Non benzodiazepines like Zolpidem Non benzodiazepines like zopiclone, Zolpidem, zaleplon and efzopiclone (Z agents) are the newer sedative hypnotic agents which have varied chemical structures. They bind selectively to a subset of benzodiazepine receptors and act as benzodiazepine receptor Agonists. Non benzodiazepines characteristic features are: As sedative-hypnotics, they are as effective as benzodiazepines and provide
Etomidate pharmacology is studied using following points. In etomidate pharmacology we find that Etomidate is a potent, direct cerebral vasoconstrictor. It decreases cerebral blood flow and CMRO2 in an independent manner. The cerebral metabolic effects of etomidate are secondary to its effect on neuronal function. As a result, previously increase ICP is lowered by etomidate
This butorphanol drug class was introduced about 25-30 years back. That was the era of morphine, pethidine, so it did not gain much acceptance. But now re-introduced, has become a major “find”. It is a classical example of “resurrection”. Butorphanol is a morphinan derivative with spectrum of activity almost like pentazocine, only that it is 20
Propofol decreases intraocular pressure and therefore has lot of propofol effects A single low dose bolus of propofol used for sedation before cataract surgery caused a moderate reduction in intraocular pressure with minimal side effects. Propofol Effect on Coagulation and Immunity System Some of the propofol effects are discussed here. Propofol does not cause significant coagulation
Oxygenation capacity is the volume of oxygen at standard pressure and temperature carried by 100 mL of blood after saturation with room air. Oxygenation capacity includes the oxygen in combination with haemoglobin (1.39 mL/g) and oxygen in solution in plasma (0.3 mL). It should also be mentioned that most of the oxygen that dissolves in
The effect of Ketamine on brain the Ketamine is traditionally considered to increase cerebral blood flow and CMRO2 however, positron emission tomography shows that subanesthetic doses of racemic ketamine increase cerebral blood flow with a minor increase in regional CBV but do not affect oxygen consumption significantly. The most profound changes in regional CBF with Ketamine on
Acute on chronic pain description is to explain the pain which was chronic and has now become suddenly severe, sharp and unbearable. It could be due to acute exacerbation of the original process. Aetiologically it could be due to sudden increase in the size of the primary or due to deposition of metastases into long bones,
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
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
Propofol related infusion syndrome is a rare complication firstly reported in paediatric patients and also observed in adults, produced due to prolonged (>48 h) high doses of propofol (>66 mcg/kg/min) intravenous infusion. Even short-term propofol related infusion syndrome for surgical anaesthesia have been associated with development of metabolic acidosis. Propofol related infusion syndrome is characterized
