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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
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