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Benzodiazepines and other sedative-hypnotics should be used sparingly by older patients, and only after alternatives have been tried and failed.

The recently revised 2012 – one of the leading sources of information about safe prescribing for older adults – suggests that older adults avoid benzodiazepines because of the substantial risks associated with them.

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Green, MD, MPHFellow, Division of Geriatric Medicine and Gerontology Johns Hopkins University School of Medicine Sei J.

Lee, MD, MASAssistant Professor, University of California San Francisco Senior Scholar, San Francisco Veterans Administration Quality Scholars Fellowship Q: What are sedative-hypnotic drugs and why are they prescribed?

There are two main types of sedative-hypnotics -- barbiturates and benzodiazepines. S., common barbiturates include Seconal (also known as secobarbital) and Luminal (phenobarbital).

They are used for patients who have trouble sleeping.

A: The best way to treat delirium is first to prevent it.

Once a person does develop delirium, they must get immediate professional attention and treatment. In addition, benzodiazepines have been linked to higher risks of cognitive (thinking and memory) problems, delirium , and motor vehicle accidents.Research suggests that the Z drugs are not a safer alternative for older adults.Caution is therefore required when such agents are prescribed for patients with receive hypnotics, sedatives and opiates/opioids to treat conditions including pain, anxiety and difficulty sleeping.Concerns have been expressed that administration of these drugs to people with co-existing .In small, single-night studies, zolpidem 20 mg, flurazepam 20 mg and triazolam 0.25 mg showed a tendency to increase numbers and duration of pauses during sleep, which was not as measured by the numbers and duration of pauses in breathing during sleep, but significant clinical and statistical decreases in minimum oxygen levels during the night were observed with remifentanil, zolpidem and triazolam; therefore prescribing these drugs for patients with (remifentanil); some studies included CPAP treatment, whilst in a significant number of participants, previous treatment with CPAP was not stated and thus a residual treatment effect of CPAP could not be excluded.

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