barbiturates

BS Medical Tropes that Need to Die, 2/? : Making People Unconscious

For Part 1 of the BS Medical Tropes series, click here!

So I got an ask the other night about a character choosing not to kill people, but knocks them out with blows to the head instead. And it’s not an unreasonable thing for writers to think is legitimate. In fact, in fiction, there are dozens of ways to produce unconsciousness! A sharp hit to the head; a sedative drug injected right into the neck, bro!, or even Darkly Dreaming Dexter with his special horse paralytic.

Hell, on Person of Interest the main characters routinely produce unconscious enemy combatants by shooting them in the @$#RY)G!@#% knees

Here’s the thing: Every single one of those is complete bullshit.

Poppycock. Nincompoopery. Asscrap. And you’d realize that it’s a crock of crap if you thought about it this way for even half a minute:

Keep reading

ST John’s Wort Can be dangerous on these meds

IT WILL REACT DANGEROUSLY WITH THE FOLLOWING MEDICATIONS:
Alprazolam (Xanax) interacts with ST. JOHN’S WORT
Aminolevulinic acid interacts with ST. JOHN’S WORT
Amitriptyline (Elavil) interacts with ST. JOHN’S WORT
Birth control pills (Contraceptive drugs) interacts with ST. JOHN’S WORT
Cyclosporine (Neoral, Sandimmune) interacts with ST. JOHN’S WORT
Digoxin (Lanoxin) interacts with ST. JOHN’S WORT
Fenfluramine (Pondimin) interacts with ST. JOHN’S WORT
Imatinib (Gleevec) interacts with ST. JOHN’S WORT
Irinotecan (Camptosar) interacts with ST. JOHN’S WORT
Medications changed by the liver (Cytochrome P450 3A4 (CYP3A4) substrates) interacts with ST. JOHN’S WORT
Medications for depression (Antidepressant drugs) interacts with ST. JOHN’S WORT
Medications for HIV/AIDS (Nonnucleoside Reverse Transcriptase Inhibitors (NNRTIs)) interacts with ST. JOHN’S WORT
Medications for HIV/AIDS (Protease Inhibitors) interacts with ST. JOHN’S WORT
Medications for pain (Narcotic drugs) interacts with ST. JOHN’S WORT
Medications moved by pumps in cells (P-Glycoprotein Substrates) interacts with ST. JOHN’S WORT
Medications that increase sensitivity to sunlight (Photosensitizing drugs) interacts with ST. JOHN’S WORT
Meperidine (Demerol) interacts with ST. JOHN’S WORT
Nefazodone (Serzone) interacts with ST. JOHN’S WORT
Nortriptyline (Pamelor) interacts with ST. JOHN’S WORT
Paroxetine (Paxil) interacts with ST. JOHN’S WORT
Pentazocine (Talwin) interacts with ST. JOHN’S WORT
Phenobarbital (Luminal) interacts with ST. JOHN’S WORT
Phenprocoumon interacts with ST. JOHN’S WORT
Phenytoin (Dilantin) interacts with ST. JOHN’S WORT
Reserpine interacts with ST. JOHN’S WORT
Sedative medications (Barbiturates) interacts with ST. JOHN’S WORT
Sertraline (Zoloft) interacts with ST. JOHN’S WORT
Tacrolimus (Prograf, Protopic) interacts with ST. JOHN’S WORT
Tramadol (Ultram) interacts with ST. JOHN’S WORT
Warfarin (Coumadin) interacts with ST. JOHN’S WORT
Alprazolam (Xanax) is commonly used for anxiety. The body breaks down alprazolam (Xanax) to get rid of it. St. John’s wort can increase how fast the body gets rid of alprazolam (Xanax). Taking St. John’s wort along with alprazolam (Xanax) might decrease the effectiveness of alprazolam (Xanax).Aminolevulinic acid can make your skin sensitive to the sunlight. St. John’s wort might also increase your sensitivity to sunlight. Taking St. John’s wort along with aminolevulinic acid might increase the chances of sunburn, blistering or rashes on areas of skin exposed to sunlight. Be sure to wear sunblock and protective clothing when spending time in the sun.The body breaks down amitriptyline (Elavil) to get rid of it. St. John’s wort can increase how quickly the body gets rid of some medications. St. John’s wort might decrease the effectiveness of amitriptyline (Elavil) by increasing how quickly the body breaks down amitriptyline (Elavil).Some birth control pills contain estrogen. The body breaks down the estrogen in birth control pills to get rid of it. St. John’s wort might increase the break down of estrogen. Taking St. John’s wort along with birth control pills might decrease the effectiveness of birth control pills. If you take birth control pills along with St. John’s wort, use an additional form of birth control such as a condom.

Some birth control pills include ethinyl estradiol and levonorgestrel (Triphasil), ethinyl estradiol and norethindrone (Ortho-Novum 1/35, Ortho-Novum 7/7/7), and others.The body breaks down cyclosporine (Neoral, Sandimmune) to get rid of it. St. John’s wort might increase how quickly the body breaks down cyclosporine (Neoral, Sandimmune). By increasing the breakdown of cyclosporine (Neoral, Sandimmune) St. John’s wort might decrease the effectiveness of cyclosporine (Neoral, Sandimmune). Do not take St. John’s wort if you are taking cyclosporine (Neoral, Sandimmune).Digoxin (Lanoxin) helps the heart beat more strongly. St. John’s wort might decrease how much digoxin (Lanoxin) the body absorbs. By decreasing how much digoxin (Lanoxin) the body absorbs St. John’s wort might decrease the effects of digoxin (Lanoxin).Fenfluramine (Pondimin) increases a chemical in the brain. This chemical is called serotonin. St. John’s wort also increases serotonin. Taking fenfluramine with St. John’s wort might cause there to be too much serotonin. This could cause serious side effects including heart problems, shivering, nausea, headache, and anxiety.The body breaks down imatinib to get rid of it. St. John’s wort might increase how quickly the body gets rid of imatinib (Gleevec). Taking St. John’s wort along with imatinib (Gleevec) might decrease the effectiveness of imatinib (Gleevec). Do not take St. John’s wort if you are taking imatinib (Gleevec).Irinotecan (Camptosar) is used to treat cancer. The body breaks down irinotecan (Camptosar) to get rid of it. St. John’s wort might increase how fast the body breaks down irinotecan (Camptosar) and decrease the effectiveness of irinotecan (Camptosar).Some medications are changed and broken down by the liver. St. John’s wort might increase how quickly the liver breaks down some medications. Taking St. John’s wort along with some medications that are broken down by the liver can decrease the effectiveness of some medications. Before taking St. John’s wort talk to your healthcare provider if you are taking any medications that are changed by the liver.

Some medications changed by the liver include lovastatin (Mevacor), ketoconazole (Nizoral), itraconazole (Sporanox), fexofenadine (Allegra), triazolam (Halcion), and many others.St. John’s wort increases a brain chemical called serotonin. Some medications for depression also increase the brain chemical serotonin. Taking St. John’s wort along with these medications for depression might increase serotonin too much and cause serious side effects including heart problems, shivering, and anxiety. Do not take St. John’s wort if you are taking medications for depression.

Some of these medications for depression include fluoxetine (Prozac), paroxetine (Paxil), sertraline (Zoloft), amitriptyline (Elavil), clomipramine (Anafranil), imipramine (Tofranil), and others.The body breaks down medications used for HIV/AIDS. St. John’s wort can increase how quickly the body breaks down these medications. Taking St. John’s wort might decrease how well some medications used for HIV/AIDS work.

Some of these medications used for HIV/AIDS include nevirapine (Viramune), delavirdine (Rescriptor), and efavirenz (Sustiva).The body breaks down medications used for HIV/AIDS to get rid of them. Taking St. John’s wort might increase how quickly the body breaks down these medications. This could decrease the effectiveness of some medications used for HIV/AIDS.

Some of these medications used for HIV/AIDS include amprenavir (Agenerase), nelfinavir (Viracept), ritonavir (Norvir), and saquinavir (Fortovase, Invirase).The body breaks down some medications for pain to get rid of them. St. John’s Wort might decrease how fast the body gets rid of some medications for pain. By decreasing how fast the body gets rid of some medications for pain, St. John’s wort might increase the effects and side effects of some medications for pain.

Some medications for pain include meperidine (Demerol), hydrocodone, morphine, OxyContin, and many others.Some medications are moved by pumps in cells. St. John’s wort can make these pumps more active and decrease how much of some medications get absorbed by the body. This might decrease the effectiveness of some medications.

Some medications that are moved by these pumps include etoposide, paclitaxel, vinblastine, vincristine, vindesine, ketoconazole, itraconazole, amprenavir, indinavir, nelfinavir, saquinavir, cimetidine, ranitidine, diltiazem, verapamil, corticosteroids, erythromycin, cisapride (Propulsid), fexofenadine (Allegra), cyclosporine, loperamide (Imodium), quinidine, and others.Some medications can increase sensitivity to sunlight. St. John’s Wort might also increase your sensitivity to sunlight. Taking St. John’s wort along with medications that increase sensitivity to sunlight could increase the chances of sunburn, blistering or rashes on areas of skin exposed to sunlight. Be sure to wear sunblock and protective clothing when spending time in the sun.

Some drugs that cause photosensitivity include amitriptyline (Elavil), Ciprofloxacin (Cipro), norfloxacin (Noroxin), lomefloxacin (Maxaquin), ofloxacin (Floxin), levofloxacin (Levaquin), sparfloxacin (Zagam), gatifloxacin (Tequin), moxifloxacin (Avelox), trimethoprim/sulfamethoxazole (Septra), tetracycline, methoxsalen (8-methoxypsoralen, 8-MOP, Oxsoralen), and Trioxsalen (Trisoralen).St. John’s wort increases a chemical in the brain called serotonin. Meperidine (Demerol) can also increase serotonin in the brain. Taking St. John’s wort along with meperidine (Demerol) might cause too much serotonin in the brain and serious side effects including heart problems, shivering, and anxiety.Nefazodone can increase a chemical in the brain. This chemical is called serotonin. St. John’s wort can also increase serotonin. Taking St. John’s wort with nefazodone might cause there to be too much serotonin. This could lead to serious side effects including heart problems, shivering, and restlessness.The body breaks down nortriptyline (Pamelor) to get rid of it. St. John’s wort can increase how quickly the body breaks down nortriptyline (Pamelor). This could decrease the effectiveness of nortriptyline (Pamelor).Paroxetine (Paxil) increases a chemical in the brain. This chemical is called serotonin. St. John’s wort also increases serotonin. Taking paroxetine (Paxil) and St. John’s wort together might cause there to be too much serotonin. This could lead to serious side effects including heart problems, shivering, and weakness.St. John’s wort increases a brain chemical called serotonin. Pentazocine (Talwin) also increases serotonin. Taking St. John’s wort along with pentazocine (Talwin) might increase serotonin too much. This could cause serious side effects including heart problems, shivering, and anxiety. Do not take St. John’s wort if you are taking pentazocine (Talwin).The body breaks down phenobarbital (Luminal) to get rid of it. St. John’s wort might increase how quickly the body breaks down phenobarbital. This could decrease how well phenobarbital works.The body breaks down phenprocoumon to get rid of it. St. John’s wort increases how quickly the body breaks down phenprocoumon. This decreases the effectiveness of phenprocoumon.The body breaks down phenytoin (Dilantin) to get rid of it. St. John’s wort might increase how quickly the body breaks down phenytoin. Taking St. John’s wort and taking phenytoin (Dilantin) might decrease the effectiveness of phenytoin (Dilantin) and increase the possibility of seizures.St. John’s wort can decrease the effects of reserpine.Medications that cause sleepiness and drowsiness are called sedatives. St. John’s wort might decrease the effectiveness of sedative medications. It is not clear why this interaction occurs.Sertraline (Zoloft) can increase a chemical in the brain. This chemical is called serotonin. St. John’s wort also increases serotonin. This can cause there to be too much serotonin in the brain. This could lead to serious side effects including heart problems, shivering, and irritability.The body breaks down tacrolimus (Prograf, Protopic) to get rid of it. St. John’s wort can increase how quickly the body breaks down tacrolimus. This can cause tacrolimus to be less effective.Tramadol (Ultram) can affect a chemical in the brain called serotonin. St. John’s wort can also affect serotonin. Taking St. John’s wort along with tramadol (Ultram) might cause too much serotonin in the brain and side effects including confusion, shivering, stiff muscles, and other side effects.Warfarin (Coumadin) is used to slow blood clotting. The body breaks down warfarin (Coumadin) to get rid of it. St. John’s wort might increase the breakdown and decrease the effectiveness of warfarin (Coumadin). Decreasing the effectiveness of warfarin (Coumadin) might increase the risk of clotting. Be sure to have your blood checked regularly. The dose of your warfarin (Coumadin) might need to be changed.


@thewitchylibrary thought you might like this 

anonymous asked:

Can you explain any additional side effects/effects of ketamine?

kicks down the door, dual-wielding syringes

Did somebody say KETAMINE?L!!?!?#$$@@!!!!!!?

…Shut it, Stethy.


Okay. Ketamine. My #1 all-time favorite pharmacological agent. (I have a feeling someone sent me this ask to cheer me up, which I’ve really needed this week, but I’m not sure so I’m going to answer it.)

There’s a phenomenal article about the “Ketamine Brain Continuum” from an amazing ER doc, which I’m going to summarize here,  but if you’re as fascinated as I am, is worth reading in its entirety.

In low doses, ketamine can relieve pain. It can also make people feel very “stoned”.

In  medium doses, it can cause hallucinations. This is what the drug using community refers to as “falling down the K-hole,” and ketamine is indeed known for its illicit uses. For example:

Then I entered an orange-brown-black space occupied by a giant inflated kiwi-bird with ruffled, long tassel-like feathers and a long curved slim black beak, and the beak curved off into infinity. The space was like a corridor, with undulating grasses at the top and bottom, and the kiwi somehow inside it, but the sides were open and the corridor stretched off into infinity and I moved toward the kiwi and it felt beautiful, amazing, with loud buzzing, ringing sounds accompanying the journey….

There are some fascinating first-hand accounts here: https://www.erowid.org/experiences/subs/exp_Ketamine.shtml  

Note: I am in no way encouraging illicit uses of pharmacological agents. Any agent can be dangerous. But if you want to know what ketamine feels like, don’t ask the medical providers, ask the people who use it for fun, right? 

This is actually where medical people want patients not to be. The hallucinations can be distressful. To quote Dr. Reuben Strayer (above article):

If the patient develops distress shortly after an initial dose, the patient is not fully dissociated and the best maneuver is usually to give more ketamine.

Personally I think that’s the best maneuver for almost any situation.

In high doses, ketamine works as an anesthetic, specifically a dissociative anesthetic. It shuts the brain off from outside stimulus completely. Basically what ketamine does is it shuts the brain off from outside stimuli. That means that even though someone’s eyes are open (and possibly twitching, medically referred to as nystagmus) their brain isn’t processing information from them. As a doc whose lectures I love likes to say, “Think of a beach. Or think of a mountaintop. Or think of a beach on a mountaintop. Anything is possible with ketamine.”

Think of it like this: with most anesthetics, the brain is temporarily turned off. With ketamine, the brain isn’t turned off – it’s just disconnected from the outside world.

However, if someone is unprepared for it, those hallucinations can seem like a nightmare. And there is a portion of patients who get ketamine and, as it starts to wear off, they start screaming uncontrollably. This is called an “emergence reaction,” as they emerge from anesthesia and slip into the K-hole.

Someone who has been sedated/anosthetized with ketamine, especially if it’s against their will (used as a “knockout drug”), will likely have very negative hallucinations. To an outsider they’ll be lying on the floor, eyes open and blinking, unable to move or react to anything. It’s a great moment for a horror scene, or a horrific element to an action plot, especially if they have an emergence reaction and come back to reality screaming.

(Ketamine is also routinely used during veterinary euthanasia, at least where I live, and eyes stay open even after death, and that’s something a good vet warns their clients about. Ketamine isn’t the lethal agent, that’s a barbiturate, I think usually just a massive overdose of phenobarbital.)

Other uses:

  • ketamine helps open up constricted airways (acts as a broncholytic or bronchodilator). This means that it’s the optimal anesthetic for intubating – putting a breathing tube in – severe asthmatics who need to go on ventilators.
  • Ketamine, in high doses, can be used to subdue patient who are physically violent and psychotic.
  • Because ketamine acts on different receptors than typical sedatives, it can be used to stop seizures when benzodiazepines (Valium, Ativan, Versed…) have failed.
  • Low-dose, slow infusions of ketamine have seen great promise in depression that’s not responding to other approaches. There are ketamine clinics around for exactly this purpose.
  • Low-dose / analgesic ketamine is often used by EMS personnel during rescue scenarios where someone is trapped or pinned in a vehicle because ketamine, unlike most pain medications, doesn’t reduce blood pressure.
  • Ketamine is typically not used as an anesthetic in head injury patients because there is some (conflicting) data on whether or not it can increase intracranial pressure.


Originally posted by rightstufanime

So that’s ketamine. Thanks for the ask and thanks for listening to my madness!

xoxo, Aunt Scripty

disclaimer    

Becoming a Patron lets you see the freaking future. Have you considered becoming a clairvoyant?

Free eBook: 10 BS “Medical” Tropes that Need to Die TODAY!  

4

SEDATIVE-HYPNOTIC-ANXIOLYTIC DRUGS

Remember:

  • All of them cause dose-dependant CNS depression: sedation -> hypnosis -> anesthesia -> medullary depression -> coma
  • BZ reach a plateau in CNS depression, alcohol and Barbiturates don’t
  • GABA A activation increases Cl- influx & GABA B increases K+ efflux: both result in hyperpolarization
  • BZ antidote: FLUMAZENIL (nonsepecific BZ receptor antagonist)
  • BZD have NO GABA mimetic activity, that means that when they bind to their respective receptor in the GABA A complex (gamma receptor) they open the Cl- channel ONLY in the presence of the GABA neurotrasmitter. This is why they plateau
  • Barbiturates and alcohol, on the other hand, HAVE GABA mimetic activity but at high dosis. The higher the dose, the more likely they’ll open the Cl- channel on their own. This is why they DON’T plateau.
  • Chronic use leads to tolerance. 
  • Cross tolerance between BZD, Barbiturates and alcohol.
  • Psycological & physical dependance
  • BZD less abused than ethanol and barbiturates
  • BZ1 receptor: sedation

  • BZ2 receptor: antianxiety. impairment of cognitive function

How to Explain Borderline to Loved Ones

“I have the emotional response stimuli of a 5 yr old w access to crack and barbiturates. I pick my poison based on daily triggers, constantly pushing me from one extreme to another no matter how contradictory, and cant remember life when it wasnt this way.”

“Oh. And also, I worry I sound like an overly sensitive twat so I’ll probably never explain this to you again.👍”