Consciousness, Neurons, and Laughing Gas
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Anaesthesia and Past Use Of
177 Correspondence were using LSD. It is more popular than other commonly Anaesthesia and past use of used hallucinogens whose quoted incidence of clients are: LSD ketamine 0.1% (super-K/vitamin K.I), psilocybin and psilocin 0.6% (the active alkaloids in the Mexican "magic To the Editor: mushroom"), and 3,4 methylenedioxymethamphetamine We report the case of a 43-yr-old lady who was admitted ~MDMA" 1% (ecstasy). The effects of the concurrent to the Day Surgery Unit for release of her carpal tunnel ingestion of LSD on anaesthesia are well described. 2-4 retinaculum. During the preoperative visit, she reported The long-term effects of the past use of LSD are largely no intercurrent illnesses, drug therapy or allergies. She unknown. We wonder if the hallucinations experienced did say, however, that she was frightened of general anaes- by our patient during anaesthesia were due to her LSD thesia, since she had experienced terrifying dreams during intake many years before. We would be interested to surgery under general anaesthesia on three occasions dur- know if others have had experience anaesthetising patients ing the previous ten years. On further questioning, she who are past users of phencyclidine-derived drugs. admitted that she had used lysergic acid diethylamide (LSD) during the late 1960's, the last occasion being 1968 Geoffrey N. Morris MRCGPFRCA when she had experienced characterstic hallucinations. Patrick T. Magee MSe FRCA She had not experienced hallucinations in the ensuing Anaesthetic Department years, except on the surgical occasions mentioned. Royal United Hospital One of the three previous operations had been per- Combe Park formed at our hospital and the anaesthetic record was Bath BA1 3NG checked. -
National Competency Framework for Anesthesia Assistance
National Competency Framework In Anesthesia Assistance Validated June 2016 201-2460 Lancaster Road Ottawa, Ontario K1B 4S5 1 INTRODUCTION ................................................................................................................ 3 ACKNOWLEDGEMENTS .................................................................................................. 3 HISTORICAL PERSPECTIVE ............................................................................................ 4 UNDERSTANDING THIS DOCUMENT ........................................................................... 6 SECTION 1: PROFESSIONAL AND ORGANIZATIONAL COMPETENCIES ............. 7 A. Demonstrate professionalism toward patients and their families, co-workers and the public .................................................................................................................................... 7 B. Demonstrate effective communication with the patient and their families, co-workers and the public ........................................................................................................................ 7 C. Demonstrate critical thinking and reasoning ............................................................... 7 D. Ensure the health and safety of the patient, co-workers and self ................................ 8 E. Use evidence to inform practice .................................................................................. 8 F. Perform administrative duties ..................................................................................... -
Guidelines for the Forensic Analysis of Drugs Facilitating Sexual Assault and Other Criminal Acts
Vienna International Centre, PO Box 500, 1400 Vienna, Austria Tel.: (+43-1) 26060-0, Fax: (+43-1) 26060-5866, www.unodc.org Guidelines for the Forensic analysis of drugs facilitating sexual assault and other criminal acts United Nations publication Printed in Austria ST/NAR/45 *1186331*V.11-86331—December 2011 —300 Photo credits: UNODC Photo Library, iStock.com/Abel Mitja Varela Laboratory and Scientific Section UNITED NATIONS OFFICE ON DRUGS AND CRIME Vienna Guidelines for the forensic analysis of drugs facilitating sexual assault and other criminal acts UNITED NATIONS New York, 2011 ST/NAR/45 © United Nations, December 2011. All rights reserved. The designations employed and the presentation of material in this publication do not imply the expression of any opinion whatsoever on the part of the Secretariat of the United Nations concerning the legal status of any country, territory, city or area, or of its authorities, or concerning the delimitation of its frontiers or boundaries. This publication has not been formally edited. Publishing production: English, Publishing and Library Section, United Nations Office at Vienna. List of abbreviations . v Acknowledgements .......................................... vii 1. Introduction............................................. 1 1.1. Background ........................................ 1 1.2. Purpose and scope of the manual ...................... 2 2. Investigative and analytical challenges ....................... 5 3 Evidence collection ...................................... 9 3.1. Evidence collection kits .............................. 9 3.2. Sample transfer and storage........................... 10 3.3. Biological samples and sampling ...................... 11 3.4. Other samples ...................................... 12 4. Analytical considerations .................................. 13 4.1. Substances encountered in DFSA and other DFC cases .... 13 4.2. Procedures and analytical strategy...................... 14 4.3. Analytical methodology .............................. 15 4.4. -
Evidence for the Involvement of Spinal Cord 1 Adrenoceptors in Nitrous
Anesthesiology 2002; 97:1458–65 © 2002 American Society of Anesthesiologists, Inc. Lippincott Williams & Wilkins, Inc. Evidence for the Involvement of Spinal Cord ␣ 1 Adrenoceptors in Nitrous Oxide–induced Antinociceptive Effects in Fischer Rats Ryo Orii, M.D., D.M.Sc.,* Yoko Ohashi, M.D.,* Tianzhi Guo, M.D.,† Laura E. Nelson, B.A.,‡ Toshikazu Hashimoto, M.D.,* Mervyn Maze, M.B., Ch.B.,§ Masahiko Fujinaga, M.D.ʈ Background: In a previous study, the authors found that ni- opioid peptide release in the brain stem, leading to the trous oxide (N O) exposure induces c-Fos (an immunohisto- 2 activation of the descending noradrenergic inhibitory chemical marker of neuronal activation) in spinal cord ␥-ami- nobutyric acid–mediated (GABAergic) neurons in Fischer rats. neurons, which results in modulation of the pain–noci- 1 In this study, the authors sought evidence for the involvement ceptive processing in the spinal cord. Available evi- Downloaded from http://pubs.asahq.org/anesthesiology/article-pdf/97/6/1458/337059/0000542-200212000-00018.pdf by guest on 01 October 2021 ␣ of 1 adrenoceptors in the antinociceptive effect of N2O and in dence suggests that at the level of the spinal cord, there activation of GABAergic neurons in the spinal cord. appear to be at least two neuronal systems that are Methods: Adult male Fischer rats were injected intraperitone- involved (fig. 1). In one of the pathways, activation of ally with ␣ adrenoceptor antagonist, ␣ adrenoceptor antago- 1 2 ␣ nist, opioid receptor antagonist, or serotonin receptor antago- the 2 adrenoceptors produces either direct presynaptic nist and, 15 min later, were exposed to either air (control) or inhibition of neurotransmitter release from primary af- 75% N2O. -
(12) Patent Application Publication (10) Pub. No.: US 2006/0110428A1 De Juan Et Al
US 200601 10428A1 (19) United States (12) Patent Application Publication (10) Pub. No.: US 2006/0110428A1 de Juan et al. (43) Pub. Date: May 25, 2006 (54) METHODS AND DEVICES FOR THE Publication Classification TREATMENT OF OCULAR CONDITIONS (51) Int. Cl. (76) Inventors: Eugene de Juan, LaCanada, CA (US); A6F 2/00 (2006.01) Signe E. Varner, Los Angeles, CA (52) U.S. Cl. .............................................................. 424/427 (US); Laurie R. Lawin, New Brighton, MN (US) (57) ABSTRACT Correspondence Address: Featured is a method for instilling one or more bioactive SCOTT PRIBNOW agents into ocular tissue within an eye of a patient for the Kagan Binder, PLLC treatment of an ocular condition, the method comprising Suite 200 concurrently using at least two of the following bioactive 221 Main Street North agent delivery methods (A)-(C): Stillwater, MN 55082 (US) (A) implanting a Sustained release delivery device com (21) Appl. No.: 11/175,850 prising one or more bioactive agents in a posterior region of the eye so that it delivers the one or more (22) Filed: Jul. 5, 2005 bioactive agents into the vitreous humor of the eye; (B) instilling (e.g., injecting or implanting) one or more Related U.S. Application Data bioactive agents Subretinally; and (60) Provisional application No. 60/585,236, filed on Jul. (C) instilling (e.g., injecting or delivering by ocular ion 2, 2004. Provisional application No. 60/669,701, filed tophoresis) one or more bioactive agents into the Vit on Apr. 8, 2005. reous humor of the eye. Patent Application Publication May 25, 2006 Sheet 1 of 22 US 2006/0110428A1 R 2 2 C.6 Fig. -
5-HT2A and 5-HT2C/2B Receptor Subtypes Modulate
5-HT2A and 5-HT2C/2B Receptor Subtypes Modulate Dopamine Release Induced in Vivo by Amphetamine and Morphine in Both the Rat Nucleus Accumbens and Striatum Grégory Porras, M.S., Vincenzo Di Matteo, Ph.D., Claudia Fracasso, B.S., Guillaume Lucas, Ph.D., Philippe De Deurwaerdère, Ph.D., Silvio Caccia, Ph.D., Ennio Esposito, M.D., Ph.D., and Umberto Spampinato, M.D., Ph.D. In vivo microdialysis and single-cell extracellular neuron firing rate in both the ventral tegmental area and recordings were used to assess the involvement of the substantia nigra pars compacta was unaffected by SR serotonin2A (5-HT2A) and serotonin2C/2B (5-HT2C/2B) 46349B (0.1 mg/kg i.v.) but significantly potentiated by SB receptors in the effects induced by amphetamine and 206553 (0.1 mg/kg i.v.). These results show that 5-HT2A morphine on dopaminergic (DA) activity within the and 5-HT2C receptors regulate specifically the activation of mesoaccumbal and nigrostriatal pathways. The increase in midbrain DA neurons induced by amphetamine and DA release induced by amphetamine (2 mg/kg i.p.) in the morphine, respectively. This differential contribution may nucleus accumbens and striatum was significantly reduced be related to the specific mechanism of action of the drug by the selective 5-HT2A antagonist SR 46349B (0.5 mg/kg considered and to the neuronal circuitry involved in their s.c.), but not affected by the 5-HT2C/2B antagonist SB effect on DA neurons. Furthermore, these results suggest 206553 (5 mg/kg i.p.). In contrast, the enhancement of that 5-HT2C receptors selectively modulate the impulse accumbal and striatal DA output induced by morphine (2.5 flow–dependent release of DA. -
General Anesthetic Actions on GABAA Receptors Paul Garcia, Emory University Scott E
General Anesthetic Actions on GABAA Receptors Paul Garcia, Emory University Scott E. Kolesky, Emory University Andrew Jenkins, Emory University Journal Title: Current Neuropharmacology Volume: Volume 8, Number 1 Publisher: Bentham Science Publishers | 2010-03, Pages 2-9 Type of Work: Article | Final Publisher PDF Publisher DOI: 10.2174/157015910790909502 Permanent URL: http://pid.emory.edu/ark:/25593/fkg4m Final published version: http://www.eurekaselect.com/71259/article Copyright information: ©2010 Bentham Science Publishers Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution 2.5 Generic License ( http://creativecommons.org/licenses/by/2.5/), which permits distribution, public display, and publicly performance, distribution of derivative works, making multiple copies, provided the original work is properly cited. This license requires credit be given to copyright holder and/or author. Accessed September 28, 2021 5:01 PM EDT 2 Current Neuropharmacology, 2010, 8, 2-9 General Anesthetic Actions on GABAA Receptors Paul S. Garcia, Scott E. Kolesky and Andrew Jenkins* Departments of Anesthesiology and Pharmacology, Emory University, School of Medicine, Rollins Research Center #5013, 1510 Clifton Rd NE, Atlanta GA, USA Abstract: General anesthetic drugs interact with many receptors in the nervous system, but only a handful of these inter- actions are critical for producing anesthesia. Over the last 20 years, neuropharmacologists have revealed that one of the most important target sites for general -
Review of Psilocybin/Psilocin Pharmacology Isaac Dehart
Review of Psilocybin/Psilocin Pharmacology Isaac DeHart Introduction Psilocybin (PY, 4-phosphoryloxy-N,N-dimethyltryptamine or O-phosphoryl-4-hydroxy- N,N-dimethyltryptamine) (Figure 1, 1) is an indolamine (Figure 1, 2), and the primary ingredient in magic mushrooms. It has been implicated as a treatment for a number of psychological ailments including depression, general anxiety disorder, various addictions, obsessive- compulsive disorder, and post-traumatic stress disorder.1–4 Because of the drug’s re-emerging relevance in clinical applications, and because of its distinctive and informative effects on brain function, it is important to understand the pharmacology and general chemistry underlying its metabolism. Psilocybin is a prodrug of psilocin Magic mushrooms, the natural source of psilocybin may refer to several different hallucination-causing fungi, but the most potent of these are found in the genus Psilocybe. When ingested, magic mushrooms cause “trips,” wherein a user experiences euphoria, colorful hallucinations, and changes in perception, cognition and mood. In the case of “bad trips,” a user may experience states of intense panic or paranoia.5,6 More generally, these trips are sometimes described in terms of psychotic states, and behavioral studies involving psilocybin have demonstrated similarities between the effects of psilocybin and schizophrenia both in subjective experience and in physiological response.7 While psilocybin is more widely known as the cause behind these effects, it is referred to by researchers as a prodrug, -
Pharmacology – Inhalant Anesthetics
Pharmacology- Inhalant Anesthetics Lyon Lee DVM PhD DACVA Introduction • Maintenance of general anesthesia is primarily carried out using inhalation anesthetics, although intravenous anesthetics may be used for short procedures. • Inhalation anesthetics provide quicker changes of anesthetic depth than injectable anesthetics, and reversal of central nervous depression is more readily achieved, explaining for its popularity in prolonged anesthesia (less risk of overdosing, less accumulation and quicker recovery) (see table 1) Table 1. Comparison of inhalant and injectable anesthetics Inhalant Technique Injectable Technique Expensive Equipment Cheap (needles, syringes) Patent Airway and high O2 Not necessarily Better control of anesthetic depth Once given, suffer the consequences Ease of elimination (ventilation) Only through metabolism & Excretion Pollution No • Commonly administered inhalant anesthetics include volatile liquids such as isoflurane, halothane, sevoflurane and desflurane, and inorganic gas, nitrous oxide (N2O). Except N2O, these volatile anesthetics are chemically ‘halogenated hydrocarbons’ and all are closely related. • Physical characteristics of volatile anesthetics govern their clinical effects and practicality associated with their use. Table 2. Physical characteristics of some volatile anesthetic agents. (MAC is for man) Name partition coefficient. boiling point MAC % blood /gas oil/gas (deg=C) Nitrous oxide 0.47 1.4 -89 105 Cyclopropane 0.55 11.5 -34 9.2 Halothane 2.4 220 50.2 0.75 Methoxyflurane 11.0 950 104.7 0.2 Enflurane 1.9 98 56.5 1.68 Isoflurane 1.4 97 48.5 1.15 Sevoflurane 0.6 53 58.5 2.5 Desflurane 0.42 18.7 25 5.72 Diethyl ether 12 65 34.6 1.92 Chloroform 8 400 61.2 0.77 Trichloroethylene 9 714 86.7 0.23 • The volatile anesthetics are administered as vapors after their evaporization in devices known as vaporizers. -
An Old Chemical That Became a New Psychoactive Substance: Study on O-Acetylpsilocin Samples Handled for Analysis and Raise of Awareness
An old chemical that became a new psychoactive substance: study on O-Acetylpsilocin samples handled for analysis and raise of awareness A. Palma1,2, L.Galindo1, Marc Grifell1,2, P. Quintana3, A. Toll1,2, M. Ventura3, I. Fornís3, M. Torrens1,2,4, M.Farré4,5, F. Fonseca1,2 1 Institut de Neuropsiquiatria i Addiccions, Parc de Salut Mar, Barcelona, Spain. 2 Institut Hospital del Mar d'Investigacions Mèdiques, Parc de Salut Mar, Barcelona, Spain. 3 Asociación Bienestar y Desarrollo, Energy Control, Barcelona, Spain. 4 Universitat Autònoma de Barcelona, Barcelona, Spain. 5 Servei de Farmacología Clínica, Hospital Germans Trías i Pujol, Barcelona, Spain. Introduction Objective l New psychoactive substances (NPS) refer to emerging substances that have The aims of this study are appeared on the market and are not under international control (1). According to the m to explore the presence of 4-AcO-DMT from the samples handled to and data provided by the European Monitoring System for Drug and Drug Addiction, NPS analyzed by harm reduction service Energy Control and have experienced an unprecedented increase in number, type and availability during m to evaluate the ratio between 4-AcO-DMT and other related tryptamines the last years (2). (mushrooms, 4-AcO-DIPT, 4-AcO-MIPT and psilocybin). l Non-controlled tryptamines have psychedelic effects similar to the tryptamines already controlled such as psilocybin from Psylocybes mushrooms (3). l O-Acetylpsilocin also known as Psilacetin and 4-Acetoxy- Material and methods DMT (4-AcO-DMT) [Figure 1] is a synthetic tryptamine patented l Sample: all samples delivered for analysis from January 2009 to December in 1963 having a psychedelic effect by stimulating the 2014 were studied: serotoninergic system (3,4) and proposed as a research m handled as 4-AcO-DMT. -
Forensic Toxicology Laboratory Office of Chief Medical Examiner City of New York
FORENSIC TOXICOLOGY LABORATORY OFFICE OF CHIEF MEDICAL EXAMINER CITY OF NEW YORK CARISOPRODOL , MEPROBAMATE and TOPIRAMATE by SOLID PHASE EXTRACTION and GAS CHROMATOGRAPHY/MASS SPECTROMETRY (Selected Ion Monitoring) PRINCIPLE Carisoprodol is a carbamate derivative first synthesized in 1959. It is primarily used as a muscle relaxant. UncontrolledMeprobamate is also a carbamate derivative used as a muscle relaxant and the primary metabolite of carisoprodol. Topiramate is a sulfamate-substituted monosaccharide used as an anticonvulsant Carisoprodol, meprobamate and topiramate are quantitated by a selected ion monitoring (SIM) method using methapyrilene as the internal standard. Carisoprodol, meprobamate and topiramate are extracted from biological specimens by solid phase extraction. Drugs are temporarily bound to a sorbent in the solid phase cartridge as the prepared sample is poured through the column. The column is washed to remove interfering compounds, followed by elution of drugs from the column. The eluate is evaporated, reconstituted and injected in the GCMS. Quantitative analysis is performed by SIM GCMS using a six point calibration curve. SAFETY The handling of all biological specimens and reagents is performed within the guidelines which are detailed in the Safety and Health manual. Copy SPECIMEN PREPARATION The procedure is routinely applied to the following biological specimens and their aliquots unless otherwise specified: Blood 0.5 mL of the undiluted specimen Urine 0.5 mL for qualitative identification Brain 0.5 mL of a 1:3 homogenate Gastric Contents 0.5 mL of a 1:10 dilution Liver 0.5 mL of a 1:5 homogenate Vitreous Humor 0.5 mL of the undiluted specimen Bile 0.5 mL of the undiluted specimen Reviewed by: Date: Page 1 of 14 T:\FINALSOP\FINAL SOP PDF\G. -
Familial Mediterranean Fever
:: Familial Mediterranean fever – This document is a translation of the French recommendations drafted by Prof Gilles Grateau, Dr Véronique Hentgen, Dr Katia Stankovic Stojanovic and Dr Gilles Bagou reviewed and published by Orphanet in 2010. – Some of the procedures mentioned, particularly drug treatments, may not be validated in the country where you practice. Synonyms: Periodic disease, FMF Definition: Familial Mediterranean fever (FMF) is an auto-inflammatory disease of genetic origin, affecting Mediterranean populations and characterised by recurrent attacks of fever accompanied by polyserositis that causes the symptoms. Colchicine is the basic reference treatment and is designed to tackle inflammatory attacks and prevent amyloidosis, the most severe complication of FMF. Further information: See the Orphanet abstract http://www.orpha.net/data/patho/Pro/en/Emergency_FamilialMediterraneanFever-enPro920.pdf ©Orphanet UK 1/5 Pre-hospital emergency care recommendations Call for a patient suffering from Familial mediterranean fever Synonyms periodic disease FMF Mechanisms auto-inflammatory disease that affects Mediterranean populations in particular, due to mutation of the MEFV gene that codes pyrin or marenostrin, this being the underlying cause of congenital immune dysfunction; repeated inflammatory attacks can lead to amyloidosis, particularly renal Specific risks in emergency situations acute inflammatory attack, particularly abdominal (pseudo-surgical), but also thoracic, articular (knees) or testicular fever as an expression