Skip to main content
NCBI home page
Anesthesia Progress logoLink to Anesthesia Progress
. 1991 Mar-Apr;38(2):33–38.

Pharmacological considerations for conscious sedation: clinical applications of receptor function.

D E Becker 1
PMCID: PMC2148692  PMID: 1667349

Abstract

Most drugs used in conscious sedation regimens act by reasonably well-defined receptor mechanisms. The variety of clinical effects produced by these agents is generally extensive, and often can be explained by their activity at more than one receptor type. Rote memorization of drug effects is a futile exercise, especially when one considers the number of new agents introduced each year. An appreciation of receptors and their effects is a more logical approach. This article reviews fundamental concepts of receptor dynamics that are applicable to agents used for conscious sedation. Using this approach, the effects and indications for various agents can be predicted based on their activity at specific receptor sites.

Full text

PDF
33

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Anderson J. A. Reversal agents in sedation and anesthesia: a review. Anesth Prog. 1988 Mar-Apr;35(2):43–47. [PMC free article] [PubMed] [Google Scholar]
  2. Baughman V. L., Becker G. L., Ryan C. M., Glaser M., Abenstein J. P. Effectiveness of triazolam, diazepam, and placebo as preanesthetic medications. Anesthesiology. 1989 Aug;71(2):196–200. doi: 10.1097/00000542-198908000-00005. [DOI] [PubMed] [Google Scholar]
  3. Becker D. E. Management of nausea and vomiting: physiological, pharmacological, and therapeutic considerations. J Am Dent Assoc. 1987 Aug;115(2):292–294. doi: 10.14219/jada.archive.1987.0233. [DOI] [PubMed] [Google Scholar]
  4. Dionne R. A. Differential pharmacology of drugs used for intravenous pre-medication. J Dent Res. 1984 Jun;63(6):842–847. doi: 10.1177/00220345840630060501. [DOI] [PubMed] [Google Scholar]
  5. Goyal R. K. Muscarinic receptor subtypes. Physiology and clinical implications. N Engl J Med. 1989 Oct 12;321(15):1022–1029. doi: 10.1056/NEJM198910123211506. [DOI] [PubMed] [Google Scholar]
  6. Greenblatt D. J., Shader R. I., Abernethy D. R. Drug therapy. Current status of benzodiazepines. N Engl J Med. 1983 Aug 18;309(7):410–416. doi: 10.1056/NEJM198308183090705. [DOI] [PubMed] [Google Scholar]
  7. Jastak J. T. Physostigmine: an antidote for excessive central nervous system depression or paradoxical rage reactions resulting from intravenous diazepam. Anesth Prog. 1985 May-Jun;32(3):87–92. [PMC free article] [PubMed] [Google Scholar]
  8. Kissin I., Vinik H. R., Castillo R., Bradley E. L., Jr Alfentanil potentiates midazolam-induced unconsciousness in subanalgesic doses. Anesth Analg. 1990 Jul;71(1):65–69. doi: 10.1213/00000539-199007000-00011. [DOI] [PubMed] [Google Scholar]
  9. Pasternak G. W. Multiple morphine and enkephalin receptors and the relief of pain. JAMA. 1988 Mar 4;259(9):1362–1367. [PubMed] [Google Scholar]
  10. Philbin D. M., Moss J., Akins C. W., Rosow C. E., Kono K., Schneider R. C., VerLee T. R., Savarese J. J. The use of H1 and H2 histamine antagonists with morphine anesthesia: a double-blind study. Anesthesiology. 1981 Sep;55(3):292–296. doi: 10.1097/00000542-198109000-00019. [DOI] [PubMed] [Google Scholar]
  11. Psaty B. M., Koepsell T. D., Wagner E. H., LoGerfo J. P., Inui T. S. The relative risk of incident coronary heart disease associated with recently stopping the use of beta-blockers. JAMA. 1990 Mar 23;263(12):1653–1657. [PubMed] [Google Scholar]
  12. Reves J. G., Fragen R. J., Vinik H. R., Greenblatt D. J. Midazolam: pharmacology and uses. Anesthesiology. 1985 Mar;62(3):310–324. [PubMed] [Google Scholar]
  13. Snyder S. H. Drug and neurotransmitter receptors. New perspectives with clinical relevance. JAMA. 1989 Jun 2;261(21):3126–3129. [PubMed] [Google Scholar]
  14. Stone D. J., DiFazio C. A. Sedation for patients with Parkinson's disease undergoing ophthalmologic surgery. Anesthesiology. 1988 May;68(5):821–821. doi: 10.1097/00000542-198805000-00043. [DOI] [PubMed] [Google Scholar]
  15. White P. F., Vasconez L. O., Mathes S. A., Way W. L., Wender L. A. Comparison of midazolam and diazepam for sedation during plastic surgery. Plast Reconstr Surg. 1988 May;81(5):703–712. doi: 10.1097/00006534-198805000-00009. [DOI] [PubMed] [Google Scholar]

Articles from Anesthesia Progress are provided here courtesy of American Dental Society of Anesthesiology

RESOURCES