Sedative-hypnotic agents common drugs

Methyprylon is a sedative-hypnotic agent that has been used in the treatment of anxiety, nervousness, and sleep disorders (insomnia). The drug was withdrawn from the US market in 1988. It was a commonly abused sedative-hypnotic agent. 

Various drugs have been used to treat muscle spasm. Most compounds in this group act as simple sedative-hypnotic agents and produce skeletal muscle relaxation indirectly. The drugs commonly used as skeletal muscle relaxants are listed in Table 11-53. Carisoprodol (Soma ) and baclofen have been abused as recreational drugs. I. Mechanism of toxicity... 

To achieve all the objectives, a combination of 2 or 3 drugs is used depending on the need. The commonly employed drugs are opioids, sedative-hypnotics, antianxiety agents, anti-cholinergics, neuroleptics and antiemetics. 

Other classes of drugs not included in Figure 22-3 that may exert sedative effects include most antipsychotic and many antidepressant drugs and certain antihistaminic agents (eg, hydroxyzine, promethazine). As discussed in other chapters, these agents differ from conventional sedative-hypnotics in both their effects and their major therapeutic uses. Since they commonly exert marked effects on the peripheral autonomic nervous system, they are sometimes referred to as "sedative-autonomic" drugs. Certain antihistaminics with sedative effects are available in over-the-counter sleep aids. Their autonomic properties and their long durations of action can result in adverse effects. 

CE and CE-ESI-MS were exploited for the analysis of lorazepam (3-hydroxy-1,4-benzodiazepine) and its metabolites in urine [157]. This drug is commonly used for the treatment of anxiety and as a sedative and hypnotic agent. The authors found that 75% of administered lorazepam is excreted in urine as its 3-0-glucuronide. Interestingly, since glucuronidation occurs at the chiral center of the molecule, two diastereoisomers can be formed, which was confirmed by MEKC analysis of urine extracts and also in vitro, via incubation of the drug with human liver microsomes and 5 -diphospho-glucuronic acid as coenzyme. The evidence of stereoselectivity of lorazepam... 

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