A narcotic analgesic that can be used for the relief of most types of moderate to severe pain, including postoperative pain and the pain of labor. Prolonged use may lead to dependence of the morphine type; withdrawal symptoms appear more rapidly than with morphine and are of shorter duration.
Involuntary contraction or twitching of the muscles. It is a physiologic method of heat production in man and other mammals.
Compounds with activity like OPIATE ALKALOIDS, acting at OPIOID RECEPTORS. Properties include induction of ANALGESIA or NARCOSIS.
Agents that are administered in association with anesthetics to increase effectiveness, improve delivery, or decrease required dosage.
The elimination of PAIN, without the loss of CONSCIOUSNESS, during OBSTETRIC LABOR; OBSTETRIC DELIVERY; or the POSTPARTUM PERIOD, usually through the administration of ANALGESICS.
A phenothiazine derivative with histamine H1-blocking, antimuscarinic, and sedative properties. It is used as an antiallergic, in pruritus, for motion sickness and sedation, and also in animals.
A histamine H1 receptor antagonist that is effective in the treatment of chronic urticaria, dermatitis, and histamine-mediated pruritus. Unlike its major metabolite CETIRIZINE, it does cause drowsiness. It is also effective as an antiemetic, for relief of anxiety and tension, and as a sedative.
A 9,10alpha-dihydro derivative of ERGOTAMINE. It is used as a vasoconstrictor, specifically for the therapy of MIGRAINE DISORDERS.
A short-acting opioid anesthetic and analgesic derivative of FENTANYL. It produces an early peak analgesic effect and fast recovery of consciousness. Alfentanil is effective as an anesthetic during surgery, for supplementation of analgesia during surgical procedures, and as an analgesic for critically ill patients.
The relief of pain without loss of consciousness through the introduction of an analgesic agent into the epidural space of the vertebral canal. It is differentiated from ANESTHESIA, EPIDURAL which refers to the state of insensitivity to sensation.
A drug-induced depression of consciousness during which patients respond purposefully to verbal commands, either alone or accompanied by light tactile stimulation. No interventions are required to maintain a patent airway. (From: American Society of Anesthesiologists Practice Guidelines)
Drugs administered before an anesthetic to decrease a patient's anxiety and control the effects of that anesthetic.
A potent narcotic analgesic, abuse of which leads to habituation or addiction. It is primarily a mu-opioid agonist. Fentanyl is also used as an adjunct to general anesthetics, and as an anesthetic for induction and maintenance. (From Martindale, The Extra Pharmacopoeia, 30th ed, p1078)
A hypnotic and sedative used in the treatment of INSOMNIA.
Extraction of the FETUS by means of abdominal HYSTEROTOMY.
Relief of PAIN, without loss of CONSCIOUSNESS, through ANALGESIC AGENTS administered by the patients. It has been used successfully to control POSTOPERATIVE PAIN, during OBSTETRIC LABOR, after BURNS, and in TERMINAL CARE. The choice of agent, dose, and lockout interval greatly influence effectiveness. The potential for overdose can be minimized by combining small bolus doses with a mandatory interval between successive doses (lockout interval).
A synthetic morphinan analgesic with narcotic antagonist action. It is used in the management of severe pain.
A narcotic analgesic structurally related to METHADONE. Only the dextro-isomer has an analgesic effect; the levo-isomer appears to exert an antitussive effect.
A pyrrolizine carboxylic acid derivative structurally related to INDOMETHACIN. It is a non-steroidal anti-inflammatory agent used for analgesia for postoperative pain and inhibits cyclooxygenase activity.
The principal alkaloid in opium and the prototype opiate analgesic and narcotic. Morphine has widespread effects in the central nervous system and on smooth muscle.
An opioid analgesic that is used as an adjunct in anesthesia, in balanced anesthesia, and as a primary anesthetic agent.
Procedure in which an anesthetic is injected directly into the spinal cord.
A pyrrolizine carboxylic acid derivative structurally related to INDOMETHACIN. It is an NSAID and is used principally for its analgesic activity. (From Martindale The Extra Pharmacopoeia, 31st ed)
An adverse drug interaction characterized by altered mental status, autonomic dysfunction, and neuromuscular abnormalities. It is most frequently caused by use of both serotonin reuptake inhibitors and monoamine oxidase inhibitors, leading to excess serotonin availability in the CNS at the serotonin 1A receptor.
The TEMPERATURE at the outer surface of the body.
A subclass of analgesic agents that typically do not bind to OPIOID RECEPTORS and are not addictive. Many non-narcotic analgesics are offered as NONPRESCRIPTION DRUGS.
A range of methods used to reduce pain and anxiety during dental procedures.
A non-steroidal anti-inflammatory agent (ANTI-INFLAMMATORY AGENTS, NON-STEROIDAL) similar in mode of action to INDOMETHACIN.
Drugs that block nerve conduction when applied locally to nerve tissue in appropriate concentrations. They act on any part of the nervous system and on every type of nerve fiber. In contact with a nerve trunk, these anesthetics can cause both sensory and motor paralysis in the innervated area. Their action is completely reversible. (From Gilman AG, et. al., Goodman and Gilman's The Pharmacological Basis of Therapeutics, 8th ed) Nearly all local anesthetics act by reducing the tendency of voltage-dependent sodium channels to activate.
A technique of inputting two-dimensional images into a computer and then enhancing or analyzing the imagery into a form that is more useful to the human observer.
Compounds, usually hormonal, taken orally in order to block ovulation and prevent the occurrence of pregnancy. The hormones are generally estrogen or progesterone or both.
Drugs intended for human or veterinary use, presented in their finished dosage form. Included here are materials used in the preparation and/or formulation of the finished dosage form.
Contraceptive substances to be used after COITUS. These agents include high doses of estrogenic drugs; progesterone-receptor blockers; ANTIMETABOLITES; ALKALOIDS, and PROSTAGLANDINS.
The variable phenotypic expression of a GENE depending on whether it is of paternal or maternal origin, which is a function of the DNA METHYLATION pattern. Imprinted regions are observed to be more methylated and less transcriptionally active. (Segen, Dictionary of Modern Medicine, 1992)

Subjective, psychomotor, and physiological effects of cumulative doses of opioid mu agonists in healthy volunteers. (1/275)

The subjective, psychomotor, and physiological effects of three opioid mu-receptor agonists were studied in healthy volunteers using a cumulative-dosing procedure. Sixteen volunteers with no history of drug abuse received i.v. injections of saline (SAL), morphine (MOR), hydromorphone (HM), or meperidine (MEP) in a randomized double-blind crossover design. Subjects received 1 injection/h for the first 4 h, and a 3-h recovery period followed. SAL was injected first during each session, then SAL or increasing doses of each drug were administered every hour for the next 3 h. The absolute doses per injection were MOR: 2.5, 5, and 10 mg/70 kg; HM: 0.33, 0.65, and 1.3 mg/70 kg; and MEP: 17.5, 35, and 70 mg/70 kg. These injections resulted in cumulative doses of MOR: 2.5, 7.5, and 17.5; HM: 0.33, 0.98, and 2.28; and MEP: 17.5, 52.5, and 122.5 mg/70 kg. Subjects completed mood forms and psychomotor tests, and physiological measures were recorded at various times after each injection and during recovery. MEP tended to produce the most intense effects immediately after drug injection, which dissipated rapidly. MOR produced the mildest effects but was associated with unpleasant side effects during recovery and after the session. HM's effects were stronger than MOR's, and the recovery from HM was slower than with MEP. None of the opioids produced consistent effects that are typically associated with abuse liability. Orderly dose-response functions suggested that our cumulative-dosing procedure is an efficient way of determining dose-response functions for multiple opioids within the same subjects within the same study.  (+info)

Comparison of oral chloral hydrate with intramuscular ketamine, meperidine, and promethazine for pediatric sedation--preliminary report. (2/275)

Fifteen consecutive pediatric patients ranging from 3 to 5 years old were selected to receive one of three sedative/hypnotic techniques. Group 1 received oral chloral hydrate 50 mg/kg, and groups 2 and 3 received intramuscular ketamine 2 mg/kg and 3 mg/kg, respectively. In addition to ketamine, patients in groups 2 and 3 received transmucosal intramuscular injections of meperidine and promethazine into the masseter muscle. Sedation for the satisfactory completion of restorative dentistry was obtained for over 40 min on average in the chloral hydrate group, but completion of dental surgery longer than 40 min was achieved in groups 2 and 3 only by intravenous supplements of ketamine.  (+info)

Binding and hydrolysis of meperidine by human liver carboxylesterase hCE-1. (3/275)

Human liver carboxylesterases catalyze the hydrolysis of apolar drug or xenobiotic esters into more soluble acid and alcohol products for elimination. Two carboxylesterases, hCE-1 and hCE-2, have been purified and characterized with respect to their role in cocaine and heroin hydrolysis. The binding of meperidine (Demerol) and propoxyphene (Darvon) was examined in a competitive binding, spectrophotometric assay. The hCE-1 and hCE-2 bound both drugs, with Ki values in the 0.4- to 1.3-mM range. Meperidine was hydrolyzed to meperidinic acid and ethanol by hCE-1 but not hCE-2. The Km of hCE-1 for meperidine was 1.9 mM and the kcat (catalytic rate constant) was 0.67 min-1. Hydrolysis of meperidine by hCE-1 was consistent with its specificity for hydrolysis of esters containing simple aliphatic alcohol substituents. Hence, hCE-1 in human liver microsomes may play an important role in meperidine elimination. Propoxyphene was not hydrolyzed by hCE-1 or hCE-2. This observation is consistent with the absence of a major hydrolytic pathway for propoxyphene metabolism in humans.  (+info)

The relationship between the myocardial kinetics of meperidine and its effect on myocardial contractility: model-independent analysis and optimal regional model. (4/275)

The myocardial kinetics of meperidine and the relationship between these kinetics and the effect of meperidine on myocardial contractility (maximum positive rate of change of left ventricular pressure) were examined by analysis of previously published data collected in sheep after the i.v. injection of 100 mg of meperidine over 1 s. There was significant hysteresis between reductions in myocardial contractility and the arterial concentrations of meperidine, but not the coronary sinus blood (effluent from the heart) or calculated myocardial concentrations. The peak reduction in contractility occurred after the peak arterial concentration, at the time of the peak myocardial concentration, but before the peak coronary sinus concentration, suggesting that the site of drug action in the heart was not in equilibrium with either arterial blood or effluent blood from the heart. The most appropriate form of a dynamic model (a linear model with a threshold) was determined, without the need to assume a kinetic model, by directly fitting the observed reductions in myocardial contractility to the calculated myocardial concentrations. To determine the optimal kinetic and combined kinetic-dynamic models, a variety of one-, two-, and three-compartment models of the myocardium were fitted to the coronary sinus concentrations by using hybrid modeling. These included "tank in series" models that accounted well for drug dispersion and "peripheral compartment" models that accounted well for deep distribution. The most appropriate model was a "compilation" model, which incorporated features of both these extremes and was a better fit to the observed data than either a traditional single flow-limited compartment or a traditional membrane-limited model.  (+info)

Change in pain threshold by meperidine, naproxen sodium, and acetaminophen as determined by electric pulp testing. (5/275)

The purpose of this study was to compare changes in pain threshold caused by meperidine, naproxen sodium, acetaminophen, and placebo. The change in pain threshold was measured by electric pulp testing. Acetaminophen elevated the pain threshold statistically significantly. Clinically, however, the superiority of acetaminophen is questionable. No elevation of the pain threshold occurred with narcotic drugs or with nonsteroidal anti-inflammatory drugs: our research shows that the electric pulp tests of patients who have taken these drugs preoperatively will have results similar to those of patients who have taken no drugs. We question the philosophy of administering these drugs for change in pain threshold at the levels used here preoperatively.  (+info)

Meperidine and lidocaine block of recombinant voltage-dependent Na+ channels: evidence that meperidine is a local anesthetic. (6/275)

BACKGROUND: The opioid meperidine induces spinal anesthesia and blocks nerve action potentials, suggesting it is a local anesthetic. However, whether it produces effective clinical local anesthesia in peripheral nerves remains unclear. Classification as a local anesthetic requires clinical local anesthesia but also blockade of voltage-dependent Na+ channels with characteristic features (tonic and phasic blockade and a negative shift in the voltage-dependence of steady-state inactivation) involving an intrapore receptor. The authors tested for these molecular pharmacologic features to explore whether meperidine is a local anesthetic. METHODS: The authors studied rat skeletal muscle mu1 (RSkM1) voltage-dependent Na+ channels or a mutant form heterologously coexpressed with rat brain Na+ channel accessory beta1, subunit in Xenopus oocytes. Polymerase chain reaction was used for mutagenesis, and mutations were confirmed by sequencing. Na+ currents were measured using a two-microelectrode voltage clamp. Meperidine and the commonly used local anesthetic lidocaine were applied to oocytes in saline solution at room temperature. RESULTS: Meperidine and lidocaine produced tonic current inhibition with comparable concentration dependence. Meperidine caused phasic current inhibition in which the concentration-response relationship was shifted to fivefold greater concentration relative to lidocaine. Meperidine and lidocaine negatively shifted the voltage dependence of steady-state inactivation. Mutation of a putative local anesthetic receptor reduced phasic inhibition by meperidine and lidocaine and tonic inhibition by lidocaine, but not meperidine tonic inhibition. CONCLUSIONS: Meperidine blocks Na+ channels with molecular pharmacologic features of a local anesthetic. The findings support classification of meperidine as a local anesthetic but with less overall potency than lidocaine.  (+info)

Tonic blocking action of meperidine on Na+ and K+ channels in amphibian peripheral nerves. (7/275)

BACKGROUND: Among opioids, meperidine (pethidine) also shows local anesthetic activity when applied locally to peripheral nerve fibers and has been used for this effect in the clinical setting for regional anesthesia. This study investigated the blocking effects of meperidine on different ion channels in peripheral nerves. METHODS: Experiments were conducted using the outside-out configuration of the patch-clamp method applied to enzymatically prepared peripheral nerve fibers of Xenopus laevis. Half-maximal inhibiting concentrations were determined for Na+ channels and different K+ channels by nonlinear least-squares fitting of concentration-inhibition curves, assuming a one-to-one reaction. RESULTS: Externally applied meperidine reversibly blocked all investigated channels in a concentration-dependent manner, i.e., voltage-activated Na+ channel (half-maximal inhibiting concentration, 164 microM), delayed rectifier K+ channels (half-maximal inhibiting concentration, 194 microM), the calcium-activated K+ channel (half-maximal inhibiting concentration, 161 microM), and the voltage-independent flicker K+ channel (half-maximal inhibiting concentration, 139 microM). Maximal block in high concentrations of meperidine reached 83% for delayed rectifier K+ channels and 100% for all other channels. Meperidine blocks the Na+ channel in the same concentration range as the local anesthetic agent lidocaine (half-maximal inhibiting concentration, 172 microM) but did not compete for the same binding site as evaluated by competition experiments. Low concentrations of meperidine (1 nM to 1 microM) showed no effects on Na+ channels. The blockade of Na+ and delayed rectifier K+ channels could not be antagonized by the addition of naloxone. CONCLUSIONS: It is concluded that meperidine has a nonselective inhibitory action on Na+ and K+ channels of amphibian peripheral nerve. For tonic Na+ channel block, neither an opioid receptor nor the the local anesthetic agent binding site is the target site for meperidine block.  (+info)

Neutral sphingomyelinase activity dependent on Mg2+ and anionic phospholipids in the intraerythrocytic malaria parasite Plasmodium falciparum. (8/275)

Sphingolipid metabolism and metabolites are important in various cellular events in eukaryotes. However, little is known about their function in plasmodial parasites. Here we demonstrate that neutral sphingomyelinase (SMase) involved in the sphingomyelin (SM) catabolism is retained by the intraerythrocytic parasite Plasmodium falciparum. When assayed in a neutral pH buffer supplemented with Mg(2+) and phosphatidylserine, an activity for the release of the phosphocholine group from SM was detected in parasite-infected, but not in uninfected, erythrocyte ghosts. The SMase activity in the parasite-infected erythrocyte ghosts was enhanced markedly by anionic phospholipids including unsaturated but not saturated phosphatidylserine. Mn(2+) could not substitute for Mg(2+) to activate SMase in parasite-infected erythrocyte ghosts, whereas both Mn(2+) and Mg(2+) activated mammalian neutral SMase. The specific activity level of SMase was higher in isolated parasites than in infected erythrocyte ghosts; further fractionation of lysates of the isolated parasites showed that the activity was bound largely to the membrane fraction of the parasites. The plasmodial SMase seemed not to hydrolyse phosphatidylcholine or phosphatidylinositol. The plasmodial SMase, but not SM synthase, was sensitive to scyphostatin, an inhibitor of mammalian neutral SMase, indicating that the plasmodial activities for SM hydrolysis and SM synthesis are mediated by different catalysts. Our finding that the malaria parasites possess SMase activity might explain why the parasites seem to have an SM synthase activity but no activity to synthesize ceramide de novo.  (+info)

Meperidine is a synthetic opioid analgesic (pain reliever) that works by binding to opioid receptors in the brain and spinal cord, blocking the transmission of pain signals. It is also known by its brand name Demerol and is used to treat moderate to severe pain. Meperidine has a rapid onset of action and its effects typically last for 2-4 hours.

Meperidine can cause various side effects such as dizziness, sedation, nausea, vomiting, sweating, and respiratory depression (slowed breathing). It also has a risk of abuse and physical dependence, so it is classified as a Schedule II controlled substance in the United States.

Meperidine should be used with caution and under the supervision of a healthcare provider due to its potential for serious side effects and addiction. It may not be suitable for people with certain medical conditions or those who are taking other medications that can interact with meperidine.

Shivering is a physical response to cold temperature or emotional stress, characterized by involuntary muscle contractions and relaxations. It's a part of the body's thermoregulation process, which helps to generate heat and maintain a normal body temperature. During shivering, the muscles rapidly contract and relax, producing kinetic energy that is released as heat. This can be observed as visible shaking or trembling, often most noticeable in the arms, legs, and jaw. In some cases, prolonged or intense shivering may also be associated with fever or other medical conditions.

Analgesics, opioid are a class of drugs used for the treatment of pain. They work by binding to specific receptors in the brain and spinal cord, blocking the transmission of pain signals to the brain. Opioids can be synthetic or natural, and include drugs such as morphine, codeine, oxycodone, hydrocodone, hydromorphone, fentanyl, and methadone. They are often used for moderate to severe pain, such as that resulting from injury, surgery, or chronic conditions like cancer. However, opioids can also produce euphoria, physical dependence, and addiction, so they are tightly regulated and carry a risk of misuse.

An adjuvant in anesthesia refers to a substance or drug that is added to an anesthetic medication to enhance its effects, make it last longer, or improve the overall quality of anesthesia. Adjuvants do not produce analgesia or anesthesia on their own but work synergistically with other anesthetics to achieve better clinical outcomes.

There are several types of adjuvants used in anesthesia, including:

1. Opioids: These are commonly used adjuvants that enhance the analgesic effect of anesthetic drugs. Examples include fentanyl, sufentanil, and remifentanil.
2. Alpha-2 agonists: Drugs like clonidine and dexmedetomidine are used as adjuvants to provide sedation, analgesia, and anxiolysis. They also help reduce the requirement for other anesthetic drugs, thus minimizing side effects.
3. Ketamine: This NMDA receptor antagonist is used as an adjuvant to provide analgesia and amnesia. It can be used in subanesthetic doses to improve the quality of analgesia during general anesthesia or as a sole anesthetic for procedural sedation.
4. Local anesthetics: When used as an adjuvant, local anesthetics can prolong the duration of postoperative analgesia and reduce the requirement for opioids. Examples include bupivacaine, ropivacaine, and lidocaine.
5. Neostigmine: This cholinesterase inhibitor is used as an adjuvant to reverse the neuromuscular blockade produced by non-depolarizing muscle relaxants at the end of surgery.
6. Dexamethasone: A corticosteroid used as an adjuvant to reduce postoperative nausea and vomiting, inflammation, and pain.
7. Magnesium sulfate: This non-competitive NMDA receptor antagonist is used as an adjuvant to provide analgesia, reduce opioid consumption, and provide neuroprotection in certain surgical settings.

The choice of adjuvants depends on the type of surgery, patient factors, and the desired clinical effects.

Obstetrical analgesia refers to the use of medications or techniques to relieve pain during childbirth. The goal of obstetrical analgesia is to provide comfort and relaxation for the mother during labor and delivery while minimizing risks to both the mother and the baby. There are several methods of obstetrical analgesia, including:

1. Systemic opioids: These medications, such as morphine or fentanyl, can be given intravenously to help reduce the pain of contractions. However, they can cause side effects such as drowsiness, nausea, and respiratory depression in the mother and may also affect the baby's breathing and alertness at birth.
2. Regional anesthesia: This involves numbing a specific area of the body using local anesthetics. The two most common types of regional anesthesia used during childbirth are epidural and spinal anesthesia.

a. Epidural anesthesia: A catheter is inserted into the lower back, near the spinal cord, to deliver a continuous infusion of local anesthetic and sometimes opioids. This numbs the lower half of the body, reducing the pain of contractions and allowing for a more comfortable delivery. Epidural anesthesia can also be used for cesarean sections.

b. Spinal anesthesia: A single injection of local anesthetic is given into the spinal fluid, numbing the lower half of the body. This type of anesthesia is often used for cesarean sections and can also be used for vaginal deliveries in some cases.

3. Nitrous oxide: Also known as laughing gas, this colorless, odorless gas can be inhaled through a mask to help reduce anxiety and provide some pain relief during labor. It is not commonly used in the United States but is more popular in other countries.

When choosing an obstetrical analgesia method, it's essential to consider the potential benefits and risks for both the mother and the baby. Factors such as the mother's health, the progression of labor, and personal preferences should all be taken into account when making this decision. It is crucial to discuss these options with a healthcare provider to determine the most appropriate choice for each individual situation.

Promethazine is an antihistamine and phenothiazine derivative, which is commonly used for its sedative, anti-emetic (prevents vomiting), and anti-allergic properties. It works by blocking the action of histamine, a substance in the body that causes allergic symptoms, and by blocking the action of dopamine, a neurotransmitter in the brain that helps transmit signals.

Promethazine is used to treat various conditions such as allergies, motion sickness, nausea and vomiting, and as a sedative before and after surgery or medical procedures. It may also be used for its calming effects in children with certain behavioral disorders.

Like all medications, promethazine can have side effects, including drowsiness, dry mouth, blurred vision, and dizziness. More serious side effects may include seizures, irregular heartbeat, and difficulty breathing. It is important to follow the instructions of a healthcare provider when taking promethazine and to report any unusual symptoms or side effects promptly.

Hydroxyzine is an antihistamine medication that is primarily used to treat symptoms of allergies such as itching, hives, and swelling. It works by blocking the effects of histamine, a substance in the body that causes allergic reactions. In addition to its antihistaminic properties, hydroxyzine also has sedative and anxiety-reducing effects, which make it useful in treating anxiety disorders, symptoms of alcohol withdrawal, and as a sleep aid. It is available in both oral and injectable forms and is usually taken orally in the form of tablets, capsules, or syrup. As with any medication, hydroxyzine should be used under the supervision of a healthcare provider, and its use may be subject to certain precautions and contraindications depending on the individual's medical history and current health status.

Dihydroergotamine is a medication that belongs to a class of drugs called ergot alkaloids. It is a semi-synthetic derivative of ergotamine, which is found naturally in the ergot fungus. Dihydroergotamine is used to treat migraines and cluster headaches.

The drug works by narrowing blood vessels around the brain, which helps to reduce the pain and other symptoms associated with migraines and cluster headaches. It can be administered via injection, nasal spray, or oral tablet. Dihydroergotamine may cause serious side effects, including medication overuse headache, ergotism, and cardiovascular events such as heart attack or stroke. Therefore, it is important to use this medication only as directed by a healthcare provider.

Alfentanil is a synthetic opioid analgesic drug that is chemically related to fentanyl. It is used for the provision of sedation and pain relief, particularly in critical care settings and during surgical procedures.

The medical definition of Alfentanil is as follows:

Alfentanil is a potent, short-acting opioid analgesic with a rapid onset of action. It is approximately 10 times more potent than morphine and has a rapid clearance rate due to its short elimination half-life of 1-2 hours. Alfentanil is used for the induction and maintenance of anesthesia, as well as for sedation and pain relief in critically ill patients. It works by binding to opioid receptors in the brain and spinal cord, which inhibits the transmission of pain signals and produces analgesia, sedation, and respiratory depression.

Like all opioids, Alfentanil carries a risk of dependence, tolerance, and respiratory depression, and should be used with caution in patients with respiratory or cardiovascular disease. It is typically administered by healthcare professionals in a controlled setting due to its potency and potential for adverse effects.

Epidural analgesia is a type of regional anesthesia used to manage pain, most commonly during childbirth and after surgery. The term "epidural" refers to the location of the injection, which is in the epidural space of the spinal column.

In this procedure, a small amount of local anesthetic or narcotic medication is injected into the epidural space using a thin catheter. This medication blocks nerve impulses from the lower body, reducing or eliminating pain sensations without causing complete loss of feeling or muscle movement.

Epidural analgesia can be used for both short-term and long-term pain management. It is often preferred in situations where patients require prolonged pain relief, such as during labor and delivery or after major surgery. The medication can be administered continuously or intermittently, depending on the patient's needs and the type of procedure being performed.

While epidural analgesia is generally safe and effective, it can have side effects, including low blood pressure, headache, and difficulty urinating. In rare cases, it may also cause nerve damage or infection. Patients should discuss the risks and benefits of this procedure with their healthcare provider before deciding whether to undergo epidural analgesia.

Conscious sedation, also known as procedural sedation and analgesia, is a minimally depressed level of consciousness that retains the patient's ability to maintain airway spontaneously and respond appropriately to physical stimulation and verbal commands. It is typically achieved through the administration of sedative and/or analgesic medications and is commonly used in medical procedures that do not require general anesthesia. The goal of conscious sedation is to provide a comfortable and anxiety-free experience for the patient while ensuring their safety throughout the procedure.

Preanesthetic medication, also known as premedication, refers to the administration of medications before anesthesia to help prepare the patient for the upcoming procedure. These medications can serve various purposes, such as:

1. Anxiolysis: Reducing anxiety and promoting relaxation in patients before surgery.
2. Amnesia: Causing temporary memory loss to help patients forget the events leading up to the surgery.
3. Analgesia: Providing pain relief to minimize discomfort during and after the procedure.
4. Antisialagogue: Decreasing saliva production to reduce the risk of aspiration during intubation.
5. Bronchodilation: Relaxing bronchial smooth muscles, which can help improve respiratory function in patients with obstructive lung diseases.
6. Antiemetic: Preventing or reducing the likelihood of postoperative nausea and vomiting.
7. Sedation: Inducing a state of calmness and drowsiness to facilitate a smooth induction of anesthesia.

Common preanesthetic medications include benzodiazepines (e.g., midazolam), opioids (e.g., fentanyl), anticholinergics (e.g., glycopyrrolate), and H1-antihistamines (e.g., diphenhydramine). The choice of preanesthetic medication depends on the patient's medical history, comorbidities, and the type of anesthesia to be administered.

Fentanyl is a potent synthetic opioid analgesic, which is similar to morphine but is 50 to 100 times more potent. It is a schedule II prescription drug, typically used to treat patients with severe pain or to manage pain after surgery. It works by binding to the body's opioid receptors, which are found in the brain, spinal cord, and other areas of the body.

Fentanyl can be administered in several forms, including transdermal patches, lozenges, injectable solutions, and tablets that dissolve in the mouth. Illegally manufactured and distributed fentanyl has also become a major public health concern, as it is often mixed with other drugs such as heroin, cocaine, and counterfeit pills, leading to an increase in overdose deaths.

Like all opioids, fentanyl carries a risk of dependence, addiction, and overdose, especially when used outside of medical supervision or in combination with other central nervous system depressants such as alcohol or benzodiazepines. It is important to use fentanyl only as directed by a healthcare provider and to be aware of the potential risks associated with its use.

Chloral hydrate is a sedative and hypnotic medication, which means it can help to promote sleep and reduce anxiety. It is a type of compound called a chloral derivative and works by increasing the activity of a neurotransmitter in the brain called gamma-aminobutyric acid (GABA), which has a calming effect on the nervous system.

Chloral hydrate is available in various forms, including tablets, capsules, and liquid solutions. It is typically used for short-term treatment of insomnia or anxiety, but it may also be used for other purposes as determined by a healthcare provider.

Like all medications, chloral hydrate can have side effects, which can include dizziness, headache, stomach upset, and changes in behavior or mood. It is important to use this medication only as directed by a healthcare provider and to report any unusual symptoms or concerns promptly.

A Cesarean section, often referred to as a C-section, is a surgical procedure used to deliver a baby. It involves making an incision through the mother's abdomen and uterus to remove the baby. This procedure may be necessary when a vaginal delivery would put the mother or the baby at risk.

There are several reasons why a C-section might be recommended, including:

* The baby is in a breech position (feet first) or a transverse position (sideways) and cannot be turned to a normal head-down position.
* The baby is too large to safely pass through the mother's birth canal.
* The mother has a medical condition, such as heart disease or high blood pressure, that could make vaginal delivery risky.
* The mother has an infection, such as HIV or herpes, that could be passed to the baby during a vaginal delivery.
* The labor is not progressing and there are concerns about the health of the mother or the baby.

C-sections are generally safe for both the mother and the baby, but like any surgery, they do carry some risks. These can include infection, bleeding, blood clots, and injury to nearby organs. In addition, women who have a C-section are more likely to experience complications in future pregnancies, such as placenta previa or uterine rupture.

If you have questions about whether a C-section is necessary for your delivery, it's important to discuss your options with your healthcare provider.

Patient-controlled analgesia (PCA) is a method of pain management that allows patients to self-administer doses of analgesic medication through a controlled pump system. With PCA, the patient can press a button to deliver a predetermined dose of pain medication, usually an opioid, directly into their intravenous (IV) line.

The dosage and frequency of the medication are set by the healthcare provider based on the patient's individual needs and medical condition. The PCA pump is designed to prevent overinfusion by limiting the amount of medication that can be delivered within a specific time frame.

PCA provides several benefits, including improved pain control, increased patient satisfaction, and reduced sedation compared to traditional methods of opioid administration. It also allows patients to take an active role in managing their pain and provides them with a sense of control during their hospital stay. However, it is essential to monitor patients closely while using PCA to ensure safe and effective use.

Butorphanol is a synthetic opioid analgesic (pain reliever) used to treat moderate to severe pain. It works by binding to the opiate receptors in the brain, which reduces the perception of pain. Butorphanol is available as an injectable solution and a nasal spray.

The medical definition of 'Butorphanol' is:

A synthetic opioid analgesic with agonist-antagonist properties. It is used in the management of moderate to severe pain, as a veterinary analgesic, and for obstetrical analgesia. Butorphanol has a high affinity for the kappa-opioid receptor, a lower affinity for the mu-opioid receptor, and little or no affinity for the delta-opioid receptor. Its actions at the mu-opioid receptor are antagonistic to those of morphine and other mu-opioid agonists, while its actions at the kappa-opioid receptor are similar to those of other opioids.

Butorphanol has a rapid onset of action and a relatively short duration of effect. It may cause respiratory depression, sedation, nausea, vomiting, and other side effects common to opioid analgesics. Butorphanol is classified as a Schedule IV controlled substance in the United States due to its potential for abuse and dependence.

Dextropropoxyphene is a mild narcotic analgesic (pain reliever) that is prescribed for the relief of moderate to moderately severe pain. It is a synthetic opioid and works by binding to opiate receptors in the brain, spinal cord, and other areas of the body to reduce the perception of pain. Dextropropoxyphene is available in immediate-release and extended-release tablets, usually in combination with acetaminophen (also known as paracetamol).

Dextropropoxyphene has a narrow therapeutic index, which means that there is only a small range between the effective dose and a potentially toxic dose. It also has a high potential for abuse and addiction, and its use has been associated with serious side effects such as respiratory depression, seizures, and cardiac arrhythmias. In 2010, the U.S. Food and Drug Administration (FDA) withdrew approval for all dextropropoxyphene-containing products due to these safety concerns.

Ketorolac tromethamine is a non-steroidal anti-inflammatory drug (NSAID) used to treat pain and inflammation in various clinical settings. It is a salt of ketorolac, which is a racemic mixture of R-(+)- and S-(-)-enantiomers.

Ketorolac tromethamine works by inhibiting the activity of cyclooxygenase (COX) enzymes, which are responsible for the production of prostaglandins, inflammatory mediators involved in pain and inflammation. By blocking the action of COX enzymes, ketorolac tromethamine reduces the production of prostaglandins, thereby alleviating pain and inflammation.

This medication is available as an injectable solution for intravenous (IV) or intramuscular (IM) administration, as well as in oral formulations. It is commonly used for short-term management of moderate to severe pain following surgery or trauma, as well as for the treatment of acute migraines and other painful conditions.

It's important to note that ketorolac tromethamine has a boxed warning from the U.S. Food and Drug Administration (FDA) due to its potential to increase the risk of serious gastrointestinal (GI) adverse events, such as bleeding, ulcers, and perforations, particularly when used for longer than recommended or at higher doses. Additionally, it may also increase the risk of cardiovascular events, renal toxicity, and anaphylaxis in some individuals. Therefore, its use should be closely monitored and managed by healthcare professionals to minimize potential risks.

Morphine is a potent opioid analgesic (pain reliever) derived from the opium poppy. It works by binding to opioid receptors in the brain and spinal cord, blocking the transmission of pain signals and reducing the perception of pain. Morphine is used to treat moderate to severe pain, including pain associated with cancer, myocardial infarction, and other conditions. It can also be used as a sedative and cough suppressant.

Morphine has a high potential for abuse and dependence, and its use should be closely monitored by healthcare professionals. Common side effects of morphine include drowsiness, respiratory depression, constipation, nausea, and vomiting. Overdose can result in respiratory failure, coma, and death.

Sufentanil is a potent, synthetic opioid analgesic that is approximately 5-10 times more potent than fentanyl and 1000 times more potent than morphine. It is primarily used for the treatment of moderate to severe pain in surgical settings, as an adjunct to anesthesia, or for obstetrical analgesia during labor and delivery.

Sufentanil works by binding to opioid receptors in the brain and spinal cord, which inhibits the transmission of pain signals to the brain. It has a rapid onset of action and a short duration of effect, making it useful for procedures that require intense analgesia for brief periods.

Like other opioids, sufentanil can cause respiratory depression, sedation, nausea, vomiting, and constipation. It should be used with caution in patients with compromised respiratory function or those who are taking other central nervous system depressants.

Spinal anesthesia is a type of regional anesthesia that involves injecting local anesthetic medication into the cerebrospinal fluid in the subarachnoid space, which is the space surrounding the spinal cord. This procedure is typically performed by introducing a needle into the lower back, between the vertebrae, to reach the subarachnoid space.

Once the local anesthetic is introduced into this space, it spreads to block nerve impulses from the corresponding levels of the spine, resulting in numbness and loss of sensation in specific areas of the body below the injection site. The extent and level of anesthesia depend on the amount and type of medication used, as well as the patient's individual response.

Spinal anesthesia is often used for surgeries involving the lower abdomen, pelvis, or lower extremities, such as cesarean sections, hernia repairs, hip replacements, and knee arthroscopies. It can also be utilized for procedures like epidural steroid injections to manage chronic pain conditions affecting the spine and lower limbs.

While spinal anesthesia provides effective pain relief during and after surgery, it may cause side effects such as low blood pressure, headache, or difficulty urinating. These potential complications should be discussed with the healthcare provider before deciding on this type of anesthesia.

Ketorolac is a non-steroidal anti-inflammatory drug (NSAID) that is used to treat moderate to severe pain. It works by reducing the levels of prostaglandins, chemicals in the body that cause inflammation and trigger pain signals in the brain. By blocking the production of prostaglandins, ketorolac helps to reduce pain, swelling, and fever.

Ketorolac is available in several forms, including tablets, injection solutions, and suppositories. It is typically used for short-term pain relief, as it can increase the risk of serious side effects such as stomach ulcers, bleeding, and kidney problems with long-term use.

Like other NSAIDs, ketorolac may also increase the risk of heart attack and stroke, especially in people who already have cardiovascular disease or risk factors for it. It should be used with caution and only under the supervision of a healthcare provider.

Serotonin syndrome is a potentially life-threatening condition that arises from excessive serotonergic activity in the central nervous system (CNS) and peripheral nervous system. It is typically caused by the interaction of medications, illicit substances, or dietary supplements that increase serotonin levels or enhance serotonin receptor sensitivity.

The diagnostic criteria for serotonin syndrome include:

1. Presence of a serotonergic medication or drug known to cause the syndrome
2. Development of neuromuscular abnormalities, such as hyperreflexia, myoclonus, tremor, rigidity, or akathisia
3. Autonomic dysfunction, including diaphoresis, tachycardia, hypertension, dilated pupils, and hyperthermia
4. Mental status changes, such as agitation, confusion, hallucinations, or coma
5. Symptoms that develop rapidly, usually within hours of a change in serotonergic medication or dosage

Serotonin syndrome can range from mild to severe, with the most severe cases potentially leading to respiratory failure, rhabdomyolysis, disseminated intravascular coagulation (DIC), and death. Treatment typically involves discontinuation of the offending agent(s), supportive care, and pharmacologic interventions such as cyproheptadine or cooling measures for hyperthermia.

Skin temperature is the measure of heat emitted by the skin, which can be an indicator of the body's core temperature. It is typically lower than the body's internal temperature and varies depending on factors such as environmental temperature, blood flow, and physical activity. Skin temperature is often used as a vital sign in medical settings and can be measured using various methods, including thermal scanners, digital thermometers, or mercury thermometers. Changes in skin temperature may also be associated with certain medical conditions, such as inflammation, infection, or nerve damage.

Analgesics, non-narcotic are a class of medications used to relieve pain that do not contain narcotics or opioids. They work by blocking the transmission of pain signals in the nervous system or by reducing inflammation and swelling. Examples of non-narcotic analgesics include acetaminophen (Tylenol), ibuprofen (Advil, Motrin), naproxen (Aleve), and aspirin. These medications are often used to treat mild to moderate pain, such as headaches, menstrual cramps, muscle aches, and arthritis symptoms. They can be obtained over-the-counter or by prescription, depending on the dosage and formulation. It is important to follow the recommended dosages and usage instructions carefully to avoid adverse effects.

Dental anesthesia is a type of local or regional anesthesia that is specifically used in dental procedures to block the transmission of pain impulses from the teeth and surrounding tissues to the brain. The most common types of dental anesthesia include:

1. Local anesthesia: This involves the injection of a local anesthetic drug, such as lidocaine or prilocaine, into the gum tissue near the tooth that is being treated. This numbs the area and prevents the patient from feeling pain during the procedure.
2. Conscious sedation: This is a type of minimal sedation that is used to help patients relax during dental procedures. The patient remains conscious and can communicate with the dentist, but may not remember the details of the procedure. Common methods of conscious sedation include nitrous oxide (laughing gas) or oral sedatives.
3. Deep sedation or general anesthesia: This is rarely used in dental procedures, but may be necessary for patients who are extremely anxious or have special needs. It involves the administration of drugs that cause a state of unconsciousness and prevent the patient from feeling pain during the procedure.

Dental anesthesia is generally safe when administered by a qualified dentist or oral surgeon. However, as with any medical procedure, there are risks involved, including allergic reactions to the anesthetic drugs, nerve damage, and infection. Patients should discuss any concerns they have with their dentist before undergoing dental anesthesia.

Tolmetin is a non-steroidal anti-inflammatory drug (NSAID) that is used to relieve pain, inflammation, and fever. It works by inhibiting the production of prostaglandins, which are hormone-like substances that cause pain and inflammation in the body. Tolmetin is available in immediate-release and sustained-release forms, and it is typically prescribed to treat conditions such as osteoarthritis, rheumatoid arthritis, and juvenile rheumatoid arthritis.

The medical definition of Tolmetin can be found in various pharmaceutical and medical references, including the Merck Manual, the American Hospital Formulary Service (AHFS) Drug Information, and the National Library of Medicine's MedlinePlus. According to these sources, the chemical name for Tolmetin is (3R,5S)-3-(4-methylbenzoyl)-5-(3-methoxy-4-hydroxyphenyl)-1H-indole-2-one, and its molecular formula is C19H16NO3.

Tolmetin has a number of potential side effects, including stomach pain, nausea, vomiting, diarrhea, gas, dizziness, and headache. It can also increase the risk of serious gastrointestinal side effects, such as bleeding, ulcers, and perforations in the stomach or intestines, especially in people who are over the age of 65 or have a history of stomach ulcers or other gastrointestinal problems. Tolmetin can also increase the risk of heart attack, stroke, and other cardiovascular events, particularly in people who take it for a long time or at high doses.

Tolmetin is available only by prescription, and it should be taken exactly as directed by a healthcare provider. It is important to follow the instructions on the label carefully and to talk to a doctor or pharmacist if there are any questions about how to take Tolmetin or what the potential side effects may be.

Local anesthetics are a type of medication that is used to block the sensation of pain in a specific area of the body. They work by temporarily numbing the nerves in that area, preventing them from transmitting pain signals to the brain. Local anesthetics can be administered through various routes, including topical application (such as creams or gels), injection (such as into the skin or tissues), or regional nerve blocks (such as epidural or spinal anesthesia).

Some common examples of local anesthetics include lidocaine, prilocaine, bupivacaine, and ropivacaine. These medications can be used for a variety of medical procedures, ranging from minor surgeries (such as dental work or skin biopsies) to more major surgeries (such as joint replacements or hernia repairs).

Local anesthetics are generally considered safe when used appropriately, but they can have side effects and potential complications. These may include allergic reactions, toxicity (if too much is administered), and nerve damage (if the medication is injected into a nerve). It's important to follow your healthcare provider's instructions carefully when using local anesthetics, and to report any unusual symptoms or side effects promptly.

Computer-assisted image processing is a medical term that refers to the use of computer systems and specialized software to improve, analyze, and interpret medical images obtained through various imaging techniques such as X-ray, CT (computed tomography), MRI (magnetic resonance imaging), ultrasound, and others.

The process typically involves several steps, including image acquisition, enhancement, segmentation, restoration, and analysis. Image processing algorithms can be used to enhance the quality of medical images by adjusting contrast, brightness, and sharpness, as well as removing noise and artifacts that may interfere with accurate diagnosis. Segmentation techniques can be used to isolate specific regions or structures of interest within an image, allowing for more detailed analysis.

Computer-assisted image processing has numerous applications in medical imaging, including detection and characterization of lesions, tumors, and other abnormalities; assessment of organ function and morphology; and guidance of interventional procedures such as biopsies and surgeries. By automating and standardizing image analysis tasks, computer-assisted image processing can help to improve diagnostic accuracy, efficiency, and consistency, while reducing the potential for human error.

Oral contraceptives, also known as "birth control pills," are medications taken by mouth to prevent pregnancy. They contain synthetic hormones that mimic the effects of natural hormones estrogen and progesterone in a woman's body, thereby preventing ovulation, fertilization, or implantation of a fertilized egg in the uterus.

There are two main types of oral contraceptives: combined pills, which contain both estrogen and progestin, and mini-pills, which contain only progestin. Combined pills work by preventing ovulation, thickening cervical mucus to make it harder for sperm to reach the egg, and thinning the lining of the uterus to make it less likely for a fertilized egg to implant. Mini-pills work mainly by thickening cervical mucus and changing the lining of the uterus.

Oral contraceptives are highly effective when used correctly, but they do not protect against sexually transmitted infections (STIs). It is important to use them consistently and as directed by a healthcare provider. Side effects may include nausea, breast tenderness, headaches, mood changes, and irregular menstrual bleeding. In rare cases, oral contraceptives may increase the risk of serious health problems such as blood clots, stroke, or liver tumors. However, for most women, the benefits of using oral contraceptives outweigh the risks.

Pharmaceutical preparations refer to the various forms of medicines that are produced by pharmaceutical companies, which are intended for therapeutic or prophylactic use. These preparations consist of an active ingredient (the drug) combined with excipients (inactive ingredients) in a specific formulation and dosage form.

The active ingredient is the substance that has a therapeutic effect on the body, while the excipients are added to improve the stability, palatability, bioavailability, or administration of the drug. Examples of pharmaceutical preparations include tablets, capsules, solutions, suspensions, emulsions, ointments, creams, and injections.

The production of pharmaceutical preparations involves a series of steps that ensure the quality, safety, and efficacy of the final product. These steps include the selection and testing of raw materials, formulation development, manufacturing, packaging, labeling, and storage. Each step is governed by strict regulations and guidelines to ensure that the final product meets the required standards for use in medical practice.

Postcoital contraceptives, also known as emergency contraception, are methods used to prevent pregnancy after sexual intercourse has already occurred. These methods are most effective when used within 24 hours of unprotected sex, but can still be effective up to 120 hours (5 days) after.

There are two main types of postcoital contraceptives:

1. Emergency contraceptive pills (ECPs): These are high-dose hormonal pills that contain levonorgestrel or ulipristal acetate. Levonorgestrel ECPs are available over-the-counter in many countries, while ulipristal acetate ECPs require a prescription.
2. Copper intrauterine device (IUD): This is a small T-shaped device made of copper that is inserted into the uterus by a healthcare provider. The copper IUD can be used as emergency contraception up to 5 days after unprotected sex, and it also provides ongoing contraception for up to 10 years.

It's important to note that postcoital contraceptives are not intended for regular use as a primary form of contraception. They should only be used in emergency situations where other methods of contraception have failed or were not used. It is also recommended to consult with a healthcare provider before using any form of emergency contraception.

Genomic imprinting is a epigenetic process that leads to the differential expression of genes depending on their parental origin. It involves the methylation of certain CpG sites in the DNA, which results in the silencing of one of the two copies of a gene, either the maternal or paternal allele. This means that only one copy of the gene is active and expressed, while the other is silent.

This phenomenon is critical for normal development and growth, and it plays a role in the regulation of genes involved in growth and behavior. Genomic imprinting is also associated with certain genetic disorders, such as Prader-Willi and Angelman syndromes, which occur when there are errors in the imprinting process that lead to the absence or abnormal expression of certain genes.

It's important to note that genomic imprinting is a complex and highly regulated process that is not yet fully understood. Research in this area continues to provide new insights into the mechanisms underlying gene regulation and their impact on human health and disease.

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