Neurotransmitters
Communicates between nerves and muscles
Acetylcholine
The loss of awareness and reaction to environmental stimuli
Sedation
Sedation, drowsiness, depression, lethargy, blurred vision, “sleep driving” and other complex behaviors, headaches, apathy, light-headedness, amnesia, and confusion.
Benzodiazepines
Risk of addiction dependence, adverse effects are lesser or greater than other sedative-hypnotic drugs
Greater
Head injury, drug overdose, environmental exposure, may precipitate seizures
Secondary seizures
Released by nerves in the sympathetic branch of the autonomic nervous system
Norepinephrine and epinephrine
Drugs that are used to lyse or break the feeling of anxiety
Anxiolytic
Antidote for Benzodiazepines
Flumezanil (Romazicon)
Relief of the signs and symptoms of anxiety and for sedation, insomnia, pre-anesthesia, and the treatment of seizures
Butabarbital (Butisol), Pentobarbital (Nembutal Sodium), Phenobarbital (generic), and Secobarbital (Seconal).
Begin in one area of the brain and rapidly spread throughout both hemispheres of the brain
Generalized Seizures
Involved in the coordination of impulses and responses, both motor and intellectual.
Dopamine
Used to help people fall asleep by causing sedation
Hypnotics
May cause severe liver toxicity, bone marrow suppression, gingival hyperplasia, potentially serious dermatological reactions (e.g., hirsutism, Stevens-Johnson syndrome), and frank malignant lymphoma, all of which are directly related to cellular toxicity.
Hydantoins
A newer anti-anxiety agent, has no sedative, anticonvulsant, or muscle-relaxant properties, and its mechanism of action is unknown.
Buspirone
Therapeutic serum phenytoin levels range from
10 to 20 mcg/mL.
Important in arousal and sleep, as well as in preventing depression and promoting motivation.
Serotonin
The most frequently used anxiolytic drugs, prevent anxiety without causing much associated sedation.
Benzodiazepines
Patients receiving parenteral benzodiazepines are at risk for
Falls.
Maintain patients who receive parenteral benzodiazepines in bed for a period of at least 3 hours. Do not permit ambulatory patients to operate a motor vehicle after an injection .
Used for the sedation of newly intubated and mechanically ventilated patients in an intensive care unit. Patients are responsive.
Dexmedetomidine (Precedex)
The therapeutic serum level range for Phenobarbital is
10 to 40 mcg/mL.
Inhibits nerve activity and is important in preventing overexcitability or stimulation such as seizure activity
Gamma-aminobutyric acid or GABA
Anxiety disorders, alcohol withdrawal, hyperexcitability and agitation, and preoperative relief of anxiety and tension to aid in balanced anesthesia.
Therapeutic Actions and Indications for Benzodiazepines
Drowsiness, somnolence, lethargy, ataxia, vertigo, a feeling of a “hangover,” thinking abnormalities, paradoxical excitement, anxiety, and hallucinations.
Serious hypoventilation may occur, and respiratory depression and laryngospasm may also result, particularly with IV administration.
Barbiturates
Anorexia, nausea, vomiting, dysphagia, and constipation or diarrhea; cardiac arrhythmias, hypotension, and palpitations; bizarre breathing patterns; urinary retention; and flushing, increased sweating, and hot flashes
Dopaminergic Agents
amantadine (generic), apomorphine (Apokyn), bromocriptine (Parlodel), levodopa (generic), carbidopa–levodopa (Sinemet), pramipexole (Mirapex), rasagiline (Azilect), ropinirole (Requip), and rotigotine (Neupro).
The mainstay of treatment for Parkinson disease
Levodopa