Oral transmucosal etomidate produces dose-related increases in sedation and clinically significant serum concentrations. Animal studies documented etomidate as highly permeable through the buccal mucosa with rapid onset and offset suggesting that oral transmucosal etomidate might be useful when brief mild to moderate sedation with rapid recovery is desirable. Oral transmucosal etomidate exhibited linear pharmacokinetics with […]
Propofol and egg allergy are quietly related as one of the side effects. Allergic reactions to propofol on first exposure are usually because of the isopropyl groups that may act as epitopes and that are present in various medications andcosmetics. Allergic reactions to propofol upon re-exposure are usually because of the phenol molecule. Propofol 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
Vasopressin dose should be calculated before giving. Vasopressin is the exogenous, parenteral form of antidiuretic hormone (ADH) that may be used for several conditions in the intensive care unit (ICU), including the treatment of central diabetes insipidus and as a vasopressor agent in shock. Endogenous vasopressin dose is an important stress hormone and plays a
Ketamine produces effective sedation, hence also known as Ketamine sedation . In pediatric patients for short surgical procedures or for putting intravenous catheters before IV induction ketamine has shown effective for producing sedation. It is highly effective with a wide margin of safety, and uniquely preserves protective airway reflexes and also does not require intravenous
Phenobarbital status epilepticus that does not respond to first-line benzodiazepines (lorazepam or diazepam) or to second-line antiepileptic drugs (phenytoin/fosphenytoin, phenobarbital or valproate) is usually considered refractory and requires more aggressive treatment. Barbiturate anaesthetics, such as pentobarbital and thiopental sodium, are the most frequently used agents and are highly effective for refractory GCSE both in children
Propofol anesthesia has become the induction drug of choice for most of the surgical procedures, especially when rapid and complete awakening is desirable. Continuous IV infusion of Propofol anesthesia with or without other anesthetic drugs, is commonly used in TIVA and for sedation. Due to its quick onset and offset characteristics it is also becoming
Ketamine cardiovascular effects resemble sympathetic nervous system stimulation. Indeed, a direct negative cardiac inotropic effect is usually overshadowed by central sympathetic stimulation. HR and BP rise were similar between S(+)ketamine and racemic mixture. Systemic blood pressure, heart rate, cardiac output, cardiac work, and myocardial oxygen requirements all are increased after IV administration of ketamine cardiovascular
At sub anesthetic doses, propofol anticonvulsant has been effectively used to suppress seizures during refractory status epilepticus, a mechanism, in part, attributed to the inhibition of neuronal sodium channels. It is effective in most patients, and the side effects are infrequent, of minor severity, and fully reversible. However, high doses of propofol may be necessary
The manifestations of midazolam overdose are sedation, somnolence, confusion, impaired coordination, diminished reflexes, and untoward effects on vital signs, coma and possible cardio respiratory arrest. Treatment of midazolam overdose is the same as that followed for overdosage with other benzodiazepines. Continuous monitoring of vital signs including ECG should be immediately instituted and general supportive measures
