Classification: Group of compounds which selectively interfere with inward calcium ion movement across myocardial and vascular smooth muscle. Four classes- Class I: Phenyl alkyl amines: Verapamil Class II: 1 ,4 dihydroxy pyrimidines: Nifedipine Nicardipine Nimodipine Israpidine Felodipine Amlodipine Class III: Benzothiazines Diltiazem Class IV: Di aryl amino propyl amine Ether (Ltype) eg: bepridil Mechanism […]
Continue ReadingPeripheral Vasodilators
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Nitroglycerin Structure Organic nitrate acts on venous capacitance. Route of administration Tablets- oral , buccal , transmucosal , lingual spray. Transdermal patch or ointment – 5 to 10mg. Over 24 hours provides sustained protection against myocardial ischaemia. Mechanism of action Generates NO with acts as mediator resulting in peripheral vasodilators in presence of two […]
Continue ReadingAntiarrhythmics-Classification
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CLASSIFICATION OF ANTIARRHYTHMIC DRUGS- FOUR CLASSES.- APD action potential, ERP-Effective refractory period. Class I Antiarrhythmic are again subclassified in three groups. Electrophysiologic activity I A IB IC Phase O Decreased Slight effect Marked decreased depolarisation prolonged Slight effect Slight effect conduction Decreased Slight effect Markedly slowed ERP Increased Slight effect Slight prolonged APD Increased Decreased […]
Continue ReadingAmiodarone
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CLASS III ANTIARRHYTHMIC DRUG- Chemical structure: ☛ Benzofuran derivative ☛ First line anti arrythmc derivative in cardio pulmonary resuscitation by ATSA in VT ☛ Effective prophylactically in preventing AF post operatively. ☛ Wide spectrum of effectiveness including supraventricular and preexcitation syndrome. Actions: Increase APD Decrease the slope of diastolic depolarization(phase 4) with depressed SA […]
Continue ReadingQuinidine
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Quinidine Class IA prototype antiarrhythmic. Dextroisomer of quinine. Antimalerial and anti pyretic action. Pharmacological structure Obtained from Cinchana Plant. Twobasic Nitrogens. pK-10. Reduces Na ion current by binding to open Na ion channels resulting in depression of automaticity of ectopic foci. Available as sulphate ,gluconate. Quinidine sulphate is oral prepn commonly,can be available as IM. […]
Continue ReadingPregnancy with Mitral stenosis
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☛ RHD is still major problem in india. ☛ Incidence is decresing due to better socioeconomic condition. ☛ MS is mostly associated with MR , the morbidity is usually related to MS. Pathophysiology ⤋ MVA 4-6 cm2 ⤋ When there is stenosis ⤋ In La presence ⤋ In PAP ⤋ Pul. Congestion ⤋ Pul. Edema […]
Continue ReadingNon Cardiac Surgical Applications
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Non Cardiac Surgical Applications of Cardiopulmonary Bypass CURRENT APPLICATIONS OF CPB FOR NON CARDIAC SURGERY Bypass is used to induce profound hypothermia. Patients with significant pulmonary disease requiring surgery that demands a bloodless field constitute second largest group. Operations on IVC require bypass procedure to return blood to the heart-venoatrial/venovenal diseases. Variety of unusual diseases. […]
Continue ReadingNeuro Anaesthesia
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Intracranial pressure[ICP] and its significance – Definition– intracranial pressure by convention means supratentorial CSF pressure measured in the lateral ventricles or over cerebral cortex. Normal range- 8-12 mm of Hg. Cranial vault is rigid structure with fixed total volume- 1.brain -80% 2.blood -12% 3.CSF – 8% [increase in any component increases ICP]. INTRACRANIAL COMPLIANCE -Change […]
Continue ReadingCarotid Endarterectomy
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Circle of Willis Common carotid origin ☛ Rt common carotid from Rt brachiocepholic trunk ☛ Lt common carotid from Arch of aorta ☛ In neck they travel in carotid sheath ☛ At level of thyroid cartilage they divide into external & internal carotid A. ☛ Internal carotid A passes through neck to enter […]
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