Etomidate mechanism of action is shown here. The GABAA receptor plays a central role in the etomidate mechanism of action Etomidate exerts its effects on the receptor by binding directly to a specific site or sites on the protein and allosterically enhancing the apparent affinity of GABA for its receptor. At much higher concentrations etomidate […]
The mechanisms for ketamine induced cardiovascular effects are complex and also Ketamine effect on blood pressure characteristics. Direct stimulation of the CNS leading to increased sympathetic nervous system outflow seems to be the most important mechanism for cardiovascular stimulation. One of the characteristic of Ketamine is related to blood pressure and is therefore termed as
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
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,
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
Of interest to the clinicians is that, while appearing minimally responsive to endogenous BNP, heart failure patients will effectively respond to exogenously administered BNP which is nesiritide drip. In patients with cardiogenic pulmonary edema due to acute decompensated heart failure, plasma brain natriuretic peptide (BNP) measurements can guide the diagnosis, distinguishing this etiology of dyspnea
The Ketamine induction dose of anaesthesia is, 1 to 2 mg/kg IV or 4 to 8 mg/kg IM. Injection of ketamine IV does not produce pain or venous irritation. Consciousness is lost in 30 to 60 seconds after IV administration and in 2 to 4 minutes after IM injection. Unconsciousness is associated with maintenance of
Interventional techniques of musculoskeletal chronic pain management include use of nerve blocks, root blocks, rhizotomies, cordotomy, etc. Musculoskeletal chronic pain management is required during the following : 1. Low back pain – Lumbosacral, spinal/vertebral syndromes – Radiculopathy – Prolapsed intervertebral disc – Lumbar canal stenosis 2. Neuropathies: Trigeminal neuralgias (Tic doloroux) 3. Phantom limb pain,
Midazolam IV is the first benzodiazepine that was produced primarily for use in anaesthesia. Walser and colleagues in 1976 “first described midazolam, the first clinically used water-soluble benzodiazepine. The imidazole ring in its structure accounts for its stability in aqueous solution and rapid metabolism. It is two to three times as potent as diazepam and
With respect to inhalation agent anesthetic , an increase in cardiac output and the consequent increased pulmonary blood flow removes more general anesthetic from the alveoli. The alveolar venous anesthetic gradient is determined by the amount of tissue uptake of an inhalation agent anesthetic . This depends on the tissue solubility, tissue blood flow and
