Tag Archives: Midazolam

Nonbenzodiazepine Hypnotics

Non-benzodiazepine hypnotics were introduced in most markets in the early 1990s. To date, three non-benzodiazepine hypnotics have been launched for insomnia — zolpidem, zopiclone, and zaleplon (Wyeth and King Pharmaceuticals’ Sonata). Characteristics that distinguish these drugs from traditional benzodiazepines (discussed later) are their increased receptor-binding specificity, favorable pharmacokinetics, and overall broader range of safety. More… Read More »

Treatment of Anxiety in the Medically Ill

Psychotherapy An overemphasis on psychopharmacology in the care of medically ill patients may result in overlooking the value of psychotherapy. The first step in the treatment of anxiety is to spend time listening to and talking with the patient. Just as in psychotherapy with any patient, empathic listening is a powerful tool to relieve distress.… Read More »

Outgrowing Epilepsy in Children

Slightly more than half of the children who have epilepsy outgrow it. This simple and positive fact raises important questions: Which children should be treated? How much medication should they receive? How long should antiepileptic drugs be used? Doctors’ views on antiepileptic drugs have changed. Several decades ago, many doctors believed that seizures must be… Read More »

Herbal Preparations And Dietary Supplments

Herbal products used as CAM are prepared from roots, stems, flowers, buds, or leaves of plants. These plant products can be used whole, dried, crushed, and steeped as tea; other preparations contain extracts. While some herbal preparations have shown some efficacy in improving some sleep parameters in a few studies, most studies are small and… 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 »

Treatment for Anxiety Disorders in the Medically Ill

Treatment of anxiety disorders in the medically ill depends upon the relationship between anxiety symptoms and physical disease. Some patients have persisting symptoms or exacerbations of anxiety disorders that existed before the onset of physical disease. In that case, treatment should be similar to that given to patients without comorbid illness. Other patients, perhaps the… Read More »

Anti-Epileptic Drug Characteristics

Phenytoin Phenytoin has been used for over 50 years. Thus, the characteristics and side-effects have been well elucidated. Its primary use is for treatment of partial epilepsy, including simple and complex partial seizures, as well as generalized tonic-clonic seizures, whether of primary or partial onset. Phenytoin can be initiated with a ‘loading dose’ of 13-20… Read More »

Delirium: Prevention Strategies

Nonpharmacological and pharmacological interventions are available to prevent delirium. Preoperative patient education or preparation was helpful in reducing delirium symptom rates. However, studies of caregiver education and environmental or risk factor interventions have had mixed results, with two not finding any significant effect on delirium rate. In contrast, Inouye et al. studied the effect on… Read More »

Ketamine And Other NMDA Antagonists

Ketamine is an anaesthetic drug with a few notable features which have resulted in its introduction to pain clinic practice. The rationale for its use is supported by animal studies which allow tentative conclusions to be drawn about a mechanism of action. However, the extrapolation of animal data, based on electrophysiological and behavioural studies, to… Read More »

Antianxiety Drugs

Pharmacologic Profile General Use Antianxiety agents are used in the management of various forms of anxiety, including generalized anxiety disorder (GAD). Some agents are more suitable for intermittent or short-term use (benzodiazepines) while others are more useful long-term (buspirone, doxepin, fluoxetine, paroxetine, sertraline, venlafaxine). General Action and Information Most agents cause generalized CNS depression. Benzodiazepines… Read More »