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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.
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benzodiazepines TERM 2
DEFINITION 2 lipid; onset TERM 3
DEFINITION 3 the blood brain barrier TERM 4
DEFINITION 4 liver; kidneys TERM 5
DEFINITION 5 bind to CNS receptors as agonists, enhance inhibitory neurotransmitter -aminobutyric acid (GABA), decreases excitation in the limbic system
reduce anxiety, sedation, anticonvulsant, skeletal muscle relaxation TERM 7
DEFINITION 7 excessive CNS, anterograde amnesia, respiratory depression, diplopia, nystagmus, xerostomia, or increased salivation, swollen tongue, bitter taste TERM 8
DEFINITION 8 can be abused or have dependence, high TI TERM 9
DEFINITION 9 may be used to treat overdoses TERM 10
DEFINITION 10 treatment of anxiety, panic attacks, insomnia, and alcohol withdrawal; seizures (but not maintenance anticonvulsant)
original sedative-hypnotics TERM 17
DEFINITION 17 narrow TI, high abuse rate, complete respiratory and cardiovascular depression TERM 18
DEFINITION 18 Barbiturates are used to treat seizure disorders and to induce general anesthesia TERM 19
DEFINITION 19 orally and rectally; liver; kidneys TERM 20
DEFINITION 20 enhancing GABA receptor binding
CNS depression, analgesia, and anticonvulsant effects TERM 22
DEFINITION 22 elderly; liver; renal TERM 23
DEFINITION 23 physical and psychologic dependence, intermittent porphyria, Barbiturates stimulate liver microsomal enzymes and interact with many different drugs TERM 24
DEFINITION 24 secobarbital - phenobarbital - sodium thiopental TERM 25
DEFINITION 25 Nonbenzodiazepine-Nonbarbiturate Sedative
ramelteon (Rozerem), highly selective = less side effects TERM 32
DEFINITION 32 act on CNS, Common side effects include GI upset, sedation (CNS), and dizziness TERM 33
DEFINITION 33
DEFINITION 34 diazepam (Valium) TERM 35
DEFINITION 35 25
Acute or recent myocardial infarction (3-6 months); Unstable/recent onset of angina pectoris; Uncontrolled CHF or arrhythmias; Significant uncontrolled BP TERM 37
DEFINITION 37 0.04mg TERM 38
DEFINITION 38 Left side failure= pulmonary edema; Right side failure= more systemic i.e. peripheral edema TERM 39
DEFINITION 39 digoxin (Lanoxin) most common/prototype TERM 40
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
depressing parts of the heart that are beating abnormally (low TI) TERM 47
DEFINITION 47 vasodilator TERM 48
DEFINITION 48 severe headache, flushing, hypotension and syncope. TERM 49
DEFINITION 49 inhibition of movement of calcium during the contraction of cardiac and vascular smooth muscle TERM 50
DEFINITION 50 decrease; increase
hypertension and cardiac arrhythmias TERM 52
DEFINITION 52 verapamil (Calan)** diltiazem ( Cardizem)* nifedipine ( Procardia)* TERM 53
DEFINITION 53 block beta stimulation which net effect is to reduce myocardial oxygen demand, may be used for angina TERM 54
DEFINITION 54 propranolol (Inderal), metoprolol (Lopresor), atenolol (Tenormin TERM 55
DEFINITION 55 heart, kidney, brain, retina
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
DEFINITION 62 Weak diuretic action, With all diuretics, patients may need potassium supplements TERM 63
DEFINITION 63 Spironolactone (Aldactone), triamterene (Dyazide) TERM 64
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
DEFINITION 65 specific (Lopressor) or non-specific (Inderal)
Non-specific B-blockers with epi (hypertension with reflex bradycardia) TERM 67
DEFINITION 67 extensions of pharmacologic effects. Hypotension= dizzy light-headed; CV= bradycardia, edema; Orally can see gingival enlargement TERM 68
DEFINITION 68 CCBs TERM 69
DEFINITION 69 erythromycin (prolongs repolarization, arrythmia, SCD) TERM 70
DEFINITION 70 maintaining BP
Alpha receptors produce vasoconstriction(in arterioles and venules) and increase peripheral resistance when stimulated. Blockers reverse this action. Doxazosin (Cardura) Terazosin (Hytrin) TERM 77
DEFINITION 77 orthostatic hypotension, CNS depression. With epi can cause severe hypotension and reflex tachycardia. TERM 78
DEFINITION 78 Clonidine (Ctapress) acts centrally in CNS Adverse rxns: xerostomia 40% and dysgeusia TERM 79
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
DEFINITION 80 warfarin (Coumadin)
TERM 82
DEFINITION 82 hemorrhage, Low TI, NO ASPIRIN TERM 83
DEFINITION 83 Heparin(injection) used in hospitals also in lines during kidney dialysis. Streptokinase clot buster for emboli and thrombus Plavix also affects platelets.