Sedative Hypnotics Denise Eberhart Physiological Complications October 21, 2011 Instructor: Jerry Van Kirk SEDATIVE HYPNOTICS FACT SHEET SEDATIVE HYPNOTICS DEFINITION TYPES OF SEDATIVE HYPNOTICS A drug, such as a barbiturate or anti-anxiety agent, that depresses the activity of the central nervous system and is used to relieve anxiety and induce sleep. Barbiturates: These drugs cause suppression of the respiratory system and are extremely addictive Benzodiazepines: These are the most commonly used form of sedative medication today used for anxiety and drug/alcohol withdrawal. Both physically and psychologically addictive. Sedative Hypnotics: These are newer forms of sedatives used primarily for sleep Intravenous Sedatives: Used for more intense sedation (barbiturate or benzodiazepine) LIST OF SEDATIVE HYPNOTICS BY NAME Benzodiazepines: Diazepam(Valium) Alprazolam (Xanax) Chlordiazepoxide (Librium) Clonazepam (Klonopin) Flurazepam (Dalmane) Triazolam (Halcion) Temazepam (Hydroxydiazepam; Methyloxazepam; Oxydiazepam Lorazepam LIST OF SEDATIVE HYPNOTICS BY NAME Barbiturates/Anesthetics Pentobarbital (Nembutal) Phenobarbital (Luminal) Thiopental (Pentothal) Secobarbital (Seconal) Sedative Hypnotics Ambien Lunesta Intravenous Sedatives STREET NAMES FOR SEDATIVE HYPNOTICS Propolol Benzo’s Downers Xanax: “Xanies” “Tranks” “Vals” (Valium) “Date rape drug;” “Ruphies” (Flunitrazepam) “Ludes” “Quaaludes” “Yellow Jackets” (Phenobarbitol) "Reds" or "Sekkies" (Secobarbital /Seconal) THERAPEUTIC USES OF SEDATIVE HYPNOTICS Barbiturates — Short-acting barbiturates used for anesthesia induction Longer-acting barbiturates are used for management of epilepsy and have a role in management of sedative withdrawal Treatment of anxiety and insomnia has largely been replaced by benzodiazepines. Benzodiazepines — Anxiety Insomnia Muscle relaxation Sedation/amnesia before medical or surgical procedures THERAPEUTIC USES OF SEDATIVE HYPNOTICS PHYSIOLOGICAL EFFECTS OF ABUSE OF SEDATIVE HYPNOTICS Epilepsy and seizure states Treatment of alcohol or sedative withdrawal Acute agitation. Intravenously as a component of balanced anesthesia. Acute mania or agitated psychosis Control of drug-induced hyper-excitable states (eg, stimulant or PCP intoxication). Drowsiness, lethargy, Muscular coordination problems, ataxia behavior disturbances Hyperactivity, irritability, difficulty in concentration. Seizures if drug is discontinued abruptly. Progressively cause sedation, then hypnosis and then stupor. Agitated mood Clumsiness Confusion Dizziness Excessive daytime drowsiness Headache Injection site reactions Lightheadedness Low blood pressure; Nausea Slow heartbeat Slowed breathing Vomiting. NEGATIVE EFFECTS OF SEDATIVE HYPNOTIC ABUSE/WITHDRAWAL Neurologic: Anxiety Fever Tremor Insomnia Hallucination Rapid Speech Ataxia Increased deep tendon reflexes Ocular Pupil dilation Cardiovascular NEGATIVE EFFECTS OF SEDATIVE HYPNOTIC ABUSE/WITHDRAWAL Tachycardia Hypertension Respiratory Tachypnea (rapid breathing) Gastric Intestinal Nausea Vomiting Diarrhea Musculoskeletal Myalgia Rhabdomyolysis (skeletal muscle tissue breaks down) Diaphoresis (excessive sweating ) References 1) The American Heritage® Dictionary of the English Language, Fourth Edition copyright ©2000 by Houghton Mifflin Company. Updated in 2009. Published by Houghton Mifflin Company. All rights reserved. 2) http://www.ehow.com/facts_5489895_types-sedative-drugs.html Author Lawerence Gould , Website eHow Health, retrieved October 19, 2011 3) [[Hobbs, W.R, Rall, T.W., and Verdoorn, T.A., Hypnotics and Sedatives: Ethanol In, Goodman and Gillman's The Pharmacologial Basis of Therapeutics, (Hardman, J.G, Limbird, L.E, Molinoff, P.B., Ruddon, R.W, and Gilman, A.G., Eds) The McGraw-Hill Companies, Inc., 1996, pp. 372-373. 4) www.drugs.com 5) Psychotherapeutic Drugs (See: Drugs in American Society, 5th, 6th, and 7th editions, Erich Goode, McGraw-Hill, 1999/2005/2008. Chapter 8 and Drugs, Society, and Human Behavior, Ray and Ksir, Mosby, 1993. Chapters 7and 13) http://www.umsl.edu/~keelr/180/prescrip.html 6) Scientific American : http://www.scientificamerican.com/article.cfm?id=propofol-michael-jackson-doctor 7) American College of Chest Physicians http://www.chestnet.org/accp/pccsu/management-alcohol-sedative-hypnotic-and-opioidwithdrawal-icu?page=0,3 8) International Hyperhydrosis Society http://www.sweathelp.org/pdf/Diaphoretic_Diseases.pdf 9) U.S Department of Justice. Drug Enforcement Administration. Office of Diversion Control http://www.deadiversion.usdoj.gov/drugs_concern/benzo_1.htm