What Are Sedative-Hypnotics?

The English name of sedative hypnotics is sedative-hypnotic. Taking sedative hypnotics normally is beneficial to human health. Sedative hypnotics help prevent insomnia from damaging human health and normal life. Sedative hypnotics are good medicines to help sleep and improve sleep effectively. Sedative hypnotics can prevent the serious harm of insomnia to the human body, sedative hypnotics can treat insomnia, and sedative hypnotics can improve sleep quality. Most sedative and hypnotic drugs are health drugs, not psychotropic drugs. There is no clear line between sedatives and hypnotics, only differences in quantity. Small doses of hypnotics have a sedative effect. Sedatives can calm people down. Proper use of sedatives is conducive to patient recuperation.

Drug Name: Sedative hypnotics
Alias: sedative-hypnotic
Dosage form: tablet

Athletes use with caution: Use with caution
Drug type: Psychiatric drugs
Species: More than 2,000 species

Introduction to Sedative Hypnotics

Sedative hypnotics

There are many types of sedative hypnotics (more than 2,000 have been synthesized so far) with an ancient history. As early as the last century, people used hypnotics such as bromine and barbiturates. Due to their unsatisfactory hypnotic effect, many side effects, and susceptibility to addiction, the above-mentioned categories have been eliminated. In 1952, someone modified the molecular structure of tolpropanol to synthesize Mian Ertong (An Ning), which was once popular because of its hypnotic effect. A few years later, the stability we were most familiar with came out. Due to its reliable action and less side effects, the use of diazepam has become more and more widespread, and it has become synonymous with sleeping pills.

Sedative hypnoticsSedative hypnotics are beneficial to human health

Sedatives and hypnotics have a wide range of effects. They have better anxiolytic effects and can improve the negative emotions of tension, anxiety, and fear. Therefore, they are also called anxiolytics. Hypnotics are also called sedative hypnotics. At low doses, they have a sedative effect. When the dose is increased to a certain amount, they have a hypnotic effect. In addition, sleeping pills have a strong anticonvulsant effect, and it is used clinically as one of antiepileptic drugs, such as nitropyridine, clonazepine, and diazepam.

Adverse effects of sedative hypnotics

The use of sleeping pills is wide, but it also inevitably has certain side effects, such as drowsiness, drowsiness, fatigue, dizziness, and large doses can cause ataxia and temporary forgetting. In severe cases, it can also lead to deep sleep.

Conditioning effects of sedative hypnotics

Most people take sleeping pills because of sleep disorders. The most common causes of insomnia are mental stress, such as study, work, and family stress. In the psychological consultation clinic, it was found that students had many sleep disturbances before the test. Parents and candidates had conflicting opinions about whether to take sleeping pills: If they did not take sleeping pills, they would really have sleepless overnight. In fact, such problems are relatively easy to solve.

Sedative hypnotics classification

Sedative hypnotics Including barbiturates, anxiolytics and other sedatives and hypnotics. These drugs produce a sedative effect at low doses and a hypnotic effect at medium doses. In addition, antihistamines, antipsychotics, analgesics, and some Chinese herbs also have a sedative and hypnotic effect.

Barbiturates are derivatives of barbituric acid. Barbituric acid itself has no sedative or hypnotic effect. The two hydrogens on the 5-position carbon atom of barbituric acid must be replaced by a hydrocarbon group (R1, R2) to have a sedative and hypnotic effect. 2, the longer the side chain (4-8 C atoms), and the side chain has branching or unsaturated bonds, the effect is accelerated and unstable, and the shorter the effect. If C2 oxygen is replaced by S, the effect is faster, stronger, and shorter. The speed, strength, and length of the effects of barbiturates depend on the degree of fat solubility. According to the speed of the action, it can be divided into four categories: slow-acting, intermediate-effect, fast-acting, and ultra-fast-acting; according to the duration of the effect, it can be divided into four types: long-term, intermediate-time, short-term, and ultra-short-term; There was no significant difference in sleep duration.

Use of sedative hypnotics

Sedative hypnotic effect

The effect on the central nervous system changes from quantitative to qualitative. Small doses can restore excessive excitement to normal, called sedation; medium doses can induce, deepen and prolong sleep, called hypnotic effects; larger doses can relieve strong twitching of skeletal muscle, called anticonvulsant effects ; At high doses, the consciousness disappears, but it is easy to recover, which is called anesthesia effect; When it is poisoned, it can stop the functional activity and not easily recover, which is called paralysis effect. Mechanism of action: Blocks the awakening effect of the brainstem reticular activation system on the cerebral cortex, inhibits diffuse diffusion, and sedative, hypnotic, anticonvulsant, anesthetic and paralytic effects occur with the dose of the drug and the shallowness of the inhibition. It is also believed that it also has a direct inhibitory effect on the cerebral cortex.

Sedative hypnotic use

Sedation: low-dose phenobarbital (15-30mg / time, 3 times / day) for anxiety, tension, hyperthyroidism, hypertension, ulcer bleeding, motion sickness, vomiting, pre-anesthetic administration and strengthening antipyretic analgesia Drug effect and so on.

Hypnosis: Sercobarbital (0.1-0.2g / time), isoprenebarbital (0.05-0.2g / time), etc. before going to bed. Phenobarbital is rarely used for hypnosis because it often has dizziness and drowsiness after awakening.

Anticonvulsions: Convulsions are intense involuntary contractions of skeletal muscles caused by central overexcitation. Isobarbital sodium, pentobarbital sodium, thiopental sodium, etc., which are fast-acting, can be selected for emergency treatment; phenobarbital sodium 0.1g, which is longer-acting, is often used intramuscularly to prevent convulsions.

Anti-epilepsy: Phenobarbital has a good effect on epileptic seizures and epilepsy status, it is not good for psychomotor seizures, and it is not effective for small seizures. Taking a sedative amount of phenobarbital for a long time can prevent major epilepsy, but it has side effects such as drowsiness and lack of energy. It should not be stopped suddenly to avoid severe convulsions. It is best to administer intravenously to the state of epilepsy to quickly control the symptoms.

Anesthesia: thiopental sodium intravenous anesthesia, used for short surgery, or as anesthesia induced by ether anesthesia, to shorten the longer induction period; it can also be used as basic anesthesia, leaving patients in a shallow anesthesia state to eliminate tension, mainly For uncooperative pediatric patients.

Treatment of hyperbilirubinemia and intrahepatic cholestatic jaundice: Barbiturates can induce liver drug enzyme production. Among them, phenobarbital has the strongest effect, and it can also promote glucuronidase in liver cells. The formation of glucuronic acid enhances the ability of glucuronic acid to bind bilirubin in the blood, which can be used to prevent and treat neonatal jaundice.

Sedative hypnotics anxiolytics

Anxiety manifests as emotional anxiety, tension, and fear, accompanied by palpitations, dizziness, and trembling. Anxiety due to mental disorders or physical illness is called anxiety. Anxiety is called an anxiety disorder only when the symptoms of persistent anxiety are outstanding without other mental disorders. It is a neurosis.

The main parts that control emotional activity are the limbic system of the brain (hypothalamus, hippocampus, amygdala, etc.). These parts play an important role in the occurrence of anxiety. Anxiolytic drugs selectively inhibit the hippocampus and amygdala of the limbic system and produce anxiolytic effects. At the same time, it can also inhibit the reticular structure of the brain stem, reduce the excitability of the cerebral cortex, and produce a sedative and hypnotic effect. It can also inhibit spinal motor neurons, produce central skeletal muscle relaxation, anticonvulsant and antiepileptic effects. Often divided into four categories:

Benzodiazepine

Lord Chlordiazepoxide Librium: low toxicity, large safety range, long-term service can produce tolerance and addiction; sudden withdrawal can produce convulsions.

Diazepam (Benazepine) Diazepam, Diapam, Valium are the drugs of choice for status epilepticus.

Demethylated hydroxyazepam (Shuning) Oxepam, Oxazepam, Limbial: It is a stable metabolite in the body.

Nitrazepam, Mogadon: Excessive dose will not produce respiratory depression and circulatory failure, but will produce dependence.

Flunitrorazepam: Flunitrazepam: 10 times stronger than diazepam.

Sulvalazol (triazolidine, anxiety cramps) Estazolam, Eurodin, Surazepam: The sedative and hypnotic effect is 2.4 to 4 times stronger than that of nitrazepam.

chlorhexidine Lorazepam

Sedative hypnotic tranquilizers

Meprobamate (Ming Ertong, Anning) Meprobamate, Miltowm: effective for small epileptic seizures, short duration of action, large doses of discontinuation will produce convulsions and exacerbate large seizures. Gastrointestinal ulcer, hypotension should be used with caution.

Diaphragm Tranquility (Isopropyl-Mentol, Caréti) Carisoprodol: a derivative of Mentral.

Sedative hypnotic diphenylmethane

An Taile (Atarox, Hydroxazine) Atarax, Hydroxyzine

Captodiamine

Piperate ethanol.

Sedative hypnotic other

Fenallu (chlorobenzophenone) Fenarol, Chlormezanone

Trimeprazine Tartrate

Trimethoxyline (trimethoxybenzoyl morphine) Trimetozine, Trioxazine, Sedoxazin

Kariya vitamin (ferulate) Oryzanol, Gamma Oryzanol

Tai Xi Ding Benzoctamine, Tacitin

Clinical application of sedative hypnotics

Sedative hypnotics (1) Sedation: Phenobarbital and diazepam are commonly used to relieve symptoms such as stress, anxiety, and restlessness.

(B) Hypnosis: Diazepam and isoprene barbitur are commonly used. For secondary insomnia caused by pain, cough, fever, etc., the cause should be eliminated first; for insomnia caused by headache, cranial pain can be used.

(3) Anticonvulsions: thiopental sodium, phenobarbital sodium, diazepam, chloral hydrate, magnesium sulfate, etc. are commonly used. Children with convulsions can choose: 10% chloral hydrate and antipyretics; phenobarbital sodium; compound aminopyrine injection, subcutaneously or intramuscularly.

(IV) Anxiety Disorder: Diazepam is preferred for oral administration. For acute patients, intramuscular injection or intravenous injection. For patients with obvious muscle tension, Mian Ertong can be used. Doxepin's anxiolytic effect seems to be stable. Triflurane Due to side effects of hydrazine and Telden, you should pay attention to it.

(5) Rickets: Those who are mainly psychiatric symptoms can use Telden or chlorpromazine; those who are extremely excited and restless can be injected with diazepam or chlorpromazine.

(6) Neurasthenia: Tribromo mixture can be selected for those with symptoms of excitement. Pasteur or Schisandra mixture can be used for those with symptoms of weakness. At the same time, it can be supplemented with diazepam as appropriate. For those who are obviously dizzy and prone to fatigue, stimulants such as caffeine and chloroester may be given twice, or a slow intravenous injection of glucose with sodium glutamate. Those with significant memory loss take glutamate or -aminobutyric acid. Lack of zinc and copper in the body is also one of the causes of neurasthenia. Zinc deficiency affects the energy metabolism and redox processes of brain cells; copper deficiency can make the nervous system's inhibitory process dysfunctional and lead to insomnia, which can cause nervous breakdown over time. Neurasthenia, in addition to conventional drug treatment and strengthen physical exercise, diet can eat more foods rich in zinc and copper. Foods rich in zinc include: oysters, herrings, other fish, lean meat, liver and kidney, dairy products, apples, walnuts, peanuts, chestnuts, etc. Foods rich in copper include: squid, squid, clams, rice dumplings, river mussels, field snails, mud snails, crabs, shrimp, loach, scallion, lamb, liver and kidney, mushrooms, broad beans, corn and mussels.

Taking sedative hypnotics is the most sought after treatment for many patients with refractory insomnia, such as diazepam, diazepam, sulpiride, triazolam and other sedatives. For traditional Chinese medicine and acupuncture treatments, it may be effective in alleviating symptoms in the early stages of insomnia, but for patients with refractory insomnia and severe insomnia, the worsening of the symptoms does not reach the effect of cure.

Other types of sedative hypnotics

Chloral Hydrate: sedative, hypnotic, strong anticonvulsant, fast, long-term, no after effects. In the liver it is reduced to trichloroethanol, which is more centrally inhibited. Strong irritation to the gastrointestinal tract, those with ulcers should not use it; large doses can cause heart, liver, kidney damage, respiratory depression, weak myocardial contraction, blood pressure drop, etc .; Jiufu can produce tolerance and addiction.

An Mian Jing Patrinia: It is an effective ingredient extracted from the rhizomes and roots of the buds of Huanghualong, which has a significant sedative and hypnotic effect.

Glutethimide, Doriden: weak, slow, short, safer. Should not be taken for a long time (tolerant, addictive).

Methyl Epiperidone (brain therapy, meprolone) Noludar, Methy Prylon: large safety range, rarely cause respiratory depression.

Adalin (diethylbromoacetylurea) Adalia, Carbromal: Mild action.

Ethinamate, Valmid: fast and short, especially suitable for those who are not easy to fall asleep, allergic to barbiturates or liver disease.

Gastrodine

Bromide: sodium bromide, potassium, and amine, each containing 3% of a tribromo mixture, can prevent electrolyte Na +, K + imbalance. Caffeine and sodium bromide can be mixed to form a pasteur mixture (also known as bromine mixture or brain strengthening mixture). Jiufu can cause accumulation of poisoning and affect children's intellectual development.

Sedative hypnotic rescue measures

The main symptoms of poisoning are respiratory depression (shallow, irregular breathing), decreased blood pressure and body temperature, cyanosis, weakened or disappeared spinal reflexes, lethargy and even coma. Time should be spent for early rescue:

detoxification: gastric lavage: those who are poisoned soon can use 1: 2000 1: 5000 potassium permanganate solution or 5% sodium bicarbonate, warm physiological saline. catharsis: 40% 50% sodium sulfate. Because the absorption of trace Mg2 + can deepen the central inhibition, it is forbidden to use magnesium sulfate. (3) Diuretic: Intravenous infusion of 10% GS to accelerate urine, which can accelerate drug excretion; Intravenous infusion of 50% GS or intravenous infusion of mannitol to control cerebral edema and accelerate drug excretion; long-acting or intermediate-effect drugs are weakly acidic, and can be instilled with carbonic acid when poisoned Sodium hydrogen or sodium lactate solution alkalizes urine, increases its water solubility, reduces renal tubular reabsorption and promotes excretion.

Symptomatic: Respiratory depression: oxygen and artificial respiration. In severe cases, you can inject methionism or return to su Ling, but you should use it with caution and not overdose. Low blood pressure: infusion or booster drugs such as new forint, Alamin. (3) Pay attention to heat preservation, strengthen nursing, and prevent infection with antibacterial drugs.

Sedative hypnotic application attention

Aftereffects: dizziness, drowsiness, etc., less used for hypnosis, tea can be used to counter it if necessary; phenobarbital should not be used by operators.

Allergic reactions: rash, fever, exfoliative dermatitis, etc., are more common in rash.

Long-term use can produce habituation (withdrawal symptoms are worsening insomnia, agitation, even convulsions).

Especially large doses have inhibitory effects. Respiratory dysfunction such as emphysema, craniocerebral trauma should be used with caution; liver and kidney dysfunction should be used with caution.