Anxiolytics sedatives

Benzodiazepines have found wide therapeutic applications as anxiolytics, sedatives, hypnotics, anticonvulsants, and central muscle relaxants. 

While the individual drugs in the benzodiazepine group differ in potency, all benzodiazepines in common use have anxiolytic, sedative-hypnotic, anticonvulsant and muscle-relaxant activity in ascending order of dose. The main clinical difference between the individual drugs lies in the time of onset of their therapeutic effect, and the intensity and duration of their clinical activity. 

Apart from the antidepressant effect, acute effects occur that are evident also in healthy individuals. These vary in degree among individual substances and thus provide a rationale for differentiated clinical use (p. 233), based upon the divergent patterns of interference with amine transmitters/modula-tors. Amitriptyline exerts anxiolytic, sedative and psychomotor dampening effects. These are useful in depressive patients who are anxious and agitated. 

In nondepressive patients whose complaints are of predominantly psychogenic origin, the anxiolytic-sedative effect may be useful in efforts to bring about a temporary psychosomatic uncoupling." In this connection, clinical use as "co-analgesics" (p. 194) may be noted. 

The synthesis of these compounds will be described in Section 3.1, Opioid analgesics. Besides opioids, benzodiazepines (diazepam, lorazepam, and midazolam), which have anxiolytic, sedative, and anticonvulsant effects, that cause amnesia and muscle relaxation, are frequently used to relieve patients anxiety during anesthesia. 

Diazepam exhibits anxiolytic, sedative, soporific, central myorelaxant, and anticonvulsant action. It suppresses feelings of fear, worry, and stress. It is nsed for nervons stress, excitement, anxiety, sleep distnrbance, neurovegetative disorders, psychonenrosis, obsessive neurosis, hysterical or hypochondriac reactions, and phobias. The most freqnently used synonyms are sednxen, relaninm, valium, sibazon, apaurin, and many others. 

This drag exhibits expressed anticonvulsant as well as anxiolytic, sedative, and central muscle relaxant action. 

Lorazepam (Ativan, Others) [C-IV] [Anxiolytic, Sedative/ Hypnotic/Benzodiazepine] Uses Anxiety preprocedure sedation control Szs Action Benzodiazepine Dose Adults. Preprocedure sedation 2.0-4.0 mg... 

Anxiolytics, sedatives, hypnotics (benzodiazepines, barbiturates, chloral derivatives, chlormethiazole, zopiclone, zolpidem)... 

The benzodiazepines constitute the most commonly used group of anxiolytics and sedative-hypnotics. Since the first member of this group, chlordiazepoxide, was introduced, many congeners have been marketed. Most of these drugs possess anxiolytic, sedative-hypnotic, and anticonvulsant properties. Thus, the clinical indications for specific benzodiazepines are not absolute, and their uses overlaps considerably. 

Anxiolytic sedatives, hypnotics, and antipsychotics are lumped together in this section because all of them act by some form of intervention with the brain and... 

Figure 2.5 Reported concentrations of various PPCPs in Wastewater effluents by several research groups. On the x axis are respective PPCPs that are primarily cosmetics (1 = HHCB, 2 = AHTN, 3 = acetophenone, 4 = camphor, 5 = isobomeol, 6 = skatol, 7 = celestolide, i.e., AHMI, 8 = Phantolide, i.e., AHMI), the lotion ingredient (9 = methyl salicylate), two disinfectants (10 = triclosan and 11 = trilocarban), antihypertensive (12 = dehydronifedipine, 13 = diltiazem, 14 = bezafibrate, and 15 = gemfibrozil), analgesics and anti-inflammatories (16 = naproxen, 17 = ibuprofen, 18 = codeine), antimicrobials (19 = chlortetracycline, 20 = erythromycin, 21 = novobiocin, 22 = oxytetracycline, 23 = sulfamethaxazole, 24 = thiabendazole, 25 = trimethoprim), anxiolytic sedative (26 = carbamazepine), antidiabetic (27 = metaformin), reproductive (28 = 17(3 estradiol, 29 = 17a-ethinyl estradiol), GIT (30 = cimetidine, 31 = ranitidine), and respiratory (32 = Albuterol). The concentrations were compiled from Boyd et al. (2003), Gagne et al. (2006), Glassmeyer et al. (2005), Halden and Pauli (2005), Huang and Sedlak (2001), Ricking et al. (2003), and Temes et al. (2003).

In this chapter, we discuss the pharmacology of medications that are classified as anxiolytic, sedative, or hypnotic—primarily the benzodiazepines, buspirone, zolpidem, eszopiclone, and zale-plon. Subsequently, we present diagnosis-specific treatment guidelines (outlined in Table 3-1). The commonly used anxiolytics and hypnotics, together with their usual doses, are shown in Table 3-2. Many antidepressant medications are also effective in the treatment of anxiety disorders. The pharmacology of antidepressants is discussed in Chapter 2 their clinical use in anxiety disorders is addressed in the diagnosis-specific sections later in this chapter. 

Nevertheless, the GABAergic properties of benzodiazepines remain their most important clinical application. Over the past 30 years, the most widely used benzodiazepine drug has been diazepam (1.6). It is an anxiolytic, sedative, and muscle relaxant the anxious, depressed person becomes more outgoing and relaxed. There have been many diazepam analogs. Oxazepam (4.177) and lorazepam (4.178) have similar effects. Temazepam (4.179), flunitrazepam (4.180), and flurazepam (4.181) are useful sedative-hypnotics. Clonazepam (4.182) is a clinically useful anticonvulsant. Brotizolam (4.183), a novel benzodiazepine analog, seems to be an effective sedative-hypnotic. Midazolam (4.184) is an imidazolo-benzodiazepine that is water soluble and thus easily injectable. It is a hypnotic sedative with marked amnestic (i.e., memory loss) properties and is used in dentistry, endoscopic procedures, and induction to anesthetics in the elderly and in... 

Adumbran 8, Seresta1 (UK), Serax (USi Oxazepam 20-150 Anxiolytic, sedative... 

Griffiths, R.R., Sannerud, Ch.A. Abuse of and dependence on benzodiazepines and other anxiolytic sedative drugs. In Meltzer, H.Y. (ed.) Psychopharmacology the Third Generation of Progress. Raven, New York. 1987, pp. 1535-1541. 

Lader, M., Petursson, H. Rational use of anxiolytic/sedative drugs. Drugs 25, 514-528, 1983. 

E.H. (1973) Length of treatment with anxiolytic sedatives and response to their sudden withdrawal , Acta psychiatrica scandanavica, 49 51-64. 

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