Transcript Depressants

Classes/Types of Depressants
 1.
Anesthetics
 2. Barbiturates
 3. Benzodiazepines (anxiolytics - _____
)
 Many
labels have been used to
describe them, which can be confusing:
-tranquilizers
-sleeping pills
-anti-anxiety pills
-sedatives
Depressants
 Mechanism
of action:
• GABA: acts mainly on inhibitory receptors
– taking off the brakes
– e.g. GHB (gamma hydroxy butyrate)
• Separate receptors identified for
barbiturates and benzos
Etherdome
History / Development
of Depressants
 Nitrous
oxide (1776) (laughing gas)
• development of ether, (MGH-etherdome)
a flammable liquid which vaporizes at room
temperature

Chloral hydrate, bromides, paraldehyde
 Barbiturates
came next in 1860s
• ___________________________
• ___________________________
• ___________________________
Barbiturates
 USES:
• some used as anesthetics if they work
quickly and then wear off
• others used to prevent seizures because
their sedating effects lasted longer
• often used as sleeping pills and anxiolytics
Barbiturate Use 2010
For example, Nembutal®, Pentobarbital, Seconal®,
Secobarbital, or Butalbital.
Source: SAMHSA, Office of Applied Studies, National
Survey on Drug Use and Health.
BARBITURATE USE declined due
to their unwanted effects:
- ____________________________
- ____________________________
- ____________________________
- ____________________________
____________________________
withdrawal SX similar to alcohol:
____________________________
____________________________
____________________________
Quaaludes (Methaqualone)
came next in the 50s and 60s and were
developed as alternatives to barbs for
sleep/anxiety disorders
 they became a street drug;
 now a schedule I drug
 no longer produced for medical reasons
Depressants (con’t)
 Benzodiazepines
• classic anti-anxiety drugs
• synthesized initially in 1950s
• more potent in 1960s with the advent of
______________________
• similar to barbs but less dangerous in that:
– ____________________________________
– ____________________________________
_____________________________________
Depressants
 Benzodiazepines
• Withdrawal symptoms: increased
anxiety, insomnia, tremors, sweating
• Dangers: ___________________
___________________
 what are the clinical implications of
treating anxiety with drugs?
 difficult to estimate non-medical misuse
or abuse of sedatives and tranquilizers
Benzodiazepine Misuse?
2010
Includes Klonopin® or clonazepam, Xanax®, or alprazolam, Ativan®, or
lorazepam, Valium® or diazepam, Librium®, Limbitrol®, Rohypnol®, Serax®,
and Tranxene®.
The case of Rohypnol
(flunitrazepam)
 a.k.a.
roofies, rib, circles, wolfies, rope,
ropies, ruffies, roach-2, “roaches” after
drug company Hoffman-La Roche
• a Benzodiazepine used in the short-term
treatment of insomnia and as a preanesthetic medication
• similar to valium in effect but 10 times
stronger
• effects begin within 30 minutes, may last for
8 hours or more
Rohypnol

made in Europe and Latin America and sold
by prescription there, not in U.S. so it is
usually smuggled via mail into country, or
comes across Mexican border
 distribution
and abuse especially in
southwest & south
 low cost < $5 per tab
 popularity among young people; “Said to be
south Florida’s fastest growing drug problem”
Rohypnol
2
COMMON MISPERCEPTIONS:
• ________________________________
• ________________________________
Adverse Effects of Rohypnol

memory impairment, drowsiness, dizziness,
confusion; can induce excitability or
aggressiveness in some users

can cause dependence: tolerance may develop;
withdrawal symptoms include - headaches,
anxiety, muscle pain, confusion, restlessness,
numbness, tingling of extremities, convulsions
and cardiac problems
Rohypnol
 used
in date rape situations….WHY?
• ___________________________________
• __________________________________
• __________________________________
 used
to augment an alcohol high without
elevating BAL

used as a “parachute” or remedy for depression
that follows a stimulant high
Inhalants
 Use
varies as products “huffed” or
sniffed include gasoline, glues, aerosol
cans, paint solvents and lighter fluid
 Mostly young kids, adolescents
 highly destructive to brain with OD
potential
 can cause cardiac arrest, known as
"sudden sniffing death."
Inhalants
Sniffing has been a fairly steady trend among 12year-olds in recent years, with lifetime rate between
7.7 percent and 6.1 percent since 2002.
1.1 % of children ages 12 to 17 engaged in sniffing
in 2008, compared with 6.7 % who smoked
marijuana.