Questions – Sedative Hypnotics

00:01 Let's move on to a question regarding benzodiazepines. The following statement about benzodiazepines is true.

00:10 A. Benzodiazepines act through the excitation of GABA on the GABA A receptor-chloride ion channel macromolecular complex.

00:20 B. Benzos bind to a region between the alpha and beta portions of the GABA A complex. C. Benzodiazepines bind to a region on the alpha portion or benzos bind to a region between the alpha and gamma portions. So which one is true? Good. So you chose D which says that benzodiazepines bind to a region between the alpha and gamma portions of the A complex.

00:59 Let's move on to comparing Ben and Barb, and this is how we commonly call them in clinical practice. Pick the correct statement.

01:07 A. Both barbiturates and benzodiazepines can be reversed by flumazenil. B. Both barbiturates and benzodiazepines act by binding to a specific site on the subunit of the GABA A complex. C. Both barbiturates and benzos inhibit the actions of GABA on a GABA A receptor complex. And D, both benzos and barbiturates have strong antiseizure activity at low doses.

01:41 If you picked C, you are right. So let's take a look at these answers. Both barbiturates and benzodiazepines can be reversed by flumazenil. Well remember that barbiturates binding site is inside the membrane itself and far away from the flumazenil binding site. So no. Barbiturates are not reversed by flumazenil while benzodiazepines are. B, both barbiturates and benzos act by binding to a specific alpha unit. That's not quite true. They actually bind between the alpha and gamma subunits.

02:16 And D is wrong, because it says here both barbiturates and benzodiazepines have strong antiseizure activity at low doses, no. Barbiturates have antiseizure activity at medium doses and benzos have antiseizure activity at high doses.