Transcript Pill For Every Ill

Benzodiazepines
& Sleep Promotion
without
Medication
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 Sleepers,
 Tranquilisers,
 Settlers,
 Yellows,
 Blues
 All
these terms are used to describe a
class of drugs called benzodiazepines
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 Benzodiazepines
work by increasing how
well a natural chemical in released in the
brain works.
 This chemical decreases the signals sent in
the brain
 Therefore it has a calming effect on the
brain
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 Typical
Examples we see every day in
community pharmacy
1. Diazepam (Valium)
2. Temazepam
3. Lorazepam
4. Nitrazepam
5. Chlordiazepoxide
6. Clonazepam (Rivotril)
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 Benzodiazepines
have several features
which make them useful in treating
various medical conditions. These
include…..
 Sedative and hypnotic (cause sleepiness)
 Anxiolytic (decrease anxiety)
 Anticonvulsant (stop fits)
 Muscle relaxants
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
1.
2.
Benzodiazepines can be used to treat a
range of medical issues
Panic Disorders
Because they have a very fast acting
calming effect.
Insomnia
Can be used to treat short term
insomnia.
Their use beyond 2-4 weeks is not
recommended
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3.
4.
5.
Seizures
They are fast acting and very good at
controlling fits
Alcohol Withdrawal
Help control the effects of withdrawal
symptoms after stopping drinking
Anxiety
They bring about rapid relief from
symptoms
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 There
are many problems with using
benzodiazepines though
 Most of the side effects are related to
their sedating and muscle relaxant
properties
 Can be major problems as these
medications can cause dependence, or
addiction
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Shot Term Effects
 They can cause drowsiness, which can be
a problem with driving, etc
 Decreased alertness and concentration
 Can decrease blood pressure which
causes dizziness
 Can cause lack of coordination, both of
which can lead to falls in the elderly.
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 Can
cause nausea and lack of appetite
 Blurred vision
 Confusion
 Even short term use can cause memory
loss
 Nightmares
 Depersonalisation
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Long Term Effects
 General Deterioration in both physical
and mental health
 Cause marked memory loss
 Confusion and loss of interest
 Social Phobia
 Increase in anxiety and depression
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 The
main long term side effects are
tolerance and dependence
Tolerance
 Tolerance shows itself as a loss in medical
effect
 It can develop very quickly, which is why
these drugs should only be used short
term
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Dependence
 Dependence is addiction
 It can lead to two main problems
1. Withdrawal Effects
If a patient has to discontinue
benzodiazepines for any reason they
can suffer withdrawal symptoms.
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 Most
1.
2.
3.
4.
5.
6.
frequent withdrawal symptoms
Insomnia
Gastric Problems
Tremors
Agitation
Fearfulness
Muscle Spasm
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Irritability
8. Sweating
9. Depression
10. Suicidal Behaviour
11. Seizures
12. Delrium Tremens
Abruptly stopping benzodiazepines can be
dangerous, therefor a reduction regime
over several weeks should be initiated
7.
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2.
Rebound
Rebound symptoms are the return of
the symptoms for which the patient
was treated but worse than before
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 There
are also problems associated with
using benzodiazepines as sleeping aids
 They improve sleep-related problems by
shortening the time spent in bed before
falling asleep
 Prolonging the sleep time
 In general, reducing wakefulness
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 However
they worsen sleep quality
 They do this by increasing light sleep and
decreasing deep sleep.
 Therefore although you may sleep a full
night, you may not feel rested the next
morning
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How to Promote Sleep Without Medication
When night starts to fall, your body should
be getting ready for sleep
 As evening settles, keep the lights low and
engage in relaxing, quiet activities that
will prepare your body for refreshing,
deep sleep.
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Stick to a routine - your adrenal glands will
thank you
 Cortisol levels should be lowest at midnight,
and low cortisol levels stimulate growth
hormone release.
 If you overstimulate yourself with activities
near bedtime, your cortisol may increase
instead of decreasing at this critical hour.
However, if you sleep at the same time every
day and wake every day at the same time,
your cortisol cycle will be correct
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Sleep in a pitch black room
 Artificial light will trick a gland into thinking it's
day and decrease melatonin production,
which is needed for good quality sleep
Eat a small protein snack before bed
 A light snack of protein such as a handful of
nuts or a glass of milk can provide a protein
that the brain uses to produce melatonin and
serotonin that promote high quality sleep
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 There
are many foods which can also
help promote sleep
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Green leafy vegetables
Bananas
Natural Yoghurts
Chicken or turkey
Beans and lentils
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 There
are also foods that we should avoid
to promote a good nights sleep
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Alcohol
Coffee
Coke
Spicy Foods
Fatty Foods
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Other Sleep Promoting Tips
 Get into a routine whereby you go to bed
and get up at the same times each day
 Avoid eating heavy meals at least 2 hours
before going to bed
 Avoid caffeine, nicotine and alcohol late
in the day or at night
 Try some chamomile tea or relaxing herb
tea blends
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
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Try a relaxation technique and deep
breathing
Avoid naps after 3pm
Get regular exercise, but make sure you don`t
do excessive exercise later at night
If light is a problem use a sleeping mask, if
noise use ear plugs
Follow a routine to help you relax and wind
down before sleep eg taking a warm bath
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
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Keep your bedroom for sleep not for TV etc
Keep your bedroom in complete darkness
while you sleep
If you have things on your mind try off loading
them into a journal, talking about them or
trying some relaxation
If you are still awake after 20 mins of
attempting to sleep, get up and do
something relaxing
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 Don`t
watch violent TV or emotionally
upsetting TV as this can stimulate your
brain and prevent sleep
 Try to make a to do list for the following
day so you don`t end up mulling over
what needs to be done the next day