Sedative in convulsions

Many patents have been issued on the use of pyrogaUol derivatives as pharmaceuticals. PyrogaUol has been used extemaUy in the form of an ointment or a solution in the treatment of skin diseases, eg, psoriasis, ringworm, and lupus erythematosus. GaUamine triethiodide (16) is an important muscle relaxant in surgery it also is used in convulsive-shock therapy. Trimethoprim (2,4-diamino-5-(3,4,5-trimethoxybenzyl)pyrimidine) is an antimicrobial and is a component of Bactrin and Septra. Trimetazidine (l(2,3,4-trimethoxybenzyl)piperazine (Vastarel, Yosimilon) is used as a coronary vasodilator. l,2,3,4-Tetrahydro-6-methoxy-l-(3,4,5-trimethoxyphenyl)-9JT-pyrido[3,4- ]indole hydrochloride is useful as a tranquilizer (52) (see Hypnotics, sedatives, ANTICONVULSANTS, AND ANXIOLYTICS). Substituted indanones made from pyrogaUol trimethyl ether depress the central nervous system (CNS) (53). Tyrosine-and glycine(2,3,4-trihydroxybenzyl)hydrazides are characterized by antidepressant and anti-Parkinson activity (54). 

In any case, it is quite clear that REM suppression is a robust consequence of prolonged alcohol abuse. This effect becomes increasingly problematic as the addiction is prolonged and the inevitable crisis is made worse even as it is postponed. Barbiturates, another CNS depressant sedative class of drug, offer a similar picture. When barbiturates are used experimentally to suppress REM—and they are very effective REM suppressants—their dose frequency and amount must be increased more and more over time until, at 3-4 weeks, it is virtually impossible to quell the REM rebound. When it finally occurs, it is characterized by such intense phasic activation (PGO waves) that the animals literally fly off their sleeping surfaces in convulsive spasms. 

Anxiolytic proprieties were observed in rats with the plus maze model after 7 min rose oil inhalation this is the only report of inhaled effects in animals after a short period of inhalation, although the procedure of leaving four cotton balls embedded with 2 mL of EO lacks standardization (Almeida et al. 2004). As previously mentioned, inhaled cedrol was shown to be sedative in rats (Kagawa et al. 2003), and the inhalation of a volatile mixture from the TCM SuHeXiang Wan composed of 21.4% borneol (29), 33.3% isoborneol (30), 5.9% eugenol (4), and other minor components delayed the appearance of PTZ-induced convulsions suggesting GABAergic modulation (Koo et al. 2004). 

There is no specific treatment for ingestion of ibotenic acid or muscimol rather, treatment is symptomatic and supportive. Anxiety, hysteria, or convulsions can be treated with sedatives, such as diazepam. This should be done cautiously, however, and with the lowest effective dose because animal studies revealed that respiratory arrest may occur. In severe cases, with prolonged nausea, vomiting, or diarrhea, monitoring of fluid and electrolyte status may be required. Recent cases of muscarine poisonings were reported by Benjamin (1992), and Tupalska-Wilczynska et al. (1997). 

Flumazenil is a benzodiazepine antagonist that is used in anaesthesia for the reversal of central sedative effects of benzodiazepines. It should not be administered rapidly so as to avoid patient wakening too rapidly, which can lead to agitation, anxiety, fear and convulsions, particularly in high-risk patients, e.g. those with a history of epilepsy or head injury. 

Obtain cultures Obtain cultures and determine susceptibility before treatment. Determine blood levels Determine blood levels weekly for patients having reduced renal function, for individuals receiving more than 500 mg/day, and for those with symptoms of toxicity. Adjust dosage to maintain blood level less than 30 mcg/mL. Anticonvulsant drugs or sedatives Anticonvulsant drugs or sedatives may be effective in controlling symptoms of CNS toxicity, such as convulsions, anxiety, and tremor. Closely observe patients receiving more than 500 mg/day for such symptoms. Pyridoxine may prevent CNS toxicity, but its efficacy has not been proven. 

Meperidine (Demerol) [C-ll] [Narcotic Analgesic] Uses Moderate/ severe pain Action Narcotic analgesic Dose Adults. 25-50 mg IV, 50-100 mg IM Peds. 1 mg/kg IV/IM (onset w/in 5 min IV and 10 min IM duration about 2 h) Caution [C, ] Contra Convulsive disorders and acute abdomen Disp Prefilled 1 mL syringes 25, 50, 75, 100 mg/mL various amps and vials oral syrup and tabs SE N/V (may be severe), dizziness, weakness, sedation, miosis, resp d ession, xerostomia (dry mouth) Interactions t CNS depression W/ opiates, sedatives/ hypnotics TCNS stimulation W/amphetamines t risk of tox W7 phenytoin EMS Pt should be receiving O2 prior to administration have resuscitation equipment and naloxone available naloxone can be used as an antidote to reverse resp depression aspirate prior to IM administration inadv tent IV admin of IM doses may cause tach and syncope mix w/ NS to make a 10 mg/mL soln and inj very slowly N/V may be sev e may premedicate w/ an antiemetic... 

The withdrawal syndrome from ethanol includes anxiety, insomnia, possibly convulsions and visual hallucinations (delirium tremens - the Dts). It is treated or better still prevented by a calm environment, adequate (but not excessive) hydration, and careful monitoring, with the added use of anticon-vulsive/sedative agents, mainly benzodiazepines to prevent or treat convulsions. The preventive effects of benzodiazepines on withdrawal morbidity has been clearly demonstrated. There do not seem to be major differences between benzodiazepines, such as chlordiazepoxide or diazepam or others. Because of the abuse potential in these highly susceptible patients, these should be rapidly weaned, and proper prevention of relapse instituted. Other drugs such as meprobamate and clomethiazole (Hemineurin) are commonly used in some countries. The effectiveness... 

The fundamental neurobiological importance of the GABA A receptor is underscored by observations that even more receptor sites exist at or near this complex (Fig. 8—20). This includes receptor sites for nonbenzodiazepine sedative-hypnotics such as zolpidem and zaleplon, for the convulsant drug picrotoxin, for the anticonvulsant barbiturates, and perhaps even for alcohol. This receptor complex is hypothetically responsible in part for mediating such wide-ranging CNS activities as seizures, anticonvulsant drug effects, and the behavioral effects of alcohol, as well as the known anxiolytic, sedative-hypnotic, and muscle relaxant effects of the benzodiazepines. 

This involves considerable art, which must be learned in the clinic. It falls into two divisions (1) surface application to the mucous membranes, especially of the eye, nose, throat, and urethra and (2) injections about nerves, in different parts of their course and distribution, from their spinal roots to their ultimate fibrils. The advantages and disadvantages in comparison with general anesthesia and the selection of the local anesthetic agent also depend on clinical discrimination. Nervous, fearful, and excitable patients often suffer severely from apprehension, which also disposes toward accidents. They may be at least somewhat quieted by sedatives, morphine (0.015 g hypodermically) half an hour before the operation, or by barbiturates. The latter also tend to prevent convulsions. 

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