Articles: flunitrazepam.
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Postoperative delirium is a common complication after major surgery and is characterized by acute confusion with fluctuating consciousness. The aim of this study was to investigate the incidence and risk factors of postoperative delirium in patients with esophageal cancer. ⋯ The development of postoperative delirium in patients with esophageal cancer is a problem that cannot be ignored. Our results suggest that the risk of developing delirium is associated with older age, use of flunitrazepam in ICU, and postoperative complications.
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'Club drugs' which include Ecstasy, gamma-hydroxybutyrate (GHB), ketamine, and Rohypnol (flunitrazepam) have become popular with participants in 'raves', because they are perceived to enhance energy, endurance, sociability and sexual arousal. These drugs vary in their pharmacologic properties, physiological and psychological effects, and potential consequences. The use of club drugs by young people has increased in the last decade, and continue to get modified and evolve, making them very difficult to monitor. ⋯ Despite the nature and extent of this problem, this area has been under-researched. Data from India are sparse barring a few newspaper and police reports. Keeping abreast of current trends in club drug use prepares the clinician to recognize the clinical effects of club drug use, to manage club drug related emergencies, and to generate social awareness.
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At present neurobiological interests are directing more attention towards the major role of the amygdalar GABA(A) receptor on orexin-dependent behaviors. This telencephalic region has been widely studied especially in view of its control on various psychiatric disorders such as anxiety and depression. Recently, cross-talking relationships between these two specific neuroreceptor systems of the central-cortical amygdalar complex has been considered an important element for anxiety type of behaviors. ⋯ In a first case, it seemed that doses of orexin administered directly into the central nucleus were responsible for greater anxiogenic type of effects as shown by more time being spent both in the dark compartment and the closed arm of the elevated plus-maze, whereas, these effects were suppressed in the presence of flunitrazepam. At the cellular level, the effects of orexin accounted for evident argyrophilic reactions (neurodegeneration phenomena) including altered cell membrane and loss of cytoplasmic architecture in most amygdalar and hippocampal neuronal fields, while in the presence of flunitrazepam these reactions resulted to either be unappreciable or absent. Overall the actions of α₂-dependent inhibitory signals tend to corroborate, for the first time, a neuroprotective role against the over-excitatory orexinergic neurodegeneration reactions and thus its abnormal anxiety-like indications may prove to be therapeutically useful for orexin-dependent sleeping disorders.
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Case Reports
Acute ischaemia of the leg following accidental intra-arterial injection of dissolved flunitrazepam tablets.
Accidental intra-arterial injection of drugs is a sporadic complication in i.v. drug addicts. A 22-year-old drug-abuser injected flunitrazepam tablets dissolved in tap water into her left femoral artery and presented with clinical signs of acute ischaemia of the left leg. ⋯ Selective arterial catheter angiography showed an acute occlusion of the posterior tibial artery. Combination therapy with i.a. urokinase, i.a. prostaglandines and i.v. anticoagulation resulted in re-opening of the obstructed distal artery and complete cessation of symptoms.
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Prog. Neuropsychopharmacol. Biol. Psychiatry · Feb 2008
Comparative StudyAntipsychotic drug administration differentially affects [3H]muscimol and [3H]flunitrazepam GABA(A) receptor binding sites.
Post-mortem studies of the human brain indicate that certain GABA(A) receptor subtypes may be differentially altered in schizophrenia. Increased binding to the total population of GABA(A) receptors using [3H]muscimol is observed in the post-mortem schizophrenic brain, yet a proportion of these receptors which bind benzodiazepines and are labelled with [3H]flunitrazepam, show decreased or unaltered expression. ⋯ While no changes were observed in [3H]muscimol binding in any region after 28 days of drug administration, [3H]flunitrazepam binding density (B(max)) was increased for both antipsychotic treatments in the PFC only. These findings confirm that the subset of GABA(A) receptors sensitive to benzodiazepines are regulated differently from other GABA(A) receptor subtypes following antipsychotic drug administration, in a time- and region-dependent manner.