The Phenobarbital schedule is listed here. The long-term administration of high doses of thiopental is associated with an increased incidence of nosocomial infections and associated mortality. Barbiturate coma may cause reversible leucopenia and an increased infection rate. Long-term administration of thiopental may also promote reversible antibiotic-induced bone marrow suppression. Thiopentone depresses T-lymphocyte function. Loop et […]
The effect of Ketamine on brain the Ketamine is traditionally considered to increase cerebral blood flow and CMRO2 however, positron emission tomography shows that subanesthetic doses of racemic ketamine increase cerebral blood flow with a minor increase in regional CBV but do not affect oxygen consumption significantly. The most profound changes in regional CBF with Ketamine on
Midazolam onset of action undergoes rapid absorption from gastrointestinal tract. Only about 50% of the orally administered dose of midazolam reaches the systemic circulation, reflecting extensive first-pass metabolism. It is highly protein bound and this does not depend on the plasma concentration of the drug. The short duration of the drug is due to its
With respect to inhalation agent anesthetic , an increase in cardiac output and the consequent increased pulmonary blood flow removes more general anesthetic from the alveoli. The alveolar venous anesthetic gradient is determined by the amount of tissue uptake of an inhalation agent anesthetic . This depends on the tissue solubility, tissue blood flow and
Epidural ketamine and its active enantiomer S(+)ketamine have been used intrathecally and epidurally (caudally) for the management of perioperative pain and in a variety of chronic pain syndromes. Although ketamine has been reported to interact with opioid receptors, binding to local opiate receptors seems to play only a minor role, whereas significant analgesia after even
Ketamine is metabolized extensively by hepatic microsornal enzymes. Ketamine metabolism is demethylated to the corresponding N-desmethyl compound to form norketamine (about 60%) the main metabolite. Norketamine rapidly appears (approximately within 5 minutes) in plasma following ketamine administration and had a terminal half-life of 63.6 +1- 23.9 minutes. In animals, norketamine is one-fifth to one-third as
Diazepam remains a popular oral drug for preoperative medication of adults and is the benzodiazepine most likely to be selected for management of delirium tremens and treatment of local anesthetic induced seizures. This is considered to be one of the diazepam uses that are very common. Production of skeletal muscle relaxation by diazepam is often
Clinical Features for acute opioid toxicity treatment is necessary at times.The clinical occurrence of acute opioid toxicity is due to any of the following three main reasons: • Clinical overdosage: Either iatrogenic or patient-controlled analgesia pumps. • Accidental overdosage by addicts. • Attempts at suicide. Whatever might be the cause, “high degree of suspicion” is
Drugs like sufentanil, alfentanil, fentanyl and other opiates although belong to phenyl piperidine group like pethidine (meperidine), their spectrum of action is more morphine-mimicking, more like mediated through β endorphin and t receptors. Actually there are some very striking differences between the two: Fentanyl and other opiates unlike, morphine, is very highly lipid soluble, so
Propofol mechanism of action exerts its sedative hypnotic effects through a GABA receptor interaction. GABA is the principal inhibitory neurotransmitter in the CNS. When GABAA receptors are activated, transmembrane chloride conductance increases, resulting in hyperpolarization of the postsynaptic cell membrane and functional inhibition of the postsynaptic neuron. The interaction of propofol mechanism of action also
