Transcript Chapter 6 CNS Depressants

Sedatives – Hypnotics

1) CNS depressants are usually not obtained
illicitly and self-administered but rather are
prescribed under the direction of a physician.

2) CNS depressants if not monitored correctly
could be potentially dangerous and harmful;
most problems stem from inadequate
professional supervision and chronic use.

3) Several drug groups have the ability to cause
CNS depression and the major reason of death
and drug overdose (Hansen, Venturelli,
Fleckenstein, 2012).
CNS depressants are a diverse group of drugs that share an
ability to reduce CNS activity and diminishes the brain’s levels
of awareness.
Depressant drugs include:
 Antihistamines: drugs that often cause CNS depression,
used to treat allergies, and are often found over-the-counter
drugs.
 Sedatives- to relieve anxiety, fear, and apprehension.
 Anxiolytic- drugs that relieves anxiety.
 Hypnotics- used to induce drowsiness and encourage sleep.
 Amnesic- causing the loss of memory.
 Anesthesia- a state characterized by loss of sensation or
consciousness (Hansen, Venturelli, Fleckstein, 2012).
Sedation
Hypnosis
Anesthesia
To treat
Anxiety
To treat
Insomnia
For Surgery
Low
Coma
Inadvertent
Overdose
Dose
(Hansen, Venturelli, Fleckenstein,
2012)
Death
Fatal
Overdose
High
Benzodiazepines: prescribed for anxiety and
sleep. They were originally referred as minor
tranquilizers but over time this terminology
conflicted with the pharmacological properties
similar to the antipsychotic drugs which were
major tranquilizers when they were very
different. Examples of benzodiazepines
include:
 Alprazolam (Xanax)
 Chlordiazepoxide (Librium)
 Clonazepam (Klonopin)
 Diazepam
(Valium)
 Estazolam (ProSom)
 Lorazepam (Ativan)
 Midazolam (Versed)
 Oxazepam (Serax)
 Quazepam (Doral)
 Temazepam (Restoril)
 Triazolam (Halcion)
 Zolpidem (Ambien; not a true
benzodiazepine
Reported side effects include drowsiness,
lightheadedness, lethargy, impairment of
mental and physical activities, skin rashes,
nausea, diminished libido, irregularities in
menstrual cycle, blood cell abnormalities, and
increased sensitivity to alcohol and other CNS
depressants (Charney, 2006).
Benzodiazepines, are also known to be a short
acting drug and are used as hypnotics to treat
insomnia which allows patients to wake in the
morning with few after effects. They are also
popular and affordable to get by prescription
only (Hansen, Venturelli, Fleckenstein, 2012).
Another type of CNS depressant is
Barbiturates, a barbituric acid component that
is used in medicine as sedatives and hypnotics.
Examples of some known barbiturates that are
used is as follows:
 Allobarbital
 Amobarbital
 Barbital
 Pentobarbital
 Phenobarbital
 Secobarbital
Barbiturates can become uncontrollable
because of their addictive agents to one’s
body. It has been known to be replaced by
Benzodiazepine’s which is safer to use and less
abuse liability.
Uncontrolled use of Barbiturates can cause a
state of acute or chronic intoxication.
Moreover, people that use Barbiturates can
have some loss of inhibition, euphoria, and
behavioral stimulation.
 Depressed
activity of nerves and skeletal,
smooth, and cardiac muscles and affect CNS
in several ways, from mild sedation to coma.
 At sedative or hypnotic dosage levels can be
the only level that the CNS is significantly
affected.
 Higher anesthetic doses can increase high
blood pressure, heart rate and flow of urine.
Can also affect liver at a level that can
damage it.
 Low
doses relieve tension and anxiety,
effects that give several Barbiturates
substantial abuse potential.
 Drawbacks of Barbiturates are extensive and
severe, for example;
1) They lack selectivity and safety
2) They have substantial tendency to
create tolerance, dependence,
withdrawal, and abuse
3) They cause problems with drug
interaction
(Hansen,Venturelli,Fleckenstein,2012)
Withdrawal from any drug or alcohol is by far a
very hard and difficult situation to obdure. Many
signs and symptoms are different in many people
because of the distribution of the drug and it’s
components. Withdrawal symptoms may include
anxiety, tremors, nightmares, insomnia, anorexia,
vomiting, seizures, delirium, and maniacal activity
(Hansen, Venturelli, Fleckenstein, 2012).
As a counselor, we face many people with many
difficulties. We trigger the problems by helping
clients confront their problems and find solutions
that are concrete for them to live healthy lives.
In either case, patients addicted to
barbiturates and benzodiazaphines should not
stop taking them on their own because of the
high-risk withdrawal state. Client’s rather
should be seen by a professional, whether it’s
a family doctor, psychologist, psychiatrist or
any counselor that is experienced with drug
and alcohol addictions. In most cases
addmitted to a rehab facility that can monitor
the dependence and give the help needed for
recovery.
It is important to remember the elimination of
physical dependence is not a cure. If an
individual is abusing a CNS depressant because
of emotional instability, personal problems, or
a very stressful environment, eliminating
physical dependence alone will not solve the
problem and drug dependence is likely to
reoccur. Without psychological support at this
stage, the detoxification will only be
temporary and therapy will fail (Hansen,
Venturelli, Fleckenstein, 2012).
1)Textbook- Hansen, Venturelli, Fleckenstein, 2012.
2)You tube video-Sedative Hypnotics
3)You tube slide- "Benzodiazepines and How They Work”
4) You tube slide-"Benzodiazepine Withdrawal Symptoms“
5) PowerPoint presentation-Chapter 6,CNS Depressants: SedativeHypnotics
6) Another PowerPoint Presentation on CNS Depressants
7) http://psychology.about.com/od/bindex/f/barbiturates.htm
8) http://www.nimh.nih.gov/index.shtml
9)http://www.addictionrecov.org/Addictions/index.aspx?AID=3
10) http://www.drugs.com/enc/barbiturate-intoxication-andoverdose.html
11) Websites on Anxiety Disorders Association of America, The Anxiety
Network International and "Freedom from Fear"