Sedative & Hypnotics Flashcards
What are the 2 types of drugs used to decrease activity in the CNS?
- Sedatives
2. Hypnotics
What does a sedative do?
Decreases the desire for physical acitvity
What does a hypnotic do?
Induces and maintains sleep
What CAN a sedative do?
put people to sleep b/c they relax and have reduced desire for physical activity
How many states is a normal sleep cycle broken up into?
2
What is the first state called?
NREM
Non-rapid eye movement
What is the second state called?
REM
Rapid eye movement
How long is a typical sleep cycle?
60-90 minutes
In NREM, how many stages and what are their names?
4 Total:
Stage 1 = 5% = somewhat aware, relaxed state
Stage 2 = 50% = unaware but easily awakened
Stage 3 & 4 = 20%
Stage 3 = Deep Sleep, Delta Brain Waves
Stage 4 = Very Deep Sleep, Delta Brain Waves
What happens during Stages 3 and 4?
Physical Rest and Restoration
In REM, how many stages and what are their names?
Just 1 - just REM = 25% (about 20 min)
What happens in REM sleep?
Mental Rest and Restoration
bursts of rapid eye movement b/c autonomic activity and dreaming
What are the 3 drug classes for sedatives & hypnotics?
- Barbitruates
- Non-barbitruates
- Benzodiazepines
What are some NON-pharmacological solves?
- Warm Milk
- Chamomile Tea
- Lavendar Scent
Which is the best stage to wake up after to feel fully rested?
Right after Stage 5 at the beginning of Stage 1
What can you generally say about barbiturates?
Oldest drug in this class, not often used anymore
What are barbiturates still used for?
- anesthesia for surgery
2. anti-convulsants
Where are the 2 main sites of action for barbiturates?
- Cerebral Cortex
2. Reticular Formation
What happens at the sites of action?
Inhibition of the RETICULAR FORMATION reduces the excitatory stimulation of the CEREBRAL CORTEX causing CNS depression - either sedative or hypnotic states
What are 3 barbiturates we need to know?
- Secobarbital
- Amobarbital
- Phenobarbital
What is the MOA for a barbiturate in a low dose?
enhance inhibitory effects of GABA (gamma aminobutyric acid) which decrease excitability in the reticular formation
So, what do low doses of barbiturates cause?
sedation
What is the MOA for a barbiturate in a high dose?
interferes with neuronal membranes that disrupts normal function and movement of ions
So, what does a high dose of barbiturate cause?
hypnosis
How do barbiturates affect the sleep cycle?
Increase Stage 2
Decrease Stages 3 & 4
Suppress REM
What can barbiturates cause in some people?
- Enzyme Induction = Tolerance
- Addiction (greater than 1-2 mos to avoid withdrawal)
- Poisoning (TOTAL CNS depression = hypotension, shock AND no antidote)
What should you NOT take with barbiturates?
Any other CNS depressant
List the 3 barbiturates in “lasting” affect from shortest to longest
- secobarbital
- amobarbital
- phenobarbital
Do non-barbiturates cause tolerance and dependency like barbiturates?
Yes
What are the 2 non-barbiturates?
- Chloral Hydrate
2. Zolpidem/Ambien
What is Chloral Hydrate commonly used for?
Hypnosis of children for medical procedures
What is Zolpidem/Ambien commonly used for?
Sleep aid for adults
Does Zolpidem interfere with sleep cycle?
NOT at all
What condition is benzodiazepines MOST commonly used for?
anxiety
What again is the MOA for benzodiazepines?
Enhance the inhibitory effect of GABA neurotransmitter to reduce excitatory stimulation in reticular formation
What does the level of benzo dose do?
Low = sedative Hight = hypnosis
Benzos are . . .
highly lipid soluble and cross BBB
Do benzos cause enzyme induction?
very little and not as much tolerance as barbiturates
How do benzodiazepines affect sleep cycle?
Increase Stage 2
Decrease Stage 4
NO effect on REM
What 3 benzodiazepines are used for a sedative/hypnotic states?
- Temazepam
- Flurazepam
- Triazolam
