Tag Archives: Meperidine

Pharmacological Treatment of Pain

While medications are often prescribed for all types of chronic pain, research has consistently shown that several classes have proven efficacy for the treatment of neuropathic pain. Ideally, pharmacotherapy of pain would be specifically selected on the basis of considerations of etiology (e.g., ischemic, neuropathic), pathophysiology (e.g., demyelination, central pain), and anatomy (e.g., C fibers,… Read More »

Delirium (Acute Confusional State)

Description of Medical Condition Delirium is a neurologic complication of illness and/or medication use that is especially common in older patients. The key diagnostic features are an acute change in mental status that fluctuates, abnormal attention, and either disorganized thinking or altered level of consciousness. Delirium is a medical emergency requiring immediate evaluation in order… Read More »

Specific Migraine-Preventive Agents: Antidepressants

Antidepressants consist of a number of different classes of drugs with different mechanisms of action. Only tricyclic antidepressants (TCAs) have proven efncacy in migraine; we cover the newer components for completeness and reader interest. Mechanism of Action TCAs, selective serotonin-reuptake inhibitors (SSRIs), and serotonin NE-reuptake inhibitors increase synaptic NE or serotonin (5-HT) by inhibiting high-affinity… Read More »

Treatment of the epilepsy: the acutely unwell or periprocedural patient

People with epilepsy are often considered to be at higher risk when undergoing procedures. This is mainly due to the possibility of seizures occurring periprocedurally or due to the potential for interactions between drugs used during the procedure and the patient’s anti-epileptic drugs. Factors which may exacerbate seizures, such as sleep deprivation and alcohol, should… Read More »

Delirium: Etiology

Delirium has a wide variety of etiologies, which may occur alone or in combination (). These include primary cerebral disorders, systemic disturbances that affect cerebral function, drug and toxin exposure (including intoxication and withdrawal), and a range of factors that can contribute to delirium but have an uncertain role as etiological factors by themselves (psychological… Read More »

Delirium: Neuropathogenesis

Even though delirium has many different etiologies, its constellation of symptoms is largely stereotyped, with some considered core symptoms. Somehow, this diversity of physiological perturbations translates into a common clinical expression that may represent dysfunction ofcertain neural circuits (as well as neurotransmitters) —  that is, a final common neural pathway. The involvement of certain specific… Read More »

Match the drug used for headache prevention or treatment with its caution…

Match the medication used for headache prevention or treatment with its caution or contraindication. Each answer can be used once, more than once, or not at all. A. Zonisamide (Zonegran) B. Phenelzine (Nardil) C. Verapamil (Calan) D. Amitriptyline (Elavil) E. Topiramate (Topamax) 1. Concomitant use of lithium 2. Allergy to sulfa medications 3. Concomitant use… Read More »

Opioid Narcotics

Opium poppies can be seen in Greek drawings and on coins that antedate written Greek literature by at least one thousand years. Homer and Hesiod wrote of the medicinal effects of poppies that symbolized sleep, even death. The standard agent for euthanasia and suicide, which was given to Socrates, was a mixture of hemlock and… Read More »

Antidepressant Drugs

Pharmacologic Profile General Use Used in the treatment of various forms of endogenous depression, often in conjunction with psychotherapy. Other uses include: Treatment of anxiety (doxepin, fluoxetine, paroxetine, sertraline, venlafaxine); Enuresis (imipramine); Chronic pain syndromes (amitriptyline, doxepin, imipramine, nortriptyline); Smoking cessation (bupropion); Bulimia (fluoxetine); Obsessive-compulsive disorder (fluoxetine, fluvoxamine, paroxetine, sertraline); Social anxiety disorder (paroxetine, sertraline).… Read More »

Opioid Analgesics

Pharmacologic Profile General Use Management of moderate to severe pain. Fentanyl is also used as a general anesthetic adjunct. General Action and Information Opioids bind to opiate receptors in the CNS, where they act as agonists of endogenously occurring opioid peptides (eukephalins and endorphins). The result is alteration to the perception of and response to… Read More »