RESUMEN
Objective: This study aimed to compare the effectiveness of prehospital emergency treatments using midazolam (MDL) intramuscularly, diazepam (DZP) enema, and chloral hydrate (CH) enema in managing pediatric convulsions. Methods: A comparative observational study was conducted, and a total of 140 children with acute convulsions treated with prehospital anti-convulsions at Qinhuangdao First Hospital's emergency department between June 2015 and May 2019 were included in this study. The children were categorized based on the prehospital anti-convulsion measures received: group M (n = 48) received MDL intramuscularly, group D (n = 46) received DZP enema, and group C (n = 46) received CH enema. The emergency effects of the three treatment groups were compared. Results: 1. Group M showed significantly shorter treatment preparation time and total rescue time compared to groups C and D (both P < .05); no significant difference was observed between groups C and D (both P > .05), including convulsion control time in the effective cases (45 in group M, 42 in group C, and 43 in group D) (all P > .05 Group M had effective rates of 93.75%, while group C and group D had rates of 91.3% and 93.48%, respectively (all P > .05); Group M had more controlled cases at 1 min, 3 min, 5 min, and 10 min than group C and group D (all P > .05). Group M had significantly fewer relapses, cases requiring intravenous maintenance treatment, and faster convulsion control after intravenous maintenance compared to groups C and D (P < .05), with no significant differences between groups C and D in time to recovery of consciousness and length of hospitalization (P > .05). 4. Systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), respiratory (R) frequency, and peripheral oxygen saturation (SpO2) showed no significant differences before and 10 minutes after medication in all three groups (P > .05); SBP and DBP levels fluctuated within the normal range, while HR decreased, R frequency decreased, and SpO2 increased significantly 10 minutes after medication compared to before treatment (P < .05). 5. No significant adverse effects were observed in the three patient groups. Conclusions: MDL intramuscular injection, DZP enema, and CH enema were effective prehospital treatments for pediatric acute convulsions. MDL intramuscular injection demonstrated advantages such as fast onset, reliable efficacy, ease of use, and high safety, making it more suitable for the prehospital treatment of pediatric convulsions.
Asunto(s)
Servicios Médicos de Urgencia , Midazolam , Niño , Humanos , Hidrato de Cloral/uso terapéutico , Diazepam/uso terapéutico , Enema , Midazolam/uso terapéutico , Convulsiones/tratamiento farmacológico , Convulsiones/inducido químicamenteRESUMEN
Studies in the field of forensic pharmacology and toxicology would not be complete without some knowledge of the history of drug discovery, the various personalities involved, and the events leading to the development and introduction of new therapeutic agents. The first medicinal drugs came from natural sources and existed in the form of herbs, plants, roots, vines and fungi. Until the mid-nineteenth century nature's pharmaceuticals were all that were available to relieve man's pain and suffering. The first synthetic drug, chloral hydrate, was discovered in 1869 and introduced as a sedative-hypnotic; it is still available today in some countries. The first pharmaceutical companies were spin-offs from the textiles and synthetic dye industry and owe much to the rich source of organic chemicals derived from the distillation of coal (coal-tar). The first analgesics and antipyretics, exemplified by phenacetin and acetanilide, were simple chemical derivatives of aniline and p-nitrophenol, both of which were byproducts from coal-tar. An extract from the bark of the white willow tree had been used for centuries to treat various fevers and inflammation. The active principle in white willow, salicin or salicylic acid, had a bitter taste and irritated the gastric mucosa, but a simple chemical modification was much more palatable. This was acetylsalicylic acid, better known as Aspirin®, the first blockbuster drug. At the start of the twentieth century, the first of the barbiturate family of drugs entered the pharmacopoeia and the rest, as they say, is history.
Asunto(s)
Química Farmacéutica/historia , Descubrimiento de Drogas/historia , Alcaloides/análisis , Alcaloides/historia , Alcaloides/aislamiento & purificación , Analgésicos/síntesis química , Analgésicos/historia , Analgésicos/uso terapéutico , Antipiréticos/síntesis química , Antipiréticos/historia , Antipiréticos/uso terapéutico , Aspirina/síntesis química , Aspirina/historia , Aspirina/uso terapéutico , Barbitúricos/síntesis química , Barbitúricos/historia , Barbitúricos/uso terapéutico , Química Orgánica/historia , Hidrato de Cloral/síntesis química , Hidrato de Cloral/historia , Hidrato de Cloral/uso terapéutico , Cloroformo/síntesis química , Cloroformo/historia , Cloroformo/uso terapéutico , Industria Farmacéutica/historia , Historia del Siglo XVIII , Historia del Siglo XIX , Historia del Siglo XX , Historia Antigua , Humanos , Preparaciones Farmacéuticas/síntesis química , Preparaciones Farmacéuticas/historia , Farmacología/historia , Preparaciones de Plantas/química , Preparaciones de Plantas/historia , Preparaciones de Plantas/aislamiento & purificación , Preparaciones de Plantas/uso terapéutico , Toxicología/historiaAsunto(s)
Hidrato de Cloral/uso terapéutico , Epilepsia/tratamiento farmacológico , Hipnóticos y Sedantes/uso terapéutico , Trastornos del Inicio y del Mantenimiento del Sueño/tratamiento farmacológico , Niño , Discapacidades del Desarrollo/complicaciones , Complejo III de Transporte de Electrones/deficiencia , Epilepsia/complicaciones , Humanos , Masculino , Miopatías Mitocondriales/complicaciones , Cuidados Paliativos/métodos , Selección de Paciente , Trastornos del Inicio y del Mantenimiento del Sueño/complicaciones , Resultado del TratamientoRESUMEN
Complaints of insomnia, i.e. problems to fall asleep or maintain asleep and/or non-restorative sleep are very common in general practice. This article presents the clinical algorithm non-restorative sleep which was devised by the German Society for Sleep Research and Sleep Medicine. This algorithm presents a guideline for the diagnosis and the treatment of insomnia.
Asunto(s)
Algoritmos , Trastornos del Sueño-Vigilia/diagnóstico , Trastornos del Sueño-Vigilia/terapia , Factores de Edad , Anciano , Ansiolíticos/uso terapéutico , Antidepresivos/uso terapéutico , Antipsicóticos/uso terapéutico , Benzodiazepinas/uso terapéutico , Hidrato de Cloral/uso terapéutico , Ritmo Circadiano , Trastornos de Somnolencia Excesiva/diagnóstico , Trastornos de Somnolencia Excesiva/terapia , Medicina Familiar y Comunitaria , Femenino , Humanos , Hipnóticos y Sedantes/uso terapéutico , Masculino , Fitoterapia , Extractos Vegetales/uso terapéutico , Guías de Práctica Clínica como Asunto , Factores de Riesgo , Factores Sexuales , Trastornos del Inicio y del Mantenimiento del Sueño/diagnóstico , Trastornos del Inicio y del Mantenimiento del Sueño/epidemiología , Trastornos del Inicio y del Mantenimiento del Sueño/terapia , Trastornos del Sueño-Vigilia/tratamiento farmacológico , Trastornos del Sueño-Vigilia/epidemiología , Sueño REM , Terminología como AsuntoAsunto(s)
Hipnóticos y Sedantes/uso terapéutico , Acetamidas/administración & dosificación , Acetamidas/uso terapéutico , Administración Oral , Consumo de Bebidas Alcohólicas , Barbitúricos/uso terapéutico , Hidrato de Cloral/uso terapéutico , Etclorvinol/efectos adversos , Etclorvinol/uso terapéutico , Agonistas de Receptores de GABA-A , Antagonistas de los Receptores Histamínicos H1/uso terapéutico , Humanos , Melatonina/uso terapéutico , Fitoterapia , Piridinas/uso terapéutico , Pirimidinas/administración & dosificación , Pirimidinas/uso terapéutico , Trastornos del Inicio y del Mantenimiento del Sueño/tratamiento farmacológico , ZolpidemRESUMEN
In 1977 it was reported that chloral hydrate could cause adynamic ileus in rats, leading to morbidity and death. The symptoms were a swollen abdomen, lethargy and anorexia. However, chloral hydrate is still used as an anaesthetic, particularly in Equithesin mixture. We report that Equithesin without chloral hydrate is an effective anaesthetic, with a slightly reduced potency compared to Equithesin itself, and anaesthesia may be maintained for several hours by supplemental doses.
Asunto(s)
Anestesia/veterinaria , Anestésicos/uso terapéutico , Hidrato de Cloral/uso terapéutico , Sulfato de Magnesio/uso terapéutico , Pentobarbital/uso terapéutico , Animales , Combinación de Medicamentos , Masculino , RatasRESUMEN
Palicourea marcgravii (Pm) is a highly toxic plant to cattle in Brazil. Previous experiments showed that Pm intoxication in rats is similar to that reported for cattle. The present study was undertaken to determine if central nervous system depressant drugs protected animals against Pm-induced seizures. Doses of 30.0 mg diazepan/kg or 2.5 or 5.0 mg xyalzine/kg increased the ET50 for seizures. Only 4.0 mg chloral hydrate/kg + 10.0 mg xylazine/kg protected animals from death. Rats treated with sodium pentobarbital, diazepan or chlorpromazine died in depression after acute Pm intoxication. The combination of 2.0 choral hydrate/kg + 10.0 mg xylazine/kg protected rats against the Pm toxic effect, since all treated animal survived.