Sedativehypnotics and Inhalants

1
Sedative-hypnotics and Inhalants

• FWS 235

2
Drugs that calm

• Sedative hypnotics are drugs which decrease
  activity of the central nervous system, resulting
  in a calming effect, and produce drowsiness and
  sleep.
• Calming effectsedative
• Sleep-inducing effectshypnotics
• Like alcohol and the narcotic analgesics,
  sedative-hypnotics are CNS depressants.

3
Subclasses

• Barbiturates
• Nonbarbiturate sedative-hypnotics
• Minor tranquilizers (anti-anxiety)
• Abused inhalants
• Major tranquilizers (not controlled substances)
  anti-psychotics

4
Misuse and Abuse

• Motivational Factors
• The search for sleep
• Coping with stress
• Appetitive drug use-motivated by desire for
  pleasurable responses and sensations
• Escape-avoidance drug use-motivated by desire for
  relief from an unpleasant sensation, tension,
  fear, or anxiety
• Potentiating (synergistic)- exaggerated
  depressant effect
• Offset effects of stimulant drugs

5
General Characteristics

• Widespread CNS depression and reduction in
  wakefulness.
• Progressive degrees of sedations
• Relief from anxiety
• Euphoria
• Calmness
• Hypnosis (sleep)
• General anesthesia, coma, and possibly death

6
General Characteristics cont.

• Potential and /or synergistic drug interactions
  with other sedative-hypnotics, narcotics, or
  ethyl alcohol
• Potentiation- one drug intensifying the action of
  another that originally had small or no effect
• Synergism- cooperative, facilitative, and
  supraadditive effect of two or more drugs that
  have the same drug action
• Sedativism- common and widespread dependence on
  sedative-type psychoactive drugs including
  development of tolerance, physiological
  dependence and psychological dependence
• Cross-tolerance- (less effects) and
  cross-dependence (prevent withdrawal symptoms of
  one with another)

7
Historical Perspectives

• Use of depressant drugs originated in ancient
  times.
• Reserpine, the active ingredient in an original
  Indian snakeroot, was the basis of the first
  so-called major tranquilizer, 1950s
• First sedative-hypnotic bromide, 1860s, often
  referred to as barbital

8
Historical cont.

• Barbiturates replaced bromides in 1903
• Truly effective sedatives and hypnotics
• Minor tranquilizers introduced-1960s
• Safer and less sedating than barbiturates

9
Barbiturates

• Prescribed or conditions requiring CNS depression
  but have been replaced by minor tranquilizers.
• Classified according to duration of action
• Ultra-short- acting-used as surgical anesthetics
  generally not abused
• Short-intermediate acting- secobarbital and
  amobarbital (often, abused)
• Long-acting- phenobarbital, mephobarbital, and
  metharbital (generally,not abused)

10
Barbiturates cont.

• After effects of legitimate use include the
  day-after hangover
• Problems of illegally sold barbiturates often are
  used with amphetamines
• Overdose can result in
• Respiratory depression
• Collapse of circulatory system
• Kidney failure
• Coma
• Possible death

11
Barbiturates cont.

• Ten times the hypnotic doestoxic
• 15 to 20 times the hypnotic doesfatal
• Maximum tolerance often never known due to
  being close to the lethal dose
• Overdosing is enhanced with the use of alcohol or
  other depressant drugs
• Tolerance and dependence happen quickly

12
Barbiturate Withdrawal

• Dangerous withdrawal
• Kicking the habit requires medical assistance
• Within 12 hours- becomes non-intoxicated and
  experience nervousness, weakness, insomnia,
  nausea, tremors of the arms and legs.
• 48-72 hours- withdrawal intensifies and
  experience vomiting, decrease in blood pressure,
  weakness, hyper-excitability, fever, sever body
  convulsions or seizures.

13
Self-Care for Inducing Sleep

• Regular bedtime routines
• Quiet and dark bedroom environment
• No consumption of caffeine-containing beverages
• Warm milk and instant breakfast
• Regular physical activity
• Hot bath before bed, read, music, TV

14
Inducing Sleep cont.

• Avoid drugs that may affect the CNS
• Rising early on regular basis
• Talk to someone about basic problems
• Dont watch the clock-causing more anxiety
• Any other suggestions?

15
Minor Tranquilizers

• anti-anxiety agent
• Treat anxiety and neurotic conditions
• Examples
• Meprobamate
• Calms patients without producing sleep
• Relief from anxiety without heavy sedation
• Heavy use produced psychological and physical
  dependence

16
Minor Tranquilizers

• Benzodiazepines
• Valium is one of these drugs and most frequently
  prescribed in the U.S. as is Xanax
• Classified according to duration of effects
• Used to reduce psychic tension, anxiety
  disorders, or temporary relief of anxiety
• Effective sedative and less sleep-producing than
  other drugs in the sedative-hypnotic
  classification

17
Minor Tranquilizers cont.

• Continued use of minor tranquilizers can result
  in tolerance and prolonged use can develop into
  benzodiazepine dependence.
• Withdrawal can be severe, but craving for the
  drug is not usually present.

18
Other Anti-anxiety

• Beta-blockers-drugs used primarily for
  cardiovascular disorders, but prescribed for
  anxiety reduction
• Certain antidepressant drugs (tricyclics and
  flouxetine) may be used in the treatment of
  anxiety
• Buspirone (BuSpar)-a prescribed drug, non
  scheduled as controlled, relieves anxiety without
  sedation or abuse

19
Inhalants

• Breathable chemicals that produce mind-altering
  vapors
• Intoxicants of the young and young adults
• Reasons for using inhalants
• Peer-group influence, cheap drug, easy
  availability, convenient packaging, attractive
  high, rapid and reliable onset of intoxication,
  legality of the non-drug compounds

20
Inhalants cont.

• General effects
• CNS depression
• Dreamlike high
• Giddy feeling
• Numbing of senses
• Hallucinations
• Eventually loss of consciousness

21
Inhalants cont.

• Categories of abused inhalants
• Commercial solvents
• Aerosols
• Anesthetics
• Health hazards
• Acute intoxication, delirium, impulsive behavior,
  sedation, hallucinations, delusions, nausea,
  vomiting, loss of motor coordination, paralysis,
  and coma fatal accidents

22
Inhalants cont.

• Prevention of inhalant abuse involves
• Reducing the availability of certain volatile
  substances
• Changing product composition
• Better warning labels
• More effective educational campaign
• Federal law now forbids the manufacture and
  retail of rush (butyl nitrate)

23
Flunitrazepam

• Also known as Rohypnol
• First appeared in the early 1990s
• Currently banned because of abuse potential
• Roofie Rape this drug is sometimes combined
  with alcohol and given to females at the bar-no
  memory of events
• Since 1996- increased legal penalties

24
Discussion

• What household products can be used as inhalants?
  
• How should inhalant products be monitored because
  they are legal?