sedatives Flashcards
sedatives
relieve anxiety, cause relaxation, mild CNS depressants
hypnotics
cause drowsiness and sleep
BZD prevalence
more popular than barbiturates, females to males = 2 to 1 ratio
barbiturates and BZDs more likely to be abused
short acting, lipid soluble
short acting sedatives used for
preanesthetic sedatives or for insomnia
longer acting sedatives used for
anticonvulsants, muscle relaxants, anxiolytics
anxiolytic
kind of medication that eases anxiety
sedative routes of administration
oral, rectal, injection
BZD absorption
less lipid soluble than barbiturates, absorbed more slowly, slower onset of action
BZD trade names
xanax, valium, klonopin, Ativan
metabolism of sedatives
liver with cyp450 system
sedative metabolism decreased in ____
infants, pregnant women, liver disease, elderly
BZD mechanism of action
binds to GABA A receptor in limbic system, reticular activating system, cortex, (not respiration)
barbiturate mechanism of action
more general effect on GABA than BZD
acute effects of sedatives
reduce muscle tone, impair coordination, reduce anxiety, learning, memory, cause bizarre uninhibited behavior
effect of sedatives on sleep
total sleep time is increased by REM sleep and restorative deep sleep are reduced
effects of sedatives on fetus
cleft palate, floppy infant syndrome
sedative drug interactions
other drugs metabolized by cyp450 system
safety of barbiturates
low TI, risk of overdose increased when used with other opioids or depressants
Therapeutic use of barbiturates and BZDs
insomnia, anxiety, seizures, alcohol withdrawal, anesthesia
why have BZDs largely replaced barbiturates?
more specific effects
fewer side effects
wider margin of safety
lower potential for abuse/tolerance
less effect on REM sleep, longer lasting effects have less potential for abuse
z drugs
ambien, Lunesta, sonata
produce sleep rhythm more like natural sleep
increased risk of car accidents, sleep walking/eating/sex/driving
chronic use of sedatives
daytime fatigue, accidents, mortality
sedative tolerance
develops for sedative/hypnotic effects but not for anticonvulsant effects
more common in barbiturates (cellular and metabolic) than BZDs
sedative addiction
barbiturates > BZDs
sedative withdrawal
should be medically supervised
insomnia, confusion, difficulty concentrating
inhalants
substances that have effects similar to sedatives/hypnotics
prevalence of inhalants
younger adolescents
volatile inhalants
glues, aerosols, cleaning agents, fuels
anesthetic inhalants
ether, nitrous oxide
nitrite inhalants
amyl/butyl nitrite
acute effects of inhalants
similar to alcohol intoxication, huffing, sudden sniffing death syndrome, incoordination and recklessness
chronic use of inhalants
nose bleeds, depression, hostility, cancer, damage to organs, cognitive impairments
