The ideal neuromuscular blocker drugs (NMB) would be rapid in onset, have a predictable offset, be nontoxic, lack deleterious cardiovascular or autonomic effects, undergo a defined means of metabolism and excretion preferably independent of end-organ function, and be inexpensive. Many of these characteristics are found in clinically available drugs like cisatracurium. To briefly review, neuromuscular […]
Two classes of drugs exist GP IIb/IIIa inhibitors that inhibit these platelet effects at the level of the glycoprotein (GP) IIb/IIIa receptor on the platelet surface membrane. The first group are the thienopyridines (clopidogrel and ticlopidine). Current treatments for acute coronary syndromes including unstable angina and non-ST-elevation myocardial infarction now include agents aimed at inhibiting platelet activation,
Reactions such as agitation, involuntary movements, hyperactivity and combativeness are usually reported during midazolam administration . Should such reactions occur, the response to each dose of midazolam and all other drugs, including local anesthetics, should be evaluated before proceeding with the midazolam administration of the drug. For induction of general anaesthesia in healthy patients, the
Etomidate dosage may be viewed as an alternative to propofol or barbiturates for the IV induction of anaesthesia, especially in the presence of an unstable cardiovascular system. After a standard induction dose of 0.2 to 0.4 mg/kg IV, the onset of unconsciousness occurs within one arm-to-brain circulation time. Involuntary myoclonic movements are common during the
Following are the therapeutic uses of opioid analgesics : 1. Pain relief: By any and all the possible routes, these drugs have been given to relieve the pain—acute, surgical, non-surgical, visceral, somatic, chronic, and oncogenic, non-oncogenic. 2. Morphine is drug of choice in IHD, myocardial infarction, obstetric analgesia. 3. Dyspnoea: Especially due to left ventricular
Several effects of ketamine are discussed here. Ketamine can attenuate important pro-inflammatory key functions of neutrophils in vitro, by inhibiting activated neutrophils, although these inhibitory effects are similar for racemic ketamine and its isomers. Thus ketamine might have role in limiting tissue injury in sepsis or ischemia/reperfusion. In the patients with sepsis caused by gram-negative
The mechanisms for ketamine induced cardiovascular effects are complex and also Ketamine effect on blood pressure characteristics. Direct stimulation of the CNS leading to increased sympathetic nervous system outflow seems to be the most important mechanism for cardiovascular stimulation. One of the characteristic of Ketamine is related to blood pressure and is therefore termed as
For sedation prior to anesthesia or procedures, for longer and/or more stimulating procedures, midazolam IM can be used to facilitate insertion of an IV catheter for titration of additional medication. Midazolam IM doses of 0.1 to 0.15 mg/kg are usually effective and do not prolong emergence from general anesthesia. For more anxious patients, doses up
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
Anesthetic propofol is a potent intravenous hypnotic agent which is widely used for the induction and maintenance of anesthesia. Propofol is a phenolic (2, 6-diisopropylphenol) derivative that is structurally unrelated to other sedative hypnotic agents. It has been used extensively as an anesthetic propofol agent, particularly in procedures of short duration. More recently it has
