Alterations in Drug Response

Question 1

With the long-term use of sedative-hypnotics, especially if
doses are increased, a state of dependence can occur.

This may
develop to a degree unparalleled by any other drug group, including the opioids.

Withdrawal from a sedative-hypnotic can have severe
and life-threatening manifestations.

Withdrawal symptoms range
from_____________.

Symptoms of
withdrawal are usually more severe following discontinuance of
sedative-hypnotics with shorter half-lives.

Answer 1

• restlessness,
• anxiety,
• weakness,
• and orthostatic hypotension
• to hyperactive reflexes and generalized seizures

Question 2

However, __________, _______ and _______appear to be exceptions to this, because withdrawal symptoms are minimal following abrupt discontinuance
of these newer short-acting agents.

Symptoms are less pronounced
with longer-acting drugs, which may partly accomplish
their own tapered withdrawal by virtue of their slow elimination.
Cross-dependence, defined as the ability of one drug to suppress
abstinence symptoms from discontinuance of another drug, is
quite marked among sedative-hypnotics. This provides the rationale
for therapeutic regimens in the management of withdrawal
states: L

Answer 2

• eszopiclone,
• zolpidem, and
• zaleplon

Question 3

Longer-acting drugs such as _______________ can be used to alleviate withdrawal symptoms
of shorter-acting drugs, including ethanol.

Answer 3

chlordiazepoxide, diazepam,
and phenobarbital