Sedatives, hypnotics, & Anxiolytics

Question 1

Sleep Pattern

Answer 1

Stage 1- “drifting off”

Stage 2-4- drowsiness through deep sleep. depressed body function, non-rapid eye movement (NREM), non dreaming, PHYSICALLY RESTORTIVE.

Stage 5- period of rapid eye movement (REM); dreaming, increased physiological activity, MENTALLY & EMOTIONALLY RESTORTIVE, then float back into stage two and repeat with longer REM each time.

Entire cycle is 90 minutes

Question 2

Sedatives, hypnotics, & Anxiolytics

Answer 2

Potentiate the effects of GABA, and inhibitory neurotransmitter in the brain that sends impulses to the “awake” center of the brain stem.

CNS depression and interfere with sleep cycles.

Question 3

Benzodiazepine Family
“am”, “zepam”, or “zolam”

Answer 3

Most widely prescribed anxiolytic medication. Also used for insomnia, muscles spasms, ETOH withdrawal, and seizure disorders.

• midazolam (Versed)
  -alprazolam (Xanax)
  -lorazepam (Ativan)- used a lot in hospital
  -diazepam (Valium)
  -clonazepam (Klonopin)

Question 4

What is the antidote for benzo overdose?

Answer 4

Flumazenil

Question 5

Barbiturates
“tal” Family

Answer 5

Affect both REM & nonREM sleep. Still wake up not feeling rested. Withdrawals cause insomnia and nightmares.

pentobarbital- hypnotic
phenobarbital- anticonvulsant (pediatrics)

Question 6

Other Sleep Medications- non-BDZ

Answer 6

Raises GABA levels at BDZ site

eszopiclone (Lunesta)
zolpidem (Ambien)- amnesic events while sleep walking and confusion in elderly

Question 7

Melatonin

Answer 7

adds to body’s natural supply of melatonin which helps regulate sleep.

3-5mg more effective than 10-20mg

ramelteon- RX version (stronger)