SEDATIVE/HYPNOTICS
DEFINITIONS
SEDATIVE - agent that quiets excitement, by calming mind and body
HYPNOTIC - induces sleep
GENERAL ANESTHETIC - total loss of sensation
ANTICONVULSANT - stops or decreases incidents of seizures
BARBITURATE PHARMACOLOGY
CENTRAL NERVOUS SYSTEM
Initial effect is excitement
Thereafter depressant effect
Sleep induction - but decreased REM Sleep
Prolonged use leads to irritability, restlessness, and nightmares
Use should not exceed 7 days
Hyperalgesia
BARBITURATE PHARMACOLOGY
General Anesthetic
Fast acting with speedy recovery
poor analgesia
Anticonvulsant
Inhibits convulsion at doses below sedative/hypnotic dose
Toxic levels decrease respiratory drive
BARBITURATE PHARMACOLOGY
HEPATIC EFFECT
Metabolic induction - speeds up metabolism of other agents
DEPENDENCY
Therapeutic Uses
Sedative/Hypnotic
Anticonvulsant
General Anesthetic
BENZODIAZEPINES
Stimulates GABA receptors
ADVANTAGES
Higher therapeutic index (safer)
No effect on hepatic metabolism
No fatalities from overdose by itself
Minimal to no effect on REM sleep
SIDE EFFECTS - drowsiness, increased hostility
BENZODIAZEPINES
WITHDRAWAL - hyperexcitability, tapering may take months to a year
Therapeutic Use
Sedative/Hypnotic
Anticonvulsant
Alcohol Withdrawal
Premedicate prior to procedure
Muscle Relaxant
MISCELLANEOUS AGENTS
CHLORAL HYDRATE
Low Therapeutic Index
Not Useful as an anticonvulsant
Toxicities may cause severe respiratory depression
BUSPIRONE
Antianxiety with no sedation