Sublimaze Mixing It and Alcohol
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Use of other central nervous system depressants with Sublimaze may decrease pulmonary arterial pressure and lead to hypertension. Extra care should be taken when administering Sublimaze to elderly or debilitated patients due to the increased risk of complications. The minimum effective initial dose should always be used. Doses can then be titrated gradually until the desired effect is achieved.
Nitrous oxide can produce cardiovascular depression when administered with high doses of Sublimaze. When tranquilizers are used with Sublimaze, pulmonary arterial pressure can decrease and lead to clinically significant hypotension (low blood pressure). In the postoperative setting, patients should be closely monitored for orthostatic hypotension (low blood pressure upon standing). Elevated blood pressure has been reported in the use of Sublimaze with neuroleptics. In these cases, postoperative monitoring of EEG patterns is necessary until patterns return to normal.
Sublimaze has a rapid onset and short duration of action. It can be given via intravenous or intramuscular injection. When administered intravenously, Sublimaze can take effect almost immediately and provides pain relief for 30 to 60 minutes. When administered via intramuscular injection, Sublimaze can take up to eight minutes to take effect and has an active duration of up to two hours.
The most common side effects of Sublimaze include apnea, bradycardia (slow heart rate), muscle rigidity, and respiratory depression. Skeletal muscle rigidity can be managed with a neuromuscular blocking agent. Severe cardiovascular depression may also occur and should be closely monitored during dosage initiation and titration.
Serotonin syndrome is a potentially life-threatening condition that can occur in patients taking serotonergic medications such as selective serotonin reuptake inhibitors (SSRIs) for depression. Adrenal insufficiency is another potential complication. Adrenal insufficiency occurs when the adrenal gland can no longer keep up with the body’s demands for the stress hormone cortisol. Adrenal insufficiency can be treated with corticosteroid replacement therapy.
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