The midazolam half life elimination of IM administration is comparable to that observed following the IV administration. Midazolam is approximately 97% plasma protein-bound in normal subjects. In patients with chronic renal failure, the free fraction of drug in plasma can be significantly higher than in healthy adults. In animals and humans, Midazolam has shown to […]
The molecular mechanisms underlying the diverse actions remain unclear, although some of the midazolam mechanism of action and sites of action of benzodiazepines effects are known. Benzodiazepines appear to produce all their pharmacologic effects by facilitating the actions of gamma-aminobutyric acid (GABA), the principal inhibitory neurotransmitter in the CNS. Benzodiazepines do not activate the GABAA
Emergence from ketamine anesthesia in the postoperative period may be associated with audiovisual ketamine hallucinations , confusional state, which may progress to delirium, proprioceptive disturbances (feelings of detachment from the body) and slightly reduced ability to recall objects seen after administration of the drugs. The ability to recall objects seen immediately before drug exposure remains
Barbiturate drugs are defined as any drug derived from barbitunc acid. Barbituric acid, which lacks central nervous system (CNS) activity, is a cyclic compound obtained by the combination of urea and malonic acid. Barbiturate drugs with sedative hypnotic properties result from substitutions at the number 2 and 5 carbon atoms of barbituric acid. Barbiturates that
Physiological response to hypoxia is commonly seen. It depends upon speed and severity of the oxygen lack. The response may be direct or indirect. The direct Hypoxia effects are on cardiorespiratory systems and the secondary effects are due to the failure of organs like brain, liver, kidney and heart. The Hypoxia effects on these organs
For the Alveolar partial pressure of oxygen we see, Increasing the inspired concentration (F1) of an anesthetic agent increases the alveolar concentration (FA). A 75% nitrous oxide (N20) in oxygen mixture increases the FI/FA ratio of N2O. The amount of nitrous oxide absorbed will be greater than the nitrogen given out in the alveoli, hence
Propofol phosphate, a water soluble propofol prodrug which is enzymatically converted to propofol, formaldehyde and inorganic phosphate, has been shown to produce sedation and anesthesia. A vegetarian formulation of propofol, Cleofol, has been used in a patient from the Jam community of India. Because it contains no lipid vehicles it is devoid of triglyceridaemia and
There is an ongoing debate as to whether propofol EEG exhibits pro- or anticoagulant effects, and whether it should be used in patients with epilepsy. In a prospective study, Meyer et al documented propofol EEG as a sedative-hypnotic agent with anticonvulsant properties as shown by depression of spike-wave patterns in children with epilepsy and by
Partial agonist buprenorphine is an opioid, which strikingly differs chemically from other opioids, in that it is not related to morphine, but to another alkaloid called thebaine. So buprenorphine is a semi synthetic opioid. Pharmacodynamically, partial agonist buprenorphine is highly potent. 0.3 mg is equianalgesic with 10 mg of morphine. It has a 50 times
Excitatory events following propofol administration are well described. The pathophysiology of these propofol myoclonus movements is not known. The drug should be used cautiously in patients with movement disorders. Miller’s anesthesia says the following about Propofol Myoclonus – Induction of anesthesia with propofol is associated with several side effects, including pain on injection, propofol myoclonus , apnea,
