Based on the pharmacokinetic parameters and reported clinical experience in preterm and term midazolam in neonates , continuous IV infusion of midazolam should be initiated at a rate of 0.0005 to 0.001 mg/kg/mm (0.5 to 1 mcg/kg/min). IV loading doses should not be used with midazolam in neonates ; rather the infusion may be run […]
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
Some of the Ketamine effects discussed here. Ketamine does not increase the intraocular pressure (lOP) in routine analgesic doses. Even after the IM injection of 8 mg/kg, ketamine doses not raise lOP. However, in an: other study, in children anaesthetized with halothane, ketamine demonstrated a dose-dependent effect on lOP. A dose of 6 mg/kg IM
John Mayow of Oxford in 1674 first observed that a component of air is essential for respiration and fire. Stephen Hale prepared oxygen along with other gases in 1927, thus making a memorable mark in the history of oxygen . Discovery, importance and history of oxygen are credited to Priestly (1777), who named it as
All barbiturates metabolism is in the liver. In Barbiturates metabolism , the haemodilution in cardiopulmonary bypass (CPB) causes reduction in total drug concentration and protein binding fraction at the onset of CPB. This decrease in protein binding is counteracted by the dilution of unbound drug, resulting in a stable unbound concentration throughout CPB. The inactive metabolites
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
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
Naloxone (N-allyl oxomorphone) and newer drugs like nalmexone, naltrexone, nalmefene, and nalbuphine belong to naloxone group. These drugs have practically no agonist action on any of the receptors or their subtypes. But these drugs completely reverse the action of all the drugs, pure, partial, agonist-antagonists at µ, K, σ, δ and other receptors including analgesia, respiratory
The use of tens electrical stimulation to reduce the pain especially of postoperative nature is the main use of this technique. The tens electrical stimulation principle is again based on “gate control theory” of Melzaek and Wall, viz: small fibres stimulation leads to transmission of nociceptive stimuli via substantia gelatinosa (SG) cells which act as
Inhalation anesthetic mechanism of action after being administered and excreted via the lungs. The dose of the agent is defined by the fraction of inhaled concentration that equates with the blood concentration and not the total amount of drug administered. The minimum alveolar concentration (MAC) was introduced in 1963 as a comparison of potency of
