الفهرس 
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Abstract
Biochemical changes of some sedatives in rats were investigated in the present study. The effect of the ultrashort acting barbiturate (thiopental sodium) and ultrashort acting benzodiazepine (midazolam) on plasma (ALT, AST, GGT, urea, creatinine, adrenaline, dopamine and histamine) and serum (sodium, potassium, serotonin, cholinesterase, IgG, IgM, IgE and IgA) were studied.
The obtained data is summarized in the following:
1- Plasma ALT:
Thiopental sodium revealed a nonsignificant increase during injection only while midazolam revealed nonsignificant changes in plasma ALT as compared to the control group in the three groups.
2- Plasma AST:
Thiopental sodium revealed a nonsignificant increase during injection only while midazolam revealed nonsignificant changes in plasma AST as compared to the control group in the three groups.
3- Plasma GGT:
Both thiopental sodium and midazolam revealed nonsignificant changes in plasma GGT as compared to the control group in the three groups.
4- Plasma urea:
Thiopental sodium revealed a nonsignificant increase during injection only while midazolam revealed nonsignificant changes in plasma urea as compared to the control group in the three groups.
5- Plasma creatinine:
Thiopental sodium revealed a nonsignificant increase during injection only while midazolam revealed nonsignificant changes in plasma creatinine as compared to the control group in the three groups.
6- Serum sodium:
Thiopental sodium revealed a nonsignificant increase during injection only while midazolam revealed nonsignificant changes in serum sodium as compared to the control group in the three groups.
7- Serum potassium:
Thiopental sodium revealed a nonsignificant decrease during injection only while midazolam revealed nonsignificant changes in serum potassium as compared to the control group in the three groups.
8- Serum serotonin:
Both thiopental sodium and midazolam revealed nonsignificant changes in serum serotonin as compared to the control group in the three groups.
9- Plasma adrenaline:
Both thiopental sodium and midazolam revealed a nonsignificant decrease during injection only in plasma adrenaline as compared to the control group in the three groups.
10- Plasma dopamine:
Both thiopental sodium and midazolam revealed nonsignificant changes in plasma dopamine as compared to the control group in the three groups.
11- Plasma histamine:
Thiopental sodium revealed nonsignificant changes while midazolam revealed a nonsignificant decrease during injection only in plasma histamine as compared to the control group in the three groups.
12- Serum cholinesterase:
Both thiopental sodium and midazolam revealed nonsignificant changes in serum cholinesterase as compared to the control group in the three groups.
13- Serum IgG:
Group I:
Thiopental sodium revealed nonsignificant changes in serum IgG by the first week of injection and a nonsignificant decrease by the second week of injection and again revealed nonsignificant changes by the third, fourth and sixth week as compared to the control group.
Group II:
Thiopental sodium revealed nonsignificant changes in serum IgG by the first week of injection and a nonsignificant decrease by the second, third and fourth week of injection and increased nonsignificantly by the sixth, eighth, tenth and twelfth week with significant increase in the eighth and tenth week as compared to the control group.
Group III:
Thiopental sodium revealed nonsignificant changes in serum IgG by the first week of injection and a nonsignificant decrease by the second, third and fourth week of injection and increased nonsignificantly by the sixth and eighth week and significantly increased by the tenth and twelfth week as compared to the control group.
Midazolam revealed nonsignificant changes in serum IgG as compared to the control group in the three groups.
14- Serum IgM:
Group I:
Thiopental sodium revealed nonsignificant changes in serum IgM by the first week of injection and a nonsignificant decrease by the second week of injection and again revealed nonsignificant changes by the third, fourth and sixth week as compared to the control group.
Group II:
Thiopental sodium revealed nonsignificant changes in serum IgM by the first week of injection and a nonsignificant decrease by the second and third week of injection and increased nonsignificantly by the fourth week of injection, sixth and eighth, week with a significant increase in the sixth week and returned to nonsignificant changes by the tenth and twelfth week as compared to the control group.
Group III:
Thiopental sodium revealed nonsignificant changes in serum IgM by the first week of injection and nonsignificant decrease by the second and third week of injection and increased nonsignificantly by the fourth, sixth, eighth, tenth and twelfth week with and a significant increase by the eighth and tenth week as compared to the control group.
Midazolam revealed nonsignificant changes in serum IgM as compared to the control group in the three groups.
15- Serum IgE:
Both thiopental sodium and midazolam revealed nonsignificant changes in serum IgE as compared to the control group in the three groups.
16- Serum IgA:
Both thiopental sodium and midazolam revealed nonsignificant changes in serum IgA as compared to the control group in the three groups.
Conclusion
This study demonstrated that:
1- The sedative dose of either thiopental sodium or midazolam is not harmful to either the liver or the kidney.
2- Benzodiazepines (midazolam) are preferred to and more safe than barbiturates (thiopental sodium) in their sedative dose as seen from the normal liver and kidney function tests studied in this research.
3- Thiopental sodium suppresses protective immunity and their therapeutic use can be associated with nosocomial infections.
4- Midazolam is not a histamine releaser.
5- Sedation with midazolam is unlikely to affect hepatocellular integrity.
However, the benzodiazepines have displaced the barbiturates as sedative-hypnotic agents and from the present study we recommend the following:
Recommendations
1- Physicians have to receive suitable and adequate information about:
i) The effective doses required for different sedatives, hypnotics or anesthetics and whether drug accumulation occurs after prolonged use or not.
ii) The differences between drugs (sedatives, hypnotics or anesthetics) as regards pharmacokinetic, pharmacodynamic properties, main side effects and contraindications.
iii) The effects of commonly prescribed medication on sedation and sleep/ wake cycle.
2- Further researches and studies are needed to:
i) Know more about the incompletely understood neurochemistry of conscious sedation or of sleep and so more effective pharmacological agents would be developed from this increased understanding.
ii) Study the effects of different drug combinations on sedation and sleep as many patients are already taking a variety of prescribed and nonprescribed medications in combinations.