Nikethamide is a drug used for stimulating the brain. Its chemical name is nicotinic acid diethylamide. Nikethamide is a cerebral stimulant and a good analeptic. It stimulates respiration due to an effect on respiratory center and not through the chemoreceptors of the carotid and aortic bodies. It has a vasoconstrictor effect on the peripheral circulation. It has
Bradycardia and asystole have been observed after induction of anesthesia with propofol. The risk of propofol bradycardia related death during propofol anesthesia has been estimated to be 1.4 in 100,000. Severe, refractory, and fatal bradycardia has been observed with long-term propofol bradycardia infusion. In contrast to thiopentone, propofol apparently lacks central vagolytic activity and may
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
Aging and liver disease affect glucuronidation less than oxidative metabolic pathways. And thus, lorazepam, oxazepam, benzodiazepines in the elderly and temazepam are preferentially used in elderly patients over other benzodiazepines as they are metabolized only by glucuronidation and have no active metabolites. Elderly patients may also be intrinsically sensitive to benzodiazepines, suggesting that the enhanced
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
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,
Ketamine interactions potentiates all non depolarizing muscle relaxants in a dose-dependent manner. Ketamine improves the intubating condition when used with rocuronium. Halothane anesthesia by decreasing uptake, distribution, redistribution and metabolism of ketamine produces significant prolongation of its pharmacologic action on the central nervous system. Ketamine administered in the presence of volatile anesthetics may result in
Following are the therapeutic uses of opioid analgesics : 1. Pain relief: By any and all the possible routes, these drugs have been given to relieve the pain—acute, surgical, non-surgical, visceral, somatic, chronic, and oncogenic, non-oncogenic. 2. Morphine is drug of choice in IHD, myocardial infarction, obstetric analgesia. 3. Dyspnoea: Especially due to left ventricular
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
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
