CNS Drugs

Influx of sodium ions

Excitation (depolarization)

Influx of chloride ions

Inhibition (hyperpolarization)

Excitatory neurotransmitters

Glutamate and Acetylcholine

NMDA receptor

N-methyl-D-aspartate receptor for glutamate (excitatory)

Muscarinic or Nicotinic receptor

Receptors for acetylcholine (excitatory)

Inhibitory neurotransmitters

GABA and Glycine

GABA receptor

Receptor that allows chloride influx, causing inhibition

Glycine receptor

Inhibitory receptor that allows chloride influx

Anxiolytics

Drugs that depress the CNS to treat anxiety and panic disorders

Hypnotics

Drugs that help induce or improve sleep quality

Benzodiazepines

Enhance GABAA receptor binding; increase frequency of chloride channel opening

Barbiturates

Increase duration of chloride channel opening via GABA receptors

Chloride influx

Causes inhibition and hyperpolarization

Flumazenil

Benzodiazepine antagonist

Benzodiazepine dependence

Occurs after prolonged high doses

Benzodiazepine withdrawal symptoms

Confusion, anxiety, agitation, restlessness, insomnia, seizure

Benzodiazepine adverse effects

Drowsiness, ataxia, confusion

Benzodiazepine contraindications

Liver disease, glaucoma, alcohol or CNS depressant use

Oxazepam

Short-acting benzodiazepine (3–8 hours)

Triazolam

Short-acting benzodiazepine (3–8 hours)

Lorazepam

Intermediate-acting benzodiazepine (10–20 hours)

Alprazolam

Intermediate-acting benzodiazepine (10–20 hours)

Temazepam

Intermediate-acting benzodiazepine (10–20 hours)

Estazolam

Intermediate-acting benzodiazepine (10–20 hours)

Diazepam

Long-acting benzodiazepine (1–3 days)

Flurazepam

Long-acting benzodiazepine (1–3 days)

Clorazepate

Long-acting benzodiazepine (1–3 days)

Chlordiazepoxide

Long-acting benzodiazepine (1–3 days)

Quazepam

Long-acting benzodiazepine (1–3 days)

Oxazepam

Used for anxiety and sleep disorders

Triazolam

Used for sleep disorders

Lorazepam

Used for anxiety and status epilepticus

Alprazolam

Used for anxiety and panic disorders

Temazepam

Used for sleep disorders

Estazolam

Used for insomnia

Diazepam

Used for anxiety, seizures, and skeletal muscle spasms

Flurazepam

Used for insomnia

Clorazepate

Used for anxiety and alcohol withdrawal

Chlordiazepoxide

Used for anxiety and alcohol withdrawal

Quazepam

Used for sleep disorders

Thiopental

Ultrashort-acting barbiturate (20 minutes)

Pentobarbital

Short-acting barbiturate (3–8 hours)

Amobarbital

Short-acting barbiturate (3–8 hours)

Secobarbital

Short-acting barbiturate (3–8 hours)

Phenobarbital

Long-acting barbiturate (1–2 days)

Butalbital

Short-acting barbiturate

Thiopental

Used for anesthesia

Pentobarbital

Used for sedation and seizure control

Amobarbital

Used for insomnia and sedation

Secobarbital

Used for sedation and preoperative anesthesia

Phenobarbital

Used as an anticonvulsant for tonic–clonic seizures

Butalbital

Used as sedative/hypnotic for tension or migraine headaches