Other Sedatives

See Table 28-8.

Table 28-8: Other Sedatives
Drug(s)DescriptionReceptor EffectsClinical Effects
PropofolSedative used for procedural sedation, anesthesiaGABAA agonist, NMDA antagonistDeep sedation, short duration of action. Infusions >4–5 mg/kg/h >48 h may be associated with propofol-related infusion syndrome (rhabdomyolysis, cardiac dysrhythmias)
EtomidateShort-acting sedative, primarily used as RSI induction agentGABAA agonistDeep sedation, short duration of action. Prolonged infusions may cause adrenal suppression
Meprobamate/carisoprodolCarbamate anxiolytic. Carisoprodol is metabolized to meprobamateGABAA agonistProfound sedation/coma possible in overdose. May cause myocardial depression
Chloral hydrateTrichloroethanol metabolite has similar effects to ethanol at lower doses. Pediatric sedative (historical)GABAA agonistDeep sedation, variable elimination half-life. Myocardial sensitization to catecholamines; cardiac dysrhythmias possible
Zolpidem, eszopiclone, zaleplonNon-benzodiazepine also binding at the benzodiazepine site. Decreases sleep latency. Used as sleep aidGABAA agonistMild sedation. Respiratory depression rare in isolation
Ramelteon/melatoninSynthetic/natural melatonin analog. Used as sleep aidMelatonin receptor (MT1/MT2) agonist

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