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Related Concept Videos

CNS Depressants: Barbiturates and Benzodiazepines01:14

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CNS depressants include drugs from the category of barbiturates and benzodiazepines. They are valuable medications for managing anxiety disorders and insomnia. Barbiturates, once used to induce and maintain sleep, have been replaced mainly by benzodiazepines due to barbiturate's toxicity, tolerance, and overdose risks. They interact with GABAA receptors, leading to sedation at low doses and potentially coma and death at higher doses. Phenobarbital, a long-acting barbiturate, possesses...
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Sedatives and Hypnotics Drugs: Benzodiazepines01:19

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Benzodiazepines have both sedative and hypnotic properties. They include compounds such as diazepam (Valium) and alprazolam (Xanax). Structurally, their cores are similar, consisting of the fusion of a benzene ring and a diazepine ring, but they share a common mechanism of action in the central nervous system (CNS).
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Benzodiazepines are a class of anxiolytic drugs known for their rapid efficacy and high therapeutic-to-lethal dose ratio, but with a potential risk of drug dependence. These drugs are lipophilic, allowing for rapid absorption after oral administration, eventually reaching the central nervous system (CNS). Once in the CNS, benzodiazepines bind to the allosteric site of the GABAA receptor. This binding enhances the inhibitory effects of the neurotransmitter GABA. By doing so, they prevent...
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Sedatives and Hypnotics Drugs: Miscellaneous Agents01:17

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Sedatives and hypnotics encompass a wide range of substances, each with its unique mechanism of action, uses, and potential adverse effects.
Melatonin congeners like ramelteon (Rozerem) and tasimelteon (Hetlioz) selectively bind to melatonin receptors (MT1 and MT2) and thus mimic the actions of melatonin, a hormone that regulates sleep-wake cycles. Tasimelteon is primarily used for non-24-hour sleep-wake disorder, common in blind patients. They are also used to treat conditions like insomnia...
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Substance Use Disorders Affecting Sleep01:24

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Substance use disorders involve a pattern of using drugs more extensively than intended and continuing use despite harmful consequences. This includes legal substances like alcohol and nicotine, as well as illegal drugs. These disorders often involve both physical and psychological dependence, reflecting compulsive use of substances that significantly alter thoughts, feelings, and behaviors, contributing to a major public health issue.
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Management of Insomnia01:19

Management of Insomnia

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The sleep cycle, an integral part of human health, consists of several stages with distinct characteristics and functions. It begins with a transition from wakefulness to sleep, known as the light sleep phase, followed by the restorative deep sleep phase, essential for physical recovery and growth. The cycle concludes with the Rapid Eye Movement (REM) phase, characterized by high brain activity and vivid dreaming. Insomnia, a prevalent sleep disorder, involves difficulty falling asleep, staying...
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Addiction Medicine: Benzodiazepine Use Disorder.

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Benzodiazepine prescribing often extends beyond short-term use, despite guidelines. Effective management requires physician awareness, screening, and patient-centered tapering for benzodiazepine use disorder.

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Area of Science:

  • Pharmacology
  • Addiction Medicine
  • Public Health

Background:

  • Practice guidelines recommend short-term benzodiazepine use for medical conditions.
  • Long-term benzodiazepine prescriptions are common for unclear indications, potentially due to perceived low risk.
  • Benzodiazepine use disorder affects an estimated 0.2% of US adults.

Purpose of the Study:

  • To examine prescribing patterns of benzodiazepines.
  • To highlight the role of physicians in preventing and managing benzodiazepine use disorder.
  • To discuss effective strategies for benzodiazepine withdrawal and misuse intervention.

Main Methods:

  • Review of current literature and clinical practice guidelines.
  • Analysis of physician prescribing patterns and their impact.
  • Discussion of intervention strategies for benzodiazepine use disorder and withdrawal.

Main Results:

  • Benzodiazepines are often prescribed long-term, contrary to guidelines.
  • Physician prescribing habits significantly influence benzodiazepine use disorder and misuse.
  • Co-prescription with opioids increases adverse event risk.
  • Gradual, patient-centered tapering is crucial for managing withdrawal.

Conclusions:

  • Primary care physicians are vital in preventing and managing benzodiazepine use disorder.
  • Addressing co-occurring conditions is essential for treatment planning.
  • Effective intervention for benzodiazepine withdrawal involves gradual dose reduction and patient support.