1. What does anterograde amnesia mean and which drugs can cause this effect?

Some benzodiazepines have the side effect of anterograde amnesia, which refers to the loss of ability to retain new information, after taking the drug. Thus the drug is found in the patient’s bloodstream.

This is why it is advised not to take BD whilst studying, driving, going to class or doing anything that needs clear cognitive function.

The specific Benzodiazepines that cause this effect are: 

• Alprazolam

• Clonazepam

• Diazepam

• Flunitrazepam

• Lorazepam

• Midazolam,

• Nimetazepam.

• Nitrazepam

• Temazepam,

• Triazolam

2. Name the effects of the sedative-hypnotic drugs on the normal sleep pattern and explain their significance to the patient.

A patient uses a BD on a long term will see a decrease in the time it takes the patient to fall asleep – thus a patient can use BD to fall asleep easier. patients that already sleep less than six hours a night will see an increase in duration of sleep to about 8 hours, but patients that usually sleep 8 or more hours will not see an effect. BDs have a small decreasing effect and REM sleep; this can explain nightmares or dreams with sudden cessation of the drug.

3. Which of the sedative-hypnotic drugs are used as a supplementary therapy in anaesthesia?  Can you explain why?

Sedative-hypnotic drugs are used because it promotes anterograde amnesia, which will mean that the patient to do not remember the trauma of a surgery.

Barbiturates (1^st gen anxiolytic sedative-hypnotic drugs) and BD (2^nd gen anxiolytic sedative-hypnotic drugs are usually used.

Midazolam, Diazepam and Lorazepam can be used in combination with Barbiturates in anaesthesia. Thiopental is also used.

4. Which of the sedative-hypnotic drugs are used as anticonvulsants?

One of the few clinical indications for barbiturates is Epilepsy, thus will Phenobarbital be used as an anticonvulsant. Certain BDs have anticonvulsant effects and are indicated for status epilepticus: Clonazepam, Lorazepam, Diazepam.

5. What is the mechanism of the muscle-relaxing effects of some of the carbamates and the BDs?

Both carbamates and BDs work in on the GABAergic synapse, thus is the effect of GABA potentiated. One of the effects of GABA is a decrease in muscle contractions – thus will it have a muscle relaxing effect.

6. Discuss the effects of the sedative-hypnotic drugs on the respiratory and cardiovascular systems.

Referring to the ceiling effect. Barbiturates will have a higher risk for respiratory depression in a patient because the benzodiazepine (when it is the only drug) reaches a plateau which means that it will not cause or have risk for respiratory depression.

But BD in combination with other BD can lead to death.

If the levels of these drugs are too high in the patient’s bloodstream it will have an effect on the brain, the brain will then stop some functions, thus will it impact the cardiovascular and respiratory system, there could be trouble breathing or tachycardia. Patient can go into a coma.