Search results for "Hypnotic"
showing 10 items of 54 documents
GABAA-receptor Subtypes: Clinical Efficacy and Selectivity of Benzodiazepine Site Ligands
1997
The main inhibitory neurotransmitter receptor of the brain, the gamma-aminobutyric acid type A receptor (GABA[A]), mediates the actions of several classes of clinically important drugs, such as benzodiazepines, barbiturates and general anaesthetics. This review summarizes the current knowledge on how classical benzodiazepines and novel nonbenzodiazepine compounds act on the benzodiazepine site of GABA(A) receptors and on their clinical pharmacology related to anxiolytic, sedative, hypnotic and cognitive effects or side-effects. Partial agonism, receptor subtype selectivity and novel binding sites are discussed as possible strategies to develop new drugs with fewer adverse effects than are s…
Zaleplon displays a selectivity to recombinant GABAA receptors different from zolipdem, zopiclone and benzodiazepines
1999
A chemically heterogeneous group of compounds acts at the benzodiazepine (BZ) recognition site of the γ-aminobutyric acid type A (GABAA) receptor complex. Whereas most 1,4-BZs recognize all GABAA/BZ receptors with similar affinity, other compounds differentiate between the large number of native GABAA receptors which assemble from the more than 14 known subunits. Here we describe the in vitro binding properties of the BZs lorazepam and Ro 15-4513 plus the three hypnotics zaleplon, zolpidem and zopiclone to eight receptors subtypes. Lorazepam fits well into the general shceme for other 1,4-BZs with respect to its receptor subtype selectivity in spite of its clinically different use. Zaleplon…
Palliative sedation in advanced cancer patients followed at home: A retrospective analysis
2012
Abstract CONTEXT: Data regarding palliative sedation at home in dying patients are lacking. OBJECTIVES: To describe the frequency, indication, and modality of palliative sedation (PS) in patients followed at home. METHODS: A retrospective analysis of home care cancer patients was performed. Patients who received PS before dying were selected and information about epidemiologic characteristics, indications, duration, drugs, and outcomes was collected. RESULTS: Of 370 medical charts of patients who died at home, 49 patients received PS before dying. PS was proposed by the team, relatives, or both in 63.3%, 4.1%, and 32.6% of cases, respectively. Delirium alone or in combination with other sym…
Palliative sedation in patients with advanced cancer followed at home: A systematic review
2011
Abstract Context Patients with advanced cancer who are near the end of life may experience intolerable suffering refractory to targeted palliative therapies. Palliative sedation (PS) is considered to be an effective treatment modality for these refractory symptoms when aggressive efforts fail to provide relief. Objectives The aim of this study was to systematically review articles regarding PS performed at home in patients with intractable symptoms. Methods Literature databases searched included MedLine, PubMed, and EMBASE. The text words and MeSH/EMTREE terms "home care" and "sedation" were used for electronic database searches. Results Six articles met the inclusion criteria for research …
Prediction of properties of chiral compounds by molecular topology
1998
Abstract A common assumption in chemistry is that chiral behavior is associated with 3-D geometry. However, chiral information is related to symmetry, which allows the topological handling of chiral atoms by weighted graphs and the calculation of new descriptors that give a weight to the corresponding entry in the main diagonal of the topological matrix. In this study, it is demonstrated that, operating in this way, chiral topological indices are obtained that can differentiate the pharmacological activity between pairs of enantiomers. The 50% inhibitory concentration (IC50) values of the D2 dopamine receptor and the σ receptor for a group of 3-hydroxy phenyl piperidines are specifically pr…
Contribution of benzodiazepines in dental care of patients with special needs.
2019
Background Conscious sedation in dental treatment of patients with special needs (PNEs) has the purpose of controlling events such as anxiety and fear, as well as promoting muscle relaxation and mastery of uncoordinated movements. Benzodiazepines (BZDs) are among the most used drugs due to their anxiolytic, hypnotic and sedative properties. The objective of this investigation is to demonstrate a study on the contribution of conscious sedation with BZD in PNEs. Material and Methods The study included 40 PNEs, non-collaborators, submitted to conscious oral sedation with Midazolam (0.5 mg/kg) for dental treatment, receiving vital signs monitoring in the pre, trans and postoperative periods. Re…
Clinical management of drug-drug interactions in HCV therapy: Challenges and solutions.
2013
Contains fulltext : 118153.pdf (Publisher’s version ) (Open Access) Hepatitis C virus (HCV) infected patients often take multiple co-medications to treat adverse events related to HCV therapy, or to manage other co-morbidities. Drug-drug interactions associated with this polypharmacy are relatively new to the field of HCV pharmacotherapy. With the advent of the direct-acting antivirals telaprevir and boceprevir, which are both substrates and inhibitors of the cytochrome P450 (CYP) 3A iso-enzyme, knowledge and awareness of drug-drug interactions have become a cornerstone in the evaluation of patients starting and continuing HCV combination therapy. In our opinion, an overview of conducted dr…
Prognostic value of blood lactate in critically ill patients
1984
Hyperlactatemia is frequently observed in critically ill patients. A correlation of blood lactate concentrations and outcome of patients has been proven in circulatory shock, circulatory arrest, acute myocardial infarction, acute hypnotic drug poisoning and severe pancreatitis. However, the prognostic relevance of hyperlactatemia yields from statistical examinations in larger groups of patients. It should not be misused as a reliable prognostic sign in the individual patient, but is of high value in comparing groups of patients. In individual patients, hyperlactatemia is a useful indicator pointing to the severity of illness and to superimposed complications. Blood lactate is of considerabl…
Analgosedierung bei neurochirurgischen Intensivpatienten
1990
Different concepts for analgosedation of neurosurgical patients are recommended during postoperative ventilation. In 30 neurosurgical patients (2 groups of 15 patients), we studied a continuous i.v. application of alfentanil (Rapifen) and midazolam (Dormicum) compared to an application of continuously given alfentanil with discontinuously given midazolam. A good analgosedation (i.e. sufficient sedation with good neurological judgement) was more frequently achieved (8/15 patients) by continuous application of both substances (alfentanil 0.023 mg/kg b.w./h, midazolam 0.10 mg/kg b.w./h), compared to discontinuous application of midazolam (4.5/15 patients; alfentanil 0.028 mg/kg b.w./h, midazol…
Premedication with midazolam in intellectually disabled dental patients: Intramuscular or oral administration? A retrospective study
2016
Background: The use of midazolam for dental care in patients with intellectual disability is poorly documented. The purpose of this study was to determine which method of premedication is more effective for these patients, 0.15 mg/kg of intramuscular midazolam or 0.3 mg/kg of oral midazolam. Material and Methods: This study was designed and implemented as a non-randomized retrospective study. The study population was composed of patients with intellectual disability who required dental treatment under ambulatory general anesthesia from August 2009 through April 2013. Patients were administered 0.15 mg/kg of midazolam intramuscularly (Group IM) or 0.3 mg/kg orally (Group PO). The predictor v…