Propofol is known to possess direct antiemetic effects. Propofol antiemetic use for induction and maintenance of anesthesia has been shown to be associated with a lower incidence of postoperative nausea and vomiting (PONV) when compared to any other anesthetic drug or technique. It has been shown that total intravenous anaesthesia (TIVA) with propofol for anesthesia […]
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
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
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
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,
Critically ill patients often require cardiac inotrope and/or cardiac pressors support to maintain adequate cardiac output and adequate blood pressure to sustain end-organ perfusion. Because end-organ perfusion has already likely been compromised and may continue to be problematic despite use of these agents, anaerobic metabolism rather than aerobic metabolism is likely to be generating a
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
Beta blockade prior to instituting other vasodilator drugs in aortic dessection management is essential. The following case presentation demonstates the importance of beta blockade in Aortic dissection management. A 44-year-old man whose only past medical history consists of hypertension and unilateral cataracts presents to his local emergency department with the acute onset of severe tearing
Nitroprusside Cyanide Toxicity is due to the cyanide groups released from metabolism of the nitroprusside molecule. After gaining an electron from the iron moiety of hemoglobin, the sodium nitroprusside produces an unstable radical and methemoglobin. Hypertension is commonly seen in the perioperative setting as well as the intensive care unit (ICU). There are many agents
Lorazepam drip or Ativan drip is a frequently used sedative in the intensive care unit (ICU). It is a benzodiazepine that can be administered enterally, as intermittent parenteral doses, or as a continuous infusion. The beneficial effects of lorazepam drip include anterograde amnesia and an opioid-sparing effect via a moderation of the anticipatory pain response.
