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% Document Info
\author{Carm (Carmilaa)}
\pdfinfo{
  /Title (sedative-hypnotic-drugs.pdf)
  /Creator (Cheatography)
  /Author (Carm (Carmilaa))
  /Subject (Sedative-Hypnotic Drugs Cheat Sheet)
}

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\fancyhead[L]{
\noindent
\begin{multicols}{3}
\begin{tabulary}{5.8cm}{C}
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    \vspace{-7pt}
    {\parbox{\dimexpr\textwidth-2\fboxsep\relax}{\noindent
        \hspace*{-6pt}\includegraphics[width=5.8cm]{/web/www.cheatography.com/public/images/cheatography_logo.pdf}}
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\begin{tabulary}{11cm}{L}
    \vspace{-2pt}\large{\bf{\textcolor{DarkBackground}{\textrm{Sedative-Hypnotic Drugs Cheat Sheet}}}} \\
    \normalsize{by \textcolor{DarkBackground}{Carm (Carmilaa)} via \textcolor{DarkBackground}{\uline{cheatography.com/49544/cs/17073/}}}
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\fancyfoot[L]{ \footnotesize
\noindent
\begin{multicols}{3}
\begin{tabulary}{5.8cm}{LL}
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  \mymulticolumn{2}{p{5.377cm}}{\bf\textcolor{white}{Cheatographer}}  \\
  \vspace{-2pt}Carm (Carmilaa) \\
  \uline{cheatography.com/carmilaa} \\
  \end{tabulary}
\vfill
\columnbreak
\begin{tabulary}{5.8cm}{L}
  \SetRowColor{FootBackground}
  \mymulticolumn{1}{p{5.377cm}}{\bf\textcolor{white}{Cheat Sheet}}  \\
   \vspace{-2pt}Published 15th September, 2018.\\
   Updated 15th September, 2018.\\
   Page {\thepage} of \pageref{LastPage}.
\end{tabulary}
\vfill
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  \vspace{-5pt}
  %\includegraphics[width=48px,height=48px]{dave.jpeg}
  Measure your website readability!\\
  www.readability-score.com
\end{tabulary}
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\begin{document}
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\begin{multicols*}{3}

\begin{tabularx}{5.377cm}{x{1.24425 cm} x{3.73275 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{5.377cm}}{\bf\textcolor{white}{Introduction:}}  \tn
% Row 0
\SetRowColor{LightBackground}
{\bf{Sedation:}} & Reduction of anxiety \tn 
% Row Count 2 (+ 2)
% Row 1
\SetRowColor{white}
{\bf{Hypnosis:}} & Induction of sleep \tn 
% Row Count 4 (+ 2)
% Row 2
\SetRowColor{LightBackground}
{\bf{Sedative:}} & Synonym=anxiolytic, Reduces anxiety and has a calming effect \tn 
% Row Count 6 (+ 2)
% Row 3
\SetRowColor{white}
{\bf{Hypnotic:}} & Produces drowziness, Induces and maintains sleep \tn 
% Row Count 8 (+ 2)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{5.377cm}{X}
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\mymulticolumn{1}{x{5.377cm}}{\bf\textcolor{white}{Dose-Responsive Curve for S-H Agents:}}  \tn
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\mymulticolumn{1}{p{5.377cm}}{\vspace{1px}\centerline{\includegraphics[width=5.1cm]{/web/www.cheatography.com/public/uploads/carmilaa_1536998615_SH1.PNG}}} \tn 
\hhline{>{\arrayrulecolor{DarkBackground}}-}
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\par\addvspace{1.3em}

\begin{tabularx}{5.377cm}{X}
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\mymulticolumn{1}{x{5.377cm}}{\bf\textcolor{white}{{\bf{Classification:}}}}  \tn
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\mymulticolumn{1}{p{5.377cm}}{\vspace{1px}\centerline{\includegraphics[width=5.1cm]{/web/www.cheatography.com/public/uploads/carmilaa_1536998707_SH2.PNG}}} \tn 
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{5.377cm}}{{\bf{Benzodiazepines:}} \newline \textgreater{}{\bf{Short-acting:}} Triazolam \newline \textgreater{}{\bf{Intermediate-acting:}} alprazolam,lorazepam,oxazepam,temazepam \newline \textgreater{}{\bf{Long acting:}} pentobarbitone, phenobarbitone,secobarbitone}  \tn 
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{5.377cm}{X}
\SetRowColor{DarkBackground}
\mymulticolumn{1}{x{5.377cm}}{\bf\textcolor{white}{Mechanism of Action:}}  \tn
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\hhline{>{\arrayrulecolor{DarkBackground}}-}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{5.377cm}{X}
\SetRowColor{DarkBackground}
\mymulticolumn{1}{x{5.377cm}}{\bf\textcolor{white}{MOA: Benzodiazepines}}  \tn
\SetRowColor{white}
\mymulticolumn{1}{x{5.377cm}}{{\bf{Receptors for BZ present =}} Thalamus, limbic structures, cerebral cortex \newline % Row Count 2 (+ 2)
{\bf{BZ receptors =}} \newline % Row Count 3 (+ 1)
\textgreater{} Part of GABA\textasciicircum{}A\textasciicircum{} receptor chloride ion channel macromolecular complex  \newline % Row Count 5 (+ 2)
\textgreater{} Major GABA\textasciicircum{}A\textasciicircum{} receptor isoform  \newline % Row Count 6 (+ 1)
\textgreater{}Five subunits: 2α1, 2β2, and 1Υ2% Row Count 7 (+ 1)
} \tn 
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{5.377cm}}{Benzodiapines bind between {\bf{α1 and Υ2 subunits }} \newline  \newline Increase the {\bf{FREQUENCY}} of GABA-mediated chloride ion opening}  \tn 
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{5.377cm}{X}
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\mymulticolumn{1}{x{5.377cm}}{\bf\textcolor{white}{MOA:Barbiturates:}}  \tn
\SetRowColor{white}
\mymulticolumn{1}{x{5.377cm}}{\textgreater{} Depress neural activity in midbrain reticular formation \newline % Row Count 2 (+ 2)
\textgreater{}Bind to {\bf{α and β subunits of the GABA\textasciicircum{}A\textasciicircum{} receptor}} \newline % Row Count 4 (+ 2)
\textgreater{}Prolong the action of GABA and glycine% Row Count 5 (+ 1)
} \tn 
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{5.377cm}}{Increase the {\bf{DURATION}} of GABA-mediated chloride ion channel opening \newline \textgreater{}may also block glutamate receptors and sodium channels at higher doses}  \tn 
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{5.377cm}{X}
\SetRowColor{DarkBackground}
\mymulticolumn{1}{x{5.377cm}}{\bf\textcolor{white}{MOA: Other Agents:}}  \tn
\SetRowColor{white}
\mymulticolumn{1}{x{5.377cm}}{Zolpidem, Zaleplon, Eszopiclone = {\bf{not Benzaodiazepines}} \newline % Row Count 2 (+ 2)
\textgreater{}Bind to benzodiazepine receptor (BZ1 or ω1) \newline % Row Count 3 (+ 1)
More selective to GABA\textasciicircum{}A\textasciicircum{} isoforms that contain α1 subunits  \newline % Row Count 5 (+ 2)
-Fewer adverse effects than benzodiazepines \newline % Row Count 6 (+ 1)
-Minimal effects on sleep patterns, less likely to cause dependence \newline % Row Count 8 (+ 2)
\textgreater{}Increase the {\bf{FREQUENCY}} of GABA-mediated chloride ion opening% Row Count 10 (+ 2)
} \tn 
\hhline{>{\arrayrulecolor{DarkBackground}}-}
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\par\addvspace{1.3em}

\begin{tabularx}{5.377cm}{p{0.68655 cm} x{1.3731 cm} x{2.51735 cm} }
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\mymulticolumn{3}{x{5.377cm}}{\bf\textcolor{white}{Effects:}}  \tn
% Row 0
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\seqsplit{Sedation} & \seqsplit{Anticonvulsant} actions & Tolerance \tn 
% Row Count 2 (+ 2)
% Row 1
\SetRowColor{white}
\seqsplit{Hypnosis} & Muscle relaxation & Psychological dependence - Compulsive use \tn 
% Row Count 4 (+ 2)
% Row 2
\SetRowColor{LightBackground}
\seqsplit{Anaesthesia} & Medullary depression & Physiological dependence - withdrawl symptoms if drug is discontinued \tn 
% Row Count 8 (+ 4)
\hhline{>{\arrayrulecolor{DarkBackground}}---}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{5.377cm}{X}
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\mymulticolumn{1}{x{5.377cm}}{\bf\textcolor{white}{CNS Effects:}}  \tn
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\mymulticolumn{1}{p{5.377cm}}{\vspace{1px}\centerline{\includegraphics[width=5.1cm]{/web/www.cheatography.com/public/uploads/carmilaa_1537001316_SH4.PNG}}} \tn 
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{5.377cm}}{{\bf{Clinical Uses:}} \newline \textgreater{} Anxiety states \newline \textgreater{} Sleep disorders \newline \textgreater{} Anesthesia \newline \textgreater{} Epilepsy  \newline \textgreater{} Alcohol withdrawal state}  \tn 
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{5.377cm}{x{2.04057 cm} x{2.93643 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{5.377cm}}{\bf\textcolor{white}{Adverse Effects:}}  \tn
% Row 0
\SetRowColor{LightBackground}
{\bf{Psychomotor Dysfunction:}} & Cognitive impairment, decreased psychomotor skills, daytime sedation \tn 
% Row Count 3 (+ 3)
% Row 1
\SetRowColor{white}
{\bf{Additive CNS Depression:}} & Alcohol, antihistamines, antipsychotic agents, opioids, tricyclic antidepressants \tn 
% Row Count 7 (+ 4)
% Row 2
\SetRowColor{LightBackground}
{\bf{Overdose:}} & CVS and respiratory depression, Antidote: Flumazenil \tn 
% Row Count 10 (+ 3)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{5.377cm}{X}
\SetRowColor{DarkBackground}
\mymulticolumn{1}{x{5.377cm}}{\bf\textcolor{white}{Pharmacokinetics:}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{5.377cm}}{\textgreater{} Most are lipid soluble, absorbed well from GIT} \tn 
% Row Count 1 (+ 1)
% Row 1
\SetRowColor{white}
\mymulticolumn{1}{x{5.377cm}}{\textgreater{} May cross the placental barrier during pregnancy - may depressed neonatal vital functions} \tn 
% Row Count 3 (+ 2)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{5.377cm}}{\textgreater{} Detectable in breast milk - may exert depressant effects in nursing infant} \tn 
% Row Count 5 (+ 2)
% Row 3
\SetRowColor{white}
\mymulticolumn{1}{x{5.377cm}}{\textgreater{} Metabolism by hepatic enzymes - renal function = no significant effect on elimination} \tn 
% Row Count 7 (+ 2)
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{5.377cm}{X}
\SetRowColor{DarkBackground}
\mymulticolumn{1}{x{5.377cm}}{\bf\textcolor{white}{Pharmacokinetics:}}  \tn
\SetRowColor{white}
\mymulticolumn{1}{x{5.377cm}}{{\bf{Benzodiazepines:}} \newline % Row Count 1 (+ 1)
-Converted to active metabolites with long half-lives \newline % Row Count 3 (+ 2)
   -{}-Potential for accumulation   \newline % Row Count 4 (+ 1)
-Lorazepam and oxazepam do not form active metabolites \newline % Row Count 6 (+ 2)
-Metabolized mainly by CYP3A4  \newline % Row Count 7 (+ 1)
{\bf{Barbiturates:}} \newline % Row Count 8 (+ 1)
-Extensively metabolized  \newline % Row Count 9 (+ 1)
  -{}-Except pentobarbital \newline % Row Count 10 (+ 1)
     -{}-{}-Excreted partly unchanged in urine% Row Count 11 (+ 1)
} \tn 
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{5.377cm}}{{\bf{Zolpidem:}} No active metabolites \newline  \newline {\bf{Drug Interactions:}} \newline -Inducers/inhibitors of CYP3A4 interact with sedative hypnotics  \newline     -{}-E.g. rifampicin (inducer), ketoconazole, cimetidine (inhibitors) \newline -Barbiturates induce metabolic enzymes}  \tn 
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{5.377cm}{X}
\SetRowColor{DarkBackground}
\mymulticolumn{1}{x{5.377cm}}{\bf\textcolor{white}{Atypical Sedative-Hypnotics:}}  \tn
\SetRowColor{white}
\mymulticolumn{1}{x{5.377cm}}{{\bf{Buspirone:}} \newline % Row Count 1 (+ 1)
\textgreater{}Partial agonist at 5-HT\textasciicircum{}1A\textasciicircum{} receptors \newline % Row Count 2 (+ 1)
\textgreater{}Selective anxiolytic effects: \newline % Row Count 3 (+ 1)
   -Minimal CNS depressant effects = No anticonvulsant or muscle relaxation effect \newline % Row Count 5 (+ 2)
\textgreater{}Minimal tolerance, dependence, and abuse potential% Row Count 7 (+ 2)
} \tn 
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{5.377cm}}{{\bf{Ramelteon, Tasimelteon:}} \newline \textgreater{} Melatonin receptor agonists \newline \textgreater{}Minimal rebound or withdrawal symptoms \newline \textgreater{}Minimal abuse potential}  \tn 
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\end{tabularx}
\par\addvspace{1.3em}


% That's all folks
\end{multicols*}

\end{document}