Also, SSRIs have very different molecular structures. Zoloft (Sertraline hydrochloride) was the second SSRI to come to market in the United States, and it was approved by the FDA in December 30, 1991. Paxil (Paroxetine hydrochloride) was the third SSRI to come to market in the United States and was approved by the FDA in December 29, 1992. Chemical structure of Paroxetine differs from other SSRIs by having a piperidine ring.The first drug in the SSRI class was Prozac (Fluoxetine), which hit the United States market in 1987. Luvox (Fluvoxamine maleate) was the next SSRI FDA approved in December 05, 1994.Patient-controlled analgesia (PCA) is a method of providing analgesia using a computerized pump that allows patients to self-administer predetermined doses of opioids.The delivery of small, frequent intravenous boluses of opioids results in reasonably constant serum concentrations of the opioid.When clonazepam is used to treat panic disorder, it is more sedating than alprazolam , another benzodiazepine drug used to treat panic disorder.However, unlike alprazolam, clonazepam may trigger depressive episodes in patients with a previous history of depression.In the event of an overdose or if combined with another sedative, many of these drugs can cause unconsciousness (see hypnotic) and even death.There is some overlap between the terms "sedative" and "hypnotic".
There are differences between SSRIs that could be clinically significant.
The strategy behind rational drug development is to design a new drug that is capable of affecting a specific neural site of action (eg, uptake pumps, receptors) while avoiding effects on other site of actions.
The goal in such development is to produce agents that are more efficacious, safer and better tolerated than older medications. Although all SSRI drugs have the same mechanism of action, each SSRI has slightly different pharmacological and pharmacokinetic characteristics.
The loading dose should be repeated every 5 -10 minutes (5 minutes for fentanyl) so that the effect of the dose is felt before the next dose is administered.
The size of the initial loading dose is influenced by: If the initial 3 to 4 loading doses are ineffective the loading dose can be increased by 25 to 50 % after an appropriate assessment of the patient.