Magazine article Clinical Psychiatry News

Users of Both Alcohol, Tobacco May Impair Sedation: Clinical Implications Unclear

Magazine article Clinical Psychiatry News

Users of Both Alcohol, Tobacco May Impair Sedation: Clinical Implications Unclear

Article excerpt

SAN DIEGO -- Patients who use both alcohol and tobacco require larger doses of narcotics and benzodiazepines to achieve adequate sedation during endoscopic procedures, Dr. Ting-Wei Yang reported in a poster session at the annual meeting of the American College of Physicians.

This study provides the first clinical evidence that patients who use alcohol and tobacco have increased dosage requirements for opioids and benzodiazepines during conscious sedation, but the clinical significance of this observation is unclear and will require further study, said Dr. Yang of the internal medicine division at Naval Medical Center, Portsmouth, Va.

"Both alcohol and tobacco are known to induce hepatic cytochrome P-450 enzymes, which can lead to altered metabolism of many drugs," he said.

The charts of 436 patients who underwent esophagogastroduodenoscopy and colonoscopy from Jan. 1 to May 31, 2002, were prospectively reviewed for the study. Prior to undergoing the procedures, the patients were asked to self-report their use of alcohol and tobacco.

At Naval Medical Center, conscious sedation during routine GI endoscopic procedures involves the combined use of opioids such as meperidine or fentanyl and benzodiazepines such as midazolam. …

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