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Continuing Care01:25

Continuing Care

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Continuing care describes the variety of health, personal, and social services provided over a prolonged period. The need for continuing care is increasing because people are living longer. Many people do not have families or others to care for them. Continuing care is mainly for patients who are disabled, functionally dependent, or suffering from a terminal disease. It is available within institutional settings or in homes. Examples include nursing centers or facilities, assisted living,...
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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

Sedatives and Hypnotics: Overview

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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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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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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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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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[Palliative sedation in a hospital unit].

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Palliative sedation helps manage refractory symptoms in end-of-life care when standard treatments fail. This guide details best practices for initiating and adapting palliative sedation in hospital settings.

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Area of Science:

  • Palliative Care
  • Symptom Management
  • End-of-Life Care

Context:

  • End-of-life patients often experience symptoms refractory to treatment.
  • Palliative sedation is indicated for intractable symptoms.
  • Most patients receiving palliative sedation die outside specialized units.

Purpose:

  • To describe the processes for initiating palliative sedation.
  • To outline best clinical practices for adapting palliative sedation.
  • To provide guidance for hospital units managing palliative sedation.

Summary:

  • This article details the procedures for implementing palliative sedation in a hospital environment.
  • It emphasizes adherence to best clinical practices for patient care.
  • The focus is on managing complex symptoms at the end of life.

Impact:

  • Improves the management of refractory symptoms in end-of-life patients.
  • Ensures consistent and ethical application of palliative sedation.
  • Supports healthcare professionals in delivering high-quality palliative care within hospital settings.