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This 4 page Class Notes was uploaded by Samuel Victoria Diaz on Monday October 26, 2015. The Class Notes belongs to a course at a university taught by a professor in Fall. Since its upload, it has received 19 views.
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Date Created: 10/26/15
Chapter 7 Depressants and lnhalants Depressants A class of drugs that decrease CNS activity Have a widespread effect in the brain As a group also called sensitivehypnotics Sedatives treat anxiety Hypnotics treat insomnia Widely used depressants include Alcohol Benzodiazepines prescription History Before Barbiturates Chloral hydrate quotknockout drops quotMickey Finn Synthesized in 1832 used clinically in 1870 Induces sleep in less than an hour Repeated use leads to gastric irritation Paraldehyde Synthesized in 1829 used clinically in 1882 Effective with a wide safety margin Noxious taste and odor Bromides Widely used as a sleep agent in patent medicines Remained in OTC drugs through the 19605 Accumulates in the body and cause toxic effects Barbiturates First introduced in 1903 So popular and useful that over 2500 varieties were synthesized Popular barbiturates included phenobarbital amobarbital and secobarbital Group based on the time of onset and duration of activity Shortacting and rapid onset used to induce sleep and often prescribed in high doses Longacting and delayed onset used to reduce anxiety and often prescribed in low doses Concerns About Barbiturates Overdose deaths Intentional and accidental Caused by respiratory depression Abuse and dependence Reinforcing effects of a drug related to the rapidity of onset of effects Shortacting drugs are more likely to lead to psychological dependence Concerns led to search for safer medications Meprobamate Widely prescribed beginning in the 1950s Used as an anxiolytic Like barbiturates can produce psychological and physical dependence Still available as a prescription drug However largely replaced by benzodiazepines Methaqualone Other names Brand Quaalude or Sopor Slang quotludesquot or quotsoporsquot Despite problems in other countries drug was introduced in the US 1965 Package insert read quotAddiction potential not established Physicians overprescribed thinking the drug was a safe alternative to barbiturates Widely misused and abused Scheduling history 1973 Schedule II 1985 Schedule Benzodiazepines First introduced in 1960 Chlordiazepoxide Librium the first commercially marketed benzodiazepine Reduces anxiety without inducing sleep Much larger safety margin than barbiturates Physical dependence was rare Overdose was rare only when combined with other depressants like alcohol 1970s Diazepam Valium became the best seller among all prescription drugs Benzodiazepines However dependence and overdose can occur Dose level and time course are critical factors Overdose deaths more likely for drugs sold in higher doses Psychological dependence more likely with drugs that have a rapid onset of effects Physical dependence morel likely with drugs that have a short duration of action Are benzodiazepines safer than barbiturates More differences among drugs within each class Fewer differences between these two classes of drugs Benzodiazepines Rohypnol A 1990s version of quotMickey Finn Produces profound intoxication when mixed with alcohol Reportedly used as a quotdaterape drug Slipped into drinks 1997 change in the formulation causes a distinctive color when dissolved in a drink However rohypnol effects are not much different from effects of other CNS depressants Nonbenzodiazepine Hypnotics quotZdrugs Similar to benzodiazepines but with a different chemical structure Zolpidem Ambien became the most widely prescribed hypnotic Short duration Rapid onset Initially thought to be safer than benzodiazepines Withdrawal symptoms have been reported Mechanism of Action Benzodiazepines and barbiturates Bind with receptors on GABA receptor complex Separate binding site for barbiturates and benzodiazepines Enhances the normally inhibitory effects of GABA Nonbenzodiazepine hypnotics Entirely new class of drugs that may selectively bind to different sites on the receptor complex Beneficial Uses Anxiolytics Sedatives often prescribed to reduce anxiety Four benzodiazepines are among the top 100 most commonly prescribed medications in the United States Xanax Ativan Klonopin Valium Concerns Anxiolytics Sedatives are not appropriate for all anxiety disorders Example OCD or specific phobias Overprescribed Most sedatives are not prescribed by psychiatrists Most patients do not have a clearly defined anxiety disorder or physical ailment
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