Non benzodiazepines like Zolpidem Non benzodiazepines like zopiclone, Zolpidem, zaleplon and efzopiclone (Z agents) are the newer sedative hypnotic agents which have varied chemical structures. They bind selectively to a subset of benzodiazepine receptors and act as benzodiazepine receptor Agonists. Non benzodiazepines characteristic features are: As sedative-hypnotics, they are as effective as benzodiazepines and provide […]
Glucocorticoid therapy are most commonly used to mitigate an inflammatory response. They are used in a wide variety of patient populations seen in the intensive care unit (ICU). Unfortunately, these agents have many side effects, which often limit their use. In the ICU setting, the functions most commonly affected are endocrine regulation, immune response, and
The depth of propofol sedation increases in a dose dependent manner. The short context-sensitive half-time of propofol, even with prolonged periods of infusion, make this a readily titratable drug for production of IV sedation. The prompt recovery without residual sedation and low incidence of nausea and vomiting make propofol particularly well suited to ambulatory conscious
Ketamine interactions potentiates all non depolarizing muscle relaxants in a dose-dependent manner. Ketamine improves the intubating condition when used with rocuronium. Halothane anesthesia by decreasing uptake, distribution, redistribution and metabolism of ketamine produces significant prolongation of its pharmacologic action on the central nervous system. Ketamine administered in the presence of volatile anesthetics may result in
Succinylcholine hyperkalemia is hyperkalemia seen after the usage of succinylcholine. Succinylcholine is a depolarizing muscle relaxant used for urgent endotracheal intubation in the operating room, intensive care unit (ICU), and emergency department. The intravenous (IV) dose is 0.5 to 1.5 mg/kg. Time to effect is 1 minute and duration of action in patients with normal
Oxygenation capacity is the volume of oxygen at standard pressure and temperature carried by 100 mL of blood after saturation with room air. Oxygenation capacity includes the oxygen in combination with haemoglobin (1.39 mL/g) and oxygen in solution in plasma (0.3 mL). It should also be mentioned that most of the oxygen that dissolves in
Flumazenil or Anexate is an imidazo benzodiazepine that binds competitively to BDZ receptors and antagonizes many of the actions of benzodiazepines. Flumazenil is a benzodiazepine antagonist. It does not block the pharmacologic effects of GABA or all GABA mimetic but it specifically antagonizes the actions of benzodiazepines. Given alone, it has minimal effect on the
Excitatory events following propofol administration are well described. The pathophysiology of these propofol myoclonus movements is not known. The drug should be used cautiously in patients with movement disorders. Miller’s anesthesia says the following about Propofol Myoclonus – Induction of anesthesia with propofol is associated with several side effects, including pain on injection, propofol myoclonus , apnea,
Diethyl ether (C2H5-O-C2H5) is one of the metabolically safe non-halogenated anesthetics . About 6% is metabolized in the liver to ethanol and acetaldehyde, thereafter to acetic acid and onto carbon dioxide and water. Examples of non-halogenated anesthetics Divinyl ether Cyclopropane Trichloroethylene Non-halogenated anesthetics are all anesthetic agents mostly inhalation agents that do not contain a hologen in their structure. Divinyl
Midazolam produces dose-dependent decrease in ventilation with 0.15 mg/kg IV producing effect similar to diazepam 0.3 mg/kg IV. Patients with chronic obstructive pulmonary disease experience even greater midazolam respiratory depression . Transient apnoea usually follows after rapid injection of large doses of midazolam (>0.15 mg/kg IV) especially in the presence of premedication with opioids. The
