| 词条 | Z-drug |
| 释义 |
Medical usesThey are used to treat insomnia.[2] Adverse effectsSleeping pills, including the z-drugs, have been associated with an increased risk of death.[2] In older people this family of medications increases the risk of fractures and falls.[3] The Z-drug zaleplon may have fewer side effects compared to benzodiazepines.[4] PharmacologyThere are three primary groups of Z-drugs:
They are categorized as nonbenzodiazepines. All of these groups are believed to modulate benzodiazepine specific subunit sites, as specific agonists of the GABAA receptors. It is thought that the primary mode of action utilized by Z-drugs is selective, and carries a high affinity for the a1 hypnotic-inducing site on the benzodiazepine subunit within the GABAA receptor. HistoryZ-drugs emerged in the last years of the 1980s and early 1990s, with zopiclone (Imovane) approved by the British National Health Service as early as 1989, quickly followed by Sanofi with zolpidem (Ambien). By 1999, King Pharmaceuticals had finalized approval with the American Food and Drug Administration (FDA) to market zaleplon (Sonata, Starnoc) across the US. In 2005, the FDA approved eszopiclone (Lunesta) the (S)-enantiomer of zopiclone. That same year, 2005, the FDA finalized approval for Ambien CR, or extended-release zolpidem. Most recently, in 2012 the FDA approved Intermezzo, which still utilizes zolpidem as its active ingredient, but is marketed for middle-of-the-night insomnia, available in doses only half of the strength of immediate-release Ambien to avoid residual next-day sedation. See also
References1. ^{{cite journal |author= |title=What's wrong with prescribing hypnotics? |journal=Drug Ther Bull |volume=42 |issue=12 |pages=89–93 |date=December 2004 |pmid=15587763 |doi= 10.1136/dtb.2004.421289|url=http://dtb.bmj.com/cgi/content/full/42/12/89}} {{Hypnotics and sedatives}}{{Insomnia pharmacotherapies}}{{GABAAR PAMs}}{{Sedative-stub}}2. ^{{cite journal |last1=Kripke |first1=DF |title=Mortality Risk of Hypnotics: Strengths and Limits of Evidence. |journal=Drug Safety |date=February 2016 |volume=39 |issue=2 |pages=93–107 |doi=10.1007/s40264-015-0362-0 |pmid=26563222}} 3. ^1 {{cite journal|last1=Treves|first1=N|last2=Perlman|first2=A|last3=Kolenberg Geron|first3=L|last4=Asaly|first4=A|last5=Matok|first5=I|title=Z-drugs and risk for falls and fractures in older adults-a systematic review and meta-analysis.|journal=Age and Ageing|date=1 March 2018|volume=47|issue=2|pages=201–208|doi=10.1093/ageing/afx167|pmid=29077902}} 4. ^{{cite journal |vauthors=Barbera J, Shapiro C |title=Benefit-risk assessment of zaleplon in the treatment of insomnia |journal=Drug Saf |volume=28 |issue=4 |pages=301–18 |year=2005 |pmid=15783240 |doi= 10.2165/00002018-200528040-00003|url=}} 5 : Benzodiazepines|Hypnotics|Nonbenzodiazepines|Sedatives|GABAA receptor positive allosteric modulators |
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