New Hypnotic Drug Development and Pharmacologic Considerations for Clinical Anesthesia
Mariah Kincaid Tanious1, Sascha S Beutler1, Alan D Kaye2
1Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA.
Anesthesiology Clinics
|May 21, 2017
Summary
Researchers are reviewing new anesthetic induction agents, focusing on rapid onset, safety, and predictable clearance. This update covers promising drugs for clinical practice, healthcare costs, and perioperative care.
Area of Science:
- Anesthesiology
- Pharmacology
Background:
- The quest for ideal anesthetics began with ether's public demonstration in 1846.
- Ideal anesthetics require rapid onset, potent sedation-hypnosis, a high therapeutic ratio, predictable metabolism, and minimal side effects.
Purpose of the Study:
- To review progress in novel anesthetic induction agent development.
- To update on promising drugs nearing clinical practice.
- To discuss trends, healthcare costs, and perioperative implications of new agents.
Main Methods:
- Literature review of current anesthetic induction agent development.
- Analysis of promising drug candidates for clinical practice.
- Examination of trends in anesthetic development and their implications.
Main Results:
- Identification of key characteristics of ideal anesthetics.
- Overview of novel induction agents under development.
- Discussion of economic and perioperative impacts.
Conclusions:
- The field continues to evolve, seeking improved anesthetic agents.
- New drugs show promise for enhancing patient care and safety.
- Development trends impact healthcare economics and surgical outcomes.
Keywords:
BarbituratesEtomidate derivativesHypnoticsKetamine derivativesPropofol analoguesRemimazolamMore Related Videos
08:49Assessing Changes in Volatile General Anesthetic Sensitivity of Mice after Local or Systemic Pharmacological Intervention
Published on: October 16, 2013
14.6K
08:16Optogenetic Activation of Afferent Pathways in Brain Slices and Modulation of Responses by Volatile Anesthetics
Published on: July 23, 2020
2.7K
Related Concept Videos
01:19Sedatives and Hypnotics Drugs: Benzodiazepines
1.1K
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...
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...
1.1K
01:23Sedatives and Hypnotics: Overview
1.7K
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...
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...
1.7K
01:24Parenteral Anesthetics: Overview
824
Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.
824
01:20Inhalational Anesthetics: Overview
1.3K
Inhalation anesthetics are drugs that induce general anesthesia upon inhalation. They work by increasing the sensitivity of GABAA receptors or inhibiting NMDA receptors, leading to a decrease in central nervous system activity. The depth of anesthesia can be rapidly adjusted by changing the concentration of the inhaled gas. Some common examples of inhalational anesthetics include volatile liquids like isoflurane, desflurane, sevoflurane and gases like xenon and nitrous oxide. Isoflurane, a...
1.3K
01:17Sedatives and Hypnotics Drugs: Miscellaneous Agents
708
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...
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...
708
01:24General Anesthesia: Overview
883
Anesthesia is a medical procedure that uses drugs for CNS suppression to enable painless surgeries and procedures. The selection of anesthetics is influenced by their pharmacokinetic properties, side effects, and patient characteristics. Various types of anesthesia include general, local, regional, spinal, and inhalational.
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
883