Tranquillizers

Introduction

Tranquillizers are those drugs that target the central nervous system, or the CNS, and act as depressants. The term tranquillizer was first coined in 1953 by F. F. Yonkman. These drugs are called tranquillizers because they cause a calming effect and a state of tranquillity in animals. In medicine, these drugs are known as neuroleptic or antipsychotic medications. They are also referred to as sedatives. Tranquillizers affect the neurotransmitter GABA gamma-aminobutyric acid. Tranquillizers are used to treat many health problems such as stress, pressure, anxiety, agitation, tension, and other illnesses. Some examples of tranquilizers are phenelzine, iproniazid etc.

Classification of Tranquillizers

Tranquillizers can be classified into two broad categories: major tranquillizers and minor tranquillizers.

Examples of Major Tranquillizers

Major tranquillizers are antipsychotic or neuroleptic drugs. These drugs are used to treat severe mental disorders such as schizophrenia. They treat symptoms such as delusions and hallucinations. Tranquillizers cannot cure these symptoms, but they greatly help in reducing their intensity. As a result, these antipsychotic agents have generally been prescribed as long-term relievers. Some examples include butyrophenones, phenothiazines, also known as chlorpromazine, rauwolfia alkaloids, also known as reserpine, and clozapine.

Examples of Minor Tranquillizers

Minor tranquillizers are also called anxiolytics. They are used mainly as sedatives. Recently, these drugs have been identified as effective anti-anxiety treatments. These drugs are utilised to treat mild mental illnesses and slight states of stress. Examples include benzodiazepine and carbamate. Serotonin, the “happiness hormone” responsible for good moods in humans, is also used as a tranquillizer. Antipsychotic tranquillizers can further be categorised into two classes: first generation (typical) tranquillizers and second-generation (atypical) tranquillizers.

Uses of Tranquillizers

Hormones like dopamine and serotonin are responsible for various bodily functions such as the movement of our muscles, emotional responses, etc. Excessive activity of the dopamine system may lead to delusions and hallucinations. Antipsychotic drugs work by blocking dopamine and serotonin receptors. Neuroleptics like phenothiazine and butyrophenone also work by blocking D2 or dopamine receptors. When the phenothiazine ring is alkylated with different aminoalkyl halogens with a catalyst like sodium amide, it results in this type of phenothiazine derivative drug. Phenothiazine results in a depressive or slowing down effect on the connection between the brainstem and the cerebral cortex. This creates a sleepy or sedative effect. Butyrophenones, on the other hand, are used for similar purposes on animals in veterinary medicine. For instance, azaperone is a drug given to pigs to reduce fighting when they are mixed. Fluanisone is also given to humans as a treatment for mania and schizophrenia. Chlorpromazine also works as an inhibitor of D2 dopamine receptors. This causes a rise in the prolactin concentration in plasma. Thioxanthenes drugs, which are often used to treat schizophrenia, are derived from chlorpromazine. Other typical neuroleptics like clozapine are derived using chloroform as a catalyst. They work by blocking neural receptors like 5-HT-2-serotonin receptors, alpha-2 adrenoreceptors, and D4 dopamine receptors. Although they are not as effective on D2 dopamine receptors, they also cause fewer extrapyramidal side effects associated with tranquillizers and antipsychotics. Thus, clozapine is often prescribed instead of phenothiazine in schizophrenia treatments. It is also used in the treatment of bipolar disorder.

Side Effects

Like all other drugs, tranquillizers have potential risk factors even when taken in doses prescribed by medical professionals like doctors and psychiatrists. They mainly occur in the initial stages of treatment, when a patient starts to take the drug, or when treatment ends and the patient is in the withdrawal stage. Common side effects of minor tranquillizers include drowsiness, loss of coordination, nausea, loss of appetite, irregular pulse, insomnia, muscle pain, seizures, panic attack, etc.

Antiseptics

Antiseptics are chemical antimicrobial substances that prevent or slow down the growth of microorganisms such as viruses, bacteria, fungi, parasites. The term ‘sepsis’ indicates the medical condition where bacterial toxins are released into the bloodstream and cause tissue damage. Antiseptics work to prevent this process. Not to be confused with antibiotic drugs or antibiotics, antiseptics cannot destroy microorganisms within the body. Instead, they work to prevent their entry into the body’s bloodstream.

Antiseptics can be classified into several categories, including phenols, quinolines, diguanides, peroxides, iodines, alcohols, octenidine dichlorides, and quat salts. These are extensively used in hospitals to decrease the chance of infection during surgeries and other medical processes. They are also used at home in case of injury to prevent infections.

Properties of an effective antiseptic include

• The ability to kill bacteria, also known as being bactericidal
• Lack of a strong smell; ideally, it should be odourless
• Non-corrosiveness on human tissue
• Non-staining
• A broad spectrum of activity against a large variety of pathogens
• Selective toxicity: it should only be toxic to harmful microorganisms
• Non-absorbability
• Inexpensive and easy availability

Examples of antiseptics include:

• A tincture of iodine is an antiseptic of weak iodine solution where 2-7% of iodine is combined with sodium/ potassium iodide and dissolved in a mixture of water and ethanol
• Boric powder is also an antiseptic used to treat infections in the eyes
• Dettol, Savlon, and Betadine are some of the most common antiseptics available in India

The Workings of Antiseptic Drugs

Antiseptics work by oxidising bacterial protoplasm to kill harmful microorganisms. Antiseptics like alcohols, phenols, and aldehydes work by disrupting the cell membrane of microorganisms and by denaturing bacterial proteins.

Detergent-like substances, on the other hand, like antiseptic soaps and cetrimide, work by weakening the cell membrane, making it easier to kill harmful microorganisms. H₂O₂, potassium permanganate, halogens are some other substances used as antiseptics.

Classification of Antiseptics:

Some categories of antiseptics include:

Phenol derivatives: They denature bacterial proteins. They are used to disinfect areas contaminated by urine, pus, and faeces. Phenol derivatives are corrosive substances that can irritate the skin if applied directly. Examples include cresol (Lysol) and chloroxylenol (Dettol).

Oxidising agents: These types of antiseptics are used to wash the stomach in cases of alkaloid poisoning. They are also used as water disinfectants. Benzoyl peroxide is an oxidising agent used as an effective treatment for acne. H2O2, on the other hand, helps in loosening and removing ear wax.

Halogens: Halogens, including iodine, act as broad-spectrum antiseptics that are effective against many kinds of infections. They are often, as a result, used on the skin before surgery, and on cuts on the skin. Chlorine, another halogen, can kill pathogens within thirty seconds. Other halogens such as iodophors are also used to disinfect ulcers and burns.

Biguanides: They are active against gram-positive bacteria. They work by disrupting bacterial cell membranes and proteins. Biguanides are used in neonatal baths for newborn babies and in mouthwash and on the skin as antiseptics. Savlon is an example of a biguanide.

Quaternary Ammonium: These antiseptics kill pathogens by weakening bacterial cell membranes. Examples include weak antiseptic soaps that function as cleansers.

Alcohols: Alcohols cause the precipitation of bacterial proteins. They make for strong antiseptics and should not be used on open cuts. Alcohol is used extensively in hand sanitisers.

Acids: Acid-derived antiseptics are gentle and work primarily as bacteriostatic substances. This means they are used to stop the growth of bacteria rather than to kill them. They are commonly used in mouthwash.

Metallic salts: Metallic salts are used on burn patients to reduce infection by pseudomonas. Zn-salts are also used in ear drops and eyewash.

Aldehydes: Not very widely used anymore; aldehydes have a bad smell and irritate the skin.

Conclusion

Tranquillizers are important medical substances that have proved valuable and effective treatments in many circumstances. However, they can also be abused for non-medical purposes, resulting in harmful consequences such as addiction. Patients may also become dependent on tranquillizers, which will ultimately have significant implications for their physical and psychological health. Similarly, the overuse of antiseptics is a severe problem in its own way. Recent studies have found that the excessive use of antiseptics on wounds can cause cytotoxicity or harm living cells in the body.