All right so let's jump in to the sedative-hypnotics.
And so, the sedative-hypnotics, we're going to start with the foundational lecture
at it's 3 main important topics are kind of have a lot of overlap between all the drugs
and in particular, you should know that the sedative-hypnotics are these GABA Channel Modifiers
and if you remember from the last lecture that GABA was an inhibitory neurotransmitter which would lead to CNS depression.
And so, we'll start off by talking about the major sub-groups and definitions of the sedative-hypnotics,
the dose dependent effects and then also the structure and function of the GABA ion channel.
So arguably the hardest of pharmacology for a medical student is getting the naming right so let's start with that.
And so, the 2 major subgroups of sedative-hypnotics are the Benzodiazepines and the Barbiturates.
Now, the Benzodiazepines luckily can easily be found by locating -azepam as a suffix in their name or -azolam.
So here's an example for commonly prescribed Benzodiazepines.
Diazepam, notice we have -azepam right here. Lorazepam, notice we have -azepam. Midazolam, notice we have an -azolam or Alprazolam, notice we have an -azolam.
Now, on the street, you might find different names for this
and there's just a couple of funny ones that I'll mention.
You might hear this on the streets referred to as downers, that's because of their you know CNS depressant effects.
My favorite though is when people call these Z bars and what they're referring to though is Xanax
and unfortunately, Xanax is spelled with an X.
Xanax is also Alprazolam.
When we look at the Barbiturates, we have the -pental and the -barbital as a suffix.
So here's 2 commonly prescribed Barbiturates. We have Thiopental or Phenobarital. So -pental, -barbital. Whatever.
Now, these are the major subgroups and in subsequent lectures, we'll talk about some of the newer hypnotics
but there's also newer hypnotics that are non-benzodiapine. We'll talk about maybe some melatonin agonists
and even some drugs that work on serotonin receptors.
But for now, here are the main two subgroups that you should know.
Now, notice here I said newer hypnotics right?
And people like to refer to the sedative effects or the hypnotic effects of a lot of these drugs.
Well what are they referring to?
And so here are just some basic definitions that will cover. One is sedative and the other is hypnotic.
Now, whenever I thought of sedative in the past, I always thought of sedative makes you sleepy.
And unfortunately that's not the exact definition that we're looking for with pharmacology.
So, when we say it's a sedative, you're right that it does have a calming effect and it decreases you know central nervous system excitability
but really, what we're going for is a reduction in anxiety and let's make just a little note here.
Let's just say in the awake patient.
So this is to differentiate a sedative from a hypnotic.
What a hypnotic does is it causes drowsiness and induction of sleep.
And so, how do most of these drugs work?
Well we'll get to that but a term that you'll hear frequently is that they potentiate the effects of GABA.
So what does potentiate mean?
Just remember these are the GABA channel modifiers or they potentiate GABA.
And so, what that means is that these drugs increase the physiologic response to endogenous GABA
and that less drug is needed to get the same effect.
All right so, they'll increase the response to GABA. Less drug is needed to get the same effect.
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