9. sedatives and hypnotics,psychopharmacology

Sedatives and Hypnotics

Sedative – A drug that reduces excitement and calms the person.

Hypnotic – A drug that produces sleep resembling normal sleep.

Benzodiazepines

• Nitrazepam• Clonazepam • Midazolam• Triazolam

• Diazepam• Oxazepam• Lorazepam• Flurazepam

Therapeutic uses

As sedative and hypnotic – preferred drug for short term-insomnia

Anticonvulsants

Diagnostic & minor operative procedures

- sedative, amnesic, analgesic & muscle

relaxant properties

As anxiolytic

Pre-anesthetic medication

Skeletal muscle relaxant (centrally acting)

To treat alcohol-withdrawal symptoms

Adverse effects Drowsiness, confusion, blurred vision, amnesia & disorientation

Tolerance & drug dependence

Withdrawal symptoms - insomnia, tremors, restlessness, nervousness & loss of appetite

During labor - respiratory depression & hypotonia

in newborn

Antipsychotics

• Antipsychotics are drugs used

to treat psychotic disorders

such as schizophrenia

• Positive/active symptoms include thought disturbances, delusions, auditory & visual hallucinations

• Negative/passive symptoms include social withdrawal, lack of motivation and emotion, strange speech, lack of personal hygiene

Schizophrenia

Examples of antipsychotics

• Chlorpromazine• Triflupromazine• Thiothixene • Haloperidol• Clozapine• Olanzapine• Aripiprazole

Overactivity of dopaminergic neurotransmission in the

mesolimbic system - symptoms of psychosis

Chlorpromazine Mechanism of action –

• Mainly blocks D2 receptors in the

mesolimbic system – antipsychotic effect

Uses of chlorpromazine

I. Psychiatric indications

1.Schizophrenia – positive symptoms, agitation, aggression, impulsive behaviour

2. Mania – suppress an acute attack of mania

3. Tourette’s syndrome (motor and phonic tics)

II. Non – psychiatric indications

1.As antiemetic

2.As preanesthetic medication 3. Intractable hiccups

Adverse effects of chlorpromazine

Parkinson-like syndrome – tremors,

rigidity, hypokinesia Acute dystonia Tardive dyskinesia – abnormal facial &

limb movements

Neuroleptic malignant syndrome

Hyperprolactinaemia in women

Loss of libido & infertility in men

Hypersensitivity reactions

Sedation

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