Hypnotics and Sedatives

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: 
Annales Francaises D'anesthesie Et De Reanimation

Analgesia and hypnosis are two separate entities and should result in distinct assessment and management for patients admitted to an intensive care unit (ICU). Those patients are exposed to moderate-severe pain and they are likely to remember pain as one bothersome experience. Any cause of patient discomfort is sought with the priority given to pain and adequate analgesia. Assessing pain must rely upon the use of clinical scoring systems, although these instruments are still underused in ICU.

Author(s): 
Payen, J.-F.
Chanques, G.
Publication Title: 
The Cochrane Database of Systematic Reviews

BACKGROUND: Labour is a normal physiological process, but is usually associated with pain and discomfort. Numerous methods are used to relieve labour pain. These include pharmacological (e.g. epidural, opioids, inhaled analgesia) and non-pharmacological (e.g. hypnosis, acupuncture) methods of pain management. Non-opioid drugs are a pharmacological method used to control mild to moderate pain. OBJECTIVES: To summarise the evidence regarding the effects and safety of the use of non-opioid drugs to relieve pain in labour.

Author(s): 
Othman, Mohammad
Jones, Leanne
Neilson, James P.
Publication Title: 
Journal of Alternative and Complementary Medicine (New York, N.Y.)

BACKGROUND: Acupuncture is commonly used in treating insomnia in China, and clinical studies have shown that acupuncture may have a beneficial effect on insomnia compared with Western medication. METHODS: We included randomized controlled trials on acupuncture for insomnia. We searched PubMed, the Cochrane Library (2008 Issue 3), China Network Knowledge Infrastructure (CNKI), Chinese Scientific Journal Database (VIP), and Wan Fang Database. All searches ended in December 2008. Two authors extracted data and assessed the trials' quality independently.

Author(s): 
Cao, Huijuan
Pan, Xingfang
Li, Hua
Liu, Jianping
Publication Title: 
Journal of Alternative and Complementary Medicine (New York, N.Y.)

BACKGROUND: Acupuncture is commonly used in treating insomnia in China, and clinical studies have shown that acupuncture may have a beneficial effect on insomnia compared with Western medication. METHODS: We included randomized controlled trials on acupuncture for insomnia. We searched PubMed, the Cochrane Library (2008 Issue 3), China Network Knowledge Infrastructure (CNKI), Chinese Scientific Journal Database (VIP), and Wan Fang Database. All searches ended in December 2008. Two authors extracted data and assessed the trials' quality independently.

Author(s): 
Cao, Huijuan
Pan, Xingfang
Li, Hua
Liu, Jianping
Publication Title: 
The Cochrane Database of Systematic Reviews

BACKGROUND: Labour is a normal physiological process, but is usually associated with pain and discomfort. Numerous methods are used to relieve labour pain. These include pharmacological (e.g. epidural, opioids, inhaled analgesia) and non-pharmacological (e.g. hypnosis, acupuncture) methods of pain management. Non-opioid drugs are a pharmacological method used to control mild to moderate pain. OBJECTIVES: To summarise the evidence regarding the effects and safety of the use of non-opioid drugs to relieve pain in labour.

Author(s): 
Othman, Mohammad
Jones, Leanne
Neilson, James P.
Publication Title: 
Journal of Neural Transmission (Vienna, Austria: 1996)

Hypothalamic-pituitary-adrenal (HPA) axis dysfunction has been implicated in the pathogenesis of addictive behaviour and especially in alcohol craving. The pro-opiomelanocortin gene (POMC), encoding a 241 amino acids stretching polypeptide hormone precursor, plays an important role in the regulation of the HPA, and is prone to epigenetic regulation due to promoter-related DNA methylation. Aim of the present study therefore was to investigate possible differences in promoter-related DNA methylation in patients suffering from alcohol dependence compared to healthy controls.

Author(s): 
Muschler, Marc Andre Nicolas
Hillemacher, Thomas
Kraus, Cornelia
Kornhuber, Johannes
Bleich, Stefan
Frieling, Helge
Publication Title: 
Epigenetics

Prenatal exposure both to maternal psychiatric illness and psychiatric medication has been linked with adverse child outcomes that affect physiological, emotional and psychiatric development. Studies suggest that epigenetic mechanisms, such as DNA methylation, may facilitate these effects. In this report, we explore the association between maternal psychiatric illness and treatment during pregnancy and neonatal DNA methylation patterns in a prospectively-characterized clinical cohort of 201 dyads.

Author(s): 
Schroeder, James W.
Smith, Alicia K.
Brennan, Patricia A.
Conneely, Karen N.
Kilaru, Varun
Knight, Bettina T.
Newport, D. Jeffrey
Cubells, Joseph F.
Stowe, Zachary N.
Publication Title: 
Theoretical Medicine and Bioethics

The use of terminal sedation to control the intense discomfort of dying patients appears both to be an established practice in palliative care and to run counter to the moral and legal norm that forbids health care professionals from intentionally killing patients. This raises the worry that the requirements of established palliative care are incompatible with moral and legal opposition to euthanasia. This paper explains how the doctrine of double effect can be relied on to distinguish terminal sedation from euthanasia.

Author(s): 
Boyle, Joseph
Publication Title: 
Journal of the Royal Naval Medical Service
Author(s): 
Wallis, G. G.

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