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Related Concept Videos

Sedatives and Hypnotics Drugs: Benzodiazepines01:19

Sedatives and Hypnotics Drugs: Benzodiazepines

Benzodiazepines have both sedative and hypnotic properties. They include compounds such as diazepam (Valium) and alprazolam (Xanax). Structurally, their cores are similar, consisting of the fusion of a benzene ring and a diazepine ring, but they share a common mechanism of action in the central nervous system (CNS).
Benzodiazepines work by enhancing the effects of the inhibitory neurotransmitter GABA. They bind to the GABAA receptor, increasing its affinity for GABA, which opens chloride...
CNS Depressants: Barbiturates and Benzodiazepines01:14

CNS Depressants: Barbiturates and Benzodiazepines

CNS depressants include drugs from the category of barbiturates and benzodiazepines. They are valuable medications for managing anxiety disorders and insomnia. Barbiturates, once used to induce and maintain sleep, have been replaced mainly by benzodiazepines due to barbiturate's toxicity, tolerance, and overdose risks. They interact with GABAA receptors, leading to sedation at low doses and potentially coma and death at higher doses. Phenobarbital, a long-acting barbiturate, possesses...
Sedatives and Hypnotics Drugs: Miscellaneous Agents01:17

Sedatives and Hypnotics Drugs: Miscellaneous Agents

Sedatives and hypnotics encompass a wide range of substances, each with its unique mechanism of action, uses, and potential adverse effects.
Melatonin congeners like ramelteon (Rozerem) and tasimelteon (Hetlioz) selectively bind to melatonin receptors (MT1 and MT2) and thus mimic the actions of melatonin, a hormone that regulates sleep-wake cycles. Tasimelteon is primarily used for non-24-hour sleep-wake disorder, common in blind patients. They are also used to treat conditions like insomnia...
Anxiolytic Drugs: Benzodiazepines and Buspirone01:29

Anxiolytic Drugs: Benzodiazepines and Buspirone

Benzodiazepines are a class of anxiolytic drugs known for their rapid efficacy and high therapeutic-to-lethal dose ratio, but with a potential risk of drug dependence. These drugs are lipophilic, allowing for rapid absorption after oral administration, eventually reaching the central nervous system (CNS). Once in the CNS, benzodiazepines bind to the allosteric site of the GABAA receptor. This binding enhances the inhibitory effects of the neurotransmitter GABA. By doing so, they prevent...
Management of Insomnia01:19

Management of Insomnia

The sleep cycle, an integral part of human health, consists of several stages with distinct characteristics and functions. It begins with a transition from wakefulness to sleep, known as the light sleep phase, followed by the restorative deep sleep phase, essential for physical recovery and growth. The cycle concludes with the Rapid Eye Movement (REM) phase, characterized by high brain activity and vivid dreaming. Insomnia, a prevalent sleep disorder, involves difficulty falling asleep, staying...
Sedatives and Hypnotics: Overview01:23

Sedatives and Hypnotics: Overview

Sedatives are drugs that alleviate anxiety, while hypnotics induce sleep. Both classes of medication suppress neuronal activity, leading to a calming effect for sedatives and facilitating sleep for hypnotics.
Sedative-hypnotics are categorized into barbiturates, benzodiazepines (BZDs), and non-benzodiazepines or Z-drugs. These drugs work by suppressing central nervous system activity, and this suppression is dose-dependent. Older sedative medications, like barbiturates, follow a linear curve in...

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Related Experiment Videos

Benzodiazepines for delirium.

Edmund Lonergan1, Jay Luxenberg, Almudena Areosa Sastre

  • 14 Captain Drive, Apt 215, Emeryville, CA, USA, 94608.

The Cochrane Database of Systematic Reviews
|January 23, 2009
PubMed
Summary

Benzodiazepines are not recommended for treating non-alcohol withdrawal delirium due to insufficient evidence from controlled trials. Further research is needed to establish their role in managing this condition.

Area of Science:

  • Medical research
  • Clinical pharmacology
  • Intensive care medicine

Background:

  • Delirium affects 30% of hospitalized patients, increasing hospital stay, morbidity, and mortality.
  • Uncontrolled studies suggest potential benefits of benzodiazepines for non-alcohol-related delirium.
  • Evidence for benzodiazepine efficacy in delirium management remains unclear.

Purpose of the Study:

  • To evaluate the effectiveness of benzodiazepines in treating non-alcohol withdrawal delirium.
  • To determine the incidence of adverse effects associated with benzodiazepine use for delirium.
  • To assess the role of benzodiazepines in managing hospital-acquired delirium.

Main Methods:

  • Systematic search of specialized databases (e.g., MEDLINE, EMBASE) for randomized controlled trials.

Related Experiment Videos

  • Inclusion criteria: unconfounded, randomized trials with concealed allocation and pre/post-treatment assessment.
  • Data extraction and analysis focused on intention-to-treat data, calculating odds ratios or average differences.

    • Main Results:

    • Only one trial met selection criteria, comparing lorazepam with dexmedetomidine in ICU patients.
    • Dexmedetomidine increased delirium- and coma-free days compared to lorazepam (7 vs. 3 days, P=0.01).
    • Partially controlled studies showed no benzodiazepine advantage over neuroleptics for agitation or acute confusion, with some indicating increased adverse effects.

    Conclusions:

    • No adequately controlled trials support benzodiazepine use for non-alcohol withdrawal delirium.
    • Benzodiazepines are currently not recommended for controlling this condition.
    • Further research with robust trial designs is required to clarify the role of benzodiazepines in delirium treatment.