Podcasts about flumazenil

Can reversing sedation be too much of a good thing? Flumazenil is a powerful benzodiazepine antagonist, but its use comes with both benefits and risks. In this episode of Everyday Oral Surgery, we welcome back Dr. Jake Stucki, a resident doctor at Case Western Reserve University School of Dental Medicine, to break down the benefits and drawbacks of flumazenil. In our conversation, we delve into the benefits, risks, cost considerations, and usage of flumazenil in oral surgery sedation. We explore using naloxone, its potential to reverse opioid effects, the associated costs of using it, and its potential for residual sedation. You'll also learn about the common misconceptions surrounding flumazenil, patient contraindications, guidelines on best practices, and more. Join us to learn about the fundamentals of flumazenil and how to use it effectively and safely in your practice with Dr. Jake Stucki. Tune in now!Key Points From This Episode:Learn about flumazenil's usage, its effects on patients, and why it is important.The associated costs, how it can be administered, and the correct dosage to use.Explore the benefits of flumazenil in oral surgery and patient recovery.  Uncover the potential risks surrounding re-sedation and other vital considerations.When not to use the drug and how it is commonly used in clinical practice.Find out about the downsides of using flumazenil and the complications it can cause.Hear about The Joint Commission's perspective on the use of flumazenil.Naloxone and how its usage and dosage are different from flumazenil.Discover an alternative approach for extracting maxillary upper third molars.Links Mentioned in Today's Episode:Dr. Jake Stucki on LinkedIn — https://www.linkedin.com/in/jake-stucki-ab19a593/  Case Western Reserve University School of Dental Medicine — https://case.edu/medicine/The Joint Commission — https://www.jointcommission.org/Dexter — https://www.imdb.com/title/tt0773262/Cobra Kai — https://www.imdb.com/title/tt7221388/Talking to Strangers — https://www.amazon.com/Talking-Strangers-Should-about-People/dp/0316478520/Everyday Oral Surgery Website — https://www.everydayoralsurgery.com/ Everyday Oral Surgery on Instagram — https://www.instagram.com/everydayoralsurgery/ Everyday Oral Surgery on Facebook — https://www.facebook.com/EverydayOralSurgery/Dr. Grant Stucki Email — grantstucki@gmail.comDr. Grant Stucki Phone — 720-441-6059

Herkese merhaba! Acilci.net ailesi olarak, Amerikan Kalp Cemiyeti'nin (AHA) zehirlenmiş hastalarda yaşamı tehdit eden toksisite ve kardiyak arrest yönetimi ile ilgili yayınladığı odaklanmış güncellemeleri​1​ sizlerle paylaşmaya devam ediyoruz. Dr. Emre Kudu'nun giriş bölümünü yazdığı yazıya buradan ulaşabilirsiniz. Bugünkü yazımızda ise, güncellemenin özellikle kritik zehirlenmelerle ilgili spesifik önerilerini ve tedavi yaklaşımlarını inceleyeceğiz. Hadi başlayalım! Benzodiazepinler Giriş Benzodiazepinler, anksiyete, uykusuzluk, nöbetler ve yoksunluk sendromları gibi durumları tedavi etmek ve genel anestezi ile prosedürel sedasyonda kullanılan yaygın sedatif-hipnotik ilaçlardır. Bu ilaçlar, genellikle opioidler veya alkol gibi diğer merkezi sinir sistemi baskılayıcıları ile birlikte, zehirlenme ile ilişkili birçok ölüme neden olabilirler. Benzodiazepin aşırı dozu, GABA-A reseptörüne etki ederek merkezi sinir sistemi depresyonuna ve solunum yolu komplikasyonlarına neden olabilir. Bu durum, hipoksemi ve hiperkarbi gibi sorunlara yol açarak doku hasarına ve ölüme sebep olabilir. Benzodiazepin zehirlenmesi olan hastalarda havayolunun açıklığının sağlanması, balon-maske ventilasyonu gereklilik halinde endotrakeal entübasyon standart yaşam desteğinin önemli basamaklarıdır. Flumazenil, benzodiazepinlerin GABA-A reseptörüne bağlanmasını engelleyen bir antagonisttir. Bu ilaç, merkezi sinir sistemi ve solunum depresyonunu tersine çevirebilir, ancak benzodiazepin bağımlısı hastalarda nöbet riskini artırabilir. Ayrıca, özellikle disritmojenik ilaçlar (örneğin, siklik antidepresanlar) veya hipoksi varlığında kalp ritmi bozukluklarına yol açabilir. Flumazenil, sempatik tonusun benzodiazepin aracılı baskılanmasını ortadan kaldırır. Flumazenil, karışık aşırı dozlarda solunum depresyonunu tamamen tersine çeviremeyebilir. Çoklu ilaçla aşırı doz zehierlenmeler sık karşılaşılan bir durumdur. Benzodiazepin doz aşımı, opioid doz aşımından şüphelenildiğinde naloksonun zamanında uygulanmasını engellememelidir. Bu durum, opioid katkılı yasadışı uyuşturucuların varlığı göz önüne alındığında önemlidir. Öneriye Özgü Destekleyici Metin İzole benzodiazepin zehirlenmesi nadiren hayatı tehdit eden hipoventilasyon veya hemodinamik instabiliteye neden olur. Böyle durumlarda opioid, etanol veya diğer SSS depresan zehirlenmelerinin olabileceği de düşünülmelidir. Opioid zehirlenmeleri benzodiazepin zehirlenmelerinden daha yaygındır, daha belirgin solunum depresyonuna neden olur ve nalokson flumazenil ile karşılaştırıldığında daha güvenilirdir. Flumazenil bazı düşük riskli durumlarda (örn. pediatrik keşif amaçlı alımlar ve prosedürel sedasyon sırasında iyatrojenik aşırı dozlar) ve yüksek riskli durumlar (örn. kronik benzodiazepin bağımlılığı ve diğer tehlikeli maddelerin birlikte alımı) güvenilir bir şekilde dışlandığında güvenlidir. Flumazenil, doğrudan kalp ritmini etkilemez veya spontan dolaşımı geri döndürmez. Benzodiazepin aşırı dozunun varsayıldığı hastalar üzerinde gerçekleştirilen randomize klinik çalışmaların meta-analiz sonuçlarına göre, flumazenil uygulaması, standart bakıma kıyasla nöbetler ve disritmiler gibi ciddi yan etkilerin daha yüksek oranda ortaya çıkmasına neden olmuştur. Flumazenil kaynaklı zararlar genellikle nadir görülmekte ve çoğunlukla etkin bir şekilde yönetilebilmektedir. Ancak, tıbbi öyküsü, madde kullanım geçmişi ve maruz kalınan potansiyel toksin(ler) hakkında yeterli bilgiye sahip olunmayan ayırıcı tanı yapılamamış koma durumundaki hastalarda, flumazenilin olası riskleri, elde edilen faydalardan daha fazladır. β-Blokerler Giriş β-Blokerler zehirlenme kaynaklı ölümlerin önde gelen nedenlerindendir. Ciddi β-bloker zehirlenmesi olan hastalarda bradikardi ve kardiyak kontraktilitenin azalmasına bağlı olarak hipotansiyon gelişir. Bazı β-blokerler ayrıca sodyum veya potasyum kanal blokajından kaynaklanan disritmilere neden olabilirler. Bradikardi,

Herkese merhaba! Geçtiğimiz aylarda Amerikan Kalp Cemiyeti (AHA) tarafından zehirlenmiş hastalarda hayatı tehdit eden toksisite veya kardiyak arrest yönetimine yönelik odaklanmış güncellenme yayınlanmıştı.​1​ Acilci.net ailesi olarak bu yazı serimizde bu güncellemeyi sizlere sunacağız.    İlk yazımızda, güncellemenin Giriş bölümüne yer vereceğiz. Serinin devam eden yazıları ise spesifik olarak kritik zehirlenmelere yönelik konular ile devam edecek. Zehirlenmiş Hastalarda Hayatı Tehdit Eden Toksisite veya Kardiyak Arrest Yönetimine Dair Eve Götürülecek 10 Mesaj Zehirlenmeye bağlı kardiyak arrest ve yaşamı tehdit eden toksisitenin tedavisi, etkili temel ve ileri yaşam desteğinin yanı sıra çoğu zaman antidotlar ve venoarteriyel ekstrakorporeal membran oksijenasyonu (VA-ECMO) gibi çoğu klinisyenin sıklıkla kullanmadığı özel tedavileri gerektirir. Tıbbi toksikolog, klinik toksikolog veya bölgesel zehir merkezi ile zamanında konsültasyon, hızlı ve etkili tedaviyi kolaylaştırır. Opioid doz aşımı, Kuzey Amerika'da zehirlenmeye bağlı kardiyak arrestin önde gelen nedeni olmaya devam etmektedir. Nalokson uygulaması solunum durmasını tersine çevirerek kardiyak arreste ilerlemeyi önleyebilir. Hayatı tehdit eden β-bloker ve kalsiyum kanal bloker zehirlenmesi olan hastaların tedavisinde erken dönemde yüksek doz insülin tedavisi önerilmektedir. Sodyum bikarbonat uygulamasının eklendiği standart ileri yaşam desteği, kokain veya diğer sodyum kanal blokerlerinin neden olduğu hayatı tehdit eden disritmilerin tedavisi için uygundur. Siyanür zehirlenmesinden şüpheleniliyorsa doğrulama testini beklenmemelidir. Hemen hidroksokobalamin (tercih edilir) veya sodyum nitrit + sodyum tiyosülfat ile tedavisi uygulanmalıdır. Digoksin spesifik immün antikor fragmanlarının uygulanması, digoksin zehirlenmesinden kaynaklanan yaşamı tehdit eden aritmileri tersine çevirebilir. Özellikle bupivakainden kaynaklanan yaşamı tehdit eden lokal anestezik toksisitesinin resüsitasyonunda %20 intravenöz lipid emülsiyonunun kullanılması etkili olabilir. Sempatomimetik zehirlenmesinden dolayı şiddetli ajitasyonu olan hastalarda sedasyon uygulamasına ihtiyaç duyarlar. Böylece hipertermi ve asidozu yönetimine, rabdomiyoliz ve yaralanmayı önlenmesine ve yaşamı tehdit eden diğer durumların değerlendirilmesine olanak sağlanmış olur. Flumazenil, benzodiazepin zehirlenmesinden kaynaklanan merkezi sinir sistemini ve solunum depresyonunu tersine çevirir, ancak önemli riskler ve kontrendikasyonlar kullanımını sınırlar. VA ECMO, diğer tedavi önlemlerine dirençli kardiyojenik şok veya disritmileri olan hastalar için hayat kurtarıcı olabilir. Venoarteriyel ECMO uygulaması zaman aldığından diğer tedavilere iyi yanıt vermeyen hastalarda işleme erken başlanmalıdır. Önsöz Nisan 2021'de sona eren 12 aylık dönemde, Amerika Birleşik Devletleri'nde 100.000'den fazla kişi zehirlenme ve ilaç aşırı dozundan dolayı öldü ve bu sayı önceki yıla göre %28,5'lik bir artış gösterdi.​2​ Bu ölümlerin yüzde doksanı kasıtsızdı. Her ne kadar bu ölümlerin çoğunluğu (75.673) opioid doz aşımına atfedilmiş olsa da diğer toksinlerden kaynaklanan zehirlenmeler önemli sayıda can kaybına yol açmaya devam ediyor. Kardiyak arrest, dirençli şok veya kardiyak arrest tehdidi oluşturan diğer durumlar olarak tanımlanan kritik zehirlenmeli hastaların yönetimi, genellikle standart resüsitasyondan farklıdır. Örneğin hastalar, β-adrenerjik reseptör antagonisti (β-bloker) veya kalsiyum kanalı antagonisti (kalsiyum kanal blokeri [CCB]) zehirlenmesinden dolayı hipotansiyon geliştirebilirler. Bu durum sıklıkla atropine, standart vazopresörlere veya kalp pili uygulamasına yanıt vermez iken hedefe yönelik yüksek doz insülin gibi tedavilerden fayda görebilir. Siyanür zehirlenmesinin mitokondriyal inhibisyonu, kalp ve beyindeki hücresel adenozin trifosfat konsantrasyonlarını eski haline getirmek için hidroksokobalamin gibi spesifik antidotlar gerektirir. Zehirlenen hastalar,

In deze podcast vertelt Erik Paling, verslavingsarts bij Brijder, specialist in verslavingszorg zijn visie op verslaving en belicht hij de macht van de benzo's vanuit zijn werk als verslavingsarts. Het ‘off-label' voorschrijven gebeurt heel veel, zegt hij. Uit zijn verhaal komt goed naar voren, hoe een pilletje toch makkelijk is voorgeschreven en cognitieve gedragstherapie voor slaapproblemen vaak niet wordt vergoed.

In this episode, we discuss the ways in which tolerance to benzodiazepines can develop, and how this can lead to extremely difficult withdrawals. We argue that the commonly held view of drug tolerance is delaying promising research avenues, such as "anti-tolerance drugs". We think that NAD+ IV therapy and flumazenil show promise for treating benzodiazepine withdrawal, and encourage people to share their experiences with these treatments.

Share this post with others: Dr. Anna Lembke is our guest today — and trust me — you don't want to miss this one! We discuss benzodiazepine tapering, substitution, the dopamine cycle, flumazenil, anxiety, social media, finding a doctor and so much more. Anna Lembke, MD is professor of psychiatry at Stanford University School of Medicine, chief of the Stanford Addiction Medicine Dual Diagnosis Clinic, and an internationally recognized leader in addiction medicine, treatment, and education.  A best-selling author, she has also testified before both the U.S. House and Senate and appeared in the Netflix documentary, “The Social Dilemma.” Welcome to Episode #110 My conversation with Dr. Anna Lembke was definitely one of the best I've ever recorded for this podcast. Look below at the chapter list and you will see the vast array of topics we covered. She is an international leader in drug addiction and dependence and her expertise shows at every turn. I'm so glad she took the time to talk with us and I know that this episode will become one of our most popular. Video ID: BFP110 Chapters 0:00:00  INTRODUCTION0:01:55  Benzos & Surgery Update0:03:25  PROTECT Study0:04:35  FEATURE: Dr. Anna Lembke0:05:28  Dr. Lembke's Bio0:06:54  Welcome / About Dr. Lembke0:09:32  Deprescribing Clinics0:10:53  Learning from Addiction Medicine0:12:17  The Bravo Protocol0:13:37  The Ashton Manual0:14:59  Benzo Horror Stories0:15:50  The Dopamine Cycle0:19:45  Addiction vs. Dependence0:21:59  Is Benzo Withdrawal Unique?0:24:52  When Did You Become Concerned?0:26:40  Changes in Prescribing Practices0:29:15  Increasing Rates of Anxiety0:30:24  Drugifying Human Behaviors0:31:28  Digital Device Addiction0:34:59  Reinforcing Negative Experiences0:38:37  Mindfulness / Expectations0:41:49  Finding Acceptance0:43:48  How Do You Taper Your Patients?0:46:48  Substitution vs. Direct Taper0:49:57  Dosing Schedule / Flexibility0:52:06  Stabilizing Before Tapering0:54:31  Finding a Doctor You Can Trust0:56:04  You Make a Difference as a Patient0:56:53  Flumazenil and Other Treatments1:00:33  Benzos and the Elderly1:02:24  The Danger of Designer Benzos1:03:59  What are Benzos Good For?1:05:31  Benzos for Medical Procedures1:07:32  Final Words for the Patient1:09:10  CLOSING About Dr. Lembke Anna Lembke, MD is professor of psychiatry at Stanford University School of Medicine and chief of the Stanford Addiction Medicine Dual Diagnosis Clinic. A clinician scholar, she is the author of more than a hundred peer-reviewed publications, has testified before the United States House of Representatives and Senate, has served as an expert witness in federal and state opioid litigation, and is an internationally recognized leader in addiction medicine treatment and education. In 2016, Anna published “Drug Dealer, MD – How Doctors Were Duped, Patients Got Hooked, and Why It's So Hard to Stop” (Johns Hopkins University Press, 2016), highlighted in the New York Times as one of the top five books to read to understand the opioid epidemic (Zuger, 2018). Dr. Lembke appeared in the Netflix documentary “The Social Dilemma,” an unvarnished look at the impact of social media on our lives. Her latest book, “Dopamine Nation: Finding Balance in the Age of Indulgence” (Dutton/Penguin Random House, August 2021) was an instant New York Times and Los Angeles Times bestseller and explores how to moderate compulsive overconsumption in a dopamine-overloaded world. Resources for Dr. Anna Lembke The following resource links are provided as a courtesy to our listeners. They do not constitute an endorsement by Benzo Free of the resource or any recommendations or advice provided therein. — WEBSITE — https://www.annalembke.com/— PROFILE: Stanford University — https://profiles.stanford.edu/anna-lembke— BOOK: “Drug Dealer, MD” — https://www.annalembke.com/drug-dealer-md— BOOK: “Dopamine Nation” — https://www.annalembke.

Dr. Anna Lembke is our guest today — and trust me — you don't want to miss this one! We discuss benzodiazepine tapering, substitution, the dopamine cycle, flumazenil, anxiety, social media, finding a doctor and so much more.Anna Lembke, MD is a professor of psychiatry at Stanford University School of Medicine, chief of the Stanford Addiction Medicine Dual Diagnosis Clinic, and an internationally recognized leader in addiction medicine, treatment, and education. A best-selling author, she has also testified before both the U.S. House and Senate and appeared in the Netflix documentary, “The Social Dilemma.”https://www.easinganxiety.com/post/conversation-with-stanford-psychiatris-anna-lembke-md-bfp110Video ID: BFP110Chapters 0:00:00 INTRODUCTION0:01:55 Benzos & Surgery Update0:03:25 PROTECT Study0:04:35 FEATURE: Dr. Anna Lembke0:05:28 Dr. Lembke's Bio0:06:54 Welcome / About Dr. Lembke0:09:32 Deprescribing Clinics0:10:53 Learning from Addiction Medicine0:12:17 The Bravo Protocol0:13:37 The Ashton Manual0:14:59 Benzo Horror Stories0:15:50 The Dopamine Cycle0:19:45 Addiction vs. Dependence0:21:59 Is Benzo Withdrawal Unique?0:24:52 When Did You Become Concerned?0:26:40 Changes in Prescribing Practices0:29:15 Increasing Rates of Anxiety0:30:24 Drugifying Human Behaviors0:31:28 Digital Device Addiction0:34:59 Reinforcing Negative Experiences0:38:37 Mindfulness / Expectations0:41:49 Finding Acceptance0:43:48 How Do You Taper Your Patients?0:46:48 Substitution vs. Direct Taper0:49:57 Dosing Schedule / Flexibility0:52:06 Stabilizing Before Tapering0:54:31 Finding a Doctor You Can Trust0:56:04 You Make a Difference as a Patient0:56:53 Flumazenil and Other Treatments1:00:33 Benzos and the Elderly1:02:24 The Danger of Designer Benzos1:03:59 What are Benzos Good For?1:05:31 Benzos for Medical Procedures1:07:32 Final Words for the Patient1:09:10 CLOSING BIO for Dr. Anna LembkeAnna Lembke, MD is professor of psychiatry at Stanford University School of Medicine and chief of the Stanford Addiction Medicine Dual Diagnosis Clinic. A clinician scholar, she is the author of more than a hundred peer-reviewed publications, has testified before the United States House of Representatives and Senate, has served as an expert witness in federal and state opioid litigation, and is an internationally recognized leader in addiction medicine treatment and education.In 2016, Anna published “Drug Dealer, MD – How Doctors Were Duped, Patients Got Hooked, and Why It's So Hard to Stop” (Johns Hopkins University Press, 2016), highlighted in the New York Times as one of the top five books to read to understand the opioid epidemic (Zuger, 2018). Dr. Lembke appeared in the Netflix documentary “The Social Dilemma,” an unvarnished look at the impact of social media on our lives. Her latest book, “Dopamine Nation: Finding Balance in the Age of Indulgence” (Dutton/Penguin Random House, August 2021) was an instant New York Times and Los Angeles Times bestseller and explores how to moderate compulsive overconsumption in a dopamine-overloaded world. Resources The following resource links are provided as a courtesy to our listeners. They do not constitute an endorsement by Easing Anxiety of the resource or any recommendations or advice provided therein. RESOURCES for Anna Lembke, MD— WEBSITE — https://www.annalembke.com/— PROFILE: Stanford University — https://profiles.stanford.edu/anna-lembke— BOOK: “Drug Dealer, MD” — https://www.annalembke.com/drug-dealer-md— BOOK: “Dopamine Nation” — https://www.annalembke.com/drug-dealer-md — VIDEO: “Benzodiazepines: The Hidden Epidemic” — https://www.youtube.com/watch?v=Ln1F2oANexw— VIDEO: “Benzodiazepines: Dependence and Withdrawal” — https://www.youtube.com/watch?v=-W9EEI2ZXKU— VIDEO: “Benzodiazepine Tolerance: An Adverse Medical Event” — https://www.youtube.com/watch?v=R7r_94vyOL4— BRAVO! A Collaborative Approach to Opioid Tapering — https://www.oregonpainguidance.org/guideline/tapering/— The Ashton Manual — https://easinganxiety.com/blog/ashton-manual/ The PodcastThe Benzo Free Podcast provides information, support, and community to those who struggle with the long-term effects of anxiety medications such as benzodiazepines (Xanax, Ativan, Klonopin, Valium) and Z-drugs (Ambien, Lunesta, Sonata). WEBSITE: https://www.easinganxiety.comMAILING LIST: https://www.easinganxiety.com/subscribe YOUTUBE: https://youtube.com/@easinganx DISCLAIMERAll content provided by Easing Anxiety is for general informational purposes only and should never be considered medical advice. Any health-related information provided is not a substitute for medical advice and should not be used to diagnose or treat health problems, or to prescribe any medical devices or other remedies. Never disregard medical advice or delay in seeking it. Please visit our website for our complete disclaimer at https://www.easinganxiety.com/disclaimer. CREDITSMusic provided / licensed by Storyblocks Audio — https://www.storyblocks.com Benzo Free Theme — Title: “Walk in the Park” — Artist: Neil Cross PRODUCTIONEasing Anxiety is produced by…Denim Mountain Presshttps://www.denimmountainpress.com ©2022 Denim Mountain Press – All Rights Reserved

Flumazenilin    Farmakolojisi    Klinik Kullanımı    Dozları    Yan Etkileri

Flumazenilin   Genel Özellikleri   Fizikokimyasal Özellikleri   Metabolizması   Farmakıkinetiği

Zehirlenmeler, sebebi ister kaza ister öz kıyım olsun, acil servis hekimlerinin sık karşılaştığı, tanısı, tedavisi ve yönetimi Tıbbi/Klinik Toksikoloji bilim dalı altında geliştirilmiş ve her acil servis hekiminin de hasta yönetimindeki temel prensipleri bilmesi gereken özel durumlardır. Akut zehirlenmelerde tıbbi yönetimin asıl hedefi klinik stabiliteyi bozan durumları tanımak, gerek destek tedavi ile gerekse özelleşmiş tedavilerle bu toksik etkileri ortadan kaldırmaktır. Genel yaklaşım prensipleri, çok sayıda ve geniş çaplı olmasına rağmen akılda kalıcılığını artırmak adına temel olanları basamaklar halinde sizlere sunmayı amaçladık. Sonraki yazı serilerimizde bu basamaklar detaylı bir şekilde tartışılacaktır. Akut Zehirlenmelerde Tıbbi Yönetim Akış Çizelgesi 1.Havayolu-Solunum değerlendirilmesi: Havayolu (A), solunum(B) ve dolaşım(C) değerlendirmesi, acil tıbbi yaklaşımın ilk basamağını oluşturur. Yüksek doz madde maruziyetine bağlı ölümlerin en sık nedeni havayolu koruyucu reflekslerin kaybına bağlı oluşan solunum arrestidir. Bilinci kapalı hastalarda havayolu temel manevralarla açıldıktan sonra solunum depresyonu veya solunum arresti söz konusu ise ileri havayolu yönetimine geçmeden önce opioid toksidrom varlığından şüphe ediliyorsa opioid reseptör antagonisti olan naloksan uygulanmalıdır.​1​ Benzodiazepin reseptör antagonisti olan flumazenil ise solunum depresyonu veya arresti olan zehirlenme şüphesi durumunda, kronik benzodiazepin kullanım öyküsü olan hastalarda yoksunluk sendromunu ve dirençli nöbetleri tetikleyeceğinden dolayı rutin kullanımı önerilmemektedir. Flumazenil, sadece akut toksik benzodiazepin maruziyeti bilinen hastalarda (acil servislerde sedasyon amaçlı kullanımın komplikasyonu gibi) durumlarda kullanılmalıdır.​2​ 2. Dolaşım Değerlendirilmesi: Genel değerlendirme nabız, tansiyon, ritm kontrolü ile başlar. Kardiyak arrest söz konusu ise İleri Kardiyak Yaşam Desteği (İKYD) Kılavuzu'na uygun şekilde tüm hastalara müdahale edilir. Toksinler, kardiyopulmoner arrestin geri döndürülebilir nedenleri arasında yer aldığından bu hastalarda uzun süreli CPR uygulanmalıdır.​3​ Antidotların kardiopulmoner resusitasyon esnasındaki kullanımları ile ilgili kanıt düzeyleri yeterli değildir. Vital bulguları kontrol edilen her hastaya güvenli bir damar yolu açılmalı, tanısal ve tedavisel yönetim sürecinde kullanılmak üzere kan örneği alınmalıdır. Her hastaya ilk 10  dakika içinde 12 derivasyonlu EKG çekimi yapılarak ayrıntılı ritm analizi yapılmalıdır. Uzun QRS varlığı , QT aralığı (Bazett formülü) ve Na kanal blokajı (QRS>100ms avR'de R>3mm, R/S>0.7) değerlendirilmelidir. Semptomatik bradikardi, taşikardi, hipotansiyon yönetiminde toksinin etki mekanizmasına ve neden olduğu komplikasyonlara yönelik tedavi yönetimi planlanmalıdır. Varsa spesifik antidotal tedaviler gözden geçirilmeli yoksa standart İKYD algoritmasına uygun şekilde hastaya destek tedavisi verilmelidir. Hipotansiyonun altta yatan mekanizmasını aydınlatmak için yatakbaşı USG ile birlikte kardiyak fonksiyonlar değerlendirilmeli, varsa toksine özgü antidotal tedaviler uygulanmalıdır ve ek olarak sıvı, vazopressör ya da inotrop ajan desteği sağlanmalıdır.​2​ Kardiyovasküler stabilizasyonu bozma ihtimali yüksek olan toksin maruziyetinde (Kalsiyum kanal blokörü, beta blokör ve diğer antiaritmik ajanlar gibi) erken dönemde ECMO uygulanabilen merkeze sevki planlanmalı ve mevcut farmakoterapiye (destek+antidotal tedavi) yanıt alınamayan kritik hastalar kardiak arrest olmadan önce mümkünse ECMO'ya bağlanmalıdır. 3. Toksikolojik Öykü ve Fizik Muayene: Toksikolojide anamnez alınırken toksine ait “Ne? Ne kadar? Ne zaman? Ne amaçla? Hangi yolla maruz kalındı?” gibi soruların cevapları aydınlatılmaya çalışılmalıdır. Zehirlenen hastanın bilinç durumunda bozulma olduğunda ve öz-kıyım amaçlı başvurularda anamnez güvenilirliği yeterli olmamaktadır. Bu nedenle öykü bilgileri aile, yakın çevre,  hastayı getiren sağlık ekipleri, hastane kayıtları,

Share this post with others: How much do you know about benzos? About withdrawal? About anxiety and insomnia? Want to test that knowledge? Well, this is the place. It's time to lighten the mood a bit and have some fun. Welcome to our first-ever Benzo Trivia episode. In today's episode of the podcast, we ask the questions, and you provide the answers. I ask a series of questions in five separate categories related to benzos, allow you time to answer, and then provide the answers with a little background on each.  I hope you enjoy it. Welcome to Episode #85 Today I decided to return to the studio and record a non-road-trip episode for once. And doing so, I also wondered if we should lighten the mood a bit. When I thought of options, trivia came to mind. So, here we are with our very first trivia episode for the Benzo Free Podcast. I ask a series of questions in five categories, and you answer, tallying up your score along the way. No pressure, just for fun. I hope you enjoy it. Video ID: BFP085 Chapters 00:00  Introduction06:18  BENZO TRIVIA – Intro08:49  Benzos, the Drug16:50  Anxiety, Insomnia, and Benzos21:30  The Benzo Community24:51  Benzo Withdrawal33:15  True or False: Rapid Fire39:28  Closing Episode Resources The following resource links are provided as a courtesy to our listeners. They do not constitute an endorsement by Benzo Free of the resource or any recommendations or advice provided therein. FEATURE - BENZO TRIVIA American Psychiatric Association (APA). Diagnostic and Statistical Manual of Mental Disorders 4th ed. text rev. (DSM-IV-TR). Washington, DC: American Psychi-atric Association, 2000.Ashton, C. Heather. “Benzodiazepines: How They Work and How to Withdraw (aka The Ashton Manual).” 2002. Accessed April 13, 2016. http://www.benzo.org.uk/manual.Ashton, C. Heather. "Benzodiazepines: The Still Unfinished Story." (Speech at Beat the Benzos Launch Conference, Croyden, London, England). https://www.benzo.org.uk/ashspeech.htm.Bachhuber, Marcus A., Sean Hennessy, Chinazo O. Cunningham and Joanna L. Starrels. "Increasing Benzodiazepine Prescriptions and Overdose Mortality in the United States, 1996-2013." American Journal of Public Health (AJPH) (April 2016). Accessed April 7, 2018. doi:10.2105/AJPH.2016.303061.Bowden, John. “CIA considered use of anti-anxiety drug in terror suspect interrogations: report.” The Hill.  November 13, 2018.  Accessed November 14, 2018. https://thehill.com/policy/defense/416485-cia-considered-potential-truth-serum-for-terror-suspects.Byrne, A. "Benzodiazepines: The End of a Dream." Australian Family Physician 23(8)(Aug 1994):1584-5. Accessed April 17, 2018. https://www.ncbi.nlm.nih.gov/pubmed/7980158.Foster, D E. “Benzo Free: The World of Anti-Anxiety Drugs and the Reality of Withdrawal.” Erie, CO: Denim Mountain Press, 2018. https://www.benzofree.org/book.Frances, Allen. "Yes, Benzos Are Bad for You." Pro Talk: A Rehabs.com Community, June 10, 2016. Accessed October 13, 2016. https://www.rehabs.com/pro-talk-articles/yes-benzos-are-bad-for-you/.Kripke, D. F., R.D. Langer and L.E. Kline. "Hypnotics' Association with Mortality or Cancer: A Matched Cohort Study." BMJ Open 2(e000850)(2012). Accessed June 21, 2017. doi:10.1136/bmjopen-2012-000850.New York City Department of Health and Mental Hygiene (NYC DOHMH). City Health Information: Judicious Prescribing of Benzodiazepines 35(2)(2016). https://docs.wixstatic.com/ugd/990dad_167113513c9445f8bc77a77370ce649f.pdf.Porter, Mark, "Addicted to Sleeping Pills? Try This Instead," The Sunday Times, October 25, 2016, accessed March 4, 2017, https://www.thetimes.co.uk/article/dr-mark-porter-how-to-avoid-sleeping-tablet-addiction-shsrnpwsm.Riechmann, Deb. “CIA considered potential truth serum for terror suspects.” Associated Press.  November 13, 2018.  Accessed November 14, 2018.  https://apnews.com/e4bc055b4fee4e0d9f47ab14adc2c173.Sharbaf Shoar N, Bistas KG, Saadabadi A. “Flumazenil.

How much do you know about benzos? About withdrawal? About anxiety and insomnia? Want to test that knowledge? Well, this is the place. It's time to lighten the mood a bit and have some fun. Welcome to our first-ever Benzo Trivia episode. In today's episode of the podcast, we ask the questions, and you provide the answers. I provide a series of questions in five separate categories related to benzos, allow you time to answer, and then provide the answers with a little background on each. I hope you enjoy it. https://www.easinganxiety.com/post/benzo-trivia-what-do-you-really-know-bfp085Video ID: BFP085 Chapters 00:00  Introduction 06:18 BENZO TRIVIA – Intro 08:49 Benzos, the Drug 16:50 Anxiety, Insomnia, and Benzos 21:30 The Benzo Community 24:51 Benzo Withdrawal 33:15 True or False: Rapid Fire 39:28 Closing  Resources The following resource links are provided as a courtesy to our listeners. They do not constitute an endorsement by Easing Anxiety of the resource or any recommendations or advice provided therein. . FEATURE – BENZO TRIVIA American Psychiatric Association (APA). Diagnostic and Statistical Manual of Mental Disorders 4th ed. text rev. (DSM-IV-TR). Washington, DC: American Psychi-atric Association, 2000.Ashton, C. Heather. “Benzodiazepines: How They Work and How to Withdraw (aka The Ashton Manual).” 2002. Accessed April 13, 2016. http://www.benzo.org.uk/manual.Ashton, C. Heather. “Benzodiazepines: The Still Unfinished Story.” (Speech at Beat the Benzos Launch Conference, Croyden, London, England). https://www.benzo.org.uk/ashspeech.htm.Bachhuber, Marcus A., Sean Hennessy, Chinazo O. Cunningham and Joanna L. Starrels. “Increasing Benzodiazepine Prescriptions and Overdose Mortality in the United States, 1996-2013.” American Journal of Public Health (AJPH) (April 2016). Accessed April 7, 2018. doi:10.2105/AJPH.2016.303061.Bowden, John. “CIA considered use of anti-anxiety drug in terror suspect interrogations: report.” The Hill. November 13, 2018. Accessed November 14, 2018. https://thehill.com/policy/defense/416485-cia-considered-potential-truth-serum-for-terror-suspects.Byrne, A. “Benzodiazepines: The End of a Dream.” Australian Family Physician 23(8)(Aug 1994):1584-5. Accessed April 17, 2018. https://www.ncbi.nlm.nih.gov/pubmed/7980158.Foster, D E. “Benzo Free: The World of Anti-Anxiety Drugs and the Reality of Withdrawal.” Erie, CO: Denim Mountain Press, 2018. https://easinganxiety.com/book.Frances, Allen. “Yes, Benzos Are Bad for You.” Pro Talk: A Rehabs.com Community, June 10, 2016. Accessed October 13, 2016. https://www.rehabs.com/pro-talk-articles/yes-benzos-are-bad-for-you/.Kripke, D. F., R.D. Langer and L.E. Kline. “Hypnotics' Association with Mortality or Cancer: A Matched Cohort Study.” BMJ Open 2(e000850)(2012). Accessed June 21, 2017. doi:10.1136/bmjopen-2012-000850.New York City Department of Health and Mental Hygiene (NYC DOHMH). City Health Information: Judicious Prescribing of Benzodiazepines 35(2)(2016). https://docs.wixstatic.com/ugd/990dad_167113513c9445f8bc77a77370ce649f.pdf.Porter, Mark, “Addicted to Sleeping Pills? Try This Instead,” The Sunday Times, October 25, 2016, accessed March 4, 2017, https://www.thetimes.co.uk/article/dr-mark-porter-how-to-avoid-sleeping-tablet-addiction-shsrnpwsm.Riechmann, Deb. “CIA considered potential truth serum for terror suspects.” Associated Press. November 13, 2018. Accessed November 14, 2018. https://apnews.com/e4bc055b4fee4e0d9f47ab14adc2c173.Sharbaf Shoar N, Bistas KG, Saadabadi A. “Flumazenil.” [Updated 2020 Sep 3]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. https://www.ncbi.nlm.nih.gov/books/NBK470180/.The PodcastThe Benzo Free Podcast provides information, support, and community to those who struggle with the long-term effects of anxiety medications such as benzodiazepines (Xanax, Ativan, Klonopin, Valium) and Z-drugs (Ambien, Lunesta, Sonata). WEBSITE: https://www.easinganxiety.comMAILING LIST: https://www.easinganxiety.com/subscribe YOUTUBE: https://www.youtube.com/@easinganx DISCLAIMERAll content provided by Easing Anxiety is for general informational purposes only and should never be considered medical advice. Any health-related information provided is not a substitute for medical advice and should not be used to diagnose or treat health problems, or to prescribe any medical devices or other remedies. Never disregard medical advice or delay in seeking it. Please visit our website for our complete disclaimer at https://www.easinganxiety.com/disclaimer. CREDITSMusic provided / licensed by Storyblocks Audio — https://www.storyblocks.com Benzo Free Theme — Title: “Walk in the Park” — Artist: Neil Cross PRODUCTIONEasing Anxiety is produced by…Denim Mountain Presshttps://www.denimmountainpress.com ©2022 Denim Mountain Press – All Rights Reserved

This patient had the trifecta of factors that can cause hypercapnia and the nurse recognized his somnolence as more than him just being due for a nap.

Será que pode acontecer sedação rebote após o uso do flumazenil para antagonizar um benzodiazepínico? Descubra nesse episódio junto com o médico anestesista Francisco Neto.

Welcome To The MedFlashGo Podcast. This Is Your Daily 4 Minutes Or Less Rapid Review For Medical Boards including USMLE, COMLEX, And Shelf Exams. We release a new episode every weekday! In this question of the day, Percy asks students to identify which drug flumazenil is not an antidote for. These questions are powered by MedFlashGo The First Voice-based interactive medical question bank currently available on Alexa. This tool allows medical students to study medical topics and be interactively tested without the use of a screen. You can study on your couch, in your car, and on the move without the use of a screen. To get access to the free audio-interactive question bank, click here or go to your Alexa application and search medflashgo In the skills section. To learn more details go to medflashgo.com and check out our frequently asked questions section. Please know that these questions were creatively designed by medical students and physicians for the purpose of education and do not replace health information given from your health professionals. We have tried our best to make sure the information is accurate please, so please let us know if you find any errors and we will be sure to correct them. --- Send in a voice message: https://anchor.fm/medflashgo/message

Flumazenil

Moderator: James P. Rathmell, M.D. Participants: Adrian W. Gelb, M.B.Ch.B. and Phillip E. Vlisides, M.D. Articles Discussed: Midazolam Sedation Induces Upper Limb Coordination Deficits That Are Reversed by Flumazenil in Patients with Eloquent Area Gliomas Pharmacologic Unmasking of Neurologic Deficits: A Stress Test for the Brain Transcript

Le benzodiazepine, quelle che comunemente si chiamano ansiolitici o sonniferi, sono una classe di farmaci dotata di un alto potenziale di pericolosità rispetto a dipendenza ed abuso. È in corso un'epidemia silenziosa e poco visibile di persone che dipendono ed abusano di farmaci ansiolitici ed ipnotici. Spesso queste persone non sono consapevoli di questo loro disagio e anche i loro famigliari non sanno come gestire la situazione.Vi interessano la Psichiatria e le Neuroscienze? Bene, allora iscrivetevi a questo canale YouTube e seguitemi sul web tramite il mio blog https://www.valeriorosso.comInoltre andate su Amazon a dare un’occhiata ai miei libri:“Psicobiotica” - Un nuovo modo di intendere il rapporto tra la Mente ed il Corpo….andate su: https://amzn.to/2IZwjhm“Psichiatria Rock” - 50 pensieri off line dal mio blog….andate su: https://amzn.to/2IVKKmJ

Le benzodiazepine, quelle che comunemente si chiamano ansiolitici o sonniferi, sono una classe di farmaci dotata di un alto potenziale di pericolosità rispetto a dipendenza ed abuso. È in corso un'epidemia silenziosa e poco visibile di persone che dipendono ed abusano di farmaci ansiolitici ed ipnotici. Spesso queste persone non sono consapevoli di questo loro disagio e anche i loro famigliari non sanno come gestire la situazione.Vi interessano la Psichiatria e le Neuroscienze? Bene, allora iscrivetevi a questo canale YouTube e seguitemi sul web tramite il mio blog https://www.valeriorosso.comInoltre andate su Amazon a dare un’occhiata ai miei libri:“Psicobiotica” - Un nuovo modo di intendere il rapporto tra la Mente ed il Corpo….andate su: https://amzn.to/2IZwjhm“Psichiatria Rock” - 50 pensieri off line dal mio blog….andate su: https://amzn.to/2IVKKmJ

Many see benzo withdrawal as an epic, exhausting, never-ending battle — but what if it doesn't have to be? In the final part of this three-part series, you'll learn how to step back, get out of your own way, and let your body heal. Kindness — both to yourself and to those around you — is a hidden secret to recovery. Anger and resentment have never been a recipe for healing. And finding acceptance of your condition and compassion for all involved is the surest way to have peace and finally discover your new life on the other side. https://www.easinganxiety.com/post/managing-the-fear-of-benzo-withdrawal-part-3-bfp005Video ID: BFP005 Chapters 00:00 Introduction03:05 Q&A09:00 Feature: Managing the Fear of Benzo Withdrawal (Part 3)21:59 Moment of Peace  Episode Summary Welcome to the third segment of our 3-part series on Managing the Fear of Benzo Withdrawal. This series is derived from a chapter in my book titled, “Managing the Fear,” which focuses on reducing the fear, anxiety, and stress during benzo withdrawal. Before we dive too deep into our featured topic, we will chat a bit and cover a couple of questions in our Q&A section on detox with flumazenil and which drug is the hardest to withdraw from  Feature Series SERIES: Managing the Fear of Benzo Withdrawal In my opinion, fear, and the stress and anxiety related to that fear, cause more distress and more complications during withdrawal than anything else. And this fear is not some natural psychological fear. It's chemically enhanced. On top of the original anxieties we had before our dependence on benzos, we now have a damaged nervous system that can't process fear correctly. A system that can send us into a panic state — both psychologically and physiologically — at the least sign of distress. Above all, stop worrying. Worry, fear and anxiety increase all withdrawal symptoms. Many of these symptoms are actually due to anxiety and not signs of brain or nervous system damage. People who fear withdrawal have more intense symptoms than those who just take it as it comes and think positively and confidently about recovery.— Prof. Ashton, The Ashton Manual This series is broken down into three separate parts: PART 1 (https://www.easinganxiety.com/post/managing-the-fear-of-benzo-withdrawal-part-1-bfp003 )— Series Introduction— 1) Taking Responsibility for Your Own Recovery PART 2 (https://www.easinganxiety.com/post/managing-the-fear-of-benzo-withdrawal-part-2-bfp004)— 2) Keeping Positive— 3) Maintaining Mental and Physical Activity PART 3 (This Video)— 4) Having Kindness for Yourself and Others— 5) Finding Acceptance of Your Condition  Episode Description Today we discuss two essential elements to maintaining a stable mindset during withdrawal: kindness and acceptance. 4) KINDNESS It may sound like a trivial suggestion, but kindness is critical to success during benzo withdrawal. Kindness to yourself. Kindness to those around you. Kindness to everyone. Anger, resentment, fear, frustration, these all are common emotions during withdrawal and expressing them can feel good — in the short-term. But the truth is, they don't help you heal. Having kindness for yourself, and for those around you trying to help you, is key to success during this difficult time. 5) ACCEPTANCE One of the best things that happened to me during withdrawal was when I found acceptance. I stopped struggling and fighting my symptoms and instead accepted my current condition. It sounds easy, but it's a difficult transition and it usually only comes with time. Most people experiencing benzo withdrawal see their recovery as a struggle. A fight. A battle of epic proportions. And it can be. They want to do everything they can to make it disappear. And if they can't make it go away, then make it as easy as possible. But the symptoms of benzo withdrawal are actually symptoms of healing. The drugs are gone, or at least reduced. All that's left is your body trying to right itself. The best thing you can do during this time is to learn to accept your condition and let your body heal.  Resources The following resource links are provided as a courtesy to our listeners. They do not constitute an endorsement by Easing Anxiety of the resource or any recommendations or advice provided therein. Ashton, C. Heather. Benzodiazepines: How They Work and How to Withdraw (aka The Ashton Manual). 2002. Accessed April 13, 2016. http://www.benzo.org.uk/manual/.“Benzodiazepine Withdrawal Support: Substitution.” BenzoBuddies. Accessed March 1, 2017. http://www.benzobuddies.org/benzodiazepine-withdrawal-methods/substitution/.Foster, D E. Benzo Free: The World of Anti-Anxiety Drugs and the Reality of Withdrawal. Erie, Colorado: Denim Mountain Press, 2018.Lader, M.H. and S.V. Morton. “A Pilot Study of the Effects of Flumazenil on Symptoms Persisting After Benzodiazepine Withdrawal.” Journal of Psychopharmacology 6(3)(January 1992):357-63. Accessed March 6, 2017. doi:10.1177/026988119200600303.  The PodcastThe Benzo Free Podcast provides information, support, and community to those who struggle with the long-term effects of anxiety medications such as benzodiazepines (Xanax, Ativan, Klonopin, Valium) and Z-drugs (Ambien, Lunesta, Sonata). WEBSITE: https://www.easinganxiety.comMAILING LIST: https://www.easinganxiety.com/subscribe YOUTUBE: https://www.youtube.com/@easinganx DISCLAIMERAll content provided by Easing Anxiety is for general informational purposes only and should never be considered medical advice. Any health-related information provided is not a substitute for medical advice and should not be used to diagnose or treat health problems, or to prescribe any medical devices or other remedies. Never disregard medical advice or delay in seeking it. Please visit our website for our complete disclaimer at https://www.easinganxiety.com/disclaimer. CREDITSMusic provided / licensed by Storyblocks Audio — https://www.storyblocks.com Benzo Free Theme — Title: “Walk in the Park” — Artist: Neil Cross PRODUCTIONEasing Anxiety is produced by…Denim Mountain Presshttps://www.denimmountainpress.com ©2022 Denim Mountain Press – All Rights Reserved

In this episode of Tox in Ten ACMT Highlights, co-host Dr. Gillian Beauchamp sits down with Emergency Medicine Physician and Medical Toxicologist Dr. Spencer Greene to discuss the use of Flumazenil and Physostigmine. 

Tox-Dogmalysis is a talk about evidence in Toxicology. It’s been said that 50% of what we learn is incorrect; we just don’t know which 50%. As the complexity of medicine increases, it is of the utmost importance for clinicians to be skeptical of old data and new data alike. Many in the FOAM community have made huge strides in busting myths that have persisted over time. However, sometimes we may declare myths busted too prematurely based on incomplete or misunderstood data. This talk will explore three topics in toxicology for which the perceived myths may actually be true, or at least not completely busted.

Die drei verschiedenen Midazolam -Medetomidin – Ketamin (MMK) Dosierungen 0,5 + 0,01 + 1,0 mg/kg (MMK A), 0,5 + 0,02 + 2,0 mg/kg (MMK B) und 0,5 + 0,03 + 3,0 mg/kg (MMK C), und eine etablierte Vergleichsgruppe mit 0,05 + 10,0 mg/kg Medetomidin und Ketamin (MK D) werden im Zusammenhang mit einer Studie zur Verbesserung der Maulhöhlengesundheit und Zahnsteinprophylaxe verglichen. Zusätzlich werden für die mittlere MMK-Dosierung 0,5 + 0,02 + 2,0 mg/kg zwei verschiedene Methoden zur Teilantagonisierung getestet: 0,05 mg/kg Atipamezol, subkutan (A/SC) und intravenös (A/IV), bzw. kombiniert je 0,05 mg/kg Atipamezol und Flumazenil, subkutan (AF/SC) und intravenös (AF/IV). Insgesamt wird jede der 18 Katzen acht- bis neunmal mit einer der verschiedenen Varianten nach dem Zufallsprinzip in Narkose gelegt. Zur Prämedikation bekommen alle Tiere 0,04 mg/kg Atropin fünf Minuten vorher intramuskulär verabreicht. Die Antagonisten werden nach durchschnittlich 68 ± 11 Minuten verabreicht. Um die umfangreichen Messungen in der Maulhöhle abschließen zu können, wird die Hypnose bei Bedarf mit Propofol nach Wirkung verlängert. In den MMK-Gruppen A, B und C wird eine durchschnittliche Anästhesiedauer von 30 ± 15, 45 ± 19 und 68 ± 28 Minuten erreicht. Alle Tiere sind gut relaxiert und eine Intubation ist in über 64% ohne Probleme möglich. Mit ansteigender Dosis wird ein signifikanter Abfall der Atemfrequenz beobachtet, der aber, im Zusammenhang mit venösen Blutgaswerten und der peripheren Sauerstoffsättigung betrachtet, nicht gravierend ist. Der diastolische Blutdruck steigt mit MMK signifikant an. Die Propofolgabe hat auf die Aufwachphase, auch nach Antagonisierung, keinen deutlichen Einfluss. Alle partiellen Antagonisierungsversuche zeigen im Vergleich zur Variante ohne Narkoseaufhebung nur eine Tendenz aber keine signifikante Verkürzung der Aufwachzeit, bzw. der Gesamtnarkosedauer. Die Wiedererlangung des Bewusstseins ist nach Antagonistengabe aber signifikant schneller. Exzitationen und Hyperästhesie treten in Gruppe AF/IV nicht auf, während nur in dieser Gruppe Speicheln beobachtet wird. Für eine Erhebung objektiverer Daten wie Atem- und Herz-Kreislauf Parameter während der Aufwachphase am bereits wachen Tier, wäre Telemetrie eine geeignete Messmethode. Die Kombination mit Flumazenil hat keinen signifikanten Vorteil gegenüber der alleinigen Atipamezolgabe, wobei Atipamezol subkutan in dieser Dosierung kaum Wirkung zeigt. MMK A ist trotz guter kardiovaskulärer Resultate nicht empfehlenswert. Das Verhältnis von Einschlafzeit und Narkosedauer von MMK B und C eignet sich dagegen gut, auch im Hinblick auf die kurative Praxis. Vor allem mit der Option einer Teilantagonisierung stellen diese beiden Dosierungen eine echte Alternative für kurze, bzw. wenig schmerzhafte Eingriffe (z.B. Zahnreinigung, Scheren, Röntgen, Wundversorgung etc.) zu etablierten Kombinationen dar, ohne das Tier mit einer hohen Dosis zu belasten.