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Related Concept Videos

Stages of General Anesthesia01:22

Stages of General Anesthesia

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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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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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Sedatives and Hypnotics Drugs: Miscellaneous Agents01:17

Sedatives and Hypnotics Drugs: Miscellaneous Agents

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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: Benzodiazepines01:19

Sedatives and Hypnotics Drugs: Benzodiazepines

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Benzodiazepines have both sedative and hypnotic properties. They include compounds such as diazepam (Valium) and alprazolam (Xanax). Structurally, their cores are similar, consisting of the fusion of a benzene ring and a diazepine ring, but they share a common mechanism of action in the central nervous system (CNS).
Benzodiazepines work by enhancing the effects of the inhibitory neurotransmitter GABA. They bind to the GABAA receptor, increasing its affinity for GABA, which opens chloride...
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CNS Depressants: Barbiturates and Benzodiazepines01:14

CNS Depressants: Barbiturates and Benzodiazepines

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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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Parenteral Anesthetics: Overview01:24

Parenteral Anesthetics: Overview

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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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Halogenated Agent Delivery in Porcine Model of Acute Respiratory Distress Syndrome via an Intensive Care Unit Type Device
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Association Between Sedative Medication Administration and Delirium Development in a Medical Intensive Care Unit.

Nicholas D Franz1, Cesar Alaniz2, James T Miller3

  • 1CHI Health Creighton University Medical Center - Bergan Mercy, Omaha, NE, USA.

Journal of Pharmacy Practice
|April 25, 2022
PubMed
Summary
This summary is machine-generated.

Reducing benzodiazepine use in the intensive care unit (ICU) did not change delirium rates. Sedation practices shifted, but delirium incidence remained stable, suggesting other factors influence its development.

Keywords:
benzodiazepinedeliriumdexmedetomidinesedation

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Area of Science:

  • Critical Care Medicine
  • Neuroscience
  • Pharmacology

Background:

  • Delirium is a common complication in intensive care unit (ICU) patients.
  • Benzodiazepines are suspected contributors to delirium development.
  • Investigating the association between sedation practices and delirium incidence is crucial.

Purpose of the Study:

  • To determine if changes in sedation administration over time correlate with alterations in delirium incidence within a medical ICU.
  • To analyze the impact of reduced benzodiazepine use and increased dexmedetomidine use on delirium rates.

Main Methods:

  • Retrospective cohort study over four years in a medical ICU.
  • Data abstracted from a local data warehouse.
  • Analysis included descriptive statistics, Spearman's correlation, and multivariate logistic regression to identify risk factors.

Main Results:

  • Annual benzodiazepine administration significantly decreased from 2015 to 2018 (p < .01).
  • Annual dexmedetomidine administration significantly increased during the same period (p < .01).
  • No significant difference in annual delirium incidence was observed; identified risk factors included ARDS, organ failure, shock, withdrawal, and various sedative/analgesic agents.

Conclusions:

  • A substantial shift in sedation strategy, decreasing benzodiazepines and increasing dexmedetomidine, did not impact delirium rates in the ICU.
  • Delirium incidence appears multifactorial, influenced by patient comorbidities and other medications rather than solely sedation type.