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Midazolam is metabolized almost completely by cytochrome P450-3A4. Atorvastatin administration along with midazolam results in a reduced elimination rate of midazolam. [63] St John's wort decreases the blood levels of midazolam. [64] Grapefruit juice reduces intestinal 3A4 and results in less metabolism and higher plasma concentrations. [65]
A review in 2006 of the literature on use of benzodiazepine and nonbenzodiazepine hypnotics concluded that more research is needed to evaluate the long-term effects of hypnotic drugs. [84] The majority of the problems of benzodiazepines are related to their long-term use rather than their short-term use. [ 85 ]
The Maternal Outcomes and Neurodevelopmental Effects of Antiepileptic Drugs (MONEAD) study showed that most blood concentrations in breastfed infants of mothers taking carbamazepine, oxcarbazepine, valproate, levetiracetam, and topiramate were quite low, especially in relationship to the mother's level and what the fetal level would have been ...
A review [42] of benzodiazepine tolerance concluded that it "appears that tolerance develops relatively quickly for the sedative and anticonvulsant actions of benzodiazepines, whereas tolerance to anxiolytic and amnesic effects probably does not develop at all", although the included randomized controlled trial evidence [134] [44] is limited to ...
Benzodiazepine withdrawal syndrome (BZD withdrawal) is the cluster of signs and symptoms that may emerge when a person who has been taking benzodiazepines as prescribed develops a physical dependence on them and then reduces the dose or stops taking them without a safe taper schedule.
Pulse pressure is calculated as the difference between the systolic blood pressure and the diastolic blood pressure. [3] [4]The systemic pulse pressure is approximately proportional to stroke volume, or the amount of blood ejected from the left ventricle during systole (pump action) and inversely proportional to the compliance (similar to elasticity) of the aorta.
Amnesia is desirable during surgery, so general anaesthesia procedures are designed to induce it for the duration of the operation. Sedatives such as benzodiazepines, which are commonly used for anxiety disorders, can reduce the encoding of new memories, particularly in high doses (for example, prior to surgery in order for a person not to recall the surgery). [2]
The most common side effects for procedural sedation include low blood pressure, high blood pressure, diastolic hypertension, systolic hypertension, low blood oxygen level, and diastolic hypotension. [5] [6] Remimazolam was approved for medical use in the United States in July 2020, [5] [6] and in the European Union in March 2021. [3]