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Basic pharmacology ofBasic pharmacology of
anaesthesia-related drugsanaesthesia-related drugs
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Premedication Drugs
Premedication is defined as administration ofPremedication is defined as administration ofmedication prior to anaesthesia.medication prior to anaesthesia.
Aims:Aims: AnxiolysisAnxiolysis
AnalgesiaAnalgesia
Antisialagogue (drying of airway secretions)Antisialagogue (drying of airway secretions) Anti-emeticAnti-emetic
Acid aspiration prophylaxisAcid aspiration prophylaxis
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MidazolamMidazolam
It is a short acting benzodiazepine.It is a short acting benzodiazepine.
It is the most common drug used for sedationIt is the most common drug used for sedation
and anxiolysis preoperatielyand anxiolysis preoperatiely
Perioperatie indications arePerioperatie indications are
sedatie!anxiolysis!amnesic!anticonulsantsedatie!anxiolysis!amnesic!anticonulsant
Preoperatiely midazolam can be gien iaPreoperatiely midazolam can be gien ia
intraenous or orally.intraenous or orally.
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MidazolamMidazolam (continued)
(continued)
"ose : #ral - $.%mg&'g"ose : #ral - $.%mg&'g
II - $.-$.%mg&'g - $.-$.%mg&'g
* should be gien %$-+$ min preop* should be gien %$-+$ min preop
,ide ffect:,ide ffect:
hypotension! respiratory depression!hypotension! respiratory depression!
apnoeaapnoea
aution:aution: reduce dose in elderly ( ery sensitie )reduce dose in elderly ( ery sensitie )
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DiazepamDi
azepam
It is a long acting benzodiazepineIt is a long acting benzodiazepine
Perioperatie indication are sedation!Perioperatie indication are sedation!
termination of status epilepticustermination of status epilepticus
/or preoperatiely diazepam normally be/or preoperatiely diazepam normally be
gien orallygien orally
"ose: oral $.-$.%mg&'g"ose: oral $.-$.%mg&'g
,ide effect : ,edation! circulatory depression,ide effect : ,edation! circulatory depression
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MorphineMor
phine
It is an opioidIt is an opioid
It be gien before op as an analgesiaIt be gien before op as an analgesia
an be gien ia i or scan be gien ia i or sc "ose: $.0-$.%mg&'g. 1otal dose $ mg."ose: $.0-$.%mg&'g. 1otal dose $ mg.
,ide effect of morphine are histamine,ide effect of morphine are histamine
release! hypotension! bronchospasm! nausea!release! hypotension! bronchospasm! nausea!
omiting! pruritus! dysphoriaomiting! pruritus! dysphoria
,hould be used with caution as it can cause,hould be used with caution as it can cause
prolonged ris' of respiratory depression.prolonged ris' of respiratory depression.
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PethidinePethidine
It is an synthetic opioidIt is an synthetic opioid
2sed preoperatiely as an analgesia (agent2sed preoperatiely as an analgesia (agent
of choice in asthma)of choice in asthma) an be used postoperatiely foran be used postoperatiely for
postoperatie shieringpostoperatie shiering
Analgesic dose -.0mg&'g I&I3Analgesic dose -.0mg&'g I&I3
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PethidinePethidine (continued)(continued)
,ide effect :,ide effect :
4espiratory depression! hypotension!4espiratory depression! hypotension!
dysphoriadysphoria ,hould be used with caution because it can,hould be used with caution because it can
cause seizure in high dosage - maximumcause seizure in high dosage - maximum
daily dose g&day ( %$ mg&'g&day)daily dose g&day ( %$ mg&'g&day)
ontraindication in pt on 3A#Iontraindication in pt on 3A#I
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Atropine sulphateAtropine sulphate
AnticholinergicAnticholinergic
2ses:2ses:
Preoperatie: Antisialogogue! reduce incidence ofPreoperatie: Antisialogogue! reduce incidence of
laryngospasm and reflex bradycardia arrythmialaryngospasm and reflex bradycardia arrythmiaduring general anaesthesiaduring general anaesthesia
Postoperatie: ounteract muscurinic effects ofPostoperatie: ounteract muscurinic effects of
anticholinergic agents used for reersal ofanticholinergic agents used for reersal of
neuromuscular bloc'ing agents.neuromuscular bloc'ing agents.ardiac: ,inus bradycardia or asystole durigardiac: ,inus bradycardia or asystole durig
cardiopulmonary resuscitation or drug toxicity.cardiopulmonary resuscitation or drug toxicity.
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"osage:"osage:
Administered I&I3 at a dose of Administered I&I3 at a dose of
$.$0-$.$%mg&'g$.$0-$.$%mg&'g
Antisialogogue:I ($.5-$.6mg) 5$ min before op .Antisialogogue:I ($.5-$.6mg) 5$ min before op .
7radyarrythmias: adult I&I3 $.0- mg max7radyarrythmias: adult I&I3 $.0- mg max
%mg. hild I&I3 $.$-$.$5 mg&'g max $.6 mg%mg. hild I&I3 $.$-$.$5 mg&'g max $.6 mg
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,ide effects:,ide effects:
"ecrease secretions! decreases lower"ecrease secretions! decreases lower
oesophageal sphincter tone! relaxes bronchialoesophageal sphincter tone! relaxes bronchial
smooth muscle.smooth muscle.
onfusion in elderly.onfusion in elderly.
#bstructie uropathy#bstructie uropathy
ontraindications&Precautions: angle closureontraindications&Precautions: angle closureglaucoma! obstructie uropathy! obstructieglaucoma! obstructie uropathy! obstructie
disease of 8I1.aution in I9"! 3I and feer.disease of 8I1.aution in I9"! 3I and feer.
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GlycopyrollateGlycopyrollate
It is an anticholinergic agentIt is an anticholinergic agent
Perioperatie indication :Perioperatie indication :
7loc'ade of muscarinic effects of7loc'ade of muscarinic effects of
anticholinesterases!anticholinesterases!
Potent antisialogoguePotent antisialogogue
uaternary ammonium thereforeuaternary ammonium therefore
cannot cross blood brain barriercannot cross blood brain barrier "ose i&im : $.$$+-$.$$;mg&'g 5$ min preop"ose i&im : $.$$+-$.$$;mg&'g 5$ min preop
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GlycopyrollateGlycopyrollate (continued)(continued)
,ide effect : Paradoxical bradycardia in small,ide effect : Paradoxical bradycardia in small
doses.doses.
4educes lower oesophageal4educes lower oesophageal
sphincter tone.sphincter tone.
aution in glaucoma and cardioascularaution in glaucoma and cardioascular
disease.disease.
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PromethazinePromethazine It is a phenothiazine groupIt is a phenothiazine group
It has an antihistamine with sedatie andIt has an antihistamine with sedatie and
antiemetic propertieantiemetic propertie
ommonly used as pediatric sedationommonly used as pediatric sedation
"ose $.%0-$.0mg&'g oral"ose $.%0-$.0mg&'g oral
,ide effect extrapyramidal reactions,ide effect extrapyramidal reactions
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MetoclopromideMetoclopromide
A procainamide deriatie.A procainamide deriatie.
It is a pro'inetic drugs .It is a pro'inetic drugs .
Act at the dopaminergc receptor.Act at the dopaminergc receptor.
Increases gastric emptying and lowerIncreases gastric emptying and lower
oesophageal sphinter tone .oesophageal sphinter tone .
"opaminergic anti-emetic"opaminergic anti-emetic
Prescribes for premedication drug in patientPrescribes for premedication drug in patient
at ris' of acid aspiration.at ris' of acid aspiration.
e.g: pregnancy! gastric outlet obstruction!e.g: pregnancy! gastric outlet obstruction!
obese!etcobese!etc
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MetoclopromideMetoclopromide (continued)(continued)
"ose : #ral&I3&I 0-%$mg"ose : #ral&I3&I 0-%$mg
,ide effect: sedation!extrapyramidal&dystonic,ide effect: sedation!extrapyramidal&dystonic
reactions.reactions.
aution with concomitant usage withaution with concomitant usage with
neuroleptic and anticholinergic! patient withneuroleptic and anticholinergic! patient with
abnormal renal or lier function! elderly ..abnormal renal or lier function! elderly ..
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RanitidineRanitidine
8astric P9 increasing drugs8astric P9 increasing drugs
9istamine (9%) receptor antagonist9istamine (9%) receptor antagonist4eduction in gastric acid secretion.4eduction in gastric acid secretion.
2se as premedication drug in patient at ris'2se as premedication drug in patient at ris'
of acid aspirationof acid aspiration
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RanitidineRanitidine (continued)(continued)
"ose :- Adult : #ral - 0$mg #< = morning"ose :- Adult : #ral - 0$mg #< = morning I - 0$-$$mg 9 preopI - 0$-$$mg 9 preop
hild : #ral - % mg&'g&dose % hourlyhild : #ral - % mg&'g&dose % hourly
or + mg&'g at nightor + mg&'g at night
I - mg&'g&dose slowly 6-;I - mg&'g&dose slowly 6-;
hourlyhourly
,ide effect : 8enerally infre>uent. 9eadache!,ide effect : 8enerally infre>uent. 9eadache!
malaise! dizziness! thrombocytopenia (clinicallymalaise! dizziness! thrombocytopenia (clinically
insignificant )insignificant )
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#meprazole#meprazole
Proton pump inhibitor.Proton pump inhibitor.
8astric P9 increasing.8astric P9 increasing.
,ignificantly reduces olume of gastric acid,ignificantly reduces olume of gastric acid
secretion but no effect on gastric emptying.secretion but no effect on gastric emptying.
linical usage: 1reatment of peptic ulcer disease!linical usage: 1reatment of peptic ulcer disease!
peptic esophangitis ! zollinger llison and can alsopeptic esophangitis ! zollinger llison and can also
be use in patient at ris' of gastric acid aspiration.be use in patient at ris' of gastric acid aspiration.
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"osage:"osage:
#ral:+$mg #< = %-5h preop#ral:+$mg #< = %-5h preop I :+$mg oer 5$ minI :+$mg oer 5$ min
,ide effect : In general well tolerated . 9eadache,ide effect : In general well tolerated . 9eadache
and diarrhoea! myalgia! rash and abdominal pain.and diarrhoea! myalgia! rash and abdominal pain.
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Na itrate !"#MNa itrate !"#M
8astric P9 increasing drugs.8astric P9 increasing drugs.
2ses: 8ien as premedication drug for patient at2ses: 8ien as premedication drug for patient at
ris' of gastric acid aspiration in particularris' of gastric acid aspiration in particular
pregnancypregnancy
"ose : #ral"ose : #ral $-5$mls ?5$ min preop$-5$mls ?5$ min preop
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Reversal DrugsReversal Drugs
Includes reersal of :Includes reersal of :
3uscle relaxation3uscle relaxation
"rug action ( antagonist )"rug action ( antagonist )
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NeostigmineNeostigmine
AnticholinesteraseAnticholinesterase
reersal of non-depolarizing muscle relaxantreersal of non-depolarizing muscle relaxant
treatment of myasthenia graistreatment of myasthenia grais
"ose:"ose:
4eersal of muscle relaxant I $.$+-$.$0mg&'g in4eersal of muscle relaxant I $.$+-$.$0mg&'g in
combination with anticholinergic agentcombination with anticholinergic agent
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Aderse&,ide effects:Aderse&,ide effects:
3uscarinic effects3uscarinic effects: nausea! omiting! epigastric: nausea! omiting! epigastric
discomfort! abdominal cramps! increase saliationdiscomfort! abdominal cramps! increase saliation
and bronchial secretions! bradycardia! miosis!and bronchial secretions! bradycardia! miosis!
hypotension.hypotension.
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Nalo$oneNalo$one
#pioid antagonist. Pure mu-receptor antagonist#pioid antagonist. Pure mu-receptor antagonist
2ses:2ses:
. 4eersal respiratory depression due to opiods.. 4eersal respiratory depression due to opiods.
%.the diagnosis of opioid oerdose.%.the diagnosis of opioid oerdose.
"osage:"osage:
4eersal of opioid:4eersal of opioid: adultadult II .0mcg&'g I $. mg.0mcg&'g I $. mg
increments at %-5 minutes interals to theincrements at %-5 minutes interals to the
desired effect.desired effect. hildhild I $.$$0-$. mg&'g repeatedI $.$$0-$. mg&'g repeated
eery %-5 min up to 5 doses if necessaryeery %-5 min up to 5 doses if necessary
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Aderse& side effects:Aderse& side effects:
Abrupt reersal of analgesia may produce aAbrupt reersal of analgesia may produce acatecholamine surge resulting in tachycardia!catecholamine surge resulting in tachycardia!
hypertension! pulmonary oedema and cardiachypertension! pulmonary oedema and cardiac
dysrhythmiasdysrhythmias
4emar's:4emar's:
7eware of renarcotization if reersing long-acting7eware of renarcotization if reersing long-acting
opioid.opioid.
aution in opiod addicts-may precipitate acuteaution in opiod addicts-may precipitate acutewithdrawal.withdrawal.
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%lumazenil%lumazenil
7enzodiazepine antagonist7enzodiazepine antagonist
2ses: reersal of centrally sedatie effects of2ses: reersal of centrally sedatie effects of
benzodiazepines.benzodiazepines.
"ose:"ose: II $.% mg increments up to -% mg$.% mg increments up to -% mg
ontraindicated in patient 'nown allergy. 3ixedontraindicated in patient 'nown allergy. 3ixed
intoxications with benzodiazepine and cyclicintoxications with benzodiazepine and cyclicantidepressants since toxic effect of the latterantidepressants since toxic effect of the latter
may emerge with the reersal of themay emerge with the reersal of the
benzodiazepine effect.benzodiazepine effect.
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aution in seere head inury or epileptic patient.aution in seere head inury or epileptic patient.
,ide effects:,ide effects:
Arrythmias!seizuresArrythmias!seizures
4emar's:4emar's:
,pecial precaution in benzodiazepine dependence,pecial precaution in benzodiazepine dependence
because can cause acute withdrawal.because can cause acute withdrawal.7eware of resedation if long-acting7eware of resedation if long-acting
benzodiazepinebenzodiazepine
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3iscellaneous:3iscellaneous:#ther drugs that are commonly used in#ther drugs that are commonly used in
anaesthesia .anaesthesia .
&asopressor ' inotropes&asopressor ' inotropes
lectrolyte replacementlectrolyte replacement
AntiarrythmiasAntiarrythmias
AntihypertensionAntihypertension
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phedrinephedrine
"irect and indirect sympathomimetic (B and C"irect and indirect sympathomimetic (B and C
adrenergic action ).adrenergic action ).
2ses: 1reatment of hypotension particularly2ses: 1reatment of hypotension particularlyfollowing general! spinal or epidural anaesthesia.following general! spinal or epidural anaesthesia.
As a nasal decongestant.As a nasal decongestant.
"ose:5-6 mg repeated ( dilute 5$ mg in $ mls"ose:5-6 mg repeated ( dilute 5$ mg in $ mlssaline) ml increments. I3: 5$ mgsaline) ml increments. I3: 5$ mg
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aution in elderly! hypertension and , disease.aution in elderly! hypertension and , disease.
an cause tachyphylaxis.an cause tachyphylaxis.
Aoid with 3A#I and tricyclic antidepressantsAoid with 3A#I and tricyclic antidepressants
may increase alpha-adrenergic effects ofmay increase alpha-adrenergic effects of
ephedrine.ephedrine.
,ide effect: Increase heart rate and blood,ide effect: Increase heart rate and blood
pressure! acute urinary retention! anxiety!pressure! acute urinary retention! anxiety!
palpitation.palpitation.
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PhenylephrinePhenylephrine
,electie direct-acting B adrenergic agonist.,electie direct-acting B adrenergic agonist.Peripheral asoconstrictionPeripheral asoconstriction
2ses: 1reatment of hypotension.2ses: 1reatment of hypotension.
"ose:"ose:
II $.-$.0 mg increments.$.-$.0 mg increments.
($mg in %$ ml saline! ml ali>uots.)($mg in %$ ml saline! ml ali>uots.)
I3: %-0 mgI3: %-0 mg Infusion: 5$-6$ D&minInfusion: 5$-6$ D&min
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ontraindication&precaution:ontraindication&precaution:
3A#I.3A#I.
aution in elderly or , diseaseaution in elderly or , disease
,ide- effects:,ide- effects:
4eflex 7radycardia! arrhythmias4eflex 7radycardia! arrhythmias
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AdrenalineAdrenaline
ndogenous cathecolamine with alpha and betandogenous cathecolamine with alpha and beta
actionaction
2ses:2ses:. 1reatment of anaphylaxis. 1reatment of anaphylaxis
%. 7ronchodilator%. 7ronchodilator
5. Positie inotrope5. Positie inotrope
+. 8ien by nebulizer for croup+. 8ien by nebulizer for croup
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"ose:"ose:
I&I3&11:I&I3&11:
ml ali>uots of :$ $$$ up to 0-$ ml ($.0- ml ali>uots of :$ $$$ up to 0-$ ml ($.0-
mg)mg)
infusion:infusion: %-%$%-%$ mcg&min($.$+-$.+mcg&min($.$+-$.+ mcg&'g&min)mcg&'g&min)
nebulisation:0ml :$$$nebulisation:0ml :$$$ max dose for infiltration:max dose for infiltration: % mcg&'g% mcg&'g
"ilution: 5mg&0$mlEml&hrEDg &min"ilution: 5mg&0$mlEml&hrEDg &min
"iluent:
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aution in elderly.aution in elderly.
an cause arrhythmias especially with halothane.an cause arrhythmias especially with halothane.
,ide effects:,ide effects:9ypertension! tachycardia! anxiety!9ypertension! tachycardia! anxiety!
hyperglycaemia! arrhythmias.hyperglycaemia! arrhythmias.
4educes uterine blood flow4educes uterine blood flow
4emar's: should be administered ia central4emar's: should be administered ia central
catheter wheneer possible.catheter wheneer possible.
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DopamineDopamine
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ontraindicated in phaeochromocytoma (due toontraindicated in phaeochromocytoma (due to
noradrenaline release)!tachyarrythmias and /.noradrenaline release)!tachyarrythmias and /.
aution in patient with peripheral ascularaution in patient with peripheral ascular
diseasedisease
4emar's:4emar's:
,hould be administered ia central catheter.,hould be administered ia central catheter.
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DoutamineDoutamine
ββ adrenergic agonist! positie inotrope and adrenergic agonist! positie inotrope and
chronotrope. 2se in cardiac failurechronotrope. 2se in cardiac failure
"ose: %.0-$ mcg&'g&min"ose: %.0-$ mcg&'g&min"ilution:%0$mg&0$ml"ilution:%0$mg&0$ml (0mg&ml)(0mg&ml)
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ontraindicated in arrhythmias and hypertension.ontraindicated in arrhythmias and hypertension.
,ide effects:,ide effects:
1achycardia! decreased peripheral and pulmonary1achycardia! decreased peripheral and pulmonaryascular resistance.ascular resistance.
4emar's:4emar's:
an cause pan cause phlebitis! but can behlebitis! but can beadministereed peripherallyadministereed peripherally
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NoradrenalineNoradrenaline
Potent cathecolaminePotent cathecolamine αα adrenergic agonist.adrenergic agonist.
asoconstriction.asoconstriction.
2ses: 1reatment of hypotension2ses: 1reatment of hypotension"ose:%-%$ mcg&min"ose:%-%$ mcg&min ($.$+-$.+ mcg&'g&min)($.$+-$.+ mcg&'g&min)
"ilution:"ilution: + mg&+$ml+ mg&+$ml ($$ mcg&ml)($$ mcg&ml)
"iluent: 0F dextrose"iluent: 0F dextrose
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,ide effects: 4eflex bradycardia! arrhythmia!,ide effects: 4eflex bradycardia! arrhythmia!
hypertensionhypertension
4emar':4emar':Administered ia central catheter only.Administered ia central catheter only.
Potentiated by 3A#I and tricyclic antidepressantsPotentiated by 3A#I and tricyclic antidepressants
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&asopressin&asopressin
-A"9.-A"9.
-asoconstriction.-asoconstriction.2ses:2ses:
1reatment of hypotension1reatment of hypotension
1reatment of diabetes insipidus1reatment of diabetes insipidus
"ose: %$ unit&ml in +$ ml
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alcium gluconatealcium gluconate
2ses:2ses:
. lectrolyte replacement. lectrolyte replacement%. Positie inotrope.%. Positie inotrope.
5. 1reatment for hyper'alemia and5. 1reatment for hyper'alemia and
hypermagnesaemia.hypermagnesaemia.
"escription:"escription:
alcium gluconate $F contains a%G %%$alcium gluconate $F contains a%G %%$
Dmol&ml.Dmol&ml.
alcium chloride contains a%G 6;$Dmol&mlalcium chloride contains a%G 6;$Dmol&ml
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"ose:"ose:
%-0 ml $F solution ($mg&'g! $.$ mmol&'g)%-0 ml $F solution ($mg&'g! $.$ mmol&'g)
,ide effects:,ide effects:Arrythmias! hypertension! hypercalcaemiaArrythmias! hypertension! hypercalcaemia
4emar's:4emar's:Jess phlebitis than calcium chlorideJess phlebitis than calcium chloride
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Potassium chloPotassium chlorideride
2ses: lectrolyte replacement2ses: lectrolyte replacement
"ose:"ose:
$-%$ mmol&h (max concentration +$ mmol&litre$-%$ mmol&h (max concentration +$ mmol&litre
peripherally).peripherally).
Kith 8 monitoring:Kith 8 monitoring:
2p to %$-+$ mmol&h ia central line (3ax %$$2p to %$-+$ mmol&h ia central line (3ax %$$mmol&day)mmol&day)
"ilution: gm in 0$mls run oer h"ilution: gm in 0$mls run oer h
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4emar's:4emar's:
"ilute solution before administration with $.HF"ilute solution before administration with $.HF
normal saline!"extrose 0F.normal saline!"extrose 0F.
4apid administration can cause cardiac arrest.4apid administration can cause cardiac arrest.
9igh concentration can cause phlebitis.9igh concentration can cause phlebitis.
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Magnesium sulphate
ssential mineral used to treat:ssential mineral used to treat:.9ypomagnesaemia.9ypomagnesaemia
%.clamptic seizures.%.clamptic seizures.
5. Arrhythmias5. Arrhythmias
3agnesium sulphate3agnesium sulphate
0$FE0$$mg&mlE%mmol 3g%G&ml.0$FE0$$mg&mlE%mmol 3g%G&ml.
&litre.&litre.
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2ses:2ses:
. 9ypomagnesaemia: $-0 mg&'g oer %$ min!. 9ypomagnesaemia: $-0 mg&'g oer %$ min!
then g&h.then g&h.
%. Arrythmias:%. Arrythmias: %g oer $ min.%g oer $ min.
5. clampsia: +g oer $ min then g&h for %+h5. clampsia: +g oer $ min then g&h for %+h..
aution:aution:
Potentiate muscle relaxants.Potentiate muscle relaxants.
3onitoring of serum leel essential during3onitoring of serum leel essential duringtreatment. an cause heart bloc'treatment. an cause heart bloc'
,ide effects:,ide effects:
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*odium icaronate*odium icaronate
1reatment for acidosis1reatment for acidosis
"ose:"ose:
Kt('g)x base deficit x $.5) mmolKt('g)x base deficit x $.5) mmol
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AmiodaroneAmiodarone
3ixed class I and III antiarrhythmic3ixed class I and III antiarrhythmicuseful in treatment of supraenticular anduseful in treatment of supraenticular and
entricular arrhythmias.entricular arrhythmias.
"ose:"ose:,hould be diluted with 0F dextrose only,hould be diluted with 0F dextrose only
Joading infusion : 0 mg&'g oer -% 9 thenJoading infusion : 0 mg&'g oer -% 9 then
0mg&'g oer %+h0mg&'g oer %+h
3aximum .% g in %+93aximum .% g in %+9
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ontraindication:ontraindication:
I in ,inoatrial heart bloc'! thyroid dysfunctionI in ,inoatrial heart bloc'! thyroid dysfunctionand pregnancyand pregnancy
,ide effects:,ide effects:
ommonly causes thyroid dysfunction! reersibleommonly causes thyroid dysfunction! reersiblecorneal deposits! prolongation of 1 interal.corneal deposits! prolongation of 1 interal.
Jung /ibrosis (rare)Jung /ibrosis (rare)
4emar's: administered ia central catheter.4emar's: administered ia central catheter.
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smololsmolol
,hort acting cardioselectie beta-bloc'er.,hort acting cardioselectie beta-bloc'er.3etabolized by red cell esterases.3etabolized by red cell esterases.
1reatment of supraentricular tachycardia or1reatment of supraentricular tachycardia or
intra-operatie hypertensionintra-operatie hypertension
"ose:"ose:
,1: $.0 mg&'g oer min! then 0$-,1: $.0 mg&'g oer min! then 0$-
%$$Dg&'g&min.%$$Dg&'g&min.
9ypertension:9ypertension: %0-$$ mg then 0$-5$$%0-$$ mg then 0$-5$$Dg&'g&minDg&'g&min
"ilution: %.0g&0$ml"ilution: %.0g&0$ml (0$ mg&ml)(0$ mg&ml)
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ontraindication:ontraindication:
Asthma! heart failure! A bloc'Asthma! heart failure! A bloc'
,ide effects:,ide effects:9ypotension! bradycardia9ypotension! bradycardia
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+aetolol+aetolol
ombined B (mild) and C adrenergic receptorombined B (mild) and C adrenergic receptor
antagonist.antagonist.
7lood pressure control without reflex tachycardia.7lood pressure control without reflex tachycardia.
"uration %-+ h"uration %-+ h
"ose:"ose:0 mg increments up to $$ mg.0 mg increments up to $$ mg.
Infusion:Infusion: %$-6$mg&h%$-6$mg&h
ontraindicated in asthma!heart failure! A bloc'.ontraindicated in asthma!heart failure! A bloc'.
,ide effects:,ide effects: 9ypotension! bradycardia!9ypotension! bradycardia!
bronchospasmbronchospasm
8/16/2019 Anaes Related Drugs
56/56
THANK YOU