Benzodiazepines are in direct GABA A receptor agonists that bind to GABA-A receptors → ↑ affinity of GABA to bind to GABA A receptors → ↑ GABA action → ↑ opening frequency of chloride channels → hyperpolarization of the postsynaptic neuronal membrane → ↓ neuronal excitability.Long-acting : ( half-life > 40 hours) : diazepam, chlordiazepoxide, clonazepam, tetrazepam, flurazepam.Intermediate-acting : ( half-life 12–40 hours) : lorazepam, temazepam, oxazepam, lormetazepam, alprazolam.Short-acting : ( half-life 1–12 hours) : midazolam, triazolam.Sleep disturbances: abnormal dreams, nightmares, sleep terrors. Antagonism of orexin ( hypocretin) receptors → ↓ wakefulness.Activation of MT1 and MT2 receptors in suprachiasmatic nuclei of the hypothalamus → ↓ sleep-onset latency.Generalized-onset and focal-onset seizures.Intermediate-acting: amobarbital, butalbital Short-term treatment for insomnia or anxiety.Short-acting: pentobarbital, secobarbital GABA A receptor agonism → ↓ neuronal excitability in the brain → ↓ ICP and sedative, hypnotic, and antiepileptic effects. Ultra-short acting: thiopental, methohexital Long-acting: diazepam, chlordiazepoxide, clonazepam, tetrazepam, flurazepam Intermediate-acting: lorazepam, temazepam, oxazepam, lormetazepam, alprazolam
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