Sedative and hypnotic

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  

Interestingly, an honest and dedicated attempt to circumvent the already discussed undesirable 

The sedatives and hypnotics are broadly classified into the following two categories, namely  

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C10H16N2O3. White crystalline powder, m.p. I22-124°C. Prepared by condensing ethyl butylethylmalonate with urea. It is used as a sedative and hypnotic. 

AHopregnanolone and similar A-ring-reduced pregnanes potentiate GABA effects at these receptors. These steroids mimic the effects of the benzodiazepines, changing chloride ion conductance and producing sedative and hypnotic behavioral effects (276,277). Neuroactive steroids can be therapeutically useful as anticonvulsants, anxiolytics, or anesthetics (qv) (see also Hypnotics, sedatives, anticonvulsants, and anxiolytics). 

Narceine has been used as a sedative and hypnotic but is believed to... 

Paraldehyde, a sedative and hypnotic agent, is prepared by treatment of acetaldehyde with an acidic catalyst. Propose a mechanism for the reaction. 

The definition of desired therapeutic and side effects in the case of the benzodiazepines very much depends on the clinical problem in question. The sedative and hypnotic actions are desired effects in the treatment of insomnia, but undesired effects in the treatment of anxiety disorders. Effects that are usually undesired include daytime drowsiness, potentiation of the sedative effects of ethanol, and anterograde amnesia. They are mediated via the benzodiazepine site of GABAa receptors, since they can be antagonized with flumazenil. 

Discuss the uses, general drug actions, adverse reactions, contraindications, precautions, and interactions of the barbiturates and miscellaneous sedatives and hypnotics. 

Sedatives and hypnotics may be divided into two classes barbiturates and miscellaneous sedatives and hypnotics. The barbiturates are divided into several groups, depending on tiieir duration of action ... 

The Summary Drug Table Sedatives and Hypnotics Barbiturates gives examples of the short-, intermediate-, and long-acting barbiturate sedatives and hypnotics. 

SUM MARY DRUG TABLE SEDATIVES AND HYPNOTICS BARBITURATES... 

Miscellaneous or nonbarbiturate sedatives and hypnotics have essentially the same mode of action as the barbiturates, that is, they depress the CNS. However,... 

Although the use of barbiturates and miscellaneous sedatives and hypnotics for sedation has largely been replaced by the antianxiety drugs (see Chap. 30), they occasionally may be used to provide sedation before certain types of procedures such as cardiac catheterization or the administration of a local or general anesthesia Sedative doses usually given during daytime hours, may be used to treat anxiety and apprehension. Fhtients with chronic disease may require sedation, not only to reduce anxiety, but also as an adjunct in the treatment of their disease... 

Paraldehyde, a miscellaneous sedative and hypnotic, may be used to treat delirium tremens and other psychiatric conditions. In addition, some barbiturates are used as anticonvulsants (see Chap. 28). 

Adverse reactions associated with administration of the miscellaneous sedatives and hypnotics vary depending on the drug used. Common adverse reactions include dizziness, drowsiness, headache, and nausea Other adverse reactions that may be seen with the administration of miscellaneous sedatives and hypnotics are listed in the Summary Drug Table Miscellaneous Sedatives and Hypnotics. 

All dragp entering the body ultimately leave the body. Some leave virtually unchanged, whereas others are transformed into other, less-potent chemicals or compounds detoxified (to make nontoxic or not harmful) before they are eliminated. Barbiturates and miscellaneous sedatives and hypnotics are detoxified by the liver... 

The sedatives and hypnotics have an additive effect when administered with alcohol, antidepressants, narcotic analgesics, antihistamines, or phenothiazines. 

Before administering a barbiturate or miscellaneous sedative and hypnotic, the nurse takes and records the patient s blood pressure, pulse, and respiratory rate In addition to the vital signs, the nurse assesses the following patient needs. 

Educating the Patient and Family hi educating the patient and family about barbiturates and miscellaneous sedatives and hypnotics, several general points must be considered, as well as teaching about two common abuses of these drugp. 

Use With Alcohol. Alcohol is a CNS depressant, as are the sedatives and hypnotics. When alcohol and a sedative or hypnotic are taken together, there is an additive effect and an increase in CNS depression, which has, on occasion, resulted in death. The nurse must emphasize tiie importance of not drinking alcohol while taking this drug and stress that the use of alcohol and any one of these drains can result in serious effects. 

However, lorazepam and oxazepam are relatively safe for older adults when given in normal dosages. Buspirone (BuSpar) also is a safe choice for older adults with anxiety because it does not cause excessive sedation, and the risk of falling is not as great. Before bus-pirone therapy is begun, benzodiazepines and sedatives and hypnotics are gradually withdrawn. Buspirone, unlike most of the benzodiazepines, must be taken regularly and is not effective on an as-needed basis. 

Sedative and Hypnotic Combinations Tuinal—amobarbital, secobarbitol... 

Most analytical work on sulphones has naturally been concerned with the compounds synthesized for special purposes, e.g. sulphonal, trional and tetronal as sedatives and hypnotics Sulphenone (4-chlorodiphenyl sulphone) and Tedion (2,4,4, 5 -tetrachlorodiphenyl sulphone) as acaricides 4,4 -diaminodiphenyl sulphone as an antileprotic. In choosing examples preference has been given to methods devoted to more than a single sulphone. 

The roots are used as an astringent, resolving anodyne and antidotal. It is also used to heal abscesses, assuage postpartum pain, and remove parasites from the skin. The plant was mentioned by Schimmel in the American Journal of Pharmacy in 1889. Clinical observation and pharmacological investigation of the sedative and hypnotic effects of the Chinese drug rhizome and root of Patrinia scabiosaefolia are discussed by Luo (43). 

General anesthetics Intravenous (IV) anesthetics Sedatives and hypnotics Ethanol and related alcohols Psycho t o m i m etic s Antipsychotics... 

Barbiturates represent a class of sedative and hypnotic drugs employed extensively in medicine. RIA provides a rapid, sensitive specific and reliable means for their determination in plasma levels upto 5 ng without indulging in any type of extraction, filtration or evaporation as required for other conventional analytical methods. ... 

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