Sedative

Main Article

Discussion

Classification[edit]

Below are examples of available sedative drugs.

Alcohols[edit]

Ethylene glycols[edit]

Chloral hydrate

Anti-adrenergics[edit]

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[edit]

Diphenhydramine

Gamma-aminobutyric acid (GABA) agonists[edit]

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 GABA_A receptors.

Barbituates[edit]

Barbituates are GABAergic by increasing receptiveness of the GABA_A receptors. Barbituates do this by increasing the duration of openings of channels in the cell membrane.^[2]

Phenobarbital

Benzodiazepines[edit]

Benzodiazepines are non-selective agonists by increasing receptiveness of the GABA_A receptors. Benzodiazepines do this by increasing the frequency of openings of channels in the cell membrane.^[2]

Benzodiazepine receptors are BZ₁ and BZ₂.

Diazepam (Valium)

BZ₁ selective agonists[edit]

Serotonin (5-HT) agonists[edit]

Agonists of the 5-HT_1A receptor can cause sedation.

Buspirone

Other[edit]

Propofol^[3]

Adverse effects[edit]

Sedatives taken for insomnia are associated with increased mortality with increasing mortality with increasing frequency of use of sedatives.^[4]^[5]

References[edit]

↑ 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.

[pmid18073360-1] 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.

[isbn0-07-145153-6-2] 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.

[3] 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.

[pmid24647164-4] 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.

[pmid22371848-5] 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.

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