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Related Concept Videos

Sedatives and Hypnotics: Overview01:23

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Sedatives are drugs that alleviate anxiety, while hypnotics induce sleep. Both classes of medication suppress neuronal activity, leading to a calming effect for sedatives and facilitating sleep for hypnotics.
Sedative-hypnotics are categorized into barbiturates, benzodiazepines (BZDs), and non-benzodiazepines or Z-drugs. These drugs work by suppressing central nervous system activity, and this suppression is dose-dependent. Older sedative medications, like barbiturates, follow a linear curve in...
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Various sedation levels offer significant advantages in facilitating procedural interventions for patients undergoing medical or invasive surgical procedures. These levels span from anxiolysis to general anesthesia, providing a spectrum of sedative effects to cater to specific patient needs. Anxiolysis reduces anxiety and is achieved through minimal sedation, enabling patients to remain awake and responsive while feeling more at ease during the procedure. This level can benefit minor...
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CNS depressants include drugs from the category of barbiturates and benzodiazepines. They are valuable medications for managing anxiety disorders and insomnia. Barbiturates, once used to induce and maintain sleep, have been replaced mainly by benzodiazepines due to barbiturate's toxicity, tolerance, and overdose risks. They interact with GABAA receptors, leading to sedation at low doses and potentially coma and death at higher doses. Phenobarbital, a long-acting barbiturate, possesses...
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Sedatives and Hypnotics Drugs: Miscellaneous Agents01:17

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Sedatives and hypnotics encompass a wide range of substances, each with its unique mechanism of action, uses, and potential adverse effects.
Melatonin congeners like ramelteon (Rozerem) and tasimelteon (Hetlioz) selectively bind to melatonin receptors (MT1 and MT2) and thus mimic the actions of melatonin, a hormone that regulates sleep-wake cycles. Tasimelteon is primarily used for non-24-hour sleep-wake disorder, common in blind patients. They are also used to treat conditions like insomnia...
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Sedatives and Hypnotics Drugs: Barbiturates01:20

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Sedatives and hypnotics encompass a drug class that acts on the central nervous system (CNS) to alleviate anxiety, promote relaxation and induce sleep.These drugs function by amplifying the actions of the neurotransmitter γ-aminobutyric acid (GABA), resulting in reduced neuronal activity. Barbiturates, a subset of sedatives and hypnotics first synthesized in the late 1800s, are categorized into ultra-short, short, intermediate, and long-acting groups based on their duration of effect. A...
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Parenteral Anesthetics: Overview01:24

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Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.
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Continuous Theta Burst Stimulation of the Posterior Medial Frontal Cortex to Experimentally Reduce Ideological Threat Responses
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[Palliative sedation for psycho-existential suffering].

Eva Weichselbaumer1, Dietmar Weixler

  • 1Palliativstation, Krankenhaus der Elisabethinen, Fadingerstraße 1, 4020, Linz, Österreich, eva.weichselbaumer@elisabethinen.or.at.

Wiener Medizinische Wochenschrift (1946)
|October 26, 2013
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Summary

Palliative sedation can manage refractory symptoms in terminally ill patients. This case study explores its use for intractable psycho-existential suffering, highlighting decision-making challenges in advanced ovarian cancer.

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Area of Science:

  • Palliative Care
  • Medical Ethics
  • Oncology

Background:

  • Sedation is a key therapy for refractory symptoms in palliative care.
  • Sedation for psycho-existential suffering remains a complex ethical and clinical issue.
  • Evidence-based guidelines for this specific indication are limited.

Observation:

  • A 56-year-old patient with advanced ovarian cancer experienced refractory psycho-existential suffering.
  • The patient required palliative sedation to alleviate distress.
  • The clinical team faced challenges in the decision-making process for sedation.

Findings:

  • Palliative sedation was initiated for the patient's intractable psycho-existential suffering.
  • The case illustrates the complexities of applying sedation in end-of-life care beyond physical symptoms.
  • The decision-making process involved careful consideration of the patient's suffering and available literature.

Implications:

  • This case highlights the need for further discussion and research on palliative sedation for psycho-existential suffering.
  • It underscores the importance of individualized care and ethical deliberation in palliative medicine.
  • The findings may inform clinical practice and policy regarding end-of-life care for patients with complex suffering.