Anxiolytics and sedative-hypnotics: Nursing pharmacology

Anxiolytics and sedative-hypnotics are medications that act as central nervous system depressants that reduce tension and induce calm or sleep, and are primarily used to relieve anxiety, as well as insomnia.

It’s important to note that the preferred medications for the long-term management of anxiety are typically selective serotonin reuptake inhibitors, or SSRIs for short, due to their low abuse potential and dependence.

But, medications that can be used for the short-term management include benzodiazepines, barbiturates, and miscellaneous anxiolytics.

First, let’s start with benzodiazepines. These medications are usually taken orally, but some of them can also be administered intravenously, intramuscularly, subcutaneously, sublingually, or even rectally.

Now, based on the overall duration of action, benzodiazepines can be subdivided into three main groups.

The first group includes short-acting benzodiazepines, which typically end in -azolam, such as alprazolam and midazolam; the second group covers intermediate-acting benzodiazepines that end in -azepam, like lorazepam and clonazepam; and finally, the third group includes long-acting benzodiazepines that also end in -azepam, such as diazepam.

In addition to treating anxiety and insomnia, benzodiazepines are also indicated for treatment for status epilepticus, where a person has ongoing or multiple seizures for over 5 minutes.