ORAL BIVALENT TYPES 1 AND 3 POLIOMYELITIS VACCINE Price

Overview

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Name

Nitrous Oxide 98 % Gas

Precaution

Before using **Nitrous Oxide 98% Gas**, it is crucial for patients to consult with their healthcare provider to ensure safe and appropriate use. Specific precautions include: - **Respiratory Issues**: Nitrous oxide is a potent respiratory depressant, and patients with **chronic obstructive pulmonary disease (COPD)**, **asthma**, or **severe respiratory impairment** should be carefully monitored during administration. It should only be used in a controlled setting with adequate ventilation and oxygen support. - **Vitamin B12 Deficiency**: Chronic or frequent use of nitrous oxide can **inactivate vitamin B12**, which is necessary for proper neurological function. Individuals with **vitamin B12 deficiency** or **pernicious anemia** should avoid prolonged exposure or undergo monitoring if nitrous oxide use is unavoidable. - **Psychiatric Disorders**: Use in individuals with **mental health disorders**, including **psychosis**, **schizophrenia**, or **anxiety**, may exacerbate psychiatric symptoms. Close monitoring is necessary if used in such patients. - **Pregnancy and Lactation**: Nitrous oxide should be used cautiously in **pregnant** and **lactating women**. While it is generally considered safe for short-term use during labor, **prolonged exposure** should be avoided as it can potentially have adverse effects on fetal development. Always consult a healthcare provider before use in pregnancy or breastfeeding. - **Closed Body Cavities**: Avoid the use of nitrous oxide in patients with conditions such as **pneumothorax** (collapsed lung), **bowel obstruction**, or **air embolism** as nitrous oxide can expand within body cavities, leading to increased pressure and possible harm.

Indication

Nitrous Oxide 98% Gas is used primarily in medical settings for its **analgesic** (pain-relieving) and **anxiolytic** (anxiety-reducing) properties. It is indicated for: - **Anesthesia for Minor Procedures**: Nitrous oxide is commonly used for sedation during **minor surgeries**, **dental procedures**, or diagnostic tests. It induces a relaxed and pain-free state while maintaining the patient's ability to breathe and respond to instructions. - **Labor Pain Management**: It is used for **pain relief during labor and delivery**, often as a non-invasive alternative to epidural anesthesia. The mixture of oxygen and nitrous oxide helps relieve pain during contractions. - **Short-Term Sedation**: It is used in **emergency departments** or outpatient settings for brief sedation during procedures like wound suturing, fracture realignment, or certain diagnostic imaging procedures. - **Anxiolysis**: Nitrous oxide is utilized for its **anxiolytic** effects in patients undergoing procedures who may have anxiety or fear, offering a quick-acting and effective solution.

Contra indication

There are several conditions where **Nitrous Oxide 98% Gas** should not be used: - **Pneumothorax**: Nitrous oxide is contraindicated in patients with a **pneumothorax** (collapsed lung) as it may expand the air in the pleural space, worsening the collapse. - **Bowel Obstruction**: In cases of **intestinal obstruction**, especially in the presence of a known **bowel perforation**, nitrous oxide should not be used as it can expand within the gastrointestinal tract and cause damage or perforation. - **Severe Respiratory Depression**: Nitrous oxide should be avoided in individuals with **severe respiratory distress** or conditions like **sleep apnea** that impair the ability to breathe properly without assistance. - **Recent Eye Surgery**: Use in patients with a history of **recent eye surgery** or **intraocular pressure concerns** (e.g., glaucoma) should be approached cautiously, as it can increase intraocular pressure. - **Substance Abuse**: Individuals with a history of **substance abuse** or those prone to **nitrous oxide misuse** (recreational use of nitrous oxide or “laughing gas”) should not use this product.

Side Effect

Most side effects associated with **Nitrous Oxide 98% Gas** are mild and resolve quickly once the gas is discontinued. Common side effects include: - **Nausea and Vomiting**: Some patients experience **nausea** or **vomiting** following nitrous oxide administration. This can often be reduced by ensuring proper oxygenation and not exceeding the recommended dose. - **Dizziness and Lightheadedness**: Nitrous oxide causes **dizziness** or a feeling of being **lightheaded** or **disoriented**. This is a common and expected effect during administration. - **Fatigue**: Some patients report feeling **tired** or **lethargic** after the gas is turned off, as it can lead to temporary sedation and a decrease in energy levels. - **Headache**: Headaches are common, particularly after prolonged exposure, due to changes in blood flow and oxygen levels. - **Hypoxia**: If not properly mixed with oxygen or used for prolonged periods, nitrous oxide may cause **hypoxia** (low oxygen levels in the blood), leading to symptoms like **confusion**, **cyanosis (bluish skin)**, and **shortness of breath**. - **Euphoria or Hallucinations**: Some patients may experience a sense of **euphoria** or altered perception of reality, though this effect is usually temporary. Serious side effects, though rare, include: - **Neuropathy**: Long-term use of nitrous oxide can impair **vitamin B12** and lead to **peripheral neuropathy**, causing symptoms such as **numbness**, **tingling**, and **muscle weakness**. - **Respiratory Depression**: In vulnerable patients, especially those with pre-existing respiratory conditions, nitrous oxide can lead to **severe respiratory depression**, requiring intervention with additional oxygen or ventilation support. - **Cardiovascular Effects**: In some cases, nitrous oxide may cause **hypotension (low blood pressure)** or **bradycardia (slow heart rate)**, especially when used alongside other sedative medications.

Pregnancy Category ID

0

Mode of Action

Nitrous oxide acts primarily as an **NMDA receptor antagonist**, which contributes to its **analgesic** and **anxiolytic** properties: - **CNS Depressant**: It inhibits the action of excitatory neurotransmitters in the central nervous system (CNS), leading to decreased pain perception and relaxation. This effect helps provide relief from discomfort during medical procedures. - **Endorphin Release**: Nitrous oxide stimulates the release of **endorphins**, the body's natural painkillers, thereby contributing to its analgesic effects. - **Cerebral Vasodilation**: It causes **vasodilation** (dilation of blood vessels) in the brain, which contributes to relaxation, lightheadedness, and mild euphoria during administration. - **Oxygenation**: The 98% concentration of nitrous oxide is paired with **oxygen** (2%), which ensures that patients remain adequately oxygenated during its use, thus preventing hypoxia.

Interaction

Nitrous oxide may interact with a variety of other drugs and substances: - **Anesthetic Agents**: When combined with other inhalational anesthetics (such as **isoflurane**, **sevoflurane**, or **desflurane**), nitrous oxide can potentiate their effects. This can lead to **excessive sedation** or respiratory depression. - **CNS Depressants**: Co-administration of nitrous oxide with **benzodiazepines**, **opioids**, or **barbiturates** may increase the risk of **sedation** and **respiratory depression**. Dosage adjustments and careful monitoring are required. - **Antibiotics (Aminoglycosides)**: Long-term exposure to nitrous oxide can potentially increase the neurotoxic effects of **aminoglycoside antibiotics** (e.g., **gentamicin**), which can contribute to **nerve damage**. - **Alcohol**: The combined use of nitrous oxide and alcohol can lead to **increased sedation**, **impaired motor skills**, and **respiratory depression**, increasing the risk of **overdose** or **serious side effects**. - **Folate Antagonists**: Long-term exposure to nitrous oxide can interfere with **folate** metabolism, increasing the risk of **deficiencies** when combined with **folate antagonists** like **methotrexate** or certain anticonvulsants.

Pregnancy Category Note

Information not available

Adult Dose

The typical **dosage of Nitrous Oxide 98% Gas** for adults is as follows: - **Sedation for Minor Procedures**: A mixture of **nitrous oxide 98% and oxygen 2%** is administered via a **face mask** or **nasal cannula**. The dose is typically titrated to effect, with **50-70% nitrous oxide** commonly used for short-term procedures. The concentration may vary based on the required level of sedation. - **Labor Pain**: In labor, **nitrous oxide** can be self-administered by the patient during contractions. The typical concentration is **50% nitrous oxide/50% oxygen**, and the patient can breathe it in as needed during the intensity of the contractions.

Child Dose

In pediatric use, **Nitrous Oxide 98% Gas** is commonly used for **dental procedures**, **minor surgeries**, or **sedation** in emergency situations: - **Dosing**: Children are typically administered a **50-70% concentration** of nitrous oxide mixed with oxygen, with careful titration based on age, size, and procedure. The patient should be closely monitored for any signs of **hypoxia** or excessive sedation.

Renal Dose

Since **nitrous oxide 98% gas** is not metabolized extensively and is eliminated primarily through the **lungs**, renal dosing adjustments are generally **not required**. However, in patients with **severe renal dysfunction**, special care should be taken to ensure that the gas mixture is not causing systemic side effects or hypoxia.

Administration

Information not available