This butorphanol drug class was introduced about 25-30 years back. That was the era of morphine, pethidine, so it did not gain much acceptance. But now re-introduced, has become a major “find”. It is a classical example of “resurrection”. Butorphanol is a morphinan derivative with spectrum of activity almost like pentazocine, only that it is 20 […]
The phencyclidine derivatives Ketamine anesthetic is a non-competitive N-methyl-D-aspartate (NMDA) receptor antagonist. It produces “dissociative anesthesia”, characterized by evidence on the EEG of dissociation between the thalamo-cortical and limbic systems and a cataleptic state in which the eyes remain open with a slow nystagmic gaze. The patient becomes noncommunicative with an apparent wakefulness state. It
Etomidate metabolism is rapidly metabolized by hydrolysis of the ethyl ester side chain to its carboxylic acid ester, resulting in a water-soluble, pharmacologically inactive compound. Hepatic microsomal enzymes and plasma esterases are responsible for this hydrolysis. Hydrolysis is nearly complete, as evidenced by recovery of < 3% of an administered dose of etomidate metabolism as
A special mention must be made here about the novel ways of using neuraxial regional anesthesia anticoagulation . The use started in 1979. Gradually they have become very popular and almost all the clinically available opioids have been tried by this route. Nowadays the flexibility of neuraxial regional anesthesia anticoagulation is available to be given
Some Etomidate side effects are explained here. Some Patients receiving etomidate as intravenous injection for induction, frequently complain about pain. The incidence of pain is about 20% and associated with the conventional formulation due to its solvent propylene glycol which causes direct injury to vascular endothelium resulting in pain and venous sequelae. Pain on injection
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
The Phenobarbital schedule is listed here. The long-term administration of high doses of thiopental is associated with an increased incidence of nosocomial infections and associated mortality. Barbiturate coma may cause reversible leucopenia and an increased infection rate. Long-term administration of thiopental may also promote reversible antibiotic-induced bone marrow suppression. Thiopentone depresses T-lymphocyte function. Loop et
The binding site is called the ‘receptor’ and the mechanism as opioid receptor mechanism . Any pharmacological activity requires an agent, a target organ and a specific binding site in that organ. The receptor due to its affinity to the drug and opioid receptor mechanism , permits attachment of the drug to itself, which then
IV lasix or Furosemide is a loop diuretic that acts by inhibiting the reabsorption of sodium and chloride (via the Na/K/2Cl cotransporter) in the thick ascending limb of the loop of Henle. IV lasix enhances the excretion of sodium, potassium, calcium, chloride, and water. IV lasix is used frequently in the intensive care unit (ICU) setting
Midazolam can be used intravenously for induction of anesthesia versed . As an inducing agent it produces sleep and amnesia but it does not have any analgesic effect. Midazolam is not as rapid acting as thiopental. At approximately equipotent doses (loss of consciousness), thiopental abolishes the eyelash reflex 50—100% faster than midazolam, but it produces
