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عمومی::
فارماکولوژیک، دارویی
Despite intense investigative efforts, pharmacologic agents that can protect the brain against ischemic injury have not been identified.
However, if the mechanism of protection is a pharmacologic effect other than a reduction in the CMR, then is it reasonable to assume equivalence among the barbiturates?
With the exception of tissue plasminogen activator (tPA) for thrombolysis, mechanical thrombectomy, and the CCBs nimodipine and nicardipine for the management of SAH, pharmacologic neuroprotective agents are not available for the treatment of patients with cerebral ischemia.
The neuroprotective efficacy of anesthetic drugs in exper- imental studies is achieved only by rigorous maintenance of physiologic homeostasis; in fact, the potential for exacerba- tion of cerebral injury, either traumatic or ischemic, with physiologic mismanagement is significantly greater than the modest protection afforded by pharmacologic drugs- these are important observations.
, perfusion pressure, oxygenation, normocapnia, temperature management, control of hyperglycemia, seizure prophylaxis) within the appropriate ranges and less on pharmacologic or anesthetic،This same retrospective study found that consumption of an oral nutri- tional supplement was a predictor of pressure ulcer healing.54,55 Whether undernutrition and weight loss reflect this ill health or have a causal relationship to pressure ulcers is not clear.56 The use of pharmacologic agents to stimulate the appetite, or orexigenic agents, has demon- strated weight gain, chiefly in patients with can- cer or acquired autoimmune deficiency disease.
True pain relief is accomplished primarily with pharmacologic intervention.
More advanced non- pharmacologic techniques that require specialist training or skilled personnel, such as the use of hypnosis or therapeu- tic touch, may be considered.
Diabetic patients with neuropathic pain or other patients with conditions arising from peripheral nerve syn- dromes may benefit from the use of certain anticonvulsants, such as gabapentin, pregab- alin9,10 phenytoin, carbamazepine, sodium valproate, or clonazepam.8 Clonazepam, although pharmacologically classified as a benzodiazepine, not as an anticonvulsant, has anticonvulsant, muscle relaxant, and anxi- olytic properties.
An example of this type of pain is when a patient is on a rescue dose for breakthrough pain every 6 hours as needed, but the medica- tion only provides relief for 4 hours because of its pharmacologic properties.
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