![]() ^ a b c d e f g Bartlett D (December 2004).If a physician administers both dextrose and thiamine, as is common in comatose patients, thiamine should be administered first. Overall, thiamine does not cause as notable issues in the cocktail, but patients can be sensitive to it nonetheless. For ethylene glycol, thiamine helps by preventing synthesis of the glycol's metabolites. Thiamine is effective for treatment of Wernicke–Korsakoff syndrome as well as ethylene glycol ingestion. įor this reason, flumazenil is recommended in scenarios with only benzodiazepine ingestion so as to avoid the other negative effects. When a patient overdoses intentionally, benzodiazepines can actually mediate the effects of other lethal drugs in the system, so flumazenil's action to reverse its effects can actually be harmful. įlumazenil raises concerns with its tendency to induce benzodiazepine withdrawal, and symptoms include seizures and agitation. It can be used in anaesthesia as well as intensive care. Flumazenil įlumazenil is an imidazobenzodiazepine that can help mediate and antagonize the effects of benzodiazepines. Opiates/opioids, such as heroin, can be contaminated with scopolamine, and if it is present, the patient may face an anticholinergic crisis. In terms of hypersensitivity, the patient may subsequently suffer from restlessness, headache, and vomiting. The major downsides to naloxone are the hypersensitivity from the patient and its reaction with substances contaminating opioids/opiates. Naloxone has well-documented effectiveness as a matter of fact, 575/609 patients (mainly with heroin overdose) showed improved consciousness and respiration within five minutes of treatment. It allows adequate ventilation for impacted patients, and health professionals administer it intravenously. Naloxone effectively treats CNS and respiratory depression caused by opiate/opioid overdose. Patients that are specifically at risk of being impacted this way are those with alcoholic tendencies or malnourishment. Dextrose contributes to the controversy of coma cocktails by inducing Wernicke–Korsakoff syndrome in patients that are deficient in thiamine. This statistic may be sufficient evidence for doctors to support the routine of administering the drug. ![]() Hypertonic dextrose is effective in treating hypoglycemia, and one in twelve patients administered for altered mental status suffer from it. ![]() If the blood glucose concentration of the patient is alternating consciousness or at least contributing to the alteration, said patient likely needs hypertonic dextrose. As medicine and assessment techniques have advanced, the preceding drugs have been mostly replaced by the modern coma cocktail as described above. Original coma cocktails included methylxanthines, physostigmine, physical stimulation (such as cold water baths or ammonium carbonate (" smelling salts")), amphetamines, strychnine, picrotoxin, nikethamide and camphor. ![]() The coma cocktail is thought to have been created in United States as a first line treatment for an unconscious patient in an era where intensive care was new and difficult to maintain. ![]()
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