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Side effects can include a decrease in efforts to breathe, low blood pressure, and sleepiness. [12] Tolerance to its effects and withdrawal syndrome may occur following long-term use. [16] Paradoxical effects, such as increased activity, can occur especially in children and older people. [16]
Nasal administration, popularly known as snorting, is a route of administration in which drugs are insufflated through the nose. It can be a form of either topical administration or systemic administration , as the drugs thus locally delivered can go on to have either purely local or systemic effects.
Sedation is the reduction of irritability or agitation by administration of sedative drugs, generally to facilitate a medical procedure or diagnostic procedure. Examples of drugs which can be used for sedation include isoflurane, diethyl ether, propofol, etomidate, ketamine, pentobarbital, lorazepam and midazolam. [1]
Inhalation sedation requires the patient to breath through the nose, which can be especially difficult in very young children or patients with learning difficulties. Additionally, the drug cannot be used alone; it must be used alongside appropriate methods of behaviour management and local anaesthetic.
Usual doses for midazolam are 1 mg to 2 mg where the older people receive smaller doses and obese people receive higher doses. Midazolam is metabolized in the liver and is excreted through the kidneys. [9] When midazolam is used alone, it has few side effects, but can cause respiratory depression if being used together with fentanyl. [8]
Remimazolam was found to have both a more rapid onset and a shorter duration than midazolam, and human clinical trials showed a faster recovery time and predictable, consistent pharmacokinetics, suggesting some advantages over existing drugs for these applications.
Nasal delivery of this gel demonstrated increased drug concentration in the brain. [17] Oxytocin is a hormone which is observed to alleviate anxiety symptoms in people with autism. Intranasal administration indicated efficient transfer of pharmacologically active oxytocin from nasal cavity to brain.
Nasal insufflation is the most common method of nasal administration. Other methods are nasal inhalation and nasal instillation. Drugs administered in this way can have a local effect or a systemic effect. The time of onset for systemic drugs delivered via nasal administration is generally only marginally slower than if given intravenously.