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Sedatives and Hypnotics Drugs: Miscellaneous Agents01:17

Sedatives and Hypnotics Drugs: Miscellaneous Agents

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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...
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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...
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Parenteral Anesthetics: Overview01:24

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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.
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Sedatives and Hypnotics: Overview01:23

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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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Inhalational Anesthetics: Overview01:20

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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...
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Sedatives and Hypnotics Drugs: Barbiturates01:20

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Sedatives and hypnotics encompass a drug class that acts on the central nervous system (CNS) to alleviate anxiety, promote relaxation and induce sleep.These drugs function by amplifying the actions of the neurotransmitter γ-aminobutyric acid (GABA), resulting in reduced neuronal activity. Barbiturates, a subset of sedatives and hypnotics first synthesized in the late 1800s, are categorized into ultra-short, short, intermediate, and long-acting groups based on their duration of effect. A...
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In Vivo Multimodal Imaging and Analysis of Mouse Laser-Induced Choroidal Neovascularization Model
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Dexmedetomidine: an update.

Jelena Zivadinovic1,2, Aleksandar Nikolic1,2, Radmilo Jankovic1,2

  • 1Clinic for Anesthesia and Intensive Therapy, University Clinical Center Nis.

Current Opinion in Anaesthesiology
|April 29, 2026
PubMed
Summary
This summary is machine-generated.

Dexmedetomidine effectively reduces opioid use and pain, while improving patient recovery. This review highlights its role as a multimodal perioperative adjunct, emphasizing careful patient selection and dosing for optimal outcomes in critical care.

Keywords:
deliriumdexmedetomidinemultimodal analgesiaorgan protectionsurgical stress response

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Area of Science:

  • Anesthesiology and Critical Care Medicine
  • Pharmacology

Background:

  • Dexmedetomidine's role has expanded beyond sedation to a multimodal perioperative adjunct.
  • Its effects encompass hypnosis, analgesia, opioid-sparing, stress response modulation, hemodynamic control, organ protection, and recovery outcomes.

Purpose of the Study:

  • To review recent clinical and translational evidence on dexmedetomidine's use in perioperative and critical care.
  • To summarize its benefits in pain management, stress response, hemodynamics, organ protection, and patient recovery.

Main Methods:

  • Review of contemporary meta-analyses and high-quality clinical evidence.
  • Analysis of studies focusing on perioperative and intensive care unit (ICU) applications.
  • Examination of evidence for renoprotective, cardiopulmonary, and neuroprotective effects.

Main Results:

  • Consistent reductions in perioperative opioid requirements and postoperative pain confirmed.
  • Attenuation of neuroendocrine and inflammatory stress responses; predictable hemodynamic control.
  • Emerging evidence for renoprotection and reduced acute kidney injury; cardiopulmonary and neuroprotective benefits less definitive.
  • Improved early recovery, including reduced delirium, smoother emergence, and shorter ICU stays, especially in high-risk patients.
  • Prolonged analgesia and reduced emergence agitation in regional and pediatric settings; ICU benefits in delirium prevention and sleep quality.

Conclusions:

  • Dexmedetomidine is a valuable multimodal adjunct for enhancing perioperative stability and recovery quality.
  • It is not a standalone anesthetic but complements other therapies.
  • Essential factors for optimal use include careful patient selection and precise dose titration.