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Sedatives & Hypnotics
Sedatives
The perfect sedative reduces
anxiety with little or no effect
on motor or mental function
within the therapeutic dosing
range.
Hypnotics
The ideal hypnotic drug should
produce drowsiness and encourage
the onset of normal sleep.
Hypnotics cause a more rponounced
depression of the central nervous
system than do the sedatives.
Sedatives and Hypnotics
It is, however, a characteristic of
these drugs as a group to depress
central nervous system function
in a dose dependent fashion.
Sedatives and Hypnotics
These drugs, as a function of dose,
will produce :
 Sleep
 Sedation
 Relief Of Anxiety
 Anesthesia
 Coma & Death
Classes Of SedativesHypnotics
Benzodiazepines
Barbituates
Benzodiazepines - Anxiolytics
Alprazolam
(Xanax)
Chlorazepate (Tranxene)
Diazepam (Valium)
Lorazepam (Ativan)
Anxiolytics cont…...
Oxazepam
(Serax)
Prazepam (Centrax)
Chlordiazepoxide (Librium)
Benzodiazepines - The Sleepers
Triazolam
(Halcion)
Temazepam (Restoril)
Flurazepam (Dalmane)
Quazepam (Doral)
Estazolam (ProSom)
Benzodiazepines
Production
of amnesia
• Midazolam (Versed)
ETOH
withdrawal - DT control
• Chlordiazepoxide (Librium)
Barbituates - Sedatives
Amobarbital
(Amytal)
Aprobarbital (Alurate)
Butabarbital (Butisol)
Barbituates - Anesthesia
Thiopental
(Pentothal)
Barbituates - Sleepers
Pentobarbital
(Nembutal)
Secobarbital (Seconal)
Barbituates - Anti-Seizure
Phenobarbital
(Luminal)
Benzodiazepines & Barbituates
Mechanism of Action
Potentiates the effects of GABA
 Causes synaptic inhibition by
membrane hyperpolarization

Clinical Considerations
Schedule
the rehabilitation sessions
when the drug is at its highest blood
levels if sedation is required for an
effective physical therapy treatment.
Clinical Considerations
Scheduling
the patient for physical
therapy before sedation is achieved may
be important when the patient’s safety
during gait or other high level activities
requiring good posture, coordination or
balance is a rehabilitation consideration.
Clinical Considerations
Aging
reduces the liver’s ability to
metabolize drugs and places the
geriatric population at risk for
drug toxicity secondary to
compromised biotransformation.
Clinical Considerations
In
elderly patients, diseases like
heart failure and CHF may
negatively effect liver function
because of low hepatic blood flow
(hepatomegaly) making drug
toxicity a major physician concern.
Clinical Considerations
Fatigue
Drowsiness
Unable
To Attend To Task
Respiratory Depression
Confusion & Unsafe Behaviors
Clinical Considerations
Patients
have to be weaned slowly off
of the benzodiazepines and the
barbituates
Clinical Considerations
Withdrawal
symptoms include :
Insomnia, delirium, hallucination,
anxiety, restlessness, tremors, seizures,
nausea, vomiting, muscle twitching,
headache, hypotension