Sedative: Difference between revisions
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===Anti-adrenergics=== | ===Anti-adrenergics=== | ||
Inhibitors of the adrenergic alpha-2 receptor can cause sedation. | Inhibitors of the adrenergic alpha-2 receptor can cause sedation. | ||
* [[Dexmedetomidine]]. In some settings, dexmedetomidine may cause less [[adverse | * [[Dexmedetomidine]]. In some settings, dexmedetomidine may cause less [[drug-related side effects and adverse reactions]]s than non-selective [[benzodiazepine]]s.<ref name="pmid18073360">{{cite journal |author=Pandharipande PP, Pun BT, Herr DL, ''et al'' |title=Effect of sedation with dexmedetomidine vs [[lorazepam]] on acute brain dysfunction in mechanically ventilated patients: the MENDS randomized controlled trial |journal=JAMA |volume=298 |issue=22 |pages=2644–53 |year=2007 |pmid=18073360 |doi=10.1001/jama.298.22.2644}}</ref> | ||
===Anti-histamines=== | ===Anti-histamines=== | ||
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* Phenobarbital | * Phenobarbital | ||
==== | ====Benzodiazepines==== | ||
[[Benzodiazepines]] are | [[Benzodiazepines]] are non-selective agonists by increasing receptiveness of the GABA<sub>A</sub> receptors. Benzodiazepines do this by increasing the frequency of openings of channels in the cell membrane.<ref name="isbn0-07-145153-6"/> | ||
[[Benzodiazepine]] receptors are BZ<sub>1</sub> and BZ<sub>2</sub>. | [[Benzodiazepine]] receptors are BZ<sub>1</sub> and BZ<sub>2</sub>. | ||
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* [[Diazepam]] ([[Valium]]) | * [[Diazepam]] ([[Valium]]) | ||
====BZ<sub>1</sub> selective agonists==== | |||
* [[Zaleplon]] | * [[Zaleplon]] | ||
* [[Zolpidem]] | * [[Zolpidem]] | ||
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Agonists of the 5-HT<sub>1A</sub> receptor can cause sedation. | Agonists of the 5-HT<sub>1A</sub> receptor can cause sedation. | ||
* [[Buspirone]] | * [[Buspirone]] | ||
===Other=== | |||
* [[Propofol]]<ref>Miner JR et al. Randomized clinical trial of propofol versus ketamine for procedural sedation in the emergency department. Acad Emerg Med 2010 Jun; 17:604.</ref> | |||
==Adverse effects== | |||
Sedatives taken for insomnia are associated with increased mortality with increasing mortality with increasing frequency of use of sedatives.<ref name="pmid24647164">{{cite journal| author=Weich S, Pearce HL, Croft P, Singh S, Crome I, Bashford J et al.| title=Effect of anxiolytic and hypnotic drug prescriptions on mortality hazards: retrospective cohort study. | journal=BMJ | year= 2014 | volume= 348 | issue= | pages= g1996 | pmid=24647164 | doi=10.1136/bmj.g1996 | pmc=PMC3959619 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24647164 }} </ref><ref name="pmid22371848">{{cite journal| author=Kripke DF, Langer RD, Kline LE| title=Hypnotics' association with mortality or cancer: a matched cohort study. | journal=BMJ Open | year= 2012 | volume= 2 | issue= 1 | pages= e000850 | pmid=22371848 | doi=10.1136/bmjopen-2012-000850 | pmc=PMC3293137 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22371848 }} </ref> | |||
==References== | ==References== | ||
<references/> | <references/>[[Category:Suggestion Bot Tag]] | ||
Latest revision as of 17:00, 16 October 2024
Classification
Below are examples of available sedative drugs.
Alcohols
Ethylene glycols
Anti-adrenergics
Inhibitors of the adrenergic alpha-2 receptor can cause sedation.
- Dexmedetomidine. In some settings, dexmedetomidine may cause less drug-related side effects and adverse reactionss than non-selective benzodiazepines.[1]
Anti-histamines
Gamma-aminobutyric acid (GABA) agonists
Gamma-aminobutyric acid (GABA) the major inhibitory neurotransmitter in the central nervous system.[2] Drugs that increase the effect of GABA are called GABAergic.
Many sedatives work by increasing receptiveness of GABAA receptors.
Barbituates
Barbituates are GABAergic by increasing receptiveness of the GABAA receptors. Barbituates do this by increasing the duration of openings of channels in the cell membrane.[2]
- Phenobarbital
Benzodiazepines
Benzodiazepines are non-selective agonists by increasing receptiveness of the GABAA receptors. Benzodiazepines do this by increasing the frequency of openings of channels in the cell membrane.[2]
Benzodiazepine receptors are BZ1 and BZ2.
BZ1 selective agonists
Serotonin (5-HT) agonists
Agonists of the 5-HT1A receptor can cause sedation.
Other
Adverse effects
Sedatives taken for insomnia are associated with increased mortality with increasing mortality with increasing frequency of use of sedatives.[4][5]
References
- ↑ Pandharipande PP, Pun BT, Herr DL, et al (2007). "Effect of sedation with dexmedetomidine vs lorazepam on acute brain dysfunction in mechanically ventilated patients: the MENDS randomized controlled trial". JAMA 298 (22): 2644–53. DOI:10.1001/jama.298.22.2644. PMID 18073360. Research Blogging.
- ↑ 2.0 2.1 2.2 Katzung, Bertram G. (2006). Basic and clinical pharmacology. New York: McGraw-Hill Medical Publishing Division. ISBN 0-07-145153-6.
- ↑ Miner JR et al. Randomized clinical trial of propofol versus ketamine for procedural sedation in the emergency department. Acad Emerg Med 2010 Jun; 17:604.
- ↑ Weich S, Pearce HL, Croft P, Singh S, Crome I, Bashford J et al. (2014). "Effect of anxiolytic and hypnotic drug prescriptions on mortality hazards: retrospective cohort study.". BMJ 348: g1996. DOI:10.1136/bmj.g1996. PMID 24647164. PMC PMC3959619. Research Blogging.
- ↑ Kripke DF, Langer RD, Kline LE (2012). "Hypnotics' association with mortality or cancer: a matched cohort study.". BMJ Open 2 (1): e000850. DOI:10.1136/bmjopen-2012-000850. PMID 22371848. PMC PMC3293137. Research Blogging.