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 […]
The detailed description of half life of phenobarbital is discussed here. Thiopentone produces hypnosis within 30 to 40 seconds of intravenous injection. For the half life of phenobarbital , the time required for equilibration of the brain with the thiopental concentration in the blood (effect-site equilibration time) is rapid. Recovery after a small dose is
Some barbiturates effects are explained here. The thiopental sodium causes profound fall in cerebral blood flow (35 to 40%) and thus ICP. Thiopentone also causes profound decrease in CMRO2. Thiopentone increases Cerebral perfusion pressure (CPP). The barbiturates effects increased the amplitudes of subcortical and early cortical components of somatosensory evoked potentials. Even full suppression of
The sedative effects of benzodiazepine receptors are due to activation of α-1 subunits of GABA receptors. The anxiolytic activity associated with the benzodiazepine is due to α-2 subunit activity. The GABAA receptor is large, providing attachment sites for GABA, benzodiazepines, barbiturates, etomidate, propofol, and alcohol. This property explains the pharmacologic synergy of these substances and
Phenobarbital liver in the absence of other drugs, produces only modest decreases in hepatic blood flow. Induction doses of thiopental do not alter postoperative liver function tests. Barbiturates increase hepatic bile flow. However, there is no correlation between the increase in bile flow and the cytochrome P-450 concentration in the liver. Thiopental decreases intraocular pressure
Propofol is a global central nervous system depressant. Propofol general anesthesia decreases cerebral metabolic rate for oxygen (CMRO2), cerebral blood flow (CBF), and intracranial pressure (ICP). Decrease in CBF is more than sevoflurane. Propofol is a cerebral vasoconstrictor and thus lowers ICP. Propofol decreases ICP greater than isoflurane and sevoflurane while cerebral perfusion pressure is
Diazepam IV is a highly lipid-soluble benzodiazepine with a more prolonged duration of action compared with midazolam. Diazepam IV is dissolved in organic solvents (propylene glycol, sodium benzoate) because it is insoluble in water. Dilution with water or saline causes cloudiness but does not alter the potency of the drug. Injection by either the IM
Benzodiazepines dependence may produce physical and psychological dependence after chronic (>6 months) use of commonly prescribed low-potency benzodiazepines. Withdrawal symptoms (irritability, insomnia, tremulousness) appear within 1 to 2 days for short-acting benzodiazepines dependence and within 2 to 5 days for longer-acting drugs. When administered to patients who have benzodiazepine induced CNS depression of benzodiazepines dependance, flumazenil produces rapid and dependable
Inadequate and incomplete pain assessment methods contribute to inadequate pain management. Thus, to gather all the information about pain is very important. There are multiple methods available depending on: A. Subjective description B. Objective description C. Characteristic of pain D. Description of pain There are many components mentioned for “Ideal pain Assessment” like patient quotes,
The sedative effect of benzodiazepines and opiods is potentiated by other CNS depressants including alcohol, barbiturates, inhaled and injected anesthetics, and opioids. Anesthetic requirements for inhaled and injected anesthetics are decreased by benzodiazepines and opiods . Benzodiazepines decrease the MAC value of inhaled anesthetics. Benzodiazepines, especially midazolam, potentiate the ventilatory depressant effects of opioids, though
