Incidences of anaphylaxis have been reported after induction with thiopental. The incidence of barbiturate allergy is estimated to be 1 per 30,000 patients. The majority of the patients who suffer from anaphylaxis due to barbiturate allergy also possess history of chronic allergy. Barbiturate Allergic reactions include urticaria, angioneurotic edema, other skin reactions, agranulocytosis and thrombocytopenic […]
Propofol contamination in an emulsion formulation, has been associated with infective complications. It becomes contaminated once the ampoules have been opened. Propofol contamination supports the growth of all microorganisms. Diphtheroid bacilli and coagulase-negative staphylococci were the most frequent microorganisms. Others are E. coli, S. aureus, and P. aeruginosa. Adding lidocaine, or storing opened ampoules at
The pharmacokinetics of ketamine is characterized by rapid onset of action, relatively short duration of action, and high lipid solubility. Ketamine half life has a pK of 7.5 at physiologic pH. Ketamine half life can be given by multiple routes: IV, TM, SC, oral, sublingual, rectal, nasal, transdermal, epidural, or intrathecal. Peak plasma concentrations of
Activation of NMDA receptors has been implicated in cerebral ischaemic damage. Therefore, by its antagonistic effect on NMDA receptors, Ketamine seizures may have a possible neuroprotective role. Systemic administration of ketamine has been reported to have neuroprotective effect, in terms of preoperative treatment, in preventing ischaemic and postischaemic spinal cord injury during thoracic and thoracoabdominal
Flumazenil or Anexate is an imidazo benzodiazepine that binds competitively to BDZ receptors and antagonizes many of the actions of benzodiazepines. Flumazenil is a benzodiazepine antagonist. It does not block the pharmacologic effects of GABA or all GABA mimetic but it specifically antagonizes the actions of benzodiazepines. Given alone, it has minimal effect on the
The effect of agonist drug of opoid group have a lot of impact as listed: Cough: The cough center in medulla is suppressed, leading to antitussive action. Pure agonists especially related with codeine have pronounced effect. Nausea and Vomiting: The emesis is usually due to direct stimulation of chemoreceptor trigger zone (CTZ) of area postrema of the
Clinical Features for acute opioid toxicity treatment is necessary at times.The clinical occurrence of acute opioid toxicity is due to any of the following three main reasons: • Clinical overdosage: Either iatrogenic or patient-controlled analgesia pumps. • Accidental overdosage by addicts. • Attempts at suicide. Whatever might be the cause, “high degree of suspicion” is
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
While very effective as an antiarrhythmic, amiodarone therapy is also associated with a wide array of adverse side effects involving the cornea, lungs, liver, skin, and thyroid. Although the majority of amiodarone therapy ‘s adverse effects on these organs result from deposition of the drug in the parenchyma, its effect on the thyroid gland is
The discussion about chronic pain management anesthesiology is incomplete until and unless the very important aspect of pain is taken into wider consideration which is the chronic pain. Chronic pain is the major symptom of the majority of the patients presenting at outpatient clinics. It is the most commonly overlooked, misunderstood or wrongly labeled and
