Drug Monitoring

Publication Title: 
AACN clinical issues

Patients with severe traumatic brain injury resulting in increased intracranial pressure refractory to first-tier interventions challenge the critical care team. After exhausting these initial interventions, critical care practitioners may utilize barbiturate-induced coma in an attempt to reduce the intracranial pressure. Titrating appropriate levels of barbiturate is imperative. Underdosing the drug may fail to control the intracranial pressure, whereas overdosing may lead to untoward effects such as hypotension and cardiac compromise.

Author(s): 
Bader, Mary Kay
Arbour, Richard
Palmer, Sylvain
Publication Title: 
AACN clinical issues

Patients with severe traumatic brain injury resulting in increased intracranial pressure refractory to first-tier interventions challenge the critical care team. After exhausting these initial interventions, critical care practitioners may utilize barbiturate-induced coma in an attempt to reduce the intracranial pressure. Titrating appropriate levels of barbiturate is imperative. Underdosing the drug may fail to control the intracranial pressure, whereas overdosing may lead to untoward effects such as hypotension and cardiac compromise.

Author(s): 
Bader, Mary Kay
Arbour, Richard
Palmer, Sylvain
Publication Title: 
Journal of Clinical Monitoring and Computing

OBJECTIVE: The field of Anaesthesia has recently witnessed numerous advances both in the drug administration and monitoring of anaesthetic state. This development has further boosted the efforts and interest of researchers in the automation of clinical Anaesthesia. The success in this direction is possible only when assessment of the depth of hypnotic component of anaesthesia is achieved accurately. This paper describes a technique to arrive at a reliable Depth of Hypnosis (DoH) index using electroencephalographic (EEG) parameters.

Author(s): 
Kumar, Amod
Anand, Sneh
Publication Title: 
Anaesthesia and Intensive Care

Propofol anaesthesia using target control infusion during cardiac surgery has become more popular recently. However, without depth of anaesthesia monitoring, the standard target concentration used may be higher than necessary to maintain adequate hypnosis during hypothermic cardiopulmonary bypass. The purpose of this study was to evaluate the effect of bispectral index monitoring on propofol administration during hypothermic cardiopulmonary bypass.

Author(s): 
Chiu, C. L.
Ong, G.
Majid, A. A.
Publication Title: 
Handbook of Experimental Pharmacology

Anesthesia cannot be defined in an unambiguous manner. The essential components of general anesthesia are absence of consciousness and pain. This translates into two particular qualities: (1) sedation and hypnosis, i.e., mental blockade and (2) analgesia/antinociception, i.e., sensory blockade. Anesthetic actions on these two subcomponents are difficult to separate. On the one hand, very few anesthetics act exclusively on one of these components. On the other hand, these components are closely related to each other.

Author(s): 
Bischoff, P.
Schneider, G.
Kochs, E.
Publication Title: 
Handbook of Experimental Pharmacology

In this chapter, drawn largely from the synthesis of material that we first presented in the sixth edition of Miller's Anesthesia, Chap 31 (Stanski and Shafer 2005; used by permission of the publisher), we have defined anesthetic depth as the probability of non-response to stimulation, calibrated against the strength of the stimulus, the difficulty of suppressing the response, and the drug-induced probability of non-responsiveness at defined effect site concentrations. This definition requires measurement of multiple different stimuli and responses at well-defined drug concentrations.

Author(s): 
Shafer, S. L.
Stanski, D. R.
Publication Title: 
Journal of Clinical Monitoring and Computing

OBJECTIVE: This study investigated the suitability of various electroencephalogram (EEG) parameters to describe anaesthetic drug effects in propofol-remifentanil anaesthesia. The investigated parameters were the Narcotrend Index (NI), the Bispectral Index (BIS), and standard spectral and entropy parameters. Additionally, it was investigated whether the effect of a fixed dosage of propofol on the attained depth of hypnosis during induction of anaesthesia is different in male and female patients.

Author(s): 
Schultz, Arthur
Siedenberg, Markus
Grouven, Ulrich
Kneif, Thomas
Schultz, Barbara
Publication Title: 
IEEE transactions on bio-medical engineering

In ambulatory surgery, anesthetic drugs must be administered at a suitable rate to prevent adverse reactions after discharge from the hospital. To realize more appropriate anesthesia, we have developed a hypnosis control system, which administers propofol as an anesthetic drug to regulate the bispectral index (BIS), an electroencephalography (EEG)-derived index reflecting the hypnosis of a patient.

Author(s): 
Sawaguchi, Yoshihito
Furutani, Eiko
Shirakami, Gotaro
Araki, Mithuiko
Fukuda, Kazhuiko
Publication Title: 
Tidsskrift for Den Norske Lægeforening: Tidsskrift for Praktisk Medicin, Ny Række

BACKGROUND: There has been a breakthrough in the understanding of anaesthetic drug effects during the last two decades, and new monitors aimed at quantifying such effects have been developed. MATERIAL AND METHODS: This review is based on publications from the last 15 years, oral presentations, and rewritten parts of the author's PhD thesis. RESULTS: General anaesthesia can be regarded as a combination of hypnosis (sleep), analgesia and muscle relaxation. Modern anaesthetic drugs aim at each of these effects separately.

Author(s): 
Høymork, Siv Cathrine
Publication Title: 
Bulletin of the World Health Organization

OBJECTIVE: To evaluate the therapeutic efficacy of sulfadoxine-pyrimethamine, amodiaquine, and the sulfadoxine-pyrimethamine-amodiaquine combination for the treatment of uncomplicated Plasmodium falciparum malaria in young children in Cameroon.

Author(s): 
Basco, Leonardo K.
Same-Ekobo, Albert
Ngane, Vincent Foumane
Ndounga, Mathieu
Metoh, Theresia
Ringwald, Pascal
Soula, Georges

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