Drug level monitoring: sedative hypnotics

Barbiturates and other traditional non-barbiturate sedative hypnotics are still extensively prescribed for the treatment of insomnia. There are a number of situations where identification or quantitative determination of these agents in biological fluids is required. Gas-chromatography offers highly sensitive and specific procedures for the determination of these compounds. The use of a nitrogen-specific detector allows a relatively simple sample preparation for sensitive detection and the use of capillary columns with bonded liquid phase allows separation of barbiturates without derivatization. In recent years liquid chromatography has also been extensively applied to the determination of these compounds. Sensitivity and selectivity of detection of barbiturates have been improved with the use of an alkaline mobile phase. Immunoassays for the determination of therapeutic concentrations of phenobarbital are very popular as the assays can be rapidly performed automatically. Use of these techniques has been extended for emergency detection of barbiturate overdose and for monitoring high-dose pentobarbital therapy.