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Hypnotics and sedatives essentially form a common group, the action of which can be described as “non-specific” in the sense of a fairly general effect on the central nervous system.
They weaken the activity, causing a feeling of drowsiness, sleep and even general anesthesia in higher doses. Sedative medications are used to reduce excessive excitement, tension and anxiety and to facilitate sleep, sleeping medications – to induce sleep. Such sleep does not have the characteristics of physiological sleep, it is “forced” by the suppression of activation centers.
Barbituric acid derivatives (barbiturates)
Depending on the biological half-life, combinations of barbituric acid are classified into four different groups: long, medium, short and very short-acting.
• Long-acting drugs: barbital, methylphenobarbital, phenobarbital.
• Intermediate acting drugs: amobarbital, aprobarbital, butobarbital, cyclobarbital, secbutabarbital.
• Short-acting drugs: hexobarbital, pentobarbital, secobarbital.
• Very short-acting drugs (barbiturates): methohexital, thiobutabarbital, thiopental
Depending on the dose, the barbiturates induce drowsiness; sleep with initially preserved and then suppressed response to verbal and then pain stimuli; finally a coma with the abolition of reflexes. Pupils are initially narrow, in severe poisoning they dilate and become uneven. Eventually, there is a decrease in body temperature, blood pressure, paralysis of the respiratory system.
First aid. Immediately after taking medications or in conscious patients, it is necessary to administer medicinal charcoal in a water solution, induce vomiting until the gastric contents become clear, and then administer Glauber’s salt. In poisoned patients with impaired consciousness (stage II-IV toxic coma) – securing basic life activities, placing the poisoned person in a recovery position, protection against cooling. Do not induce vomiting, do not drink any fluids.
Treatment. Should be run at a poison center.
Benzodiazepine derivatives
Medicines from this group were introduced for the first time in the XNUMXs. They are one of the most frequently prescribed groups of preparations, as well as the most common cause of drug poisoning, despite the fact that they are characterized by a high safety index. The pharmacological activity of benzodiazepines is primarily anxiolytic, sedative and, in higher doses, a sleep-promoting effect. They are also used due to their antiepileptic and muscle relaxant effects.
Depending on the biological half-life, they are divided into:
• very short-acting (estazolam, flurazepam, midazolam, prazepam, temazepam, triazolam);
• short-acting (alprazolam, bromazepam, flunitrazepam, halazepam, clobazam, lorazepam, lormetazepam, oxazepam);
• long-acting (chlordiazepoxide, diazepam, flurazepam, clorazepate, clonazepam, medazepam, nitrazepam, prazepam).
Benzodiazepine derivatives with short and medium half-lives are used as hypnotics. The sedative-hypnotic benzodiazepines are: flurazepam, flunitrazepam, lorazepam, lormetazepam, temazepam, triazolam, estazolam, midazolam, nitrazepam. The anxiolytic effect is demonstrated by diazepam (it also has antiepileptic and muscle relaxant effects), halazepam, alprazolam, prazepam, lorazepam, clorazepate, medazepam, oxazepam, chlordiazepoxide.
Benzodiazepines easily pass into the cerebrospinal fluid and into breast milk, they also cross the placenta, accumulating in the tissues of the fetus. Older people and children are more sensitive to their depressant effects on the central nervous system.
Due to their weak but sufficient euphoric effects, benzodiazepine derivatives administered orally for an extended period may induce symptoms of tolerance and dependence. Tolerance towards their hypnotic effect develops the slowest and the slowest, and the fastest towards the sedative effect. The most dangerous, due to the very strong euphoric effect, is the intravenous administration of benzodiazepines. Short-acting benzodiazepines (most often used as hypnotics) may cause depersonalisation-type mental disorders as well as other psychotic symptoms the very next day after administration.
- Order today Shipment test for the presence of psychoactive substances – semi-quantitative determination.
Symptoms. The most common symptoms of intoxication with benzodiazepines include: balance disorders, somnolence, coordination disorders, speech disorders, coma, double vision, ataxia, decreased intellectual performance. Respiratory depression and hypothermia may occur. Even from massive overdose, symptoms are usually mild. It is extremely rare for an overdose of benzodiazepines alone to kill. More serious symptoms are observed in mixed poisonings with ethanol or other drugs depressing the central nervous system.
Treatment. Should be run at a poison center.
Read also: Poisoning