Of interest to the clinicians is that, while appearing minimally responsive to endogenous BNP, heart failure patients will effectively respond to exogenously administered BNP which is nesiritide drip. In patients with cardiogenic pulmonary edema due to acute decompensated heart failure, plasma brain natriuretic peptide (BNP) measurements can guide the diagnosis, distinguishing this etiology of dyspnea […]
The chronic pain syndrome pathophysiology is disturbance in the process of acute nociception. The processes of transduction, transmission, modulation and perception have somehow got disturbed. The pain stimuli which were supposed to be sent forward before closing of gate, get more and more intensely forwarded rather than getting modulated. In addition, due to sustained partial
Propofol is an insoluble drug that requires a lipid vehicle for emulsification. The standard propofol emulsion formulation contains 10% soya oil as the oil phase and egg lecithin as the emulsifying agent that is composed of long-chain triglycerides. This formulation supports bacterial growth new formulations contain preservatives with bactericidal action, such as propofol with EDTA
For premedication, the recommended midazolam dosage is 0.07 to 0.08 mg/kg IM (usual dose is about 5 mg IM for an average adult) administered 30 to 60 minutes preoperatively. Lower doses should be used in elderly or debilitated patients. In a study of patients 60 years or older who did not receive concomitant narcotics, 2
Inhalation anesthetic mechanism of action after being administered and excreted via the lungs. The dose of the agent is defined by the fraction of inhaled concentration that equates with the blood concentration and not the total amount of drug administered. The minimum alveolar concentration (MAC) was introduced in 1963 as a comparison of potency of
The binding site is called the ‘receptor’ and the mechanism as opioid receptor mechanism . Any pharmacological activity requires an agent, a target organ and a specific binding site in that organ. The receptor due to its affinity to the drug and opioid receptor mechanism , permits attachment of the drug to itself, which then
The most commonly used barbiturate is pentobarbital. Induced coma with use of barbiturates like thiopentone sodium or pentothal is called barbiturate coma or pentobarbital coma . High-dose barbiturates have been used for more than 60 years in critically ill neurologic patients. The most common application has been to lower elevated intracranial pressure (ICP) in patients
There is an ongoing debate as to whether propofol EEG exhibits pro- or anticoagulant effects, and whether it should be used in patients with epilepsy. In a prospective study, Meyer et al documented propofol EEG as a sedative-hypnotic agent with anticonvulsant properties as shown by depression of spike-wave patterns in children with epilepsy and by
The sedative midazolam side effects and fluctuations in vital signs were the most frequent findings following parenteral administration of midazolam injection. These are affected by the lightening or deepening of anesthesia, instrumentation, intubation and use of concomitant drugs. The more frequently encountered fluctuations in vital signs of midazolam side effects included decreased tidal volume and/or
Naloxone (N-allyl oxomorphone) and newer drugs like nalmexone, naltrexone, nalmefene, and nalbuphine belong to naloxone group. These drugs have practically no agonist action on any of the receptors or their subtypes. But these drugs completely reverse the action of all the drugs, pure, partial, agonist-antagonists at µ, K, σ, δ and other receptors including analgesia, respiratory
