Pharmacology of Sedation Agents and Reversal Agents | Zendy

Argyro Fassoulaki | Zendy; Kassiani Theodoraki | Zendy; Aikaterini Melemeni | Zendy

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Pharmacology of Sedation Agents and Reversal Agents

Author(s) -

Argyro Fassoulaki,

Kassiani Theodoraki,

Aikaterini Melemeni

Publication year - 2010

Publication title -

digestion

Language(s) - English

Resource type - Journals

SCImago Journal Rank - 0.882

H-Index - 75

eISSN - 1421-9867

pISSN - 0012-2823

DOI - 10.1159/000285351

Subject(s) - sedation , medicine , midazolam , remifentanil , propofol , fentanyl , ketamine , anesthesia , pethidine , sedative , droperidol , (+) naloxone , benzodiazepine , opioid , pharmacology , analgesic , receptor

Sedation for gastrointestinal endoscopies is obtained by opioids, benzodiazepines, propofol, ketamine and/or droperidol. The pharmacokinetic profile of some sedatives/anesthetics renders them advantageous over others. Opioids, mainly pethidine and fentanyl, are the most popular. Though newer opioids provide a faster recovery, fentanyl is safe and advantageous due to its lower cost. Remifentanil, due to its pharmacokinetic profile (elimination half-life: 9 min), is advantageous for ambulatory patients, though it is not known whether the high cost compensates the benefits. Midazolam is the benzodiazepine of choice as it has a shorter duration of action and a better pharmacokinetic profile than diazepam. Propofol, an intravenous anesthetic, has become very popular for gastrointestinal endoscopies in sedative doses. The opioid and benzodiazepine antagonists, naloxone and flumazenil, are indicated only in particular circumstances, like deep sedation with threatening respiratory depression. Ketamine and droperidol are not popular agents for sedation in the modern endoscopic practice.

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