Hypnotics ideal

Ideally limit hypnotic therapy to short-term use, and reevaluate after 2 to 3 weeks of therapy. 

Nitrous oxide, which is also called laughing gas, is a weak anesthetic. It is usually used together with hypnotics, analgesics, and muscle relaxants. It is sometimes called an ideal anesthetic because of the absence of any kind of suppressive influence on respiration. However, according to the latest information, use of nitrous oxide for more than 2 h is counterproductive since it causes a severe reduction of methionine synthesis, which in turn can cause a severe decrease in the level of vitamin Bj2 with all its subsequent consequences. 

Most anxiolytic and sedative-hypnotic drugs produce dose-dependent depression of central nervous system function. The ideal anxiolytic drug should calm the patient without causing too much daytime sedation and drowsiness and without producing physical or psycho-... 

Through studies of hypnotics, anaesthetics and CNS depressants in particular, it has been proposed that an octanokwater log P of 2.0 0.3 is the ideal lipophilic character to design into a neutral molecule for passive penetration into the CNS (Gupta, 1989). (For acidic or basic molecules, log D is often measured at physiological pH and taken as the relevant value. Thus, a log D of about 2.0 at pH 7.4 is the ideal for weak acids and bases, and probably also for zwitterions.)... 

Despite the lack of an ideal pediatric sedative/hypnotic medication, pharmacological agents are widely used for sleep problems in pediatrics. A summary of pharmacological and clinical properties of medications currently most commonly used in the treatment of pediatric insomnia are discussed below (Tables 1 and 2). Although many different classes of medications have sedating properties, only those used in clinical practice for treatment of insomnia are reviewed. 

Palermo TM, Koren G, Blumer JL (2002) Rational pharmacotherapy for childhood sleep disturbances Characteristics of an ideal hypnotic. Current Therapeutic Research 63 (Suppl B) B67-B79... 

Any new hypnotic should induce and maintain natural sleep without producing residual sedative effects during the day it should not cause dependence or interact adversely with other sedatives, including alcohol. The ideal hypnotic should not cause respiratory depression or precipitate cardiovascular collapse when taken in overdose. So far no drug fulfils all these criteria. 

May not be ideal for patients who desire immediate hypnotic onset and eat just prior to bedtime... 

The characteristics of an ideal hypnotic for the elderly have been summarized as follows (1) ... 

Although a lot of progress has been made towards the goal of finding the ideal hypnotic, in the absence of having found such an agent, research towards the goal must continue. 

The goal of sleep research is to help find hypnotic drugs that will approximate the ideal hypnotic drug. 

Dier and sudden unforeseen emotional crisis invariably create such clinical situations that exceptionally demand the essential use of sedatives and hypnotics. A plethora of insomnia (sleeplessness) inadvertently caused due to short-term situational stress is usually regarded as the most suitable and ideal circmnstantial condition(s) which necessiates drug-treatment not only to facilitate but also to augment sleep. After a vigorous and intensive research the introduction of rather newer yet safer and definitely more efficacious sedative and hypnotic drug has always been greeted with great fervour and optimism. 

In a broader perspective, therefore, an ideal sedative and hypnotic must fulfil the following essential pre-requisites and requirements, namely ... 

Short-acting sedative-hypnotics are ideal for patients who need assistance falling asleep but who must awaken early without experiencing a Kngering aftereffect from the medication. Intermediate-acting sedative-hypnotics are useful to sustain sleep. Patients may experience residual drowsiness (hangover) after awakening. 

---