Indications for the use of hypnotics ...

Indications for use of hypnotics is extremely broad. These include episodic insomnia (lasting up to one week) resulting from increased sensitivity to external stimuli (noise, light, etc.), stress of everyday life (both emotionally negative and positive), emergency desynchronosis, individual reactions to physical illness, misuse of drugs (eg stimulants), a special operating mode (desinhronozoz in shift work). Hypnotics are indicated for short-term insomnia (lasting from one to three weeks), which occurs in disorders of adaptation, grief (bereavement), chronic somatic diseases, chronic pain syndrome, skin diseases accompanied by itching. Prescribe hypnotics and chronic insomnia (lasting more than three weeks), which is seen not only as a primary disorder (eg, in old age), but more often included in the structure of mental or somatitcheskoy pathology. The problem of drug therapy of sleep disorders hypnotic in its modern representation splits into two independent tasks. The first of these choice of drug, induces sleep and its hypnotic effect approaching the so-called ideal hypnotic, requirements for which are formulated Prinquey N. in 1993. This drug should: contribute to the rapid fall asleep in the minimum dose, do not have advantages in increasing doses (to avoid increasing the dose by the patients themselves) to reduce the number of nighttime awakenings. The second problem is much broader and does not concern the quantitative assessments and qualitative indicators of hypnotic effect on the human body as a whole, searching for drugs that cause sleep, but to a lesser degree of interfering in its complexly organized structure; drugs that restore the body's own inherent self-oscillation processes that do not affect on the habits of everyday life, daytime well-being and functioning, ie, does not reduce the quality of life. It is now possible to ascertain the appearance of the pharmaceutical market of three generations of hypnotics. For first-generation drugs include barbiturates, paraldehyde, antihistamines, propanediol, chloral hydrate. Hypnotics second generation represented a wide range of derivatives of benzodiazepine Nitrazepam, flunitrazepam, midazolam, flurazepam, triazolam, estazolam, Temazepam. The third generation of hypnotics nebenzodiazepinovyh includes a relatively new drugs derived tsiklopirrolona (zopiclone) and derivative imidazopiridina (zolpidem). And to modern hypnotic offered currently on the pharmaceutical market, are treated as foreign drugs, and domestic (Relakson). The main differences represented generations of hypnotics are manifested in the analysis of neurochemical mechanism of action, pharmacokinetic and pharmacodynamic characteristics of qualitative and quantitative parameters to assess their effect, tolerability and safety, consideration of which reflects the progress of pharmacology and pharmacotherapy in the synthesis and use of the most effective and safe drugs.