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Category – Depressants Property Benzodiazapines Physical dependence more likely with Physical dependence drugs that have a short duration of action Psychological dependence more likely with drugs that have a rapid onset of Psychological dependence effects Tolerance Generally, tolerance to the hypnotic and Drug disposition sedative effects occurs within days, however, tolerance to the anxiolytic effects of benzodiazepines takes longer Behavioral to develop. Cross tolerance can occur also. Cross tolerance means that tolerance will Pharmacodynamic develop to other depressants such as barbiturates and alcohol Anxiety, insomnia, tremors, delirium, Withdrawal convulsions possible death Frequent visits to different physicians for prescriptions to treat "nervousness," "anxiety," "stress," and so on. Symptoms of alcohol intoxication with no alcohol odor on breath (remember that Abuse potential depressants are frequently used with alcohol) lack of facial expression or animation flat affect flaccid appearance slurred speech Most abuse associated with oral use of legally manufactured products Two types of typical abusers Older adults using prescription drug, tolerance develops, dose increases Younger people who obtain drugs to get high; may take high doses and/or mix with alcohol Depends on time course and dosasge Craving potential Depends on time course and dosage Addictive potential (disease) 1. Acute Toxicity Chronic toxicity Physiological Toxicity Physiological Respiratory depression Especially dangerous if combined with alcohol Behavioral Alcohol-like intoxication with impaired judgment and coordination Increased risk of injury while driving or engaging in other activities Additive effects if combined with alcohol Behavioral toxicity Reinforcer Oral ingestion Route of administration Depends on type of benzodiazepine Time course See http://helpingaddicts.net/tranquilizers.htm Depends on type see How long effects last http://helpingaddicts.net/tranquilizers.htm Depends on type Effective dose See http://helpingaddicts.net/tranquilizers.htm Depends on type Lethal dose http://helpingaddicts.net/tranquilizers.htm Safety margin Can interact with alcohol and Drug interactions barbiturates which will increase sedation and psychomotor impairment See How much needed http://helpingaddicts.net/tranquilizers.htm See table 7.2 on page 163 in Ksir book Half-life Metabolized by Cytochrome P450 in the How metabolized liver Benzodiazapines bind to GABA receptor sites which enhances GABA’s inhibitory effects on its receptors. There are different Neurotransmitters affected subtypes of GABA receptors, so its possible to separate out the anti-anxiety effects from the hypnotic effects. Lunesta and Ambien are examples of benzodiazapines that are better at sleep induction (hypnotic effects) Circuitry affected Ativan, Dalmane, Halcyon, Librium, Trade/street name Valium, Xanax Possible effects Shallow respiration, cold and clammy Effects of overdose skin, weak and rapid pulse, coma, possible death drowsiness, ataxia, confusion, vertigo, impaired judgment, slurred speech, memory loss and a number of other Side Effects effects are common Problems can be particularly bad among the elderly Anxiolytic effects – anti-anxiety effects. Xanax, Ativan, Klonopin and Valium are found on the top 100 most commonly Beneficial effects prescribed drugs list. Also work as muscle relaxants Also work as hypnotics