Chapter 9

Sedative-Hypnotic Drugs

SEDATIVE-HYPNOTICS

SEDATIVE = SEDATIONHYPNOTIC = 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 SEDATIVE-HYPNOTICS

BARBITURATESNONBARBITURATESMINOR TRANQUILIZERS

BARBITURATES

CLASSIFIED BY ONSET AND DURATION OF ACTION

ULTRASHORT SHORT-INTERMEDIATE LONG-ACTING

USES FOR BARBITURATES

ULTRASHORT (ANESTHESIA) EXAMPLE: THIOPENTALINTERMEDIATE: (SLEEP) EXAMPLE: SECONAL Referred to as ‘Solid Alcohol’LONG-ACTING: (ANTIEPILEPTIC,

HEADACHES:) 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

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

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

NAUSEA VOMITING SEIZURES MEMORY LOSS HALLUCINATIONS COMA RESPIRATORY DISTRESS

GHB + ALCOHOL

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)EtherNitrous 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