RT Book, Section A1 Mihic, S. John A1 Mayfield, Jody A2 Brunton, Laurence L. A2 Knollmann, Björn C. SR Print(0) ID 1193230418 T1 Hypnotics and Sedatives T2 Goodman & Gilman's: The Pharmacological Basis of Therapeutics, 14th Edition YR 2023 FD 2023 PB McGraw-Hill Education PP New York, NY SN 9781264258079 LK hemonc.mhmedical.com/content.aspx?aid=1193230418 RD 2024/10/05 AB A sedative drug decreases activity, moderates excitement, and calms the recipient, whereas a hypnotic drug produces drowsiness and facilitates the onset and maintenance of a state of sleep that resembles natural sleep in its electroencephalographic characteristics and from which the recipient can be aroused easily. Sedation is a side effect of many drugs that are not considered general CNS depressants (e.g., antihistamines and antipsychotic agents). Although these and other agents can augment the effects of CNS depressants, they usually produce their desired therapeutic effects at concentrations lower than those causing substantial CNS depression. For example, benzodiazepine sedative-hypnotics do not produce generalized CNS depression. Although coma may occur at very high doses, neither surgical anesthesia nor fatal intoxication is produced by benzodiazepines unless other drugs with CNS depressant actions are concomitantly administered; an important exception is midazolam, which has been associated with decreased tidal volume and respiratory rate. Moreover, specific antagonists of benzodiazepines exist, such as flumazenil, which is used to treat cases of benzodiazepine overdose. This constellation of properties sets the benzodiazepine receptor agonists apart from other sedative-hypnotic drugs and imparts a measure of safety, such that benzodiazepines and the newer benzodiazepine receptor agonists (the “Z compounds”) have largely displaced older agents for the treatment of insomnia and anxiety.