Perioperative steroids are steroids that are used before, during or after a surgery. Human steroids are produced by the adrenal gland and are under the direct or indirect control of the hypothalamus, pituitary, and adrenal glands. The two major classes of steroids that have significant clinical metabolic effects are the glucocorticoids (mainly cortisol), which regulate
John Mayow of Oxford in 1674 first observed that a component of air is essential for respiration and fire. Stephen Hale prepared oxygen along with other gases in 1927, thus making a memorable mark in the history of oxygen . Discovery, importance and history of oxygen are credited to Priestly (1777), who named it as
The midazolam dose must be carefully individualized. In elderly and debilitated patients, lower doses are required. The midazolam dose should further be adjusted according to the type and amount of premedication used. Excess doses or rapid IV administration may result in respiratory depression and/or arrest, particularly in elderly or debilitated patients. For IM use, midazolam
Ketamine Preemptive Analgesia is an antinociceptive treatment targeted to block CNS hyperexcitability, and thereby leads to a reduced postoperative pain state. Excitatory amino acids aspartate, released by the C fibers, interacts with the NMDA receptors of the dorsal horn neurons, and thus, leads to increase in intracellular calcium ions, which is thought to be the
Flumazenil is the first specific benzodiazepine antagonist, used as a specific antidote in known or suspected benzodiazepine overdose treatment . In addition, flumazenil could be employed to reverse sedation produced by benzodiazepines during general anesthesia and prolonged sedation in intensive care units. Flumazenil is a specific and competitive antagonist at the central benzodiazepine receptor, reversing
To know about Ketamine mechanism of action we need to know that Ketamine is a non-competitive antagonist to the phencyclidine site of N-methyl-d-aspartate (NMDA) receptor for glutamate, though Ketamine mechanism of action has effects that are mediated by interaction with many others receptors. N-Methyl-D-Aspartate Receptor Antagonism : NMDA receptors are ligand-gated ion channels that are
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
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
Midazolam use is helpful with hypnotic amnesic during maintenance of general anesthesia. It proved superior to thiopental because fewer adjuvant anesthetics are required to maintain an acceptable depth of anesthesia. Midazolam use , however, cannot be implemented alone to maintain adequate anesthesia. It may be used with inhalational drugs as well. The MAC of halothane
Based on the pharmacokinetic parameters and reported clinical experience in preterm and term midazolam in neonates , continuous IV infusion of midazolam should be initiated at a rate of 0.0005 to 0.001 mg/kg/mm (0.5 to 1 mcg/kg/min). IV loading doses should not be used with midazolam in neonates ; rather the infusion may be run
