Albia Dugger • Miami Dade College

Chapter 9 Sedative-Hypnotic

Drugs

Sedative-Hypnotics Drugs

• Sedative-hypnotic drugs are central nervous system depressants that produce relaxing to sleep-inducing effects depending on dosage

• Three main types of sedative-hypnotic drugs:• Barbiturates• Nonbarbiturate sedatives• Minor tranquilizers

Adolescents and Prescription Drugs

• In 2011, 4.3% of high school seniors had used a sedative for nonmedical purposes within the previous 12 months

• Girls are more likely to intentionally abuse prescription drugs than boys

• One misconception among adolescents is that these drugs provide a medically safe high

Barbiturates

• Barbital • Sedative-hypnotic drug used to treat anxiety and

nervousness; the original barbiturate

• Veronal • Brand name for barbital

• Phenobarbital • Second barbiturate developed• Produces relaxation and relieves anxiety

Types of Barbiturates

• Classified based on potency and the length of time they act:• Ultra-short-acting• Short-acting (less than 4 hours)• Intermediate-acting (4 to 6 hours)• Long-acting (more than 6 hours)

• Drugs that take effect rapidly have a higher abuse potential than slow-acting drugs

Selected Barbiturates

Effects of Barbiturates

• Barbiturates produce a depressed, mood-altering action on the central nervous system

• They also affect activity of the muscle tissue, the heart, and respiration

• Can cause confusion, short attention span, impaired cognitive functioning, inadequate emotional control, slurred speech, poor judgment, hangovers, and intoxication

Potential Hazards

• Reduced attention span• Impaired cognitive

functioning• Diminished hand-eye

coordination• Inadequate emotional

control• Nausea• Vomiting

• Birth defects• Confusion• Poor judgment• Slurred speech• Vertigo• Diarrhea• Respiratory failure• Violent behavior

Potential Hazards

• Combination of alcohol and barbiturates can lead to accidental or intentional death

• Withdrawal is life-threatening without medical supervision: marked by profuse sweating, insomnia, muscular twitching, paranoia, vomiting, aches and pains, cramps, quick temper, nightmares, hallucinations, and seizures

Medical Uses

• Used primarily as sleeping pills, for certain convulsive disorders, and for anxiety

• Short-acting barbiturates such as thiopental (Pentothal) continue to be used for anesthetic purposes

• The effectiveness of barbiturates as sleep agents is questionable, because they interfere with rapid eye movement (REM), and may result in rebound insomnia

Some Prescription Depressants

Nonbarbiturate Sedatives

• Chloral hydrate (“knockout drops” or Mickey Finns)• Induces sleep• Works rapidly• Margin between effective dose (ED) and lethal dose (LD)

is slight• Risk of hepatoxicity• Produces gastric distress, vomiting, and flatulence

Nonbarbiturate Sedatives

• Paraldehyde • Effective and safe central nervous system depressant• Used with severely disturbed mental patients• Produces a terrible smell and taste

• Bromides • Used to treat epileptic convulsions• Build up in the body, cause depression, and can be highly

toxic

Nonbarbiturate Sedatives

• Meprobamate (Miltown and Equanil)• Minor tranquilizer used for psychosomatic conditions• Severe withdrawal and low margin of safety

• Minor tranquilizer • Drug used primarily to relieve anxiety

• Anxiolytic • Anxiety-reducing drugs

Methaqualone (Quaalude)

• Methaqualone (Quaalude)• Relieves tension and anxiety without barbiturate-like

aftereffects• Withdrawal symptoms can be extremely severe, including

mania, seizures, vomiting, convulsions, and death• Induces dreamlike moods at low dosage levels• Memory is affected• Especially lethal in combination with alcohol

Minor Tranquilizers

• Benzodiazepines (Librium and Valium)• Used primarily to treat anxiety• Addictive; produces tolerance and withdrawal symptoms• Have a wider margin of safety, fewer side effects, and less

severe side effects than barbiturates• Some women who took Valium while pregnant had

children with fetal benzodiazepine syndrome• Halcion (triazolam) reportedly produces a number of

distressing side effects

Selected Benzodiazepines

Date-Rape Drugs

• Rohypnol • A depressant 5-10 times more powerful than Valium• Dangerous in combination with alcohol• Can cause sedation, muscle relaxation, blackouts,

addiction, complete memory loss, and death• Takes effect 20 to 30 minutes after ingestion, and lasts for

2 to 10 hours• Dependency and withdrawal symptoms

Date-Rape Drugs

• Gamma-hydroxybutyrate (GHB) • Neurotransmitter that produces relaxation and sleepiness• Used in opiate detoxification• Potentially deadly; shuts down the respiratory system• When mixed with alcohol, the person may lose memory

and consciousness• Other effects are vomiting, nausea, seizures,

hallucinations, coma, and respiratory distress

Inhalants

• Inhalants serve as gateway drugs

• Most frequently used class of illegal drugs among adolescents aged 12 and 13

• Strong relationship between inhalant use and other problem behaviors and sensation-seeking

• Long-term effects: nosebleeds, liver and kidney damage, sores, weight loss, depression, irritability, disorientation, paranoia, hostility, and bone marrow abnormalities

“Huffing” Inhalants

• Twice as many 8th-grade students use inhalants as 12th-grade students

Inhalants

• Glue (volatile hydrocarbon solvents)• Psychoactive agent is toluene• Possible immediate cardiorespiratory arrest• Brain damage and memory loss

• Anesthetic inhalants• Ether used as industrial solvent and anesthetic• Nitrous oxide (laughing gas) • Can cause irreparable brain damage or death due to

decreased oxygen (hypoxia)

Nitrite Inhalants

• Nitrite inhalants• Inhaled for sexual purposes• Amyl nitrite: used to treat angina pectoris and congestive

heart failure• Butyl nitrite: found in perfume and antifreeze• Isobutyl: used to treat angina pain; causes vasodilation,

flushing, and warmth• Suppresses the immune system• Linked to HIV and AIDS