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Sedative Hypnotic Medications

Sedative Hypnotic Medications

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Published by Edward Arlu

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Published by: Edward Arlu on Mar 01, 2010
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01/19/2013

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Page: Assignment in Pharmacology
 
Dinoy Edward Arlu V. BSN II-D
Sedative-HypnoticMedications
What are sedative-hypnotics?
Sedative-hypnotics are drugs whichdepress or slow down the body's functions.Often these drugs are referred to astranquilizers and sleeping pills orsometimes just as sedatives. Their effectsrange from calming down anxious people topromoting sleep. Both tranquilizers andsleeping pills can have either effect,depending on how much is taken. At highdoses or when they are abused, many ofthese drugs can even cause unconsciousnessand death.
 What are some of the sedative-hypnotics?
Barbiturates and benzodiazepines arethe two major categories of sedative-hypnotics. The drugs in each of these groupsare similar in chemical structure. Somewell-known barbiturates are secobarbital(Seconal) and pentobarbital (Nembutal).Diazepam (Valium), chlordiazepoxide (Librium),and chlorazepate (Tranxene) are examplesof benzodiazepines. A few sedative-hypnotics do not fit in either category. Theyinclude methaqualone (Quaalude),ethchlorvynol (Placidyl), chloral hydrate(Noctec), and mebrobamate (Miltown). All ofthese drugs can be dangerous when theyare not taken according to a physician'sinstructions.
 Can sedative-hypnotics cause dependence?
Yes. They can cause both physical andpsychological dependence. Regular use overa long period of time may result intolerance, which means people have totake larger and larger doses to get thesame effects. When regular users stopusing large doses of these drugs suddenly,they may develop physical withdrawalsymptoms ranging from restlessness,insomnia and anxiety, to convulsions anddeath. When users become psychologicallydependent, they feel as if they need thedrug to function. Finding and using the drugbecomes the main focus in life.
 Is it true that combining sedative-hypnoticswith alcohol is especially dangerous?
Yes. Taken together, alcohol andsedative-hypnotics can kill. The use ofbarbiturates and other sedative-hypnoticswith other drugs that slow down the body,such as alcohol, multiplies their effectsand greatly increases the risk of death.Overdose deaths can occur whenbarbiturates and alcohol are usedtogether, either deliberately oraccidentally.
 Can sedative-hypnotics affect an unbornfetus?
Yes. Babies born to mothers who abusesedatives during their pregnancy may bephysically dependent on the drugs andshow withdrawal symptoms shortly afterthey are born. Their symptoms may includebreathing problems, feeding difficulties,disturbed sleep, sweating, irritability, andfever. Many sedative-hypnotics passthrough the placenta easily and havecaused birth defects and behavioralproblems in babies born to women who haveabused these drugs during their pregnancy.
 What are barbiturates?
Barbiturates are often called "barbs"and "downers." Barbiturates that arecommonly abused include amobarbital(Amytal), pentobarbital (Nembutal), andsecobarbital (Seconal). These drugs are soldin capsules and tablets or sometimes in aliquid form or suppositories.
 What are the effects of barbiturates whenthey are abused?
 
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Page: Assignment in Pharmacology
 
Dinoy Edward Arlu V. BSN II-D
The effects of barbiturates are, in manyways, similar to the effects of alcohol.Small amounts produce calmness and relaxmuscles. Somewhat larger doses can causeslurred speech, staggering gait, poorjudgment, and slow, uncertain reflexes.These effects make it dangerous to drive acar or operate machinery. Large doses cancause unconsciousness and death.
How dangerous are barbiturates?
Barbiturate overdose is a factor innearly one-third of all reported drug-related deaths. These include suicides andaccidental drug poisonings. Accidentaldeaths sometimes occur when a user takesone dose, becomes confused andunintentionally takes additional or largerdoses. With barbiturates there is lessdifference between the amount thatproduces sleep and the amount that kills.Furthermore, barbiturate withdrawal canbe more serious than heroin withdrawal.
 What other sedative-hypnotics are abused?
All the other sedative-hypnotics canbe abused, including the benzodiazepines.Diazepam (Valium), chlordiazepoxide (Librium),and chlorazepate (Tranxene) are examplesof benzodiazepines. These drugs are alsosold on the street as downers. As with thebarbiturates, tolerance and dependencecan develop if benzodiazepines are takenregularly in high doses over prolongedperiods of time. Other sedative-hypnoticswhich are abused include glutethimide(Doriden), ethchlorvynol (Placidyl), andmethaqualone (Sopor, Quaalude).
 What is methaqualone?
Methaqualone ("Sopors," "ludes") wasoriginally prescribed to reduce anxietyduring the day and as a sleeping aid. It isone of the most commonly abused drugs andcan cause both physical and psychologicaldependence. The dangers from abusingmethaqualone include injury or death fromcar accidents caused by faulty judgmentand drowsiness, and convulsions, coma, anddeath from overdose.
 What are sedative-hypnotic "look-alikes"?
These are pills manufactured to looklike real sedative-hypnotics and mimic theireffects. Sometimes look-alikes contain over-the-counter drugs such as antihistaminesand decongestants, which tend to causedrowsiness. The negative effects caninclude nausea, stomach cramps, lack ofcoordination, temporary memory loss,becoming out of touch with thesurroundings, and anxious behavior.
 
Source:
National Institute on DrugAbuse, 1984
 
 
3 |
Page: Assignment in Pharmacology
 
Dinoy Edward Arlu V. BSN II-D
Alternative
&
ComplementaryTherapies for Anxiety
Adrian R White, Max H Pittler
Anxiety is an unpleasant emotionalstate involving both fear and physicalsymptoms. It is a normal reaction tostressful events (state anxiety), but can beregarded as pathological when it is undulysevere or prolonged (trait anxiety). Anxietymay present as one symptom of a cluster ofrelated, overlapping conditions, the mostcommon of which are generalised anxietydisorder, phobic disorder and panic disorder.Generalised anxiety disorder is common,affecting about 2
5% of a typical westernpopulation, and may present with a rangeof psychological and/or physical symptoms.Conventional treatment for anxiety mayinclude tranquillisers such asbenzodiazepines for short-term use and arange of psychological therapies fromsuperficial psychotherapy to cognitive andbehaviour therapies. These conventionalpsychological therapies will not beconsidered in this review. We shallconsider the effect of complementarytherapies only on the psychologicalsymptoms of anxiety. Physical disordersthat may be secondary to anxiety (such ashypertension) or may be aggravated by it(such as asthma) are not the major focus ofthis article.Therapies for anxiety are notuniversally successful and, as thesymptoms of anxiety are chronic and (ingeneral) non-life-threatening, patients arelikely to seek help from complementarymedicine. Recent survey data suggest thatanxiety is one of the most frequentconditions treated with complementarytherapies.1 An important distinction must bedrawn between treatments that haveeffects on state anxiety and those that arecapable of producing lasting effects ontrait anxiety. Short-term relief of anxietymay lead to dependency on the practitioner.
Relaxation techniques
There is a range of therapies or self-learned practices that uses physical andmental/spiritual procedures to differentextents, with the aim of inducing apeaceful mental and physical state. Bensonand Clipper2 emphasised the bidirectionalnature of the relationship between mindand body and provided evidence of aneffect of progressive muscular relaxation.Rigorous investigation of these methodsfaces the problem of selecting a suitablecontrol procedure: often, trials thatcompare two similar techniques show littledifference, so no conclusion can be madeabout the specific effects of either. If atherapy is found to be superior to anuntreated control, this could be the result
of many ‘context’ effects, such as the
therapeutic relationship, instead of or inaddition to any therapeutic effect.In an extensive meta-analysis of 76controlled trials of all forms ofrelaxation and meditation techniques inthe management of anxiety, Eppley et al.3found overall evidence of a small butsignificant effect of the interventions,grouped by the type of relaxation ormeditation. Psychiatric patients werespecifically excluded, so the role of thesetherapies in generalised anxiety disorder isnot known. Separate analyses of thestudies that used situation- or attention-control arms were not performed, so thisreview does not demonstrate specificeffects unequivocally.There is clear evidence from morethan 10 randomised controlled trials (RCTs)in healthy volunteers that musclerelaxation may lead to a significantreduction in state anxiety. Among employees,those practising regular relaxation feltmore in control of their health4 and more

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