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13 terms

Pharm 18

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benzodiazepines
potentiate the effects of GABA, resulting in increased CNS depression; treat anxiety, sleep, seizures, muscle relaxation, alcohol withdraw, anesthesia, sedation and conscious sedation; prototype: lorazepam
lorazepam
benzodiazepine; treats anxiety and insomnia; adverse: mild drowsiness, ataxia, confusion, resp disturbance, bradycardia; pt: can become tolerant and need larger doses, paradoxical excitement can occur, wide therapeutic index, avoid CNS depressants, short duration of action, larger half life in asians
sleep stages
I. light sleep, muscles relax, brain waves are irregular and rapid; II. brain waves are larger than in stage 1, with bursts of electrical activity; III and IV. deep sleep, with even larger, slower brain waves called delta waves
hydroxyzine
anti-anxiety drug and CNS depressant; rapidly produces feeling of calm and relieves anxiety without impaired mental status; can be coadministered with narcotic to control pain and minimize narcotic nausea
meprobamate
short term management of anxiety, effects the thalamus and limbic system; mild tranquilizer w/ anticonvulsant and muscle relaxant qualities; pregnancy D and CNS adverse effects
Buspirone
not related to benzos, treats anxiety, but action is not known. optimum relief within three to four weeks; short term therapy but no tolerance effect
eszopiclone
lunesta; non benzo hypnotic for sleep- prevents waking during the night; GABA; the only sleep med approved for long term use
zaleplon
sonata; sedative for sleep for up to 28 days, non benzo; can lead to dependency and rebound insomnia
zolpidem
ambien; short term treatment of insomnia; take immediately before bed
ramelteon
melatonin receptor agonist; for difficulty falling asleep
trazodone
atypical antidepressant; causes significant sedation as an adverse effect; commonly used for sleep now
chloral hydrate
nonbarbituate hypnotic used to sedate and induce sleep; has adverse CNS effects
barbituates
phenobarbitol, secobarbitol; these are old drugs that are highly habit forming although they are effective in short term treatment of insomnia