Transcript Sedative-Hypnotic Drugs

Chapter 9
Sedative-Hypnotic Drugs
SEDATIVE-HYPNOTICS
SEDATIVE = SEDATION
HYPNOTIC = SLEEP
Early Examples
Bromides: Used as sedatives and
anticonvulsants in 1800’s – potential
for toxicity
Paraldehyde: Used to treat alcohol
withdrawal, highly addictive.
Chloral hydrate: sedative and hypnotic –
“knockout” drops
TYPES OF SEDATIVEHYPNOTICS
BARBITURATES
NONBARBITURATES
MINOR TRANQUILIZERS
BARBITURATES
CLASSIFIED BY ONSET AND DURATION
OF ACTION

ULTRASHORT

SHORT-INTERMEDIATE

LONG-ACTING
USES FOR BARBITURATES
ULTRASHORT (ANESTHESIA)

EXAMPLE: THIOPENTAL
INTERMEDIATE: (SLEEP)
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EXAMPLE: SECONAL
Referred to as ‘Solid Alcohol’
LONG-ACTING: (ANTIEPILEPTIC,
HEADACHES:)
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EXAMPLE: BUTABARBITAL,
PHENOBARBITAL
PROBLEMS WITH
BARBITURATES
 WITHDRAWAL CAN BE LIFE
THREATENING
 IMPAIRMENT OF JUDGMENT AND
COORDINATION (HANGOVER)
 DECREASE IN RESPIRATORY RATE
 TOXIC WITH ALCOHOL
 STRONG POTENTIAL FOR ABUSE
Nonbarbiturates
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Chloral Hydrate
Paraldehyde
Bromides
Meprobamate
Methaqualone
Chloral Hydrate, Paraldehyde, and
Bromides
 Chloral Hydrate: Induces sleep and
once used as “knockout drops.”
 Paraldehyde: Once used to treat
mental and emotional problems. No
longer used
 Bromides: Rarely prescribed as a
sleep agent
Meprobamate
 Marketed in mid-1950s under the
brand name Miltown
 Extremely popular anti-anxiety drug
 Concerns regarding physical and
psychological dependence –
withdrawal is severe
 Low margin of safety
Methaqualone
METHAQUALONE (QUAALUDES)
 INTRODUCED IN 1965 AS A
HYPNOTIC
 THOUGHT TO DEPRESS RAS
 USED AS AN ANTI-C0NVULSANT
 STRONG DEPENDENCE POTENTIAL
 QUAALUDES WERE RESCHEDULED (I)
Minor Tranquilizers
 Referred to as anti-anxiety drugs
 Benzodiazepines are the most commonly
prescribed benzodiazepines.
 Examples of benzodiazepines include
Valium, Xanax, and Rohypnol.
 Besides reducing anxiety, benzodiazepines
induce sleep, reduce panic attacks, and
control some seizures
 Benzodiazepines are addictive and
produce tolerance and withdrawal
symptoms
 Benzodiazepines have a wider margin
of safety and less severe side effects
than barbiturates
DATE-RAPE DRUGS
MOST DATE-RAPE DRUGS ARE
BENZODIAZEPINES
EXAMPLE: ROHYPNOL
ROHYPNOL
 SIMILAR TO VALIUM
 ALSO KNOWN AS “ROOFIES,”
“ROPE,” AND “ROCHE”
 ROHYPNOL’S EFFECTS ARE
NORMALLY FELT 20-30 MINUTES
AFTER INJECTION
 EFFECTS CAN LAST FOR HOURS
ROHYPNOL AND ALCOHOL
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SEDATION
MUSCLE RELAXATION
BLACKOUTS
DEATH
LEGAL STATUS
 ROHYPNOL IS ILLEGAL IN THE
UNITED STATES
 IT IS AVAILABLE LEGALLY IN OTHER
COUNTRIES
 USED TO TREAT ANXIETY, INSOMNIA,
AND SEIZURE DISORDERS
OTHER DATE RAPE DRUGS
 GAMMA y-hydroxybutyrate
 KNOWN AS GHB
 DEVELOPED IN THE 1980’S AS A
SURGICAL ANESTHETIC
 GHB IS BOTH A METABOLITE AND
PRECURSOR TO GABA
 Used illicitly by some bodybuilders as
a growth hormone stimulant
GHB
 ODORLESS
 TASTELESS
GHB SIDE EFFECTS
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NAUSEA
VOMITING
SEIZURES
MEMORY LOSS
HALLUCINATIONS
COMA
RESPIRATORY DISTRESS
GHB + ALCOHOL
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LOSS OF MEMORY
UNCONSCIOUSNESS
AMNESIA
DEATH
Gamma butyl lactone
 GBL is an active metabolite of GHB
 Found in liquid paint stripper
 Can be quickly formulated into an
elixir and produce effects similar to
GHB
Inhalants
Inhalant abuse is also called “huffing”
Inhalants have anesthetic-like
properties
Short term effects of inhalants include
drooling, nausea, sneezing,
hypersensitivity, loss of coordination
and coughing
Long-term effects include frequent
nosebleeds, liver and kidney damage,
weight loss, depression, paranoia,
hostility, and bone marrow
abnormalities
Types of Inhalants
Glue (toluene)
Ether
Nitrous Oxide (“laughing gas”)
Nitrite Inhalants (amyl nitrite, butyl
nitrite, and isobutyl
Summary
 Sedative hypnotic drugs are capable
of inducing sedation and sleep
 Barbiturates, nonbarbiturates, and
minor tranquilizers are types of
sedative hypnotics
 Barbiturates are classified by onset
and duration of action
 Date rape drugs are drugs from the
sedative hypnotic category
 Rohypnol is a sedative hypnotic and
used in date rapes
 Rohypnol is illegal in the United
States
 GHB is another example of a date
rape drug
 Inhalants can exert a sedative
hypnotic effect and are extremely
dangerous