Sedative - Hypnotic Drugs

seeking effects that include calming, sleep and intoxication

Subclasses of the Sedative - Hypnotics Barbiturates Non-Barbiturate sedative hypnotics Minor tran uili!ers Ma"or tran uli!ers #nhalants

$hy are these drugs used%

Sedation &oping 'ith stress and anxiety Smoothing effects of stimulants (otentiation of narcotics )reatment of serious mental disorders (leasurable sensations, including intoxication

*eneral &haracteristics
$idespread &NS depression (otentiation + synergism 'ith other depressant drugs )olerance (hysiological and + or psychological dependence ,-sedativism./ &ross-tolerance &ross-dependence
anxiety euphoria relief calmness sleep general coma anesthesia death

Barbiturates
0ses
0ltrashort acting ,e1g1, thiopental/2 surgical anesthetics Short-intermediate acting ,e1g1, secobarbital/2 sedativehypnotics 3ong acting ,e1g1, phenobarbital/2 sedative hypnotics4 anticonvulsants

(roblems most commonly abused ,specifically the shortintermediate group/ rapid development of tolerance 5 dependence 'ithdra'al creates a medical emergency

Non-Barbiturate Sedative Hypnotics

0ses
6lternative to barbiturates Specific to treatment for sleeplessness 7xamples2 chloral hydrate, ethchlorvynol, and some of the ben!odia!epines ,flura!epam, tria!olam, tema!epam/

(roblems
adverse drug reactions ,especially 'ith tria!olam/ abuse potential ,especially 'ith street versions of metha ualone/ rapid tolerance 5 dependence rebound effects

6natomy of Sleep
Non-8apid-7ye-Movement ,non-87M/ sleep2 deep level of
sleep characteri!ed by drops in blood pressure, heart and breathing rates, and body temperature4 slo', even brain 'ave activity ,serotonin/

8apid-7ye-Movement ,87M/ sleep2 shallo' level of sleep

characteri!ed by increases and fluctuations in blood pressure, heart and breathing rates4 complete relaxation of muscles in arms and legs resulting in temporary paralysis4 high level of brain activity ,norepinephrine/

6natomy of Sleep
Awake Light sleep

REM NREM
0 1 2 3 4 5 6 7 8

Deep sleep

6natomy of Sleep
87M Sleep 3atency2 from onset of sleep to the first 87M ,9: - ;:: minutes/
hypnogogy

Sleep &ycle2 from one 87M sleep period to the next ,< =: minutes/4 > ? cycles per night
6s the night progresses, 87M stages lengthen in time and less time is spent in Stages @ 5 >1

6natomy of Sleep
9: ?: B: >: @: A: ;: : Coung 6dult &hildren - ; yr 7lderly 87M Stage ; Stage A Stage @ 5 >

HSS 4933 - Drug Education

Sleep Deprivation
Stage > Deprivation - hypoactive4
depressed response state
exercise increases length of Stage 4

87M Deprivation - hyperactive4

increased response state
Balance seems to exist bet'een 'aking and sleeping activity levels1

87M 8ebound
Most sedative - hypnotic sleep medicines depress the amount of 87M and increase the amount of N87M ,especially Stages @ 5 >/ Dnce body is medicine-free, 87M increases substantially ,latency decreases, fre uency and length increases/ Best &hoices2 flura!epam ,8x/4 diphenhydramine ,D)&/4 l-tryptophan ,amino acid/

6nti - 6nxiety Medicines

)reatment of anxiety and neurotic conditions ,including physical manifestations/, not psychoses Ben!odia!epines2 dia!epam ,Ealium/ and alpra!olam ,Fanax/ Beta-blockers2 oxprenolon and propranolol