Clonidine is an alpha-2 receptor agonist that down regulates the sympathetic nervous system. By stimulating alpha-2 adrenergic receptors in the brain stem, clonidine activates inhibitory pathways in the central nervous system (CNS), which results in reduced catecholamine release and reduced sympathetic outflow from the CNS. This effectively causes a decrease in blood pressure, heart rate, […]
Despite the rapid clearance of propofol pharmacokinetics by metabolism, there is no evidence of impaired elimination in patients with cirrhosis of the liver. Chronic alcoholism does not change the propofol pharmacokinetics significantly. Extrahepatic elimination of propofol occurs during the anhepatic phase of orthotopic liver transplantation. Renal dysfunction does not influence the clearance of propofol. Patients
For sedation prior to anesthesia or procedures, for longer and/or more stimulating procedures, midazolam IM can be used to facilitate insertion of an IV catheter for titration of additional medication. Midazolam IM doses of 0.1 to 0.15 mg/kg are usually effective and do not prolong emergence from general anesthesia. For more anxious patients, doses up
All of these nonsteroidal anti inflammatory drugs side effects collectively lead to breach of the integrity of gastric mucosal lining, and gastric ulceration is the result. Following are the nonsteroidal anti inflammatory drugs side effects : Gastritis : As an overall decrease in production of prostaglandins takes place. Some of the protective PGs like PGE1, PGE2,and
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Glucocorticoid therapy are most commonly used to mitigate an inflammatory response. They are used in a wide variety of patient populations seen in the intensive care unit (ICU). Unfortunately, these agents have many side effects, which often limit their use. In the ICU setting, the functions most commonly affected are endocrine regulation, immune response, and
The sedative effects of benzodiazepine receptors are due to activation of α-1 subunits of GABA receptors. The anxiolytic activity associated with the benzodiazepine is due to α-2 subunit activity. The GABAA receptor is large, providing attachment sites for GABA, benzodiazepines, barbiturates, etomidate, propofol, and alcohol. This property explains the pharmacologic synergy of these substances and
Among the common benzodiazepines that are used in anesthesia today are three: namely diazepam, midazolam and lorazepam. Benzodiazepines produce varying degree of anxiolysis, sedation, anticonvulsant actions and anterograde amnesia. Benzodiazepines also produce some degree of skeletal muscle relaxation but that is not sufficient for surgical procedures; and they also do not decrease the dose requirements
Vasopressin dose should be calculated before giving. Vasopressin is the exogenous, parenteral form of antidiuretic hormone (ADH) that may be used for several conditions in the intensive care unit (ICU), including the treatment of central diabetes insipidus and as a vasopressor agent in shock. Endogenous vasopressin dose is an important stress hormone and plays a
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
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
