Quazepam: a new hypnotic
Article Abstract:
Benzodiazepine drugs are potent sedatives which are used predominantly to induce sleep and to decrease anxiety. Quazepam is a new benzodiazepine drug recently approved for treating insomnia, the inability to sleep. Other benzodiazepines used to treat insomnia include flurazepam, which has a long duration of action but may cause sedation during the day; temazepam, which has an intermediate duration of action; and triazolam, which is short-acting, but may cause withdrawal symptoms such as anxiety after the drug is discontinued. Quazepam is rapidly absorbed from the gastrointestinal tract and reaches maximum levels in the blood within two hours after administration. It is broken down in the liver to a metabolite that is identical to that of flurazepam. The time required for fifty percent of the metabolite to be excreted from the body in the urine or feces is 75 hours, and this duration may increase in elderly patients. Studies show that this long-acting benzodiazepine has no advantages over the widely used and less expensive flurazepam. Treatment with 15-milligram doses of quazepam was shown to cause memory loss, confusion, disorientation, delirium, delusions, hallucinations, and daytime drowsiness. Because all benzodiazepines can cause tolerance, which is a decreased effectiveness of the drug, and physical dependence, these drugs should not be used for long periods. The dosage and cost of quazepam are described. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Medical Letter on Drugs and Therapeutics
Subject: Health
ISSN: 0025-732X
Year: 1990
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Propofol
Article Abstract:
Propofol is a sedative-hypnotic drug given intravenously that was recently marketed for inducing anesthesia and maintaining general anesthesia. The drug distributes rapidly into the brain resulting in a loss of consciousness within one minute. It has a short duration of action, lasting three to five minutes, because it redistributes from the brain to other tissues. Half of the dose is eliminated from the body within three to eight hours, although this period may be longer in elderly patients. Among 35 patients given propofol or thiopental for inducing anesthesia, recovery was more rapid and pleasant with propofol than thiopental. Propofol caused a more rapid return to an alert state and fewer symptoms than thiopental. In addition, propofol resulted in faster recovery from general anesthesia and less nausea and vomiting after the operation as compared with thiopental. Adverse effects of propofol include pain on injection, respiratory depression such as apnea or absence of breathing, slowing of the heart rate, depression of heart function, and low blood pressure. The methods for determining the effective dose in individuals are discussed. Thus, propofol used for inducing and maintaining anesthesia causes rapid and relatively pleasant recovery from anesthesia, but its adverse effects may limit its usefulness. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Medical Letter on Drugs and Therapeutics
Subject: Health
ISSN: 0025-732X
Year: 1990
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Zolpidem for insomnia
Article Abstract:
Zolpidem, sold as Ambien by Searle, is an effective hypnotic that is newly available in the US for treatment of insomnia. It has been used to treat insomnia for several years in Europe. Zolpidem binds to benzodiazepine receptors in the brain as do drugs such as Valium, but it does not affect the stages of sleep as the benzodiazepines do. Taking zolpidem just before going to bed reduces the time needed to fall asleep and improves the quality and length of sleep. Side effects that have been noticed include diarrhea, dizziness, some drowsiness the next day, headache and nausea. The likelihood of these types of side effects increases as the dose of the drug is increased. Elderly patients given larger doses, 20 milligrams or more, have become confused and some have fallen down. Some patients may experience rebound insomnia after discontinuing use of zolpidem. It does not interact with other drugs such as chlorpromazine, cimetidine, haloperidol, imipramine or ranitidine.
Publication Name: Medical Letter on Drugs and Therapeutics
Subject: Health
ISSN: 0025-732X
Year: 1993
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