Skip to Main Content

++

HISTORY OF DEVELOPMENT

++

Sedative–hypnotics are a relatively new class of anesthetics, beginning with the introduction of sodium thiopental in the early 1930s. Since then, several ­sedative–hypnotics have been introduced (Table 6–1), with more in the drug development pipeline, such as remimazolam, fospropofol, and isomers of etomidate. Goals of these modified drugs include fast metabolism and breakdown as well as creating “soft” drugs with safer profiles. A major goal in developing methoxycarbonyl-etomidate is the removal of adrenocortical suppression by modifying the pyrrole ring in etomidate. Fospropofol is water-soluble as opposed to propofol, which is administered as an oil–water emulsion. In 2008, fospropofol was approved by the US Food and Drug Administration, although many clinical trials are still underway for specific uses of the drug.1

++
Table Graphic Jump Location
Table 6–1   History of sedative–hypnotics. 
++

MECHANISM OF ACTION AND DRUG EFFECTS

++

Most sedative–hypnotics work via the γ-aminobutyric acid (GABA) receptor complex by enhancing the effect of GABA (Figure 6–1), the major inhibitory neurotransmitter in the central nervous system. GABA receptors are transmembrane, made up of 5 subunits (2 α, 2 β, 1 γ), with a central pore. There are several types of each subunit, leading to a variety of slightly different GABA receptors. Overall, there are 2 types: type A, a chloride channel, and type B, a ...

Want remote access to your institution's subscription?

Sign in to your MyAccess profile while you are actively authenticated on this site via your institution (you will be able to verify this by looking at the top right corner of the screen - if you see your institution's name, you are authenticated). Once logged in to your MyAccess profile, you will be able to access your institution's subscription for 90 days from any location. You must be logged in while authenticated at least once every 90 days to maintain this remote access.

Ok

About MyAccess

If your institution subscribes to this resource, and you don't have a MyAccess profile, please contact your library's reference desk for information on how to gain access to this resource from off-campus.

Subscription Options

AccessAnesthesiology Full Site: One-Year Subscription

Connect to the full suite of AccessAnesthesiology content and resources including procedural videos, interactive self-assessment, real-life cases, 20+ textbooks, and more

$995 USD
Buy Now

Pay Per View: Timed Access to all of AccessAnesthesiology

24 Hour Subscription $34.95

Buy Now

48 Hour Subscription $54.95

Buy Now

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.