Dr.Pravin Dullur. Consultant child psychiatrist. Austrellia.
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Dr.Vrunda Karanjgoankar Consultant Oncogyanacologist. Mumbai.MH.
Continue ReadingDr.Manasi Karandikar
Dr.Manasi Karandikar. Consultant obstretacian and infertility specialist. Dombivalli. MH.
Continue ReadingDr.Digvijay Shinde
Dr.Digvijay Shinde Consultant Intensivist MGM Hospital & College, Aurangabad.
Continue ReadingKetamine
Ketamine Non barbiturate induction agent. Structure- Phencyclidene derivative that produces “Dissociate anaesthesia” Dissociation between thalamus and limbic system – catalyptic state in which eyes remain open with a slow nystagmic gaze, noncommunication although wakefulness present. Hypertonic and purposeful skeletal muscle movement often occur independently. Chemical properties- Water soluble phencyclidine derivative ‘s’ isomer – intense analgesia,rapid […]
Continue ReadingOpioids
Classification- Phenanthrene Benzyl iso quinolone Morphine Papaverine Codeine Noscaepine Tuebaine pH – 7.7- Water soluble molecule Synthetic opioids: Morphine derivative- levorphanol, Benzomorphan derivative meperidine , fentanyl (mol wt-236-325) OPIOIDS Morphine Fentanyl Meperidine Sufentanyl Remifentanyl Codeine Dextromethorphan Oxymorphane Methadone Herion OPIOID– AGONIST Pentazocine Butarphenol Nalbuphine Buprenorphine Bromazocine Degocine OPIOID ANTAGONSTS Morphine: Nalaxone , […]
Continue ReadingInhaled Anaesthetics
History- 1840– DISCOVERY OF NITROUS OXIDE , DIETHYL ETEHR AND CHLOROFORM 1951– First halogenated hydro carbon anaesthetic , fluroxene introduced – inflammable and had organ toxicity 1956 – halothane clinically used 1960 – methyl flurane , methyl ether was first derivative – in clinical use devoid of dysrhythmogenic effect with epinephrine , prolonged […]
Continue ReadingEpinephrine
Produced by adrenal medulla ACTIONS: DIRECT AGONIST OF ALPHA 1 ,2, BETA 1 AND 2 RECEPTOR. DOSE (mcg/kg/min) RECEPTOR ACTION SVR 10-30 beta May decrease 30-150 beta and alpha Variable >150 alpha and beta Increase PROTOTYPE DRUG. NATURAL FUNCTIONS- Increase myocardial contractility Increase heart rate Increase vascular and bronchial smooth muscle tone Increase glandular […]
Continue ReadingNor Epinephrine
Released from post ganglionic sympathetic nerve endings. Potent action on beta 1 alpha receptors . no action on beta 2 receptors. ACTIONS: Heart rate : variable, no change or increases if blood pressure is low. Contractility increases. Cardiac out put increases. Systemic vascular resistance increases. Peripheral vascular resistance increases. Off set by redistribution neural uptake […]
Continue ReadingCardioplegia Solution
Cardioplegia solution is used to arrest the cardiac activity during cardiopulmonay bypass. Types- ST Thomas I (Maccarthy) Nacl-144mmol/l Kcl -20mmol/l Mgcl -16 Cacl2 -2.4 meq/l NaHco3- Procaine-1.0 pH – 5.5-7.0 osmolarity -300-320 ST Thomas II (Plegisol) Nacl -110 Kcl -16 Mgcl -16 Cacl2-1.2 NaHco3 -10 pH- 7.8 osmolarity -285-300 MYOCARDIAL PROTECTION STRATEGIES Anaesthetic […]
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