The document discusses insomnia and treatment with hypnotic drugs such as benzodiazepines. Insomnia complaints include difficulty falling asleep, frequent awakening, short sleep duration, and unrefreshing sleep. Benzodiazepines are the preferred treatment but tolerance may develop. Adverse effects of benzodiazepines include drowsiness, impaired judgment, reduced motor skills, and impairing new learning. They should be avoided with other central nervous system depressants like alcohol or antidepressants due to increased side effects.

1. INSOMNIA
the complaint of insomnia may include
difficulty in falling asleep, frequent
awakening, short duration of sleep, and
unrefreshing sleep.
evaluation to find other causes before
hypnotic drugs. Benzodiazepines are
preferred but tolerance may occur.
Adverse affects--drowsiness, impaired
judgement, reduced motor skills, impair new
learning. lethal dose is variable except
benzodiazepines. possible fetal damage

2. 
avoid using with other CNS depressants
such as alcohol, narcotic analgesics,
antihistamines, antidepressants.
Benzodiazepines
Mechanism
of Action
•Benzodiazepines bind to benzodiazepine receptors
•in the CNS and act as agonists.
•They enhance the action of the inhibitory neurotransmitter
•gamma-aminobutyric acid (GABA).
•Reduce anxiety and panic.
•Cause sedation.
•Skeletal muscle relaxation

3. Benzodiazepines

anything ending with ‘am’ and also
chlordiazepoxide(Librium)

Ativan--Lorazepam

Estazolam Flurazepam Midazolam HCL
Temazepam Triazolam Alprazolam Clorazepate
DiazepamOxazepam Clonazepam
