Benzodiazepine

Use: brief surgical procedures; sometimes used for seizures refractory to other medications; may be given to children pre sx

Causes anterograde amnesia

Mechanism: competes for benzo (all subtypes) receptor, separate from barbiturate and EtOH receptors

Uses: long term treatment of insomnia

Sedative hypnotic

Mechanism: NOT BENZO but binds BZ1 subtype receptor, facilitate GABA inhibition, leading only to sedation (not the other effects); short half life

Use: short term insomnia, FDA halved dose for women

Side effects: Worst for sleep related behaviors, rebound insomnia, sleepwalking, drowsiness/dizziness

Other drugs: Zaleplon (Sonata^®) 

Mechanism: Melatonin agonist, regulates and maintains circadian rhythms

Actions: shortens delay to sleep onset

Contraindications: Sever liver disease due to slower metabolism

Sedative hypnotic (nursing homes)

Uses: insomnia, conscious pediatric dental procedurer

Side effects: low margin of safety (resp and vasomotor depression), long term can cause liver damage+ fatal intoxication; 

Antihistamine- 1st gen

Use- occasional insomnia for benzo and EtOH addicts