Barbiturates mechanism of action is described here. Barbiturates most likely produce their sedative hypnotic effects through an interaction with the inhibitory neurotransmitter gamma-aminobutyric acid (GABA) in the CNS. Barbiturates cause reversible depression of all excitable tissues, the CNS being exquisitely sensitive. They bind to beta subunit of the inhibitory GABA-A receptor, a site distinct from […]
Etomidate sedation infusion can be used as a suitable alternative for neuroanesthesia when nitrous oxide is contraindicated. Etomidate sedation (100 micrograms/kg/ minute) has been used as a part of total intravenous anesthetic technique with a mean recovery time of about 10 minutes. The infusion is associated with minimal incidences of side effects such as thrombophiebitis
Propofol is known to possess direct antiemetic effects. Propofol antiemetic use for induction and maintenance of anesthesia has been shown to be associated with a lower incidence of postoperative nausea and vomiting (PONV) when compared to any other anesthetic drug or technique. It has been shown that total intravenous anaesthesia (TIVA) with propofol for anesthesia
The midazolam dose must be carefully individualized. In elderly and debilitated patients, lower doses are required. The midazolam dose should further be adjusted according to the type and amount of premedication used. Excess doses or rapid IV administration may result in respiratory depression and/or arrest, particularly in elderly or debilitated patients. For IM use, midazolam
Some of the Phenobarbital side effects are discussed. Intra-arterial injection of thiopental usually results in immediate, intense vasoconstriction and severe pain radiates along the distribution of the vessel into which it has been administered. Vasoconstriction may obscure distal arterial pulses, and blanching of the extremity is followed by cyanosis. In awake patients, hypoaesthesia, muscular weakness,
Propofol at common clinical concentrations-is potent ventilatory depressant and therefore it is sometimes common with the name propofol respiratory depression . The Propofol respiratory depression of ventilation is dose dependent. After induction of anesthesia with propofol apnoea occurs in 25% to 35% of patients which may persist till 3 minutes. It reduces tidal volume (by
A syrup is effective for producing sedation and anxiolysis at a Midazolam oral dose of 0.25 mg/kg with minimal effect on ventilation even when administered at doses as large as 1 mg/kg. Midazolam oral is the most commonly used oral preoperative medication for children. Midazolam oral dose which is, 0.5 mg/kg given orally 30 minutes before
For induction of general anesthesia before administration of other anesthetic agents, Individual response to midazolam drip is variable, particularly when a narcotic premedicant is not used. The dosage should be titrated according to the patient’s age and clinical status. Midazolam drip is administered over 20 to 30 seconds, allowing 2 minutes for effect. The recommended
For the phenobarbital metabolism the binding of thiopentone in human serum is about 85% and remarkably constant over the concentration range between 4 and 80 micrograms/mL. The higher percentage of protein binding occurs at lower plasma concentrations of thiopental In phenobarbital metabolism . The percentage binding increases with increasing pH from approximate 75% at pH
For the Barbiturate therapy , High-dose barbiturates appear to be useful adjuncts in the control of intracranial hypertension refractory to other methods of therapy. Barbiturates decrease ICP by decreasing cerebral blood volume through drug-induced cerebral vascular vasoconstriction and an associated decrease in cerebral blood flow. This therapy in used either as a anti seizure medication
