08_Sedative-Hypnotics, Benzos, and Beta Blockers Flashcards
Sedative-Hypnotics:
Three Classes
Barbiturates
Anxiolytics
Alcohol
Sedative-Hypnotics:
Overview
Generalized CNS depressants
Effects are dose-dependent
Sedative-Hypnotics:
Low doses
Reduce arousal and motor activity
Sedative-Hypnotics:
Moderate doses
Induce sedation and sleep
Sedative-Hypnotics:
High Doses
Anesthesia
Coma
Death
Sedative-Hypnotics:
Subjective experience
Initial increase in activity and feelings of elation
*suppression of inhibitory mechanisms
Sedating and hypnotic effects
*supppression of excitatory mechanisms
Sedative-Hypnotics:
Cross-tolerance
When tolerance develops to one sedative-hypnotic, is likely to be shown for others as well
Barbiturates:
Four Main Examples
Phenobarbital
Amobarbital
Pentobarbital
Secobarbital
Barbiturates:
Uses
Sedatives and anesthetic agents
Infrequently prescribed present-day
Barbiturates:
Mechanism of action
Interrupts impulses to the reticular activating system
Barbiturates:
Side effects
Slurred speech
Nystagmus
Dizziness
Irritability
Impaired motor and cognitive performance
Barbiturates:
Overdose Symptoms
Ataxia
Confusion
Agitation
Respiratory depression
Death
Barbiturates:
Dangers
Tolerance occurs but respiratory system does not adapt
Increased dose to maintain soporific effects can be lethal
High abuse potential
Frequently involved in suicides and accidental deaths
Benzodiazepines:
Overview
Most commonly prescribed anxiolytic
*Anxiolytics are the most widely used psychiatric medication
Benzodiazepines:
Seven Main Examples
Diazepam (Valium)
Alprazolam (Xanax)
Lorazepam (Ativan)
Clonazepam (Klonopin)
Triazolam (Halcion)
Chlordiazepoxide (Librium)
Oxazepam (Serax)
Benzodiazepines:
Uses
Relieve anxiety (Primary Use)
Seizures
Sleep disturbance
Cerebral palsy
Alcohol withdrawal
Benzodiazepines:
Mechanism of action
Stimulate inhibitory action of GABA
Benzodiazepines:
Side effects
Drowsiness, Dizziness Lethargy
Ataxia
*Side effects alleviated by lowering the dosage
Benzodiazepines:
Less common side effects
Paradoxical excitation/agitation
Irritability, hostility
Benzodiazepines:
Abrupt withdrawal symptoms
Rebound hyperexcitability
Seizures
Depersonalization
Panic
Stroke
Anxiolytics:
Azapirone (buspirone)
Reduces anxiety without sedation
Nonaddictive
Non-habit-forming
Not subject to abuse
*Therapeutic effects require several weeks
Beta-Blockers:
Overview and Main example
Reduce physical symptoms associated with anxiety
Propranolol (Inderal)
Beta-Blockers:
Uses
High blood pressure
Angina
Tremors
Migraine
Glaucoma
Beta-Blockers:
Propanolol (Inderal) Side effects
Bradycardia
Shortness of breath
Arterial insufficiency (e.g. Raynaud’s)
Nausea
Diarrhea
Depression
Dizziness
Sexual dysfunction
Beta-Blockers:
Abrupt Discontinuation Symptoms
Sweating
Palpitations
Headache
Tremulousness
Cardiac arrhythmia
Propranolol (Inderal):
Contraindication
Obstructive pulmonary disease
Respiratory problems
