The work required to initiate and sustain gas flow from most modern microprocessor-based ventilators is negligible and can be adjusted through selection of trigger modes, either pressure or flow, and selection of breath types. However, even more critical is the imposed WOB created by artificial airways. Care is required in the selection of a properly sized artificial airway and also in maintaining its patency with appropriate bronchial hygiene procedure. Inadvertent narrowing of an endotracheal or tracheotomy tube, from accumulated secretions or compression, will result in a profound increase in patient work.
GHB's unique attributes have some legitimate uses. In Europe, it is still used as an anesthetic, for alcohol and opiate addiction therapy, and for narcolepsy therapy. Only this last indication of narcolepsy is recognized by the US Food and Drug Administration, which recently approved GHB (ie, sodium oxybate [Xyrem]) to treat a small subset of patients with narcolepsy who have episodes of weak or paralyzed muscles (ie, cataplexy). Because of sodium oxybate's history of abuse as a recreational drug, the FDA approved it as a Schedule III Controlled Substance. A limited distribution program that includes physician education, patient education, a patient and physician registry, and detailed patient surveillance has been established. Under the program, prescribers and patients will be able to obtain the product only through a single centralized pharmacy.
Hi Steve, It’s Adrian got off Nexium 10 days ago, had minor heartburn all was good, but awful problem with swallowing, got panicked and started Nexium again. It turns out it was tonsil stones causing the problem, do you know whether dry mouth (Nexium side effect) could have caused the tonsil stones. I hate those PPIs I can’t stand them and yet I am taking them. H2 blockers seemed not to help with heartburn although I take them with 8 oz glass of water. Once I am off the meds I will start a petition against PPIs being prescribed without upper gastroscopy. This experience is hell.. Lost 20 pounds being on them..