The foregoing discussion is in the situation of a normal blood brain barrier about blood brain barrier crossing drugs. In a brain lesion, where the integrity of BBB varies according to the severity of damage, the control of fluid molecules is further complex. The osmotic/oncotic gradient will not be effective in areas of complete blood […]
When administered intrathecal ketamine shows local anesthetic effects in both animals and humans. Intrathecal ketamine when used as a sole agent (0.7-0.95 mg/kg) with or without epinephrine for intrathecal use, although produces motor and sensory block but the analgesia is inadequate and of short duration along with varied psychomimetic disturbances. When added to the intrathecal
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
Broadly chronic pain syndrome type can be classified on the basis of aetiopathological origin of the syndrome of chronic pain. The advantage of using this classification is that while deciding the modality of control and management it becomes simpler to choose specific plan of management. 1. Non-oncogenic chronic pain: Chronic pain commonly seen in skeletal
As a group, paediatric patients generally require higher doses of midazolam than do adults and younger children may require higher doses than older children. In obese individuals, the midazolam syrup dose should be calculated based on ideal body weight. Oral premedication: Oral midazolam syrup is effective for sedation and anxiolysis at the doses of 0.25—1
Ketamine analgesia produces intense analgesia at sub anesthetic doses and prompt induction of anesthesia when administered IV at higher doses. Ketamine analgesia has an analgesic action at many sites both centrally and peripherally. These actions are mediated via multiple receptor subtypes, including opioid, NMDA, kainate, and GABAA receptors. Ketamine also inhibits serotonin and dopamine reuptake.
The ideal neuromuscular blocker drugs (NMB) would be rapid in onset, have a predictable offset, be nontoxic, lack deleterious cardiovascular or autonomic effects, undergo a defined means of metabolism and excretion preferably independent of end-organ function, and be inexpensive. Many of these characteristics are found in clinically available drugs like cisatracurium. To briefly review, neuromuscular
Some of the Phenobarbital side effects are discussed. Intra-arterial injection of thiopental usually results in immediate, intense vasoconstriction and severe pain radiates along the distribution of the vessel into which it has been administered. Vasoconstriction may obscure distal arterial pulses, and blanching of the extremity is followed by cyanosis. In awake patients, hypoaesthesia, muscular weakness,
Among benzodiazepine equivalence , differences in the onset and duration of action are due to their potency, lipid solubility and pharmacokinetics. Benzodiazepine equivalence is used to understand the relative differences in the action and effects of the different types of benzodiazepines. All benzodiazepines are highly lipid soluble and are highly bound to plasma proteins, especially
Benzodiazepines effects appear to produce all their pharmacologic effects by facilitating the actions of gamma-amino butyric acid (GABA). The area where it causes it effect is the principal inhibitory neurotransmitter in the CNS by enhancing their affinity towards GABA receptors leading to increased chloride conductance and hyperpolarization of the postsynaptic cell membrane, and thereby rendering
