Sedative Hypnotic Drugs

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Sedative - Hypnotic Drugs

• seeking effects that include calming, sleep and
  intoxication

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Subclasses of the Sedative - Hypnotics

• Barbiturates
• Non-Barbiturate sedative hypnotics
• Minor tranquilizers
• Major tranqulizers
• Inhalants

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Why are these drugs used?

• Sedation
• Coping with stress and anxiety
• Smoothing effects of stimulants
• Potentiation of narcotics
• Treatment of serious mental disorders
• Pleasurable sensations, including intoxication

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General Characteristics

• Widespread CNS depression
• Potentiation / synergism with other depressant
  drugs
• Tolerance
• Physiological and / or psychological dependence
  (sedativism)
• Cross-tolerance
• Cross-dependence

anxiety relief
euphoria
calmness
sleep
general anesthesia
coma
death
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Barbiturates

• Uses
• Ultrashort acting (e.g., thiopental) surgical
  anesthetics
• Short-intermediate acting (e.g., secobarbital)
  sedative-hypnotics
• Long acting (e.g., phenobarbital) sedative
  hypnotics anticonvulsants

• Problems
• most commonly abused (specifically the
  short-intermediate group)
• rapid development of tolerance dependence
• withdrawal creates a medical emergency

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Non-Barbiturate Sedative Hypnotics

• Uses
• Alternative to barbiturates
• Specific to treatment for sleeplessness
• Examples chloral hydrate, ethchlorvynol, and
  some of the benzodiazepines (flurazepam,
  triazolam, temazepam)

• Problems
• adverse drug reactions (especially with
  triazolam)
• abuse potential (especially with street versions
  of methaqualone)
• rapid tolerance dependence
• rebound effects

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Anatomy of Sleep

• Non-Rapid-Eye-Movement (non-REM) sleep deep
  level of sleep characterized by drops in blood
  pressure, heart and breathing rates, and body
  temperature slow, even brain wave activity
  (serotonin)
• Rapid-Eye-Movement (REM) sleep shallow level of
  sleep characterized by increases and fluctuations
  in blood pressure, heart and breathing rates
  complete relaxation of muscles in arms and legs
  resulting in temporary paralysis high level of
  brain activity (norepinephrine)

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Anatomy of Sleep
REM
NREM
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Anatomy of Sleep

• REM Sleep Latency from onset of sleep to the
  first REM (70 - 100 minutes)
• hypnogogy
• Sleep Cycle from one REM sleep period to the
  next ( 90 minutes) 4 ? 6 cycles per night

As the night progresses, REM stages lengthen in
time and less time is spent in Stages 3 4.
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Anatomy of Sleep
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Sleep Deprivation

• Stage 4 Deprivation - hypoactive depressed
  response state
• exercise increases length of Stage 4
• REM Deprivation - hyperactive increased response
  state

Balance seems to exist between waking and
sleeping activity levels.
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REM Rebound

• Most sedative - hypnotic sleep medicines depress
  the amount of REM and increase the amount of NREM
  (especially Stages 3 4)
• Once body is medicine-free, REM increases
  substantially (latency decreases, frequency and
  length increases)
• Best Choices flurazepam (Rx) diphenhydramine
  (OTC) l-tryptophan (amino acid)

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Anti - Anxiety Medicines

• Treatment of anxiety and neurotic conditions
  (including physical manifestations), not
  psychoses
• Benzodiazepines diazepam (Valium) and alprazolam
  (Xanax)
• Beta-blockers oxprenolon and propranolol

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Inhalants

• Commercial solvents
• Aerosols
• Anesthetics

Video Presentation EducateCreating Inhalant
Abuse Awareness Together
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Signs of Inhalant Abuse

• Slurred speech
• Glassy eyes
• Skin discoloration and rashes (mouth nose)
• Severe headaches
• Nervous tremors
• Coughing and sneezing
• Loss of appetite / weight