than with thiazides. Furosemide (Lasix) Also used in CHF. Similar adverse affects as with thiazides TERM 62

Potassium-sparing diuretics*

DEFINITION 62 Weak diuretic action, With all diuretics, patients may need potassium supplements TERM 63

Potassium-sparing diuretic Examples:

DEFINITION 63 Spironolactone (Aldactone), triamterene (Dyazide) TERM 64

Beta Adrenergic

Blockers

DEFINITION 64 used for hypertension, Beta -1: stimulation assoc. with increase heart rate, cardiac contractility and AV conduction. Beta-2: stimulation produces vasodilation in skeletal muscle and bronchodilatioon TERM 65

Beta blockers can be specific or non-

specific

DEFINITION 65 specific (Lopressor) or non-specific (Inderal)

Beta Adrenergic Blockers Drug

interactions

Non-specific B-blockers with epi (hypertension with reflex bradycardia) TERM 67

CCB adverse reactions

DEFINITION 67 extensions of pharmacologic effects. Hypotension= dizzy light-headed; CV= bradycardia, edema; Orally can see gingival enlargement TERM 68

anti-hypertensives whose effect is not

reduced by NSAIDs

DEFINITION 68 CCBs TERM 69

CCBs interact with

DEFINITION 69 erythromycin (prolongs repolarization, arrythmia, SCD) TERM 70

Renin-angiotensin-aldosterone system is a

mechanism for

DEFINITION 70 maintaining BP

Alpha-adrenergic Blockers

Alpha receptors produce vasoconstriction(in arterioles and venules) and increase peripheral resistance when stimulated. Blockers reverse this action. Doxazosin (Cardura) Terazosin (Hytrin) TERM 77

Alpha-adrenergic Blockers Adverse rxns

DEFINITION 77 orthostatic hypotension, CNS depression. With epi can cause severe hypotension and reflex tachycardia. TERM 78

Other Alpha-adrenergic Blockers

DEFINITION 78 Clonidine (Ctapress) acts centrally in CNS Adverse rxns: xerostomia 40% and dysgeusia TERM 79

ANTIHYPERLIPIDEMIC

DEFINITION 79 Therapy of these agents is to reduce LDL cholesterol. HMG Co-A Reductase Inhibitors: (this enzyme is involved in cholesterol synthesis) end in statin i.e. levastatin (Mevacor) atorvastatin (Lipitor) TERM 80

most important ANTICOAGULANTS

DEFINITION 80 warfarin (Coumadin)

INR= International Normalized Ratio (dental

range)

TERM 82

ANTICOAGULANTS Adverse effects

DEFINITION 82 hemorrhage, Low TI, NO ASPIRIN TERM 83

other anticoagulants

DEFINITION 83 Heparin(injection) used in hospitals also in lines during kidney dialysis. Streptokinase clot buster for emboli and thrombus Plavix also affects platelets.