Pharmacology for Dentistry

(Ben Green) #1

(Mode of Action of Drugs)


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Chapter


1.4


Chapter


2.2


Sedative


&


Hypnotics


Sedative


&


Hypnotics


Sedative (anxiolytic) are the agents which
reduce anxiety and exert a calming effect
with little or no effect on motor or mental
functions.


Hypnotics are the drugs which produce
drowsiness and encourage the onset and
maintenance of sleep. They are classified
into different categories (Table 2.2.1.)


BARBITURATES

Barbiturates are the derivatives of
barbituric acid. They are general CNS
depressants. They can cause sedation,
hypnosis and general anaesthesia
depending upon the particular barbiturates
used and its dose.


Pharmacological Actions


CNS: Barbiturates produce depression
of central nervous system in dose dependent
manner. In small dose, barbiturates relieve
anxiety and are generally used as sedative.
In hypnotic dose, it produces sleep resem-
bling normal physiological sleep. Hypnotic
dose of barbiturates produce motor incoor-
dination.


Pain: Barbiturates do not have any an-
algesic effect.
Anaesthesia: The ultra short acting bar-
biturates produce general anaesthesia (de-
tails are given in chapter ‘General
anaesthetics’).
Anticonvulsant action: In anaesthetic
dose all barbiturates e.g. phenobarbitone,
mephobarbitone possess anticonvulsant ac-
tion. Phenobarbitone is drug of choice for
the treatment of grandmal epilepsy (details
are given in chapter ‘Antiepileptic drugs’).
CVS: In hypnotic dose, hypotension and
decrease in heart rate occurs. In toxic dose,
there is a severe decrease in blood pressure
due to ganglionic blockade.
Respiration: In higher dose, barbiturates
depress the respiration. It depresses the sen-
sitivity of respiratory centre to CO 2.
GIT: They depress the tone and motil-
ity of GIT, but thiobarbiturates may stimu-
late the intestinal smooth muscles.
Kidney: They directly depress the tubu-
lar reabsorption of sodium, reduce urine
flow and increase ADH release.
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