Background: Etomidate drug is commonly used for procedural sedation in the emergency department (ED). The incidence rate of etomidate-induced myoclonus is 33%. Aims and Objectives: In this study, we aimed to contradict that etomidateinduced myoclonus is less significant than the reported incidence rate. Materials and Methods: This prospective study was performed between June 2016 and November 2016 in the ED of Amrita Institute of Medical Sciences, a tertiary care hospital. In the ED, procedural sedation was carried out by the physician. Adult patients receiving etomidate were enrolled for the study. Results: The presence of myoclonus was noticed, and its duration was reported using the myoclonus scale. A total of 166 (116 males and 50 females) patients enrolled in the ED for procedural sedation with etomidate were taken. The dose administered was 0.3 mg/kg. Myoclonus was observed in 4 (2.4%) of 166 sedations. The mean age was observed to be male and female. During procedural sedation, etomidate-induced myoclonus in ED was less significant than the reported values. Conclusion: From this, we came to the conclusion that the incidence to occur myoclonus with administration of etomidate is less when compare with other ED studies.
Psychotropic medications are used in the treatment of chronic psychotic disorders like anxiety, depression, insomnia, bipolar disorders, cognitive impairment, seizure, loss of consciousness, altered sensorium, delirium etc. The objective of this study is to describe the pattern of use of psychotropic medications in patients presenting to geriatrics department, to compare the pattern of usage of psychotropic medication at the time of admission versus at the time of discharge and to find out the dose optimization pattern in elderly patients. Observational retrospective study, conducted in the department of geriatrics. The sample size calculated for the study was 35. The study was carried out through AHIS and by reviewing case files. The data were collected on specially designed data collection forms. Consumption of the psychotropic drugs was the highest within 71-80 years of age group, of which 49.15% of patients fall in this age group. All of the patients prescribed with psychotropic medications had insomnia (26.70%), followed by anxiety (20.30%), seizure (20.30%) and depression (16.90%). Among the 2nd generation anti psychotropics, quetiapine was the most frequently prescribed drug (54.24%). Benzodiazepines were the preferred antidepressants (36%) followed by SSRIs. Sixty two percent of the patients continued the same dose prescribed from the outside hospital and a dose increment was done for 37.5% of the patients. The incidence of usage of psychotropic medications were found to be more with females. Atypical antipsychotic drugs were the most commonly used ones. Current evidence shows no superiority for atypical antipsychotics over haloperidol.
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