Buy Sedative for its Significant Effects

35 Responses

  1. Medical Procedures says:

    The Model for Assistance in the Orientation of a User within Coding Systems (MAOUSSC) project has been designed to provide a representation for medical and surgical procedures that allows several applications to be developed from several viewpoints. It is based on a conceptual model, a controlled set of terms, and Web server development. The design includes the UMLS knowledge sources associated with additional knowledge about medico-surgical procedures. The model was implemented using a relational database. The authors developed a complete interface for the Web presentation, with the intermediary layer being written in PERL. The server has been used for the representation of medico-surgical procedures that occur in the discharge summaries of the national survey of hospital activities that is performed by the French Health Statistics Agency in order to produce inpatient profiles. The authors describe the current status of the MAOUSSC server and discuss their interest in using such a server to assist in the coordination of terminology tasks and in the sharing of controlled terminologies.

    In France, a national survey of hospital activities is performed every 10 years by the governmental Health Statistics Agency (SESI) in order to produce inpatient profile statistics concerning patient demographics and clinical information. A representative sample of inpatient coded discharge summaries from public and private hospitals is collected. Over 80,000 records were collected from 423 hospitals during the last survey (1993). The medical information was coded using the French Catalogue des Actes Médicaux (CdAM) for the medico-surgical procedures. Information about medico-surgical procedures is needed by several participants in the health care delivery system, including clinicians, hospital managers, health policy makers, and clinical researchers. Each of them has a specific viewpoint on the information. The CDAM is a catalog; that means that data analysis based, for example, on the anatomic sites on which the procedures are focused, the types of surgical approaches, or the nature of the actions, requires construction of specific computer programs due to absence of a more sophisticated structure within the nomenclature. A representation based on the semantics of the procedure labels is a fundamental requirement in this context.1

    In order to be usable by several participants in the health care system, information dealing with medical procedures must be sharable. By sharable, we mean two things: the first one deals with the conceptual model, the second one with the availability of the data. The model must include existing concepts and a standard representation format. Therefore, we have explored the possibility of reusing the UMLS knowledge-base,2,3 and we have integrated the recommendations of the European prestandard defined by the CEN/TC251 workgroup.4 The availability of controlled terminologies on wide-area networks allows a collaborative development of the terminologies, makes possible their updating by several users, and facilitates their evaluation. A terminology system that includes network services can allow multiple applications built upon the unique database and can serve a wide range of health-care needs.5,6 Therefore, we have been developing since 1995 a terminology server for medico-surgical procedures in a Web server-accessible form, available to any workstation on the Internet.

    There have been two phases in the development of the MAOUSSC (Model for Assistance in the Orientation of a User within Coding Systems, in French Modèle d’Aide à l’Orientation d’un Utilisateur au Sein de Systèmes de Codage) application. The first phase occurred before the development of the Web server. The system in use was a 4D prototype running on the Macintosh.7 There were as many databases as medical domains. Each database was initially filled with a relevant list of procedure codes and labels and included a subset of the UMLS Metathesaurus8 captured by an automated process. The second phase is the one described here which implements the Web server.
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    Methods

    Our approach is based on a conceptual model, a controlled terminology, and Web server distribution.
    A Conceptual Model

    Medical terminology requires a deeper representation than the traditional tree-structured hierarchy, which is insufficient to precisely define what a term is and how it differs from the others. The aim of the MAOUSSC project is to provide a conceptual model for medical and surgical procedures. It is expected to have the independence and the flexibility that will accommodate several points of view.

    A medical procedure may be more or less complex. There are four levels of complexity. The lower level corresponds to MAOUSSC procedures that are described by a multi-axial model. The basic units of information which describe procedures have been categorized in eight axes. The mandatory axes conform with the CEN TC251 recommendation.4 Four of them are mandatory:

    Nature; i.e., what is done (ectomy, insertion, etc.)
    Topography; i.e., the anatomic site the action focuses on
    Instrumentation
    Approach

    Four complementary dimensions must be added to the description, depending on the nature axis value:

    An additional topography (i.e., axis topography complement) is required for procedures such as anastomosis.
    The matter or device (i.e., matter/device) involved must be specified as the direct object of ectomy or insertion verbs.
    A body process (i.e., BodyProcess) is mentioned when the action focuses on a biologic function instead of an organ.
    The disease axis is instantiated only for expressions like treatment of female genital prolapse.

    The second level consists of MAOUSSC procedures which may be qualified by modifiers; these are called elementary procedures. Modifiers can be used to indicate that a procedure is altered by some specific circumstance but is not changed in its definition. Modifiers are either general modifiers (e.g., “operation on child”) or modifiers for billing, such as information about when the procedure is performed (week-end, etc.). Whereas an axis is instantiated with a single value, several modifiers may be included for one procedure.

    The third level, associations, allows representation of several elementary procedures that are performed during a single operative session. The conjunction “AND” is used to connect the elementary procedures. Associated procedure terms may be combined into more complex sentences with the “OR” connective. Such sentences refer to composed procedures that correspond to the upper level in existing nomenclatures, in particular in the CDAM. It is obvious that a sentence like “A or B” is ambiguous, since we do not know what procedure was actually performed. Whereas ambiguous terms must be absent from a well-built terminology, the objective for the SESI study was to represent existing CDAM codes

  2. Tranquilizer says:

    Major and minor tranquilizers
    There are two types or classes of tranquilizers: major tranquilizers and minor tranquilizers. The former are antipsychotic drugs and the latter are considered antianxiety drugs. Antipsychotic drugs are used to treat patients with a severe mental illness, like schizophrenia (pronounced skit-zo-FREH-nee-uh). Antianxiety drugs are given to patients with emotional problems, like anxiety. Both types of tranquilizers were first introduced in the 1950s. At the time, they revolutionized psychiatry for they seemed to offer physicians a way to manage psychoses (pronounced sy-KOH-sees), which are severe forms of mental illness, and to make their patients emotionally calm and quiet. They also seemed to offer an alternative to people simply trying to cope or put up with the everyday anxieties, tension, and sleeplessness that many experience in their normal lives.

    Major tranquilizers for psychoses
    The major tranquilizers were first developed in the very early 1950s when scientists discovered that the organic compound called phenothiazine (pronounced fee-no-THY-uh-zeen) had a strong sedative effect, meaning it calmed or relaxed the person taking it. In 1952, a phenothiazine derivative called chlorpromazine (pronounced klor-PRO-muhzeen) was seen to make highly agitated patients quiet and calm without making them unconscious. However, it also made them much less aware mentally, as they seemed to have little or no interest in anything going on around them. These calming effects led doctors to begin giving this new drug (whose trade name was Thorazine) to severely disturbed, psychotic patients, since for the first time, science had found a drug that specifically targeted the central nervous system.

  3. Definition says:

    Sedatives are compounds that cause physiological and mental slowing of the body. They have many legitimate medical uses. However, people who use them improperly may develop symptoms of abuse, dependence, and withdrawal. Several other classes of compounds, including sleep-promoting drugs (hypnotics) and some anti-anxiety (anxiolytic) drugs produce effects and disorders similar to those of sedatives. Sedatives are often referred to as tranquilizers, and the similar classes of sedatives and hypnotics are sometimes thought of as one group: the sedative-hypnotics.

  4. Description says:

    Sedatives and similar drugs are available by prescription and have many medical uses. They are used in conjunction with surgery and are prescribed to treat pain, anxiety, panic attacks, insomnia , and in some cases, convulsions. Most people who take prescription sedatives take them responsibly and benefit from their use. Some people misuse these drugs. They may do so unintentionally by increasing their prescribed dose without medical advice. Intentional abusers buy these drugs off the street for recreational use or get them from friends or family members who have prescriptions. Sedatives are not popular street drugs, and when they are used recreationally, it is usually in conjunction with other illicit drugs or alcohol. When taken exactly as prescribed, sedatives rarely create major health risks.

    A chemically diverse group of drugs are discussed together in this entry because they all appear to work in the body the same way and produce similar problems of abuse, dependence, intoxication, and withdrawal. These drugs work in the brain by increasing the amount of the neurotransmitter gamma-aminobutyric acid (GABA). Neurotransmitters help to regulate the speed at which nerve impulses travel. When the amount of GABA increases, the speed of nerve transmissions decreases. Thus these drugs depress the nervous system and cause reduced pain, sleepiness, reduced anxiety, and muscle relaxation.

    The most widely prescribed and best-studied sedatives belong to a group called benzodiazepines. Prescription benzodiazepines and their relatives include alprazolam (Xanax), chlordiazepoxide (Librium), clonazepam (Klonopin), clorazepate (Tranxene), diazepam (Valium), estazolam (ProSom), flurazepam (Dalmane), halazepam (Paxipam), lorazepam , (Ativan), oxazepam (Serax), prazepam (Centrax), quazepam (Doral), temazepam (Restoril), triazolam (Halcion). Other drugs that act in a similar manner include the barbiturates amobarbital (Amytal), aprobarbital (Alurate), butabarbital (Butisol), phenobarbitol, (Nebutal), and secobarbital, (Seconal). In addition, chloral hydrate (Notec), ethchlorvynol (Placidyl), glutehimide (Doriden), meprobamate (Miltown, Equanil, Equagesic, Deprol) and zolpidem (Ambien) have similar actions.

  5. Causes and symptoms says:

    Sedatives and other drugs in this class are physically and sometimes psychologically addicting. People taking sedatives rapidly develop tolerance for the drugs. Tolerance occurs when a larger and larger dose must be taken to produce the same effect. Because sedatives are physically addicting, people with sedative dependence experience physical withdrawal symptoms when these drugs are discontinued.

    Sedative abuse occurs when people misuse these drugs but are not addicted to them. Many people who abuse sedatives also use other illicit drugs. They may use sedatives to come down off a cocaine high or to enhance the effect of methadone , a heroin substitute.

    Sedative dependence occurs when there is a physical addiction , when a person actively seeks sedatives (for example, by going to several doctors and getting multiple prescriptions) and when a person continues to use these drugs despite the fact that they cause interpersonal problems and difficulties meeting the responsibilities of daily life.

  6. Sedative intoxication says:

    Sedative intoxication occurs when a person has recently used one of these drugs and shows certain psychosocial symptoms such as hostility or aggression, swings in mood, poor judgment, inability to function in social settings or at work, or inappropriate sexual behavior. Because sedatives depress the central nervous system, physical symptoms include slurred speech, lack of coordination, inattention, impaired memory or “blackouts” and extreme sluggishness, stupor, or coma. Sedative intoxication can appear very similar to alcohol intoxication in its symptoms. Overdoses can be fatal.

  7. Sedative withdrawal says:

    Physical addiction is the main problem with sedative dependence. Sedative withdrawal is similar to alcohol withdrawal. Symptoms of sedative withdrawal are almost the reverse of the symptoms of sedative intoxication. They include:

    increased heart rate
    faster breathing
    elevated blood pressure
    increased body temperature
    sweating
    shaky hands
    inability to sleep
    anxiety
    nausea
    restlessness
    About one-quarter of people undergoing sedative withdrawal have seizures . If withdrawal is severe, they may also have visual or auditory hallucinations (sedative withdrawal delirium ). Often people who experience these more severe symptoms are using other drugs and not just sedatives.

    The timeframe for withdrawal symptoms to appear varies depending on the chemical structure of the drug being taken. Withdrawal symptoms can occur hours or days after stopping use. For example, people withdrawing from Valium may not develop withdrawal symptoms for a week, and may not have peak symptoms until the second week. Low-level symptoms may linger even longer. Generally the longer a person takes a drug and the higher the dose, the more severe the withdrawal symptoms. It is possible to have withdrawal symptoms when a therapeutically prescribed dose is taken for a long time.

    Sedative dependence is thought to be able to induce other mental health disorders, although there is some disagreement in the mental health community about how these disorders are defined and classified. Other disorders that may result from sedative dependence and withdrawal include:

  8. Demographics says:

    Many people, including about 90% of those who are hospitalized, are given some type of prescription sedative. Of the people who use sedatives, only a few become dependent. People who become dependent usually fall into three categories. Some are drug addicts who use sedatives along with other street drugs. These are usually young people between the ages of 15 and 25. Others are alcoholics who use sedatives to treat chronic anxiety or sleep problems associated with their alcohol dependence. Still others use sedatives under the direction of a doctor to treat long-term pain, anxiety, or sleeplessness. These people may become dependent by increasing the amount of sedative they take as tolerance develops without telling their doctor.

    Sedative abuse is not a major addiction problem with street drug users. Many people who are dependent on sedatives are middle-age and middle-class people who start taking the drug for a legitimate medical reason. Women may be more at risk than men for developing sedative dependence. Sedative dependence is the most common type of drug addiction among the elderly. Older people do not clear the drug from their bodies as efficiently as younger people, and thus may become dependent on lower, therapeutic doses.

  9. Diagnosis says:

    Diagnosis of sedative intoxication is made based on recent use of the drug, presence of the symptoms listed above, and presence of the drug in a blood or urine sample. Without a blood or urine test, sedative intoxication can be difficult to distinguish from alcohol intoxication except for the absence of the odor of alcohol. People experiencing sedative intoxication usually remain grounded in reality. However, if they lose touch with reality they may be diagnosed as having sedative intoxication delirium.

    Diagnosis of sedative withdrawal is based on the symptoms listed above. It can be difficult to distinguish from alcohol withdrawal. Withdrawal may occur with or without hallucinations and delirium. Diagnosis depends on whether a person remains grounded in reality during withdrawal.

    Diagnosis of other mental disorders induced by sedative dependence requires that the symptoms be in excess of those usually found with sedative intoxication or withdrawal. They cannot be accounted for by other substance abuse or another mental or physical disorder.

  10. Treatments says:

    Treatment depends on how large a dose of sedative the patient is taking, the length of time it has been used, and the patient’s individual psychological and physical state.

  11. Physiological treatment says:

    Successful treatment of sedative dependence is based on the idea of gradually decreasing the amount of drug the patient uses in order to keep withdrawal symptoms to a manageable level. This is called a drug taper. The rate of taper depends on the dependency dose of the drug, the length of time the drug has been taken, a person’s individual mental and physical response to drug withdrawal, and any complicating factors such as other substance abuse or other physical or mental illness.

    For people dependent on a low dose of sedatives, the current level of use is determined, then the amount of drug is then reduced by 10 to 25 percent. If withdrawal symptoms are manageable, reduction is continued on a weekly basis. If withdrawal symptoms are too severe, the patient is stabilized at the lowest dose with manageable symptoms until tapering can be re-started. This gradual reduction of use may take weeks, and the rate must be adjusted to the response of each patient individually.

    People dependent on high doses of sedatives are usually hospitalized because of the possibility of life-threatening withdrawal symptoms. A blood or urine test is used to determine the current level of usage. The patient is often switched to an equivalent dose of a different sedative or phenobarbitol (a barbiturate) to aid in withdrawal while controlling withdrawal symptoms. The tapering process begins, but more gradually than with low-dose dependency. Often other drugs are given to combat some of the withdrawal symptoms.

  12. Prognosis says:

    The people who have the best chance of becoming sedative-free are those who became dependent through taking long-term therapeutic doses. Although stopping any addiction takes time and work, with a properly managed course of treatment, chances of success are good.

    People who abuse multiple street drugs must receive treatment for their multiple drug dependencies. Sedative abuse is low on their list of problems, and the chances of their becoming drug-free are low. Alcoholics also have a difficult time withdrawing from sedatives.

  13. ORGANIZATIONS says:

    National Clearinghouse for Alcohol and Drug Information. P. O. Box 2345, Rockville, MD 20852. (800) 729-6686. .

    National Institute on Drug Abuse. 5600 Fishers Lane, Room 10 A-39, Rockville, MD 20857. 1-888-644-6432 .

  14. OTHER says:

    Benzodiazepine Recovery. . This site offers chat and support groups for people recovering from sedative dependence and has links to many sources of information on these drugs.

    Tish Davidson, A.M.

  15. Symptoms says:

    Symptoms of dependence: tolerance resulting in higher levels needed to achieve the same calming effect.

    Symptoms of psychological dependence: needing the drug to function and being obsessed with obtaining the drug.

    Symptoms of withdrawal: restlessness, insomnia, anxiety, seizures, even death in some cases.

    To be clinically diagnosed with having a sedative, hypnotic, or anxiolytic use disorder there must be a problematic pattern of impairment or distress, with at least two of the following symptoms, within the previous 12-month period:

    Sedatives, hypnotics, or anxiolytics are taken in larger dosage and/or for a longer period of time than intended.
    There is a desire and failed effort/failed attempt to reduce or control sedative, hypnotic, or anxiolytic drug use.
    A large amount of time goes into the procuring or using the sedative, hypnotic, or anxiolytic; or recovering from the effects of the sedative, hypnotic, or anxiolytic drug.
    An overwhelming desire, urge, or craving to use the sedative, hypnotic, or anxiolytic.
    The inability, due to sedative, hypnotic, or anxiolytic drug use, to maintain obligations for one’s job, school, or homelife; or absence from job, school, or family.
    Continued sedative, hypnotic, or anxiolytic drug use in the face of social/interpersonal problems that result from, or are made worse by, the use of the stimulant.
    Sedative, hypnotic, or anxiolytic use becomes prioritized to such an extent that social, occupational, and recreational activities are either given up completely, or are reduced drastically.
    Sedative, hypnotic, or anxiolytic use occurs even in situations where it becomes physically hazardous for the individual.
    Use of the sedative, hypnotic, or anxiolytic drug continues even with knowing the physical and psychological risks and exacerbations associated with it.
    Tolerance is increased by one of the following:

    Large increases in the amount of the sedative, hypnotic, or anxiolytic drug to achieve wanted effect (not met as a criteria if under medical supervision).
    The same use of the sedative, hypnotic, or anxiolytic drug no longer reaches desired effect (not met as a criteria if under medical supervision).
    Withdrawal due to one of the following:

    The Individuals displays withdrawal symptoms and characteristics of the sedative, hypnotic, or anxiolytic drug (not met as a criteria if under medical supervision).
    Symptoms of withdrawal diminish with use of the sedative, hypnotic, or anxiolytic drug and is used to relieve or avoid symptoms of withdrawal (not met as a criteria if under medical supervision).

  16. GENERAL CLINICAL APPLICATIONS says:

    Sedatives may be used to relieve anxiety or to provide chemical restraint. They facilitate the handling of patients, allowing thorough examination, positioning for radiography, etc. Sedatives are also used for preanesthetic medication. Their use renders the patient more tractable, thereby improving staff safety and assisting the placement of intravenous catheters.

    There are benefits for the patient too! By reducing fear and anxiety prior to induction of anesthesia, the potential for catecholamine-induced dysrhythmias is reduced. Generally, the quality of anesthetic induction and recovery is improved by sedatives, there being less risk of excitement. In addition, the dose of induction agent required is reduced.

    Many sedative drugs do not possess analgesic activity and will therefore not have an effect in animals that are in pain or are subject to painful procedures. In these cases the sedative should be combined with an opioid analgesic, a practice termed neuroleptanalgesia. Such combinations have a number of advantages and their use is to be recommended even in the nonpainful patient. The sedative and opioid act synergistically to enhance sedation; thus lower doses are required and the risk of adverse effects is reduced. In addition, the sedative may counteract some of the undesirable effects of the opioid, such as vomiting or excitement.

    Where high doses of a very potent opioid are combined with a sedative the degree of CNS depression may be sufficient to permit minimally invasive surgery. Such combinations have been termed ‘neuroleptanesthetics’. They are generally associated with a greater incidence of adverse effects and should be distinguished from neuroleptanalgesic combinations. There is further discussion of the use of opioids to induce anesthesia in Chapter 5.

    The sedatives used in veterinary medicine fall into four main categories.


    Phenothiazines


    Butyrophenones


    Benzodiazepines


    α2-adrenergic agonists

  17. Sedative-Hypnotic Withdrawal says:

    Sedative-hypnotic agents include benzodiazepines, barbiturates, γ-hydroxybutyric acid (GHB), and γ-butyrolactone (GBL), and withdrawal from these drugs may be indistinguishable from alcohol withdrawal because the presenting symptoms are nearly identical. However, the chronology may offer a clue to the cause of the withdrawal. Because of rapid metabolism and the lack of active metabolites, withdrawal from GHB or GBL generally occurs within 2 to 3 hours of cessation of drug use.2 In contrast, diazepam has active metabolites, and thus withdrawal symptoms may not be manifested for a week. Seizures may result from any sedative-hypnotic withdrawal. Different sedative-hypnotic agents often share enough common receptor or meta-bolic activity that one drug can be substituted for the other to treat withdrawal—a phenomenon known as cross-tolerance.

  18. Hypnotics says:

    Sedative–hypnotic drugs depress CNS function and are used to reduce anxiety or induce sleep. Although alcohol, opioids, and GHB fall into this general category, barbiturates and benzodiazepines are considered the two major classes of sedative–hypnotics. A QTL associated with pentobarbital withdrawal was mapped to a region containing 15 genes of mouse chromosome 1, and Girk3 was identified as a particularly promising candidate (Kozell et al., 2009). Less severe pentobarbital withdrawal was associated with lower Girk3 mRNA expression, suggesting that a Girk3 null mutation would decrease pentobarbital withdrawal compared to that of wild-type mice. As observed for ethanol, Girk3−/− mice experienced less severe withdrawal from pentobarbital and zolpidem (Table 2), providing evidence for GIRK3-containing channels in acute withdrawal from barbiturates and benzodiazepines (Kozell et al., 2009). Girk3−/− and wild-type mice did not differ in pentobarbital-induced sedation and hypothermia, suggesting that Girk3 mediates a subset of sedative–hypnotic effects.

  19. Describe the syndrome says:

    Sedative-hypnotic agents include benzodiazepines, barbiturates, and miscellaneous other central nervous system depressants (e.g., chloral hydrate). Sedative-hypnotic withdrawal is symptomatically similar to alcohol withdrawal. The time of onset and duration of the syndrome vary with the half-life of the agent; symptoms may start several hours after stopping short-acting agents to several days for longer-acting agents. Withdrawal can be life-threatening. Treatment consists of a gradual taper of the agent or an equivalent dose of a longer-acting agent (e.g., diazepam for benzodiazepine withdrawal or phenobarbital for barbiturates).

  20. USE OF SEDATIVES POSTOPERATIVELY says:

    Sedative hypnotics are frequently administered after surgery for complaints of insomnia. As discussed earlier in this chapter, sedative hypnotics and anxiolytics should be avoided due to the adverse effects on arousal thresholds, as well as apnea duration and severity. For patients with OSAS, short-acting non-benzodiazapine hypnotic agents may be safer than benzodiazepine hypnotics. Zaleplon (half-life 1 hour) and zolpidem tartrate (half-life 2.5 hours) have no significant effect on the Apnea/Hypopnea Index compared to placebo in mild to moderate sleep apnea patients.41 However, while zaleplon had no effect on the oxygen saturation, zolpidem reduced the lowest oxygen saturation compared to placebo as well as the total time with SaO2<90% and 80%, compared to the placebo group.

  21. Understanding the Side Effects of Sleeping Pills says:

    Between a third and half of all Americans have insomnia and complain of poor sleep. Perhaps you’re one of them. If so, you may be considering taking a sleeping pill.

    A sleeping pill may be effective at ending your sleep problems short-term. But it’s important to make sure you understand everything you need to know about sleeping pills. That includes knowing about sleeping pill side effects. When you do, you can avoid misusing these sedatives.

  22. What Are Sleeping Pills? says:

    Most sleeping pills are classified as “sedative hypnotics.” That’s a specific class of drugs used to induce and/or maintain sleep. Sedative hypnotics include benzodiazepines, barbiturates, and various hypnotics

  23. What are sedative-hypnotics? says:

    Sedative-hypnotics are drugs that depress or slow down the body’s functions. Often these drugs are referred to as tranquilizers and sleeping pills or sometimes just as sedatives. Their effects range from calming down anxious people to promoting sleep. Both tranquilizers and sleeping pills can have either effect, depending on how much is taken.

    Barbiturates and benzodiazepines are the two major categories of sedative-hypnotic. Some well-known barbiturates are secobarbital (Seconal) and pentobarbital (Nembutal), diazepam (Valium), chlordiazepoxide (Librium), chlorazepate (Tranxene), lorazepam (Ativan), and alprazolam (Xanax). A few sedative-hypnotics do not fit in either category. They include methaqualone (Quaalude), ethchlorvynol (Placidyl), chloralhydrate (Noctec), and mebrobamate (Miltown). Additionally, alcohol belongs to the sedative-hypnotic group.

  24. What are the warning signs? says:

    All of these drugs can be dangerous when they are not taken according to a physician’s instructions. They can cause both physical and psychological dependence. Regular use over a long period of time may result in tolerance, which means people have to take larger and larger doses to get the same effects. When regular users stop using large doses of these drugs suddenly, they may develop physical withdrawal symptoms ranging from restlessness, insomnia, anxiety, convulsions, and death. When users become psychologically dependent, they feel as if they need the drug to function. Finding and using the drug becomes the main focus in life.

  25. What are the effects? says:

    The effects of barbiturates are, in many ways, similar to the effects of alcohol. Small amounts produce calmness and relax muscles. Larger doses can cause slurred speech, memory loss, irritability, changes in alertness, decreased interpersonal functioning, staggering gait, poor judgment, and slow, uncertain reflexes. These effects make it dangerous to drive a car or operate machinery. Large doses can cause unconsciousness and death. Accidental deaths sometimes occur when a user takes one dose, becomes confused and unintentionally takes additional or larger doses. Additionally, there is less difference between the amount that produces sleep and the amount that kills.

    Babies born to mothers who abuse sedatives during their pregnancy may be physically dependent on drugs and show withdrawal shortly after birth. Their symptoms may include breathing problems, feeding difficulties, disturbed sleep, sweating, irritability, and fever. Sedative-hypnotics may also pass through the placenta, creating birth defects and behavioral problems in babies

  26. How can someone get help? says:

    The first step is to determine if there is a problem. A Certified Addictions Counselor can effectively perform an assessment to determine what level of care is most appropriate. For a free confidential assessment, call the Illinois Institute for Addiction Recovery at (800) 522-3784. An assessment can be completed 24 hours a day, 7 days a week. Appointments are preferred, but walk-ins are always welcome.

    Sources: National Institutes on Health, U.S. Department of Health and Human Services, American Psychiatric Association

  27. Sedative-hypnotic drug says:

    Sedative-hypnotic drug, chemical substance used to reduce tension and anxiety and induce calm (sedative effect) or to induce sleep (hypnotic effect). Most such drugs exert a quieting or calming effect at low doses and a sleep-inducing effect in larger doses. Sedative-hypnotic drugs tend to depress the central nervous system. Since these actions can be obtained with other drugs, such as opiates, the distinctive characteristic of sedative-hypnotics is their selective ability to achieve their effects without affecting mood or reducing sensitivity to pain.

  28. Sedative-hypnotic says:

    For centuries alcohol and opium were the only drugs available that had sedative-hypnotic effects. The first substance introduced specifically as a sedative and as a hypnotic was a liquid solution of bromide salts, which came into use in the 1800s. Chloral hydrate, a derivative of ethyl alcohol, was introduced in 1869 as a synthetic sedative-hypnotic; it was used notoriously as “knock-out” drops. Paraldehyde was introduced into clinical medicine in the 1880s and was followed by the synthesis of barbital in 1903. Phenobarbital became available in 1912 and was followed, during the next 20 years, by a long series of other barbiturates. In the mid-20th century new types of sedative-hypnotic drugs were synthesized, chief among them the benzodiazepines (the so-called minor tranquilizers).

    Barbiturates were extensively used as “sleeping pills” throughout the first half of the 20th century. They also were used to reduce voluntary inhibition during psychiatric examinations (for which they have sometimes been dubbed “truth serums”). Among the most commonly prescribed kinds were phenobarbital, secobarbital (marketed under Seconal and other trade names), amobarbital (Amytal), and pentobarbital (Nembutal). When taken in high-enough doses, these drugs are capable of producing a deep unconsciousness that makes them useful as general anesthetics. In still higher doses, however, they depress the central nervous and respiratory systems to the point of coma, respiratory failure, and death. Additionally, the prolonged use of barbiturates for relief of insomnia leads to tolerance, in which the user requires amounts of the drug much in excess of the initial therapeutic dose, and to addiction, in which denial of the drug precipitates withdrawal, as indicated by such symptoms as restlessness, anxiety, weakness, insomnia, nausea, and convulsions. Analysis of electroencephalographic (EEG) patterns during barbiturate-induced sleep has further revealed that the use of some of these drugs produces sleep disruption.

    The use of barbiturates declined after the development in the 1950s of the benzodiazepines. The latter are more effective in relieving anxiety than in inducing sleep, but they are superior to barbiturates because of the reduced dangers they present of tolerance and addiction and because they are much less likely to injuriously depress the central nervous system when used at high doses. They also require a much smaller dosage than barbiturates to achieve their effects. The benzodiazepines include chlordiazepoxide (Librium), diazepam (Valium), alprazolam (Xanax), oxazepam (Serax), and triazolam (Halcion). They are, however, intended only for short- or medium-term use, since the body does develop a tolerance to them and withdrawal symptoms (anxiety, restlessness, and so on) develop even in those who have used the drugs for only four to six weeks. The benzodiazepines are thought to accomplish their effect within the brain by facilitating the action of the neurotransmitter gamma-aminobutyric acid, which is known to inhibit anxiety.

    Antipsychotic drugs (major tranquilizers), tricyclic antidepressants, and antihistamines can also induce drowsiness, though this is not their primary function. Most over-the-counter sleeping aids use antihistamines as their active ingredient.

    Alcoholic beverages in particular are only of modest benefit in inducing sleep. On frequent exposure to alcohol, the nervous system adapts to the drug, and this results in early-morning awakening.

  29. Pharmaceutical industry says:

    Pharmaceutical industry, the discovery, development, and manufacture of drugs and medications (pharmaceuticals) by public and private organizations. The modern era of the pharmaceutical industry—of isolation and purification of compounds, chemical synthesis, and computer-aided drug design—is considered to have begun in the 19th century, thousands of years after intuition and trial and error led humans to believe that plants, animals, and minerals contained medicinal properties. The unification of research in the 20th century in fields such as chemistry and physiology increased the understanding of basic drug-discovery processes. Identifying new drug targets, attaining regulatory approval from government agencies, and refining techniques in …(100 of 13438 words)

  30. Parturition says:

    Parturition, also called birth or childbirth, process of bringing forth a child from the uterus, or womb. The prior development of the child in the uterus is described in the article human embryology. The process and series of changes that take place in a woman’s organs and tissues as a result of the developing fetus are discussed in the article pregnancy.

  31. Fetal presentation and passage through the birth canal says:

    The manner in which the child passes through the birth canal in the second stage of labour depends upon the position in which it is lying and the shape of the mother’s pelvis. The sequence of events described in the following paragraphs is that which frequently occurs when the mother’s pelvis is of the usual type and the child is lying with the top of its head lowermost and transversely placed and the back of its head (occiput) directed toward the left side of the mother (see onset of labour in the figure). The top of the head, accordingly, is leading, and its long axis lies transversely.

    Sequential changes in the position of the child during labour.
    Sequential changes in the position of the child during labour.
    Encyclopædia Britannica, Inc.
    The force derived from the uterine contractions and the bearing-down efforts exerts pressure on the child’s buttocks and is transmitted along the vertebral column to drive the head into and through the pelvis. Because of the attachment of the spine to the base of the skull, the back of the head advances more rapidly than the brow with the result that the head becomes flexed (i.e., the neck is bent) until the chin comes to lie against the breastbone (see flexion in the figure). As a consequence of this flexion mechanism, the top of the head becomes the leading pole and the ovoid head circumference that entered the birth canal is succeeded by a smaller, almost circular circumference, the long diameter of which is about 2 centimetres (0.75 inch) shorter than that of the earlier circumference.

    As the head descends more deeply into the birth canal, it meets the resistance of the bony pelvis and of the slinglike pelvic floor, or diaphragm, which slopes downward, forward, and inward. When the back of the head, the leading part of the child, is forced against this sloping wall on the left side, it naturally is shunted forward and to the right as it advances (see internal rotation of head in the figure). This internal rotation of the head brings its longest diameter into relation with the longest diameter of the pelvic outlet and thus greatly assists in the adaptation of the advancing head to the configuration of the cavity through which it is to pass.

    Further descent of the head directly downward in the direction in which it has been traveling is opposed by the lower portion of the mother’s bony pelvis, behind, and the resisting soft parts that are interposed between it and the opening of the vagina (see internal rotation of head in the figure). Less resistance, on the other hand, is offered by the soft and dilatable walls of the lower birth canal, which is directed forward and upward. The back of the child’s head accordingly advances along the lower birth canal, distending its walls and dilating its cavity while the head progresses. Soon the back of the child’s neck becomes impinged against the bones of the pelvis, in front, and the chin is forced farther and farther away from the breastbone. Thus, as extension (bending of the head backward) takes the place of flexion, the occiput, brow, eye sockets, nose, mouth, and chin pass successively through the external opening of the lower birth canal and are born (see extension in the figure).

    The neck, which was twisted during internal rotation of the head, untwists as soon as the head is born. Almost immediately after its birth, therefore, the top of the head is turned toward the left and backward.

    As the child’s lower shoulder advances, it meets the sloping resistance of the pelvic floor on the right side and is shunted forward and to the left toward the middle of the pelvis in front. This position brings the long diameter of the shoulder circumference into relation with the anteroposterior, or long diameter, of the pelvic cavity. Because of this internal rotation of the shoulders, the top of the head undergoes further external rotation backward and to the left so that the child’s face comes to look directly at the inner aspect of the mother’s right thigh (see external rotation of head in the figure).

    Soon after the shoulders rotate, the one in front appears in the vulvovaginal orifice and remains in this position while the other shoulder is swept forward by a lateral bending of the trunk through the same upward and forward curve that was followed by the head as it was being born. After this shoulder is delivered, the shoulder in front and the rest of the child’s body are expelled almost immediately and without any special mechanism.

    An average of about one hour and 45 minutes is required for the completion of the second stage of labour in women who give birth for the first time. In subsequent labours the average duration of the stage of expulsion is somewhat shorter.

  32. Systemic drugs says:

    Meperidine and morphine, given intravenously, are common narcotic drugs used for pain relief (analgesia) during labour. There are side effects associated with both drugs—namely, nausea and vomiting. When promethazine is given in conjunction with meperidine, these side effects are ameliorated. Other negative maternal effects caused by systemic analgesics are drowsiness, respiratory depression, and lowering of blood pressure (hypotension). Because systemic drugs cross the placental barrier, they can also affect the newborn, causing respiratory depression, decreased alertness, and abnormal reflexes. The longer the duration between the administration of the narcotic and the birth of the child, the higher the level of the drug in the infant and the greater its effects. Another drug commonly used for systemic analgesia is butorphanol, which produces less neonatal depression.

    Barbiturates, once important for lessening labour pains, are now only rarely administered during labour. Although they are sedatives, which normally induce a relaxed state, they are not analgesics and actually may increase sensitivity to pain. Barbiturates also cause respiratory depression in the newborn if administered in active labour, which can be exacerbated by the concomitant use of narcotic analgesics. Sedatives are used only in the early stages of labour to help the woman relax and rest before the contractions of active labour begin.

  33. Childhood disease and disorder says:

    Childhood disease and disorder, any illness, impairment, or abnormal condition that affects primarily infants and children—i.e., those in the age span that begins with the fetus and extends through adolescence. Childhood is a period typified by change, both in the child and in the immediate environment. Changes in the child related to growth and development are so striking that it is almost as if the child were a series of distinct yet related individuals passing through infancy, childhood, and adolescence. Changes in the environment occur as the surroundings and contacts of a totally dependent infant become those of a progressively …(100 of 15074 word

  34. Childhood disease and disorder says:

    Pharmacological intervention can play an important role in many veterinary procedures as well as with behavior modification. The terms tranquilizer and sedative often are used interchangeably, and the true meaning of the two can sometimes get lost in translation. This article will explain the two, how they are used in veterinary medicine and how they compare to anti-anxiety medications and calming supplements.

    A sedative is a drug that reduces excitement or irritability, therefore allowing the horse to become sleepy. These include xylazine (Rompun), detomidine (Dormosedan) and romifidine (SediVet). These are short-acting and provide reliable sedation with some analgesia (pain relief) as well. Sedated horses are often unaware of their surroundings, but these drugs cannot prevent all reactions (kicking, biting) and may even increase the risk. Sedatives are commonly used to facilitate short veterinary procedures.

    A tranquilizer, on the other hand, is a drug that decreases anxiety without causing excessive sedation. Typically, tranquilizers do not provide any pain relief and work by stabilizing mood, reducing anxiety and controlling aggressiveness. Horses that have been given tranquilizers are typically aware of their surroundings, but they appear more relaxed.

  35. anti-anxiety medications, says:

    Most anti-anxiety medications, including clomipramine (Clomicalm) and fluoxetine (Prozac), work by altering the way serotonin is processed in the brain. Serotonin is a chemical that provides a feeling of comfort and happiness. In the horse, most of these drugs are used with varying degrees of success, have significant side effects or are used extra-label, meaning they were tested and approved for a condition other than anxiety or were designed for another species.

    Many horse owners turn to calming supplements to modify their horses’ behavior. Calming supplements, which do not require a prescription, typically include magnesium, vitamin B1, valerian root and other natural ingredients. Supplements have not been FDA-approved and any effect noted should be interpreted carefully.

    Another nutritional supplement is Zylkene, which according to the manufacturer contains alpha-casozepine, a patented, milk-derived protein with calming properties. Zylkene is a GABA-agonist with a very specific site of attachment on the 4-ABU site of the gamma amino butyric acid (GABA) receptor. The manufacturer states that specificity of this attachment improves the coping mechanism of the animal when faced with a challenge without side effects of sedation, disinhibition or loss of memory. The manufacturer of alpha casozepine (Zylkene) said this nutritional supplement has been well-researched with documented support of its efficacy in dogs, cats and horses. With over 10-years of use globally, Zylkene maintains a wide safety profile with no serious side effects reported.

    If your horse has a behavioral problem for which you are considering medicating, first:

    1. Consult your veterinarian for an evaluation to make sure that a behavior is not related to an underlying medical problem;

    2. Work with your trainer and veterinarian to come up with strategies to solve a behavioral problem;

    3. Use pharmacologic intervention as a last resort once all other options have been exhausted.

    Sources:

    Equine Behavior: A Guide for Veterinarians and Equine Scientists. McGreevy, P. 2004

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