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

Anterograde amnesia is when someone is unable to remember things they did or events that take place, while the drug’s effects was still active in their body.

Benzodiazepines (midazolam) cause this effect

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

When pharmacological treatment is needed to sleep, drugs are used to ensure rapid onset of sleep and prolongation of stage 2

When using drugs will see that:

• Time to fall asleep is reduced
• Time slept is increased (only if you (as patient) are not able to get more than 6 h of sleep)
• BDs don’t have a large effect on Rem sleep but:

• It increases the duration of phase 2 NREM
• Increase duration of phase 4 NREM

• Zolpidem decreases REM sleep and has a small effect on slow sleep wave
• The newer hypnotics namely like Zolpidem the decreases the latency to persistent sleep
• Patients must keep in mind that they can develop tolerance if use for longer than 1-2 weeks.

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

IV administration of Diazepam, lorazepam and midazolam are used in combination with other drugs in anaesthesia

Some barbiturates like thiopental or methohexital (work well because of short time of action and useful in recovery from anaesthesia)

These medications are used to put patients asleep so surgery can be done.

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

BDs

• Clonazepam
• Nitrazepam
• Lorazepam
• Diazepam

Barbiturates

• Phenobarbital
• Methabarbital

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

They have inhibitory effects on polysynaptic reflexes and internuncial transmission

When a large dose is administered it can reduce transmission at the neuromuscular junction

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

CVS and respiratory effects are more distinct when it is adminestered intravenously.

It can cause pulmonary depression in people with COPD or asthma.

Dose-related with some (with BDs only when used in combination with other drugs): it can cause medullary depression that can be fatal

Cardiovascular depression also a possibility if people struggle with heart diseases, hypovolemic states etc.

Toxic doses: Depression of myocardial contractility and vascular tone may appear by to central and peripheral effects due to facilitation of the actions adenosine  that leads to a circulatory collapse.

Bibliography

Brand, L. 2021. FKLG Study unit 2: Sedative-hypnotic drugs. Potchefstroom: NWU, Potchefstroom campus.

Katzung, B.G. 2018. Basic & Clinical Pharmacology. 14^th ed. New York: McGraw-Hill Education