Sedative & Hypnotics

Question 1

What are the 2 types of drugs used to decrease activity in the CNS?

Answer 1

1. Sedatives

2. Hypnotics

Question 2

What does a sedative do?

Answer 2

Decreases the desire for physical acitvity

Question 3

What does a hypnotic do?

Answer 3

Induces and maintains sleep

Question 4

What CAN a sedative do?

Answer 4

put people to sleep b/c they relax and have reduced desire for physical activity

Question 5

How many states is a normal sleep cycle broken up into?

Answer 5

2

Question 6

What is the first state called?

Answer 6

NREM

Non-rapid eye movement

Question 7

What is the second state called?

Answer 7

REM

Rapid eye movement

Question 8

How long is a typical sleep cycle?

Answer 8

60-90 minutes

Question 9

In NREM, how many stages and what are their names?

Answer 9

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

Question 10

What happens during Stages 3 and 4?

Answer 10

Physical Rest and Restoration

Question 11

In REM, how many stages and what are their names?

Answer 11

Just 1 - just REM = 25% (about 20 min)

Question 12

What happens in REM sleep?

Answer 12

Mental Rest and Restoration

bursts of rapid eye movement b/c autonomic activity and dreaming

Question 13

What are the 3 drug classes for sedatives & hypnotics?

Answer 13

1. Barbitruates
2. Non-barbitruates
3. Benzodiazepines

Question 14

What are some NON-pharmacological solves?

Answer 14

1. Warm Milk
2. Chamomile Tea
3. Lavendar Scent

Question 15

Which is the best stage to wake up after to feel fully rested?

Answer 15

Right after Stage 5 at the beginning of Stage 1

Question 16

What can you generally say about barbiturates?

Answer 16

Oldest drug in this class, not often used anymore

Question 17

What are barbiturates still used for?

Answer 17

1. anesthesia for surgery

2. anti-convulsants

Question 18

Where are the 2 main sites of action for barbiturates?

Answer 18

1. Cerebral Cortex

2. Reticular Formation

Question 19

What happens at the sites of action?

Answer 19

Inhibition of the RETICULAR FORMATION reduces the excitatory stimulation of the CEREBRAL CORTEX causing CNS depression - either sedative or hypnotic states

Question 20

What are 3 barbiturates we need to know?

Answer 20

1. Secobarbital
2. Amobarbital
3. Phenobarbital

Question 21

What is the MOA for a barbiturate in a low dose?

Answer 21

enhance inhibitory effects of GABA (gamma aminobutyric acid) which decrease excitability in the reticular formation

Question 22

So, what do low doses of barbiturates cause?

Answer 22

sedation

Question 23

What is the MOA for a barbiturate in a high dose?

Answer 23

interferes with neuronal membranes that disrupts normal function and movement of ions

Question 24

So, what does a high dose of barbiturate cause?

Answer 24

hypnosis

Question 25

How do barbiturates affect the sleep cycle?

Answer 25

Increase Stage 2 Decrease Stages 3 & 4 Suppress REM

Question 26

What can barbiturates cause in some people?

Answer 26

1. Enzyme Induction = Tolerance 2. Addiction (greater than 1-2 mos to avoid withdrawal) 3. Poisoning (TOTAL CNS depression = hypotension, shock AND no antidote)

Question 27

What should you NOT take with barbiturates?

Answer 27

Any other CNS depressant

Question 28

List the 3 barbiturates in "lasting" affect from shortest to longest

Answer 28

1. secobarbital 2. amobarbital 3. phenobarbital

Question 29

Do non-barbiturates cause tolerance and dependency like barbiturates?

Answer 29

Yes

Question 30

What are the 2 non-barbiturates?

Answer 30

1. Chloral Hydrate | 2. Zolpidem/Ambien

Question 31

What is Chloral Hydrate commonly used for?

Answer 31

Hypnosis of children for medical procedures

Question 32

What is Zolpidem/Ambien commonly used for?

Answer 32

Sleep aid for adults

Question 33

Does Zolpidem interfere with sleep cycle?

Answer 33

NOT at all

Question 34

What condition is benzodiazepines MOST commonly used for?

Answer 34

anxiety

Question 35

What again is the MOA for benzodiazepines?

Answer 35

Enhance the inhibitory effect of GABA neurotransmitter to reduce excitatory stimulation in reticular formation

Question 36

What does the level of benzo dose do?

Answer 36

``` Low = sedative Hight = hypnosis ```

Question 37

Benzos are . . .

Answer 37

highly lipid soluble and cross BBB

Question 38

Do benzos cause enzyme induction?

Answer 38

very little and not as much tolerance as barbiturates

Question 39

How do benzodiazepines affect sleep cycle?

Answer 39

Increase Stage 2 Decrease Stage 4 NO effect on REM

Question 40

What 3 benzodiazepines are used for a sedative/hypnotic states?

Answer 40

1. Temazepam 2. Flurazepam 3. Triazolam