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 […]

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 , […]

 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 […]

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 […]

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 […]

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 […]

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 […]

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 […]

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 […]

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 […]