Chapter 12 Flashcards
automatism
drug-induced confusion that can cause increased drug consumption
barbiturate
CNS depressant drug possessing the barbituric acid ring sturcture
benzodiazepine
class of drugs used to treat anxiety and sleep disorders
GABA
gamma-aminobutyric acid, an inhibitory neurotransmitter in the CNS
hypnotic
drug used to induce and maintain sleep
nonbarbiturte
refers to sedative-hypnotic drugs that do no possess the barbituric acid structure, such as benzodiazepines and related drugs
NREM sleep
stages of sleep characterized by non rapid eye movement
REM sleep
stage of sleep characterized by rapid eye movement and dreaming
sedative
drug used to produce mental relaxation and to reduce the desire for physical activity
How many stages are there in NREM
4
Define Stage 1 NREM
individuals are somewhat aware of surrounding but relaxed. eyes are normally closed. Alpha waves predominate in this stage.
Normally lasts 5 min and occupies 4-5% total sleep time
Define Stage 2 NREM
individuals become unaware of surrounding but can be easily awakened. Brain waves are increased in amplitude compared to alpha waves but occur at a lower frequency.
occupies about 50% of total sleep time
Define Stage 3 & 4 NREM
referred to as “slow-wave sleep” because of the high amplitude, low frequency delta waves observed on the electroencephalogram. these are deeper stages of sleep and are particularly important for physical rest and restoration.
occupies 20-25% of total sleep time.
an affect of aging is reduction in amount of time spent in slow wave sleep
REM
characterized by burst of rapid eye movement, increased autonomic activity and dreaming. essential for mental restoration. During REM daily events are reviewed and information is integrated into memory. it appears to be an active state of sleep. individuals are harder to awaken in this state. also referred to as “paradoxical sleep”
occupies 20-25 percent of total sleep time.
influx
moves in through
efflux
moves out of
Flurazepam
(benzo)
- increase NREM stages 2 and decrease stages 4
no suppression of REM
-no suppression of REM
Advantages
- do not cause REM rebound
- less tolerance levels
- do not induce microsomal metabolizing enzymes
Adverse Effects - sedation or hangover effects
Temazepam
(benzo)
- increase NREM stages 2 and decrease stages 4
no suppression of REM
-no suppression of REM
Advantages
- do not cause REM rebound
- less tolerance levels
- do not induce microsomal metabolizing enzymes
Triazolam
(benzo)
- increase NREM stages 2 and decrease stages 4
no suppression of REM
-no suppression of REM
Advantages
- do not cause REM rebound
- less tolerance levels
- do not induce microsomal metabolizing enzymes
Adverse effects- rebound insomnia and increased daytime anxiety
Flumazenil
(benzo)
- increase NREM stages 2 and decrease stages 4
no suppression of REM
-no suppression of REM
Advantages
- do not cause REM rebound
- less tolerance levels
- do not induce microsomal metabolizing enzymes
its a benzodiazepine receptor antagonist
-used to reverse depressant effects
Cimetidine
used to treat acid reflux or intenstinal ulcers. if taken with benzodiazephines it inhibits the metabolizm of the benzo and increase the duration of action for the benzo
Hypnotic Drugs
diverse group of drugs.
- differ in chemical structures and pharmacological characteristics
bind selectively to a subunit of the benzo receptor
-increase the inhibitory effects of GABA
-do not disrupt the normal stages of sleep like barbiturates and benzodiazepines
What is a preferred drug for a person with insomnia?
Zolpidem or eszopiclone
What is a preferred drug for a person with insomnia coupled with anxiety?
- benzodiazepines
- flurazepam or quazepam
What is a preferred drug for a person with troubles falling asleep?
zalaphlon&ramelton
problems falling asleep
What is a preferred drug for a person who needs sedation?
benzodiazepines
what is the advantages of benzodiazopine-hypnotics over barbiturates?
benzo- don’t interfere with the REM sleep, they produce less tolerance therefore are effective for a few weeks longer than barbiturates- when abused cause less physical dependence than barbiturates
(for both sedation and hypnosis)
