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Midazolam

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https://www.readbyqxmd.com/read/29028762/intermittent-versus-continuous-and-intermittent-medications-for-pain-and-sedation-after-pediatric-cardiothoracic-surgery-a-randomized-controlled-trial
#1
Jamie S Penk, Cheryl A Lefaiver, Colleen M Brady, Christine M Steffensen, Kimberly Wittmayer
OBJECTIVES: Compare continuous infusions of morphine and midazolam in addition to intermittent doses with an intermittent only strategy for pain and sedation after pediatric cardiac surgery. DESIGN: Randomized controlled trial. SETTING: Advocate Children's Hospital, Oak Lawn, IL. PATIENTS: Sixty patients 3 months to 4 years old with early extubation after pediatric cardiac surgery. INTERVENTIONS: Patients received a continuous infusion of morphine and midazolam or placebo for 24 hours...
October 12, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/29027845/the-potent-mechanism-based-inactivation-of-cyp2d6-and-cyp3a4-with-fusidic-acid-in-in-vivo-bioaccumulation
#2
Xiu-Xian Lin, Guang-Hui Lian, Ying Xu, Qing Zhao, Jian Xiao, Shi-Fang Peng, Mei-Fang Xiao, Dong-Sheng Ouyang, Zhi-Rong Tan, Yi-Cheng Wang, Jing-Bo Peng, Wei Zhang, Yao Chen
1. The accumulation of fusidic acid (FA) after multiple doses of FA has been reported on in previous studies but the related mechanisms have not been clarified fully. In the present study, we explain the mechanisms related to the mechanism-based inactivation of CYP2D6 and CYP3A4. 2. The irreversible inhibitory effects of FA on CYP2D6 and CYP3A4 were examined via a series of experiments, including: a) time-, concentration- and NADPH-dependent inactivation, b) substrate protection in enzyme inactivation and c) partition ratio with recombinant human CYP enzymes...
October 13, 2017: Xenobiotica; the Fate of Foreign Compounds in Biological Systems
https://www.readbyqxmd.com/read/29025452/management-of-failed-spinal-anaesthesia-for-caesarean-section
#3
Gavin Wyndham Jones, Raphael Anthony Samuel, Bruce McClure Biccard
BACKGROUND: Failed spinal anaesthesia for caesarean section (CS) may be partial or complete and the subsequent discomfort is the most commonly cited cause of litigation in obstetric anaesthesia. OBJECTIVES: To determine if there is a standardised approach to: (i) testing the level of block of spinal anaesthesia; and (ii) the management of failed spinal anaesthesia for CS. METHODS: A structured questionnaire to ascertain the current practice of testing the level of block and management of three different scenarios of failed spinal anaesthesia was distributed to 51 government hospitals in KwaZulu-Natal, South Africa (SA)...
June 30, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/29022274/midazolam-prevents-motor-neuronal-death-from-oxidative-stress-attack-mediated-by-jnk-erk-pathway
#4
Guo-Zheng Li, Hong-Lei Tao, Cheng Zhou, Dong-Dong Wang, Cong-Bin Peng
Midazolam is a sedative used by patients with mechanical ventilation. However, the potential clinical value is not fully explored. In this report, we made use of a neuroblastoma-spinal cord hybrid motor neuron-like cell line NSC34, and elucidated the potential role of Midazolam on these cells under the insult of oxidative stress. We found the protective effect of Midazolam on motor neurons against cytotoxicity induced by the combination of oligomycin A and rotenone (O/R) or phenylarsine oxide. The characteristics of apoptosis, such as the ratio of TUNEL+ cells or the expression level of cleaved Caspase-3, was decreased by 22 or 45% in the presence of Midazolam...
October 11, 2017: Human Cell
https://www.readbyqxmd.com/read/29020926/a-comparison-of-the-use-of-propofol-alone-and-propofol-with-midazolam-for-pediatric-magnetic-resonance-imaging-sedation-a-retrospective-cohort-study
#5
RyungA Kang, Young Hee Shin, Nam-Su Gil, Ki Yoon Kim, Hyean Yeo, Ji Seon Jeong
BACKGROUND: Pediatric MRI sedation performed by a variety of specialists such as sedationists and anesthesiologists commonly uses propofol, which has similar effects to an ideal sedative agent for maintaining deep sedation. However, when propofol is used, adverse airway events are relatively more common than when using other sedative agents. The concomitant administration of midazolam and propofol can reduce the dose of propofol needed for adequate sedation and might also reduce the frequency of airway obstruction without affecting the patient's recovery profile...
October 11, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28994677/comparison-of-dexmedetomidine-and-ketamine-versus-propofol-and-ketamine-for-procedural-sedation-in-children-undergoing-minor-cardiac-procedures-in-cardiac-catheterization-laboratory
#6
Vidya Sagar Joshi, Sandeep S Kollu, Ram Murti Sharma
BACKGROUND: The ideal anaesthetic technique for management of paediatric patients scheduled to undergo cardiac catheterisation is still not standardised. AIM: To compare the effects of ketamine-propofol and ketamine-dexmedetomidine combinations on hemodynamic parameters and recovery time in paediatric patients undergoing minor procedures and cardiac catheterisation under sedation for various congenital heart diseases. MATERIAL AND METHODS: 60 children of either sex undergoing cardiac catheterisation were randomly assigned into two groups Dexmedetomidine-ketamine group (DK) and Propofol-ketamine (PK) of 30 patients each...
October 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28992870/evaluating-clinical-effectiveness-and-pharmacokinetic-profile-of-atomized-intranasal-midazolam-in-children-undergoing-laceration-repair
#7
Sarah A Mellion, David Bourne, Lina Brou, Alison Brent, Kathleen Adelgais, Jeffrey Galinkin, Joseph Wathen
BACKGROUND: Atomized intranasal midazolam is a common adjunct in pediatrics for procedural anxiolysis. There are no previous studies of validated anxiety scores with pharmacokinetic data to support optimal procedure timing. OBJECTIVES: We describe the clinical and pharmacokinetic profile of atomized intranasal midazolam in children presenting for laceration repair. METHODS: Children 11 months to 7 years of age and weighing <26 kg received 0...
September 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28989912/effect-of-low-dose-atracurium-on-laryngeal-mask-airway-insertion-conditions-a-randomized-double-blind-clinical-trial
#8
Karim Nasseri
BACKGROUND: The amount of sedation and muscle relaxation of the jaw may have an impact on complications caused by laryngeal mask airway (LMA). The aim of this study is to evaluate the effect of low-dose Atracurium on conditions of insertion, complications, and hemodynamic responses to LMA insertion following induction of anesthesia with propofol, in patients undergoing cataract surgery. PATIENTS AND METHODS: In this double-blind randomized clinical trial study, 60 patients were randomly divided into two groups...
2017: Advanced Biomedical Research
https://www.readbyqxmd.com/read/28986606/effect-of-breviscapine-on-cyp3a-metabolic-activity-in-healthy-volunteers
#9
Xuan Zhou, Yang-Yang Gao, Jian-Yong Hu, Yu Dong, Hai-Zhu Zhang, Yong Lai
OBJECTIVE: The purpose of this study was to investigate the influence of breviscapine on the pharmacokinetics of concomitantly administered midazolam (MID) and its associations with and effects on genetic polymorphism of the gene encoding cytochrome P450 3A5 (CYP3A5) in healthy volunteers. METHODS: The study group comprised 17 healthy volunteers who had been genotyped for CYP3A5*3 prior to start of the study. These volunteers were given daily doses of 120 mg (40 mg, three times a day) of breviscapine or a placebo for 14 days, followed by 7...
October 6, 2017: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28986475/pediatric-cytochrome-p450-activity-alterations-in-nonalcoholic-steatohepatitis
#10
Hui Li, Canet J Mark, John D Clarke, Dean Billheimer, Stavra A Xanthakos, Joel E Lavine, Robert P Erickson, Nathan J Cherrington
Variable drug responses(VDRs) are dependent upon individual variation in the activity of drug-metabolizing enzymes including cytochrome P450s(CYPs). As the most common chronic liver disease in children and adults, nonalcoholic steatohepatitis(NASH) has been identified as a source of significant inter-individual variation in hepatic drug metabolism. Compared to adults, children present age-related differences in pharmacokinetics and pharmacodynamics. The purpose of this study was to determine the impact of fatty liver disease severity on the activity of a variety of CYPs in children and adolescents...
October 6, 2017: Drug Metabolism and Disposition: the Biological Fate of Chemicals
https://www.readbyqxmd.com/read/28982107/risk-factor-for-vital-signs-fluctuation-during-colonoscopy-under-conscious-sedation-consisting-of-midazolam-and-meperidine
#11
Shigeo Banno, Motohiko Kato, Yukie Sunata, Yuichiro Hirai, Yoko Kubosawa, Keiichiro Abe, Yoshiaki Takada, Tetsu Hirata, Yusaku Takatori, Michiko Wada, Satoshi Kinoshita, Hideki Mori, Kaoru Takabayashi, Masahiro Kikuchi, Toshio Uraoka
BACKGROUND: Sedatives or analgesics are widely used to relieve a patient's discomfort during colonoscopy (CS). Although cardiopulmonary adverse events are sometimes experienced during the examination, the risk factors for vital signs fluctuation (VSF) have not been fully elucidated. This study thus aimed to identify the risk factors for VSF during the examination, as well as to evaluate the frequency and the degree of VSF. SUMMARY: A total of 755 consecutive subjects who received CS under endoscopist-administrated sedation using midazolam, meperidine, or combination of both were retrospectively analyzed...
October 6, 2017: Digestive Diseases
https://www.readbyqxmd.com/read/28980398/external-validation-of-prediction-models-for-time-to-death-in-potential-donors-after-circulatory-death
#12
A M M Kotsopoulos, F Böing-Messing, N E Jansen, P Vos, W F Abdo
Predicting time to death in controlled donation after circulatory death (cDCD) donors following withdrawal of life-sustaining treatment (WLST) is important but poses a major challenge. The aim of this study is to determine factors predicting time to circulatory death within 60 minutes after WSLT and validate previously developed prediction models. In a single-center retrospective study we used the data of 92 potential cDCD donors. Multivariable regression analysis demonstrated that absent cough-, corneal reflex, lower morphine dosage, and midazolam use were significantly associated with death within 60 minutes (area under the curve (AUC) 0...
October 5, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28979712/colonoscopy-quality-with-entonox-%C3%A2-vs-intravenous-conscious-sedation-18608-colonoscopy-retrospective-study
#13
Alexander R Robertson, Nicholas A Kennedy, James A Robertson, Nicholas I Church, Colin L Noble
AIM: To compare colonoscopy quality with nitrous oxide gas (Entonox(®)) against intravenous conscious sedation using midazolam plus opioid. METHODS: A retrospective analysis was performed on a prospectively held database of 18608 colonoscopies carried out in Lothian health board hospitals between July 2013 and January 2016. The quality of colonoscopies performed with Entonox was compared to intravenous conscious sedation (abbreviated in this article as IVM). Furthermore, the quality of colonoscopies performed with an unmedicated group was compared to IVM...
September 16, 2017: World Journal of Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28978899/subarachnoid-block-induced-deafferentation-pain-successfully-treated-with-pentazocine
#14
Hiroaki Kishikawa, Zen'ichiro Wajima, Toshiro Shitara, Toru Shimizu, Hitoshi Adachi, Atsuhiro Sakamoto
Deafferentation pain induced by subarachnoid block (SAB) is rare, but it can appear in the form of recurrent phantom lower limb pain, new acute-onset stump pain in amputees, lower limb pain in patients with tabes dorsalis, and neuropathic pain. We have previously reported that thiopental is an effective treatment for deafferentation pain induced by therapeutic SAB applied to treat neuropathic pain of central origin. Here, we report the case of an amputee who developed new stump pain in his lower limb immediately after subarachnoid tetracaine was administered prior to appendectomy...
2017: Journal of Nippon Medical School, Nippon Ika Daigaku Zasshi
https://www.readbyqxmd.com/read/28978489/development-and-validation-of-a-sensitive-assay-for-analysis-of-midazolam-free-and-conjugated-1-hydroxymidazolam-and-4-hydroxymidazolam-in-pediatric-plasma-application-to-pediatric-pharmacokinetic-study
#15
Ganesh S Moorthy, Harini Jogiraju, Christina Vedar, Athena F Zuppa
Pharmacokinetic, pharmacodynamic and pharmacogenomic studies of midazolam are currently being performed in critically ill children to find suitable dose regimens. Sensitive assays using small volumes of plasma are necessary to determine the concentrations of midazolam and its respective metabolites in pediatric studies. Midazolam is metabolized to hydroxylated midazolam isomers, which are present as free as well as the corresponding glucuronide conjugates. A high-performance liquid chromatographic method with tandem mass spectrometry has been developed and validated for the quantification of midazolam, and free and total 1-hydroxymidazolam and 4-hydroxymidazolam metabolites in small volumes of plasma...
September 28, 2017: Journal of Chromatography. B, Analytical Technologies in the Biomedical and Life Sciences
https://www.readbyqxmd.com/read/28974435/evaluation-of-intestinal-metabolism-and-absorption-using-the-ussing-chamber-system-equipped-with-intestinal-tissue-from-rats-and-dogs
#16
Masateru Miyake, Satoshi Kondo, Toshihisa Koga, Noriaki Yoda, Satoru Nakazato, Chie Emoto, Tadashi Mukai, Hajime Toguchi
The purpose of this study was to evaluate the intestinal metabolism and absorption in a mini-Ussing chamber equipped with animal intestinal tissues, based on the transport index (TI). TI value was defined as the sum of drug amounts transported to the basal-side component (X(corr)) and drug amounts accumulated in the tissue (T(corr)), which are normalized by AUC of a drug in the apical compartment, as an index for drug absorption. Midazolam was used as a test compound for the evaluation of intestinal metabolism and absorption...
September 30, 2017: European Journal of Pharmaceutics and Biopharmaceutics
https://www.readbyqxmd.com/read/28969441/the-effect-of-a-single-dose-of-intravenous-ketamine-on-suicidal-ideation-a-systematic-review-and-individual-participant-data-meta-analysis
#17
Samuel T Wilkinson, Elizabeth D Ballard, Michael H Bloch, Sanjay J Mathew, James W Murrough, Adriana Feder, Peter Sos, Gang Wang, Carlos A Zarate, Gerard Sanacora
OBJECTIVE: Suicide is a public health crisis with limited treatment options. The authors conducted a systematic review and individual participant data meta-analysis examining the effects of a single dose of ketamine on suicidal ideation. METHOD: Individual participant data were obtained from 10 of 11 identified comparison intervention studies that used either saline or midazolam as a control treatment. The analysis included only participants who had suicidal ideation at baseline (N=167)...
October 3, 2017: American Journal of Psychiatry
https://www.readbyqxmd.com/read/28969245/effect-of-different-dosages-of-intravenous-midazolam-premedication-on-patients-undergoing-head-and-neck-surgeries-a-double-blinded-randomized-controlled-study
#18
Roshni Gupta, Neeta Santha, Madhusudan Upadya, Jesni Joseph Manissery
INTRODUCTION: Benzodiazepines primarily acts on the central nervous system. Most patients are extremely anxious in the pre-operative period. Excessive anxiety adversely influences anaesthetic induction and often leads to functional impairment and poor recovery after surgery. AIM: To determine whether amnesia, anxiety, sedation and cardio respiratory symptoms are affected while administering two different doses of intravenous midazolam (0.02 mg/kg & 0.06 mg/kg). MATERIALS AND METHODS: Two forty patients posted for head and neck surgeries were involved in this double blinded prospective randomised controlled trial...
August 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28969235/super-refractory-status-epilepticus-a-therapeutic-challenge-in-paediatrics
#19
Shrikiran Aroor, Kanaparthi Shravan, Suneel C Mundkur, C Jayakrishnan, Sai Sripad Rao
A status epilepticus which persists for 24 hours or more after starting treatment with anaesthesia or has recurred inspite of general anaesthesia is known as Super-Refractory Status Epilepticus (SRSE). It includes cases where status epilepticus recurs on reduction or withdrawal of anaesthesia. SRSE, though infrequently seen, constitutes a medical emergency due to the associated high morbidity and mortality. No clear cut guidelines are available till date for the management of SRSE. Most of the published literature was case reports and expert opinion...
August 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28967732/endobronchial-ultrasound-guided-transbronchial-needle-aspiration-under-conscious-sedation-with-meperidine-and-midazolam
#20
Lorenzo Agostini, Nicola Facciolongo, Mirco Lusuardi, Eleonora Casalini, Carla Galeone, Luciano Lasagni, Luigi Zucchi
Endobronchial Ultrasound guided transbronchial needle aspiration (EBUS-TBNA) is usually performed under general anesthesia or deep sedation with drugs such as Propofol that, at least in Italy, can be administered only by an anesthesiologist. Aim of the study was to assess conscious sedation feasibility, safety and tolerability using Meperidine and Midazolam as administered by Pulmonologist and relevant impact on the efficiency of the sampling procedures.All patients undergoing EBUS-TBNA from February 2013 to July 2014 were examined retrospectively...
July 18, 2017: Monaldi Archives for Chest Disease, Archivio Monaldi Per le Malattie del Torace
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