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Drugs for Anxiety, Daytime Sedation, and Insomnia

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Reticular formation a network of neurons found along the entire length of the brain stem. Stimulation of the reticular formation causes heightened alertness and ... – PowerPoint PPT presentation

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Title: Drugs for Anxiety, Daytime Sedation, and Insomnia


1
Drugs for Anxiety, Daytime Sedation, and Insomnia
  • Chapter 8

2
Introduction
  • More clients routinely experience nervousness and
    tension than any other symptom.
  • Most health care providers agree that even though
    drugs are not the cure for this problem, they can
    help on a short-term basis to calm clients who
    are apprehensive or have difficulty falling
    asleep.

3
Classifications of Anxiety
  • Two major classifications of anxiety are
    generalize anxiety disorder and panic disorder

4
Classifications of Anxiety
  • Anxietystate of apprehension and ANS activation
    resulting from exposure to a nonspecific or
    unknown cause.
  • Generalized anxietydifficult to control,
    excessive anxiety that lasts 6 months or more and
    interferes with normal day-to-day functions or
    causes considerable distress.

5
Classifications of Anxiety
  • Panic disordersis characterized by episodes of
    immediate and intense apprehension, fearfulness,
    or terror associated with dread of future attacks
    and changes in behavior to avoid them. When a
    panic attack occurs, it is usually over within 10
    minutes, although it may be described by a client
    as seemingly endless.

6
Classifications of Anxiety
  • Phobiasare fearful feelings attached to specific
    situation or objects that compel a client to
    avoid the fearful stimulus.

7
Classifications of Anxiety
  • Obsessive-compulsive disordersinvolves
    recurrent, intrusive impulses or thoughts and
    repetitive behaviors aimed at reducing the
    distress associated with them.

8
Classifications of Anxiety
  • Post-traumatic stress disordersa type of anxiety
    that develops in response to the threat or
    experience of severe injury or death.
  • War, physical or sexual abuse, natural disasters,
    and murder may lead to a sense of helplessness
    and re-experiencing of the traumatic event.

9
Classifications of Anxiety
  • Fast Facts pg. 109

10
Specific Brain Regions
  • Specific regions of the brain are responsible for
    anxiety and wakefulness.
  • Neural systems associated with anxiety and
    restlessness include the limbic system and the
    reticular activating system.

11
Specific Brain Regions
  • Limbic Systemregion in the middle of the brain
    responsible for emotional expression, learning,
    and memory.
  • Signals routed through the limbic system
    ultimately connect with the hypothalamus.
  • Emotional states associated with this connection
    include anxiety, fear, anger, aggression,
    remorse, depression, sexual drive, and euphoria.

12
Specific Brain Regions
  • Reticular formationa network of neurons found
    along the entire length of the brain stem.
  • Stimulation of the reticular formation causes
    heightened alertness and arousal, while
    inhibition of the reticular formation causes
    general drowsiness and the induction of sleep.

13
Specific Brain Regions
  • Reticular activating system (RAS)it is
    responsible for sleeping and wakefulness and
    performs an alerting function for the cerebral
    cortex.
  • It also helps a client to focus attention on
    individual tasks by transmitting information to
    higher brain centers.

14
Insomnia
  • Insomnia has more than one cause.
  • Insomniathe inability to fall asleep or stay
    asleep.

15
Short Term or Behavioral Insomnia
  • Stress by a hectic lifestyle.
  • Worry about work, marriage, children, or health.
  • Foods or beverages containing stimulants such as
    caffeine
  • Nicotine
  • Uncomfortable room temperature
  • Snoring
  • Sleep apnea
  • Recurring nightmares

16
Long-Term Insomnia
  • Psychiatric disorders
  • Chronic pain
  • Medication side effect

17
Insomnia
  • Long-term use of sleeping medications is likely
    to worsen insomnia and may cause physical or
    psychological dependence.
  • Some may experience a phenomenon referred to as
    rebound insomnia when hypnotic medications are
    discontinued abruptly or after taken for a long
    time sleeplessness and symptoms of anxiety
    become markedly worse.

18
Insomnia
  • Fast facts pg. 111!

19
Antidepressants
20
Antidepressants
  • Typical antidepressants used to treat anxiety and
    insomnia include
  • SSRIselective serotonin reuptake inhibitors
  • TCAstricyclic antidepressants
  • MAOIsmonoamine oxidase inhibitors.
  • Mechanism covered in chapter 9, however, look at
    the bulleted section on pg. 113!!

21
CNS Depressants
  • CNS depressants used to treat anxiety and
    restlessness.
  • Calms clients
  • Sedativesdepress the CNSable to sedate and
    relax
  • HypnoticsCNS depressant drugs prescribed to help
    patient sleep.
  • Tranquilizera drug that produces a calm or
    tranquil feeling.

22
CNS Depressants
  • CNS depressants used for anxiety and sleep
    disorders are categorized into 2 major classes
  • Benzodiazepines
  • barbiturates

23
CNS Depressants
  • The withdrawal syndrome for some CNS depressants
    can cause life-threatening neurologic reactions,
    including fever, psychosis, and seizures.
  • Other withdrawal symptoms include increased
    heart rate, lowered BP, loss of appetite, muscle
    cramps, impaired memory, concentration, and
    orientation abnormal sounds in the ears and
    blurred vision insomnia, agitation, anxiety, and
    panic.
  • Noticeable withdrawal symptoms typically last 2
    to 4 weeks. Subtle ones can last months

24
Benzodiazepines
  • Benzodiazepinestreat panic disorder, generalized
    anxiety, phobias, and insomnia.
  • Chlordiazepoxide (Librium) and diazepam
    (Valium)introduced in 1960s
  • Schedule IV drugs
  • Prescribed for seizure activity, alcohol
    withdrawal symptoms, muscle relaxation, induction
    agent in general anesthesia
  • DPlorazepam (Ativan) pg. 117.

25
Benzodiazepines forSleep Disorders
  • Benzodiazepines are drugs of choice for
    short-term insomnia caused by anxiety.
  • Increase total sleep time

26
Barbiturates
  • Barbiturates are drugs derived from barbituric
    acid
  • They act as CNS depressants and are used for
    their sedative, hypnotic, and anti-seizure effects

27
Barbiturates
  • Barbiturates are used for the short-term therapy
    of severe insomnia.
  • Should be short-term because of the risk of
    psychological and physical dependence.

28
Barbiturates
  • The withdrawal syndrome from barbituates is
    extremely severe and can be fatal.
  • Overdose results in profound respiratory
    depression, hypotension, and shock.
  • People have used to commit suicide, and death due
    to overdose is not uncommon.
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