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INTRODUCTION

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Chapter 9 Hypnotics, Sedatives, and Ethanol is a combination of Chapter 17, Hypnotics and Sedatives and Chapter 23, Ethanol and Methanol from Goodman and Gilman’s The Pharmacological Basis of Therapeutics, 12th Edition. An understanding of the material in those chapters will be helpful in following the material presented in this chapter. In addition to the material presented here, the above chapters in the 12th Edition include:

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  • A detailed discussion of the pharmacological properties of benzodiazepines, including animal models of anxiety, the effects of benzodiazepines on the electroencephalogram (EEG) and sleep stages, the molecular targets of benzodiazepines, and GABAA receptor–mediated electrical events

  • Table 17-1 Benzodiazepines: Names and Structures

  • A discussion of miscellaneous sedative hypnotic drugs used less commonly today

  • A detailed discussion of the management of insomnia

  • The history of ethanol consumption details of the pharmacological effects of ethanol

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In addition, the mechanisms of action of methanol and acute methanol poisoning, including treatment with ethanol and fomepizole are covered in this book Chapter 3 Clinical and Environmental Toxicity.

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LEARNING OBJECTIVES

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  • Know the pharmacological effects, mechanisms of action, untoward effects, and therapeutic uses of benzodiazepines.

  • Know the pharmacological effects, mechanisms of action, untoward effects, and therapeutic uses of barbiturates.

  • Understand the management of insomnia.

  • Know the effects of ethanol on physiological systems.

  • Describe the issues of physical dependence and tolerance of chronic ethanol use.

  • Understand the genetics of ethanol disposition.

  • Know the drugs used to treat alcoholism.

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DRUGS INCLUDED IN THIS CHAPTER

  • Acamprosate (CAMPRAL)

  • Alprazolam (XANAX)

  • Amobarbital (AMYTAL)

  • Butabarbital (BUTISOL, others)

  • Carisoprodol (SOMA)

  • Clomethiazole—not approved in the United States

  • Chloral Hydrate (NOCTEC)

  • Chlorazepate (TRANXENE, others)

  • Chlordiazepoxide (LIBRIUM, others)

  • Clonazepam (KLONIPIN)

  • Diazepam (VALIUM, others)

  • Disulfiram (ANTABUSE)

  • Estazolam (PROSOM, others)

  • Eszopiclone (LUNESTA)

  • Etomidate (AMIDATE)

  • Flumazenil (ROMAZICON)

  • Flurazepam (DALMANE, others)

  • Lorazepam (ATIVAN)

  • Mephobarbital (MEBERAL)

  • Meprobamate

  • Methohexital (BREVITAL)

  • Midazolam (VERSED)

  • Nalmefene (REVEX)

  • Naltrexone (REVIA, VIVITROL)

  • Oxazepam (SERAX)

  • Paraldehyde—no longer used in the United States

  • Pentobarbital (NEMBUTAL)

  • Phenobarbital (LUMINAL, others)

  • Propofol (DIPRIVAN)

  • Quazepam (DORAL)

  • Ramelteon (ROZEREM)

  • Secobarbital (SECONAL)

  • Temazepam (RESTORIL)

  • Thiopental (PENTOTHAL)

  • Triazolam (HALCION)

  • Zaleplon (SONATA)

  • Zolpidem (AMBIEN)

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MECHANISMS OF ACTION OF SEDATIVES, HYPNOTICS, AND DRUGS USED TO TREAT ALCOHOLISM

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