What Are the Pros and Cons of Hypnotic Drugs?

Name: Diazepam, a hypnotic (diazepam)

[cu mián yào]
Drugs that induce drowsiness and promote sleep. Commonly used hypnotic drugs have inhibitory effects on the central nervous system, small doses cause sedation, and excessive amounts cause general anesthesia.

Basic information about hypnotics

Name: Diazepam, a hypnotic (diazepam)
English name: hypnotic drug
Diazepam (diazepam) hypnotic drugs are drugs that induce drowsiness and promote sleep. Commonly used hypnotic drugs have inhibitory effects on the central nervous system, sedation caused by small doses, general anesthesia caused by excessive doses, long-term use has toxicity, tolerance and withdrawal effects. See: Sedatives; substance use disorders. Normal use of hypnotic drugs is beneficial to human health and helps to prevent insomnia from damaging normal lives. Hypnotics are effective medicines to help sleep and improve sleep, can avoid the serious harm of insomnia to the human body, treat insomnia, and improve sleep quality. Most hypnotic drugs are health drugs, not psychotropic drugs, and are allowed to be sold legally in pharmacies. General hypnotics are safer and have fewer adverse reactions, but children and pregnant women should not take them.

About Hypnosis

Hypnotic
Hypnotics have various degrees of inhibition on various parts of the central nervous system. With increasing doses, clinical manifestations can be mildly sedative, hypnotic and even comatose. Hypnotic drugs can generally be divided into short-acting sleeping pills, mainly to help fall asleep earlier; medium-acting sleeping pills, mainly to increase sleep time; long-acting sleeping pills, mainly to treat severe insomnia.
Western medicine for insomnia are:
(1) Benzodiazepines: such as diazepam, nitroazepam, sulbutazol, clonazepam, alprazolam (jialordine), midazolam, laurazepam (rolla), etc .;
(2) Barbiturates: such as phenobarbital (lumina), sek barbitur;
(3) Diphenylmethanes: such as Antaile;
(4) Other categories: such as oryzanol, zolpidem tablets (Snows, Lottan), triazolam (Lexin), Zolpidone (Yimengfan) and so on.
These sleeping pills, Zaleplon Tablet, have their own time requirements. Short-term insomnia can be discontinued after 2 weeks. Chronic insomnia should be taken for a long time. Generally insomnia can not fall asleep more than 3 times a week, you need to take medicine every day, if less than 3 times, you should take medicine as needed. Most sleeping pills are addictive and belong to state-controlled drugs. They must be used in a limited amount prescribed by a doctor. Generally, it is best to take some sleeping pills continuously for no more than 4 months. If you must continue to use them, you should change to another medicine or alternative medicine under the guidance of a doctor.

Hypnotic pharmacological effects

Hypnotics [1]
Hypnotics have a diffuse inhibitory effect on the entire cerebral cortex. The main pharmacological effects are hypnosis and weaker sedative effects. They are mainly used to treat insomnia and mild neurosis. The main part of the weak stabilizer is the limbic system and the interbrain, which can relieve emotional anxiety and mental tension, adjust emotional disorders and dysfunction of the autonomic nervous system. The main indication is neurosis with prominent symptoms of anxiety and tension. Strong antipsychotic drugs mainly work on the brainstem reticular structure. The ascending system of the reticular structure is related to maintaining excitability and arousal in the cerebral cortex, while the descending system is related to movement and behavior. The effect of this choice can clear pathological excitement, reduce mental symptoms such as anxiety and tension, hallucinations and pathological thinking; at the same time, the treatment dose does not cause consciousness disorders such as deep sleep. The main indications are schizophrenia and mania Isometric mental illness.

Hypnotic effects and uses

Sedation, hypnosis, for insomnia caused by various reasons. Second, some hypnotic drugs also have anxiolytic, anticonvulsant, and antiepileptic effects. The anti-anxiety effect can be produced in small doses that do not cause sedation, which can significantly improve the symptoms of tension, anxiety, fear and insomnia in patients.

Hypnotic side effects

Hypnotics [1]
Triazolam diazepam and other benzodiazepines have low toxicity and large safety range. Common side effects of continuous doses of treatment are drowsiness, dizziness, fatigue, etc. Large doses occasionally cause ataxia. Abuse or long-term use of diazepam in large doses can produce tolerance, habituation, and addiction. With sudden withdrawal of medication for a long time, withdrawal symptoms such as insomnia, excitement, anxiety, tremor and even convulsions can occur, and withdrawal psychosis can also occur. Barbiturates can cause dizziness, drowsiness and other after effects, and prolonged use can produce tolerance and addiction. Repeated use should be alert to accumulation of poisoning. A small number of patients may develop allergic reactions such as rash, drug fever, and exfoliative dermatitis. Sudden withdrawal of medication for long-term use in the treatment of epilepsy can cause seizures and even a state of epilepsy. Generally, 5 to 10 times the amount of hypnosis can cause moderate poisoning, and 10 to 15 times can cause severe poisoning. When the blood concentration is higher than 8 to 10 mg / 100 ml, there is a danger to life. The symptoms of acute poisoning are drowsiness, which leads to superficial breathing, greatly reduced ventilation, and eventually death due to respiratory failure. Triazolam The main side effects of triazolam are central nervous system depression. After waking up, the patient is mentally dizzy, dizzy, unstable, unconscious, and loses memory. In addition, triazolam can also inhibit the neurosuppressive function of the forebrain, making patients appear manic, aggressive, and even human nature. The side effects of triazolam can be worsened in some cases, such as drinking alcohol, taking other drugs, eating grapefruit, and so on.

Hypnotic note

Normal use of hypnotic drugs is beneficial to human health and helps to prevent insomnia from damaging normal lives. Hypnotics are good medicines to help sleep and improve sleep effectively. Hypnotics can avoid the serious harm of insomnia to the human body, treat insomnia, and improve sleep quality. Most hypnotic drugs are health drugs, not psychotropic drugs, and are allowed to be sold legally in pharmacies. Hypnotics are safer and have fewer adverse reactions, but children and pregnant women should not take them.

Hypnotic poisoning first aid

Hypnotic symptoms

1. Nervous system symptoms: dizziness, loss of memory, drowsiness, ataxia, loss of consciousness, loss of tendon reflexes, severe coma, convulsions, dilated pupils, and disappearance of light response. 2. The respiratory rate of the breathing and circulatory system slows down and is regular in the early stage, and then slows down and irregularly in the future. Severe breathing difficulties, cyanosis, accelerated pulse, decreased blood pressure, oliguria, and circulatory failure. 3. Skin rash, nausea, vomiting, and constipation. 4. Patients whose sleeping pills are given too much at one time and have not been found for a long time can cause death.
It can be divided into three degrees: 1. Mild poisoning: lethargy, impaired judgment and orientation, gait instability, unclear speech, and nystagmus. Various reflexes exist, and body temperature, pulse, breathing, and blood pressure are normal. 2. Moderate poisoning: shallow coma, awakened by strong stimulus, can not answer questions, and quickly enters a coma. Tendon reflexes disappeared, breathing was shallow and slow, blood pressure was still normal, corneal reflexes and pharyngeal reflexes were present. 3. Severe poisoning: deep coma, increased muscle tension in early limbs, hypertenoid reflex, and positive pathological reflex. In the later period, the whole body muscles relax, and various reflections disappear. The pupil responds to light. The pupil is sometimes dilated and sometimes dilated. Breathing is shallow and slow, irregular or tidal breathing. The pulse is small and blood pressure drops.

Hypnotic treatment principles

Gastric lavage, catharsis, oxygen, fluid replacement, and detoxification. Treatment plan: 1. Stomach lavage should be performed within 6-12 hours after taking the medicine. 2. Give a magnesium sulfate laxative. 3. Oxygen absorption is 3 4L / min. 4. Application of awakening agent: Nikosa. 5. Meiexian 50mg diluted in 10% glucose 10ml intravenously, or 200 ~ 300mg diluted in 10% glucose slowly intravenously. 6. Appropriate administration of mannitol or furosemide and urination to reduce intracranial pressure. 7. Patients with severe coma and anuria can be treated with renal dialysis therapy.

Clinical application of hypnotics

Taking hypnotics is the most sought-after treatment for many patients with refractory insomnia, such as diazepam, diazepam, sulpiride, triazolam and other sedatives, but the addictiveness and dependence of these chemicals cannot completely help patients Treatment of insomnia, on the contrary, will make the patient's insomnia problem worse because it prevents the patient from getting off the drug to sleep normally. For traditional Chinese medicine and acupuncture treatment, it may have some effect to relieve symptoms in the early stage of insomnia, but for patients with refractory insomnia and severe insomnia, the worsening of the disease will not lead to cure effect. At present, in the field of traditional Chinese medicine, intractable insomnia has appeared. Many pure Chinese medicines with exact curative effects, the treatment mechanism is from the liver's eyes, traffic to the heart and kidneys, and overall conditioning; there are also some drugs that nourish the heart, soothe the nerves, and strengthen the brain.

First-generation sedative hypnotics

Including barbiturates, chloral hydrate, tribromide, and hydroxyzine (antelol); barbiturates were artificially synthesized (barbituric acid) as early as 1864, but it was only discovered to have a sedative effect in 1903 , And recognize the pharmacological effects of barbituric acid derivatives. They have a low therapeutic index and require moderate doses to improve sleep. The interaction between drugs is relatively large, and large doses can affect breathing. Among them, hydroxyzine is more suitable for patients with autonomic dysfunction; chloral hydrate has few interactions with drugs, and is widely used for rapid hypnosis of drug clinical trials and certain special examinations with uncooperatives; phenobarbital Substitute and decrease benzodiazepines and other hypnotic drugs, can also be used in children with sleepwalking, sleep terrors and nightmares and other diseases, or used to antagonize the central excitability of drugs such as ephedrine, amphetamine, aminophylline reaction.

Second-generation sedative hypnotics

Mainly refers to sedative hypnotics. This class of drugs is the most commonly used sedative, hypnotic and anxiolytic drug in clinical practice. Diazepam (Diazepam) was once the most frequently used drug in clinical practice. Clozazem (Li Mian Ning) is the first to be synthesized in this class of drugs. Later, the psychoactive activity of such drugs was discovered in the animal laboratory of the Pharmacology Department of La Rochey Pharmaceutical Factory in Switzerland; shortly after, the second drug diazepam was introduced. In this class of drugs, methaqualone, meprobamin, clozazone, diazepam, and sulpiride were developed in the early stages; triazolam, midazolam, fluoxazim, nitrazepam, and estazolam were developed in the later stages. Lun, Alprazolam, Laurazepam, etc. These sleeping pills are characterized by high therapeutic indices, low visceral toxicity, and safe use. So far, it is still commonly used in the treatment of insomnia. Benzodiazepines can quickly induce patients to fall asleep, reduce the number of nightly awakenings, prolong sleep time and improve sleep quality, but also change the usual sleep pattern, make shallow sleep longer, shorten the duration of REM sleepy eyes, and appear for the first time in REM sleep time delay. Dreaming decreases or disappears. Benzodiazepines have their own characteristics. Such as triazolam: fast absorption, rapid onset, no accumulation, no aftereffects, is an ideal hypnotic drug; but the shortcomings are short half-life, easy to produce morning insomnia and daytime anxiety. Fluoxan: It has a long half-life, and rarely suffers from early morning insomnia and anxiety during the day, but because its main metabolites are active, and the active metabolites have a half-life of 47 to 100 hours, it is easy to accumulate.

Hypnotics The third generation of sedative hypnotics

It mainly includes Zolpidem, Zaleplon, and Zopiclone. Some sedative hypnotics are safe. In the late 1980s, a new generation of non-benzodiazepine hypnotics was developed. Zolpidem is the first such drug to be on the market. Developed and developed by French company Sythelabo. It was launched in France in 1988 under the trade name Stilnox (Chinese translation: Shu Sleep Chen Shuang). Zolpidem can significantly shorten the time to fall asleep, at the same time can reduce the number of nightly awakenings, increase the total sleep time, improve sleep quality, no obvious after effects in the next morning. "Sleep" rarely occurs, nor does it affect the mental activity and alertness of the next morning. Some safer sleeping pills are not addictive for a long time, and they rarely cause rebound insomnia after stopping the drug. They rarely accumulate after repeated application and are safer to use. Therefore, it has been widely recognized after being marketed, and has become the standard drug for the treatment of insomnia, with a tendency to gradually replace benzodiazepines. The third-generation sedative and hypnotic drugs are well absorbed orally, reaching a peak blood concentration in half an hour, and excretion of drug metabolism is rapid, with a half-life of 3 to 6 hours, which is metabolized by the kidneys. This class of drugs has a high therapeutic index and high safety. Basically does not change the normal physiological sleep structure, does not produce tolerance, dependence. Adverse reactions are related to the patient's individual sensitivity, with occasional sleepiness, dizziness, mouth pain, nausea, and forgetfulness. Such safer hypnotics include Zolpidem, Zaleplon, Zopiclone, and others.

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