nonbarbiturate

Nonbarbiturate is a descriptive term for drugs that are not barbiturates. In pharmacology and medicine, it is commonly applied to sedatives, hypnotics, anxiolytics, and anesthetics used as alternatives to barbiturates. The term emphasizes what the drug is not rather than a single pharmacologic class, since nonbarbiturate agents work by varied mechanisms and belong to different chemical families.

Unlike barbiturates, which act directly on the GABA-A receptor at specific barbiturate sites to enhance chloride conductance, nonbarbiturate sedatives include drugs with different mechanisms, such as benzodiazepines that potentiate GABA at a distinct site, Z-drugs with selective GABA-A subtype activity, propofol and etomidate that modulate GABA-A, and ketamine which blocks NMDA receptors.

Common examples include benzodiazepines (diazepam, lorazepam, temazepam), nonbenzodiazpine hypnotics (zolpidem, zaleplon, eszopiclone), and intravenous anesthetics (propofol, etomidate, ketamine). Historically other nonbarbiturate sedatives such as chloral hydrate were used. Nonbarbiturate agents are chosen based on onset and duration of action, patient condition, and respiratory and cardiovascular effects.

Because many nonbarbiturate agents can depress respiration and alter hemodynamics, monitoring and dosing are essential. They may carry risks of dependence, misuse, or withdrawal for long-term use, particularly with benzodiazepines. Their roles span anesthesia, premedication, procedural sedation, and treatment of sleep disorders, reflecting a broad, non-homogeneous category rather than a single pharmacologic class.