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 […]
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
Drugs like sufentanil, alfentanil, fentanyl and other opiates although belong to phenyl piperidine group like pethidine (meperidine), their spectrum of action is more morphine-mimicking, more like mediated through β endorphin and t receptors. Actually there are some very striking differences between the two: Fentanyl and other opiates unlike, morphine, is very highly lipid soluble, so
Midazolam drug interactions should be taken into account before administering this medication. The hypnotic effect of IV Midazolam and the risk of apnoea are accentuated by premedication, particularly narcotics (e.g., morphine, meperidine and fentanyl), secobarbital, and the droperidol-fentanyl combination. Consequently, the midazolam drug interactions should be adjusted according to the type and amount of premedication
From time immemorial mankind has been aware of opium classification . The word opium itself is derived from Greek word for juice. Arabian traders popularized it and introduced it to Europe. Paracelsus (1493—1541) reintroduced it and made it popular. It was at one time considered as “God’s own medicine” and used in various remedies from
One may ask what is methylene blue ? Methylene blue is a water-soluble blue thiazine dye used most commonly as a treatment for methemoglobinemia or as an indicator dye. Its utility as an indicator dye has been applied to several clinical situations including identification of aspiration or placement of nasogastric tubes in critically ill patients;
Benzodiazepine half life is commonly administered through oral, intramuscular and intravenous routes. Intramuscular absorption of diazepam is erratic, whereas midazolam and benzodiazepine half life have good bioavailability through this route. Diazepam and lorazepam are well absorbed from gastrointestinal tract. However, meals and antacids may decrease absorption from the gastrointestinal tract. Midazolam has also been used
Emergence from ketamine anesthesia in the postoperative period may be associated with audiovisual ketamine hallucinations , confusional state, which may progress to delirium, proprioceptive disturbances (feelings of detachment from the body) and slightly reduced ability to recall objects seen after administration of the drugs. The ability to recall objects seen immediately before drug exposure remains
Effects of Barbiturates on the body are listed here. Thiopentone decreases the tidal volume and the effect on respiratory rate is biphasic ranging from tachypnea during light anesthesia to a progressive slowing of respiration with deepening anesthesia. However, like propofol, functional residual capacity is not reduced by thiopentone. Effects of Barbiturates on the body administered
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
