Download Benzodiazepines and Barbiturates: Mechanism of Action, Effects, and Adverse Reactions and more Quizzes Health sciences in PDF only on Docsity!
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.
