Benzodiazepines/ Nonbenzodiazepine Hypnotics

POPP 1

gamma aminobutyric acid (GABA)

inhibitory neurotransmittor

1. alprazolam (Xanax)

2. chlordiazepoxide

3. lorazepam (Ativan)

4. diazepam (Valium)

anxiolytic benzodiazepines (4)

anxiolytic

medication that reduces anxiety

1. clonazepam (Klonopin)

2. diazepam (Valium)

3. midazolam (Nayzilam)

anticonvulsant/ antipanic benzodiazepines (3)

1. anxiolytic benzodiazepines

2. anticonvulsant/ antipanic benzodiazepines

3. hypnotic benzodiazepines

3 classes of benzodiazepines

clonazepam (Klonopin)

drug for absence seizures and panic disorder

diazepam (Valium)

drug, rectal gel- rescue medication for home treatment of seizures

Indicated for 2 year olds and up

relaxes skeletal muscle

1. temazepam (Restoril)

2. triazolam (Halcion)

hypnotic benzodiazepines (2)

1. somnolence

2. avoid alcohol

3. don’t D/C abruptly

4. anterograde/ retrograde amnesia

Patient counseling for benzodiazepines (4)

anxiolytic

reduces anxiety

hypnotic benzos

enhance the effects of GABA inhibitory NT.

Decrease activity in the CNS

reduces anxiety, reduces seizures

Amytryptiline

Drug of choice for pharmacist suicide

Anticholinergic effects: everything is shut down

diazepam (Valium)

Rectal gel = Rescue med. for home treatment of seizures

Indicated for 2 yrs and older

only oral benzo that is indicated to relax skeletal muscle. Ued orally as ADJUNCTIVE treatment of seizures.

1. absence seizures

2. panic disorder

2 indications for clonazepam (Klonopin)

midazolam (Nayzilam)

nasal spray, rescue medication for home treatment of seizures

1. petit-mal

2. generalized

3. staring spells

4. absence

seizures treated by clonazepam (Klonopin), 4 names for one type of seizure

1. diazepam (Valium)

2. midazolam (Nayzilam)

rescue medications for home treatments of seizures (2)

insomnia

Indication hypnotic benzodiazepines

retrograde amnesia

Can’t remember the distant past

Anterograde amnesia

Can’t form new, short-term memories

eszopiclone (Lunesta)

causes dysgeusia. non-benzo hypnotic

1. eszopiclone (Lunesta)

2. zolpidem (Ambien)

3. zaleplon

4. suvorexant (Belsomra)

5. lemborexant (Dayvigo)

6. daridorexant (Quviviq)

Non-benzodiazepine hypnotics (6)

zaleplon

non-benzo hypnotic with shortest DOA: 4 hours

Ind. “middle of night awakening”

1. eszopiclone

2. zolpidem

3. zaleplon

BBW: somnambulism (3) complex sleep behaviors

somnambulism

clinical term sleep walking

dysgeusia

Altered or distorted sense of taste

orexin

NT promoting wakefulness

On an empty stomach

For Benzos and Non-Benzos: anytime you take anything for sleep: take it 1.

orexin

You suppress “wake drive” when you block these receptors

increasing daytime drowsiness

daily dosing of orexin receptor antagonists may lead to

1. suvorexant (Belsomra)

2. lemborexant (Dayvigo)

3. daridorexant (Quviviq)

Orexin receptor antagonists (3)