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nasal midazolam

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https://www.readbyqxmd.com/read/27780297/pharmacokinetics-and-pharmacodynamics-of-a-new-highly-concentrated-intranasal-midazolam-formulation-for-conscious-sedation
#1
Lenneke Schrier, Rob Zuiker, Frans W H M Merkus, Erica S Klaassen, Zheng Guan, Bert Tuk, Joop M A van Gerven, Ronald van der Geest, Geert Jan Groeneveld
AIM: To evaluate the pharmacokinetics, pharmacodynamics, nasal tolerance and effects on sedation of a highly concentrated aqueous intranasal midazolam formulation (Nazolam) and to compare these to intravenous midazolam. METHODS: In this four-way crossover, double-blind, double-dummy, randomized, placebo-controlled study, 16 subjects received 2.5 mg Nazolam, 5.0 mg Nazolam, 2.5 mg intravenous midazolam or placebo on different occasions. Pharmacokinetics of midazolam and α-hydroxy-midazolam were characterized and related to outcome variables for sedation (Saccadic Peak Velocity, the Bond and Lader Visual Analogue Scale for sedation, the Simple Reaction Time Task and the Observer's Assessment of Alertness/Sedation)...
October 25, 2016: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/27652069/evaluation-of-the-effects-of-sedation-administered-via-three-different-routes-on-the-procedure-child-and-parent-satisfaction-during-cystometry
#2
Sengül Özmert, Feyza Sever, Hüseyin Tuğrul Tiryaki
PURPOSE: In this study, we retrospectively investigated case reports with and without midazolam administration via oral, intranasal and rectal before cystometry procedure. We aimed to compare the data to evaluate the effects of sedation before cystometry on the pediatric patients and parents' satisfaction. METHODS: A total of 124 ASA I-II pediatric cases aged 5-14 years were retrospectively investigated from the hospital records. One of the three administration routes was chosen; oral midazolam at a dose of 0...
2016: SpringerPlus
https://www.readbyqxmd.com/read/27625485/comparison-of-preanesthetic-sedation-in-pediatric-patients-with-oral-and-intranasal-midazolam
#3
Purvashree Vijay Deshmukh, Sadhana Sudhir Kulkarni, Mukund Kachru Parchandekar, Sneha Purshottam Sikchi
BACKGROUND AND AIMS: Preoperative anxiety in children leading to postoperative negative changes and long-term behavioral problems needs better preanesthetic sedation. Across the world, midazolam is the most commonly used premedicant in pediatric patients. The fact that no single route has achieved universal acceptance for its administration suggests that each route has its own merits and demerits. This study compares oral midazolam syrup and intranasal midazolam spray as painless and needleless systems of drug administration for preanesthetic sedation in children...
July 2016: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/27448414/upper-airway-collapsibility-assessed-by-negative-expiratory-pressure-while-awake-is-associated-with-upper-airway-anatomy
#4
Raquel P Hirata, Fabiola Schorr, Fabiane Kayamori, Henrique Takachi Moriya, Salvatore Romano, Giuseppe Insalaco, Eloisa M Gebrim, Luis Vicente Franco de Oliveira, Pedro R Genta, Geraldo Lorenzi-Filho
STUDY OBJECTIVES: There is a growing interest to develop a simple method to characterize the mechanisms leading to upper airway collapse in order to guide treatment options in patients with obstructive sleep apnea (OSA). Critical closing pressure (Pcrit) during sleep is able to predict the anatomical component of OSA. However, Pcrit is a laborious method that is only used for research purposes. The application of negative expiratory pressure (NEP) is a simple method to assess upper airway collapsibility that can be easily performed during wakefulness...
October 15, 2016: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
https://www.readbyqxmd.com/read/27224039/ventriculoperitoneal-shunt-insertion-under-monitored-anesthesia-care-in-a-patient-with-severe-pulmonary-hypertension
#5
Mark A Burbridge, Jessica Brodt, Richard A Jaffe
A 32-year-old man with severe pulmonary arterial hypertension and Eisenmenger syndrome secondary to congenital ventricular septal defects presented for ventriculoperitoneal shunt insertion. Consultation between surgical and anesthesia teams acknowledged the extreme risk of performing this case, but given ongoing symptoms related to increased intracranial pressure from a large third ventricle colloid cyst, the case was deemed urgent. After a full discussion with the patient, including an explanation of anesthetic expectations and perioperative risks, the case was performed under monitored anesthesia care...
July 15, 2016: A & A Case Reports
https://www.readbyqxmd.com/read/27145560/the-use-of-midazolam-as-an-intranasal-sedative-in-dentistry
#6
Anwen Greaves
The administration of midazolam intranasally exploits the unique structure of the nasopharynx thus ensuring rapid delivery to the systemic circulation (The Nose - Brain Pathway). The absorption of midazolam nasally is influenced by the volume and concentration of midazolam, its physicochemical properties and the characteristics of the nasal mucosa. Delivering midazolam intranasally is non-titratable. The level of conscious sedation may be equivalent to that achieved by intravenous routes but is approached in a less controlled manner...
January 2016: SAAD Digest
https://www.readbyqxmd.com/read/27132703/impact-of-acute-changes-in-cpap-flow-route-in-sleep-apnea-treatment
#7
R G S Andrade, F Madeiro, V S Piccin, H T Moriya, F Schorr, P S Sardinha, G M Gregório, P R Genta, G Lorenzi-Filho
INTRODUCTION: CPAP is the gold standard treatment for obstructive sleep apnea (OSA) and was conceived to be applied through a nasal interface. This study was designed to determine the acute effects of changing the nasal CPAP route to oronasal and oral in upper airway patency during sleep in patients with OSA. We hypothesized that the oronasal route may compromise CPAP effectiveness to treat OSA METHODS: Eighteen patients (age: 44±9 years, body mass index: 33.8±4.7 Kg/m(2), apnea-hypopnea: 49...
April 28, 2016: Chest
https://www.readbyqxmd.com/read/26930911/-analysis-of-risk-factors-for-emergence-agitation-in-adults-undergoing-general-anesthesia-for-nasal-surgery
#8
Zhan Liu
OBJECTIVE: To identify the incidence and the risk factors for emergence agitation (EA) in adults undergoing general anesthesia for nasal surgery. METHOD: We examined 674 patients aged ≥ 18 years who underwent general anesthesia for nasal surgery between February 2013 and February 2015. The patients were divided into control group (518 cases) and EA group (156 cases) by Sedation-agitation scale (SAS) method. Demographic and clinical variables were assessed and the data were analyzed by multiple logistic regression analysis...
November 2015: Journal of Clinical Otorhinolaryngology, Head, and Neck Surgery
https://www.readbyqxmd.com/read/26922313/efficacy-and-safety-of-anti-epileptic-drugs-in-patients-with-active-convulsive-seizures-when-no-iv-access-is-available-systematic-review-and-meta-analysis
#9
REVIEW
Puneet Jain, Suvasini Sharma, Tarun Dua, Corrado Barbui, Rashmi Ranjan Das, Satinder Aneja
OBJECTIVES: To explore the existing evidence for anti-convulsant drugs and their routes of administration in treating acute seizures in children and adults when intravenous access is not available. METHODS: All major databases including Medline via Ovid, PubMed, Cochrane CENTRAL, Embase, and Google Scholar were searched till May 2015. Randomized and quasi-randomized controlled trials comparing two anti-convulsant drugs (at least one comparator being administered through non-intravenous route) for treatment of acute seizures were included...
May 2016: Epilepsy Research
https://www.readbyqxmd.com/read/26920416/treatment-of-convulsive-status-epilepticus
#10
Eric H Grover, Yara Nazzal, Lawrence J Hirsch
Convulsive status epilepticus (CSE) is a medical emergency with an associated high mortality and morbidity. It is defined as a convulsive seizure lasting more than 5 min or consecutive seizures without recovery of consciousness. Successful management of CSE depends on rapid administration of adequate doses of anti-epileptic drugs (AEDs). The exact choice of AED is less important than rapid treatment and early consideration of reversible etiologies. Current guidelines recommend the use of benzodiazepines (BNZ) as first-line treatment in CSE...
March 2016: Current Treatment Options in Neurology
https://www.readbyqxmd.com/read/26887587/a-randomised-double-blind-controlled-trial-of-intranasal-midazolam-for-the-palliation-of-dyspnoea-in-patients-with-life-limiting-disease
#11
Janet Hardy, Clare Randall, Eve Pinkerton, Christopher Flatley, Kristen Gibbons, Simon Allan
PURPOSE: Anxiety is a major component of breathlessness and is often palliated with benzodiazepines. Midazolam is a short-acting water-soluble benzodiazepine with a rapid onset of action and short half-life. Intranasal midazolam had been shown to be of marked clinical benefit in an uncontrolled pilot study for the control of dyspnoea. A blinded randomised controlled study was therefore undertaken across four Australasian palliative care services. METHODS: All participants received six numbered study nasal spray (SNS) bottles, three of which contained midazolam and three placebo...
July 2016: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/26512627/oxygen-supplementation-before-induction-of-general-anaesthesia-in-horses
#12
H van Oostrom, M W H Schaap, J P A M van Loon
REASONS FOR PERFORMING STUDY: Hypoventilation or apnoea, caused by the induction of general anaesthesia, may cause hypoxaemia. Pre-oxygenation may lengthen the period before this happens. No scientific studies are published on pre-oxygenation in equine anaesthesia. OBJECTIVES: To determine whether supplementation of oxygen at a flow rate of 15 litres per minute for 3 minutes via a nasal cannula before induction of general anaesthesia is effective in elevating the arterial partial pressure of oxygen (PaO2 ) directly after induction...
October 29, 2015: Equine Veterinary Journal
https://www.readbyqxmd.com/read/26417129/a-comparison-of-intranasal-ketamine-and-intranasal-midazolam-for-pediatric-premedication
#13
P L Narendra, Ramesh W Naphade, Samson Nallamilli, Shanawaz Mohd
AIMS AND OBJECTIVES: The aim of our study is to compare the efficacy and side-effects of Ketamine and Midazolam administered nasally for the pediatric premedication. MATERIALS AND METHODS: We studied 100 American Society of Anesthesiology I and II children aged from 1 to 10 years undergoing various surgical procedures. Totally, 50 children were evaluated for nasal ketamine (using 50 mg/ml vials) at the dose of 5 mg/kg and the other 50 received nasal midazolam 0...
May 2015: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/26346210/safety-and-efficacy-of-intranasally-administered-medications-in-the-emergency-department-and-prehospital-settings
#14
REVIEW
Megan Corrigan, Suprat Saely Wilson, Jeremy Hampton
PURPOSE: The safety and efficacy of medications that may be administered via the intranasal route in adult patients in the prehospital and emergency department (ED) settings are reviewed. SUMMARY: When medications of appropriate molecular character and concentration are delivered intranasally, they are quickly transported across this capillary network and delivered to the systemic circulation, thereby avoiding the absorption-limiting effects of first-pass metabolism...
September 15, 2015: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/26286872/a-randomized-controlled-trial-comparing-intranasal-midazolam-and-chloral-hydrate-for-procedural-sedation-in-children
#15
RANDOMIZED CONTROLLED TRIAL
Marie Christy Sharafine Stephen, John Mathew, Ajoy Mathew Varghese, Mary Kurien, George Ani Mathew
OBJECTIVES: To evaluate the efficacy and safety of intranasal midazolam and chloral hydrate syrup for procedural sedation in children. STUDY DESIGN: Prospective randomized placebo-controlled trial (double blind, double dummy). SETTING: Tertiary care hospital over 18 months. SUBJECTS AND METHODS: Eighty-two children, 1 to 6 years old, undergoing auditory brainstem response testing were randomized to receive either intranasal midazolam with oral placebo or chloral hydrate syrup with placebo nasal spray...
December 2015: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/26236429/comparison-of-oral-and-intranasal-midazolam-ketamine-sedation-in-3-6-year-old-uncooperative-dental-patients
#16
Masoud Fallahinejad Ghajari, Ghassem Ansari, Ali Asghar Soleymani, Shahnaz Shayeghi, Faezeh Fotuhi Ardakani
Background and aims. There are several known sedative drugs, with midazolam and ketamine being the most commonly used drugs in children. The aim of this study was to compare the effect of intranasal and oral midazolam plus ketamine in children with high levels of dental anxiety. Materials and methods. A crossover double-blind clinical trial was conducted on 23 uncooperative children aged 3-6 (negative or definitely negative by Frankel scale), who required at least two similar dental treatment visits. Cases were randomly given ketamine (10 mg/kg) and midazolam (0...
2015: Journal of Dental Research, Dental Clinics, Dental Prospects
https://www.readbyqxmd.com/read/26221857/cytotoxic-effects-of-intranasal-midazolam-on-nasal-mucosal-tissue
#17
COMPARATIVE STUDY
I Ozbay, C Kucur, A Değer, I Ital, Cayci M Kasim, F Oghan
The aim of this experimental study was to investigate the cytotoxic effects of intranasal midazolam on nasal mucosal tissue in rats. Forty healthy rats were randomly divided into 5 groups. Group 1 (n = 8) was the control group, group 2 (n = 8) received intranasal saline, group 3 (n = 8) received intranasal midazolam, group 4 (n = 8) received intraperitoneal saline, and group 5 received intraperitoneal midazolam (n = 8). Midazolam and saline were administered via intraperitoneal and intranasal routes at doses of 200 μg/kg...
September 2015: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/26200465/a-randomized-prospective-double-blinded-study-of-physostigmine-to-prevent-sedation-induced-ventilatory-arrhythmias
#18
RANDOMIZED CONTROLLED TRIAL
Suzanne B Karan, Elia Rackovsky, William A Voter, Jason A Kanel, Nick Farris, Joshua Jensen, Lynn Liu, Denham S Ward
BACKGROUND: Physostigmine, a centrally acting acetylcholinesterase inhibitor, is most commonly used by anesthesiologists in the postanesthetic setting to reverse confusion caused by central anticholinergic medication effects. It has also been proposed as a treatment for sleep-disordered breathing. We investigated whether physostigmine was effective in decreasing the frequency of ventilatory arrhythmias produced during moderate sedation with midazolam and remifentanil during the conditions of breathing room air or 2 L/min nasal O2...
September 2015: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/26147820/the-effect-of-nasal-midazolam-premedication-on-parents-child-separation-and-recovery-time-in-dental-procedures-under-general-anaesthesia
#19
RANDOMIZED CONTROLLED TRIAL
T Eskandarian, S Arabzade Moghadam, S Reza Ghaemi, M Bayani
AIM: For many children medical and dental procedures, unfamiliar dental staff and treatment places are disturbing and stressful. Stress in children often makes them uncooperative. General anaesthesia is indicated for anxious uncooperative children or those who are disabled, immature or too young to undergo dental treatment by other means. Moreover parents' separation while entering the operative room is a traumatic experience for children. Thus premedication such as midazolam is recommended to decrease child's stress...
June 2015: European Journal of Paediatric Dentistry: Official Journal of European Academy of Paediatric Dentistry
https://www.readbyqxmd.com/read/26131153/comparison-of-dexmedetomidine-and-propofol-used-for-drug-induced-sleep-endoscopy-in-patients-with-obstructive-sleep-apnea-syndrome
#20
Ufuk Kuyrukluyıldız, Orhan Binici, Didem Onk, Serap Ayhan Celik, Mumtaz Taner Torun, Edhem Unver, Adalet Ozcicek, Aysin Alagol
UNLABELLED: Backround: Surgical operations are alternative treatments in persons with Obstructive Sleep Apnea Syndrome who cannot tolerate continuous positive airway pressure therapy. Drug-Induced Sleep Endoscopy is a method with which somnolence is pharmacologically induced and collapse is evaluated through nasal endoscopy in patients with Obstructive Sleep Apnea Syndrome. AIMS: We aimed to evaluate efficiency of dexmedetomidine or propofol used for sedation in patients undergoing drug-induced sleep endoscopy...
2015: International Journal of Clinical and Experimental Medicine
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