BradyKinin

An endogenous vasodilator occurring in blood vessel walls. 
At least two distinct receptor types, B1 and B2, appear to exist for BradyKinin

Roles of bradykinin:

1) Mediator of inflammation and pain.
2) Regulation of microcirculation.
3) Their production is interrelated with clotting and fibrinolysin systems.
4) Responsible for circulatory change after birth.
5) Involved in shock and some immune reactions.

Etomidate  -Intravenous Anesthetics

- A nonbarbiturate anesthetic used primarily to induce surgical anesthesia.
- It does not produce analgesia.
- Etomidate has minimal effect on the cardiovascular system and respiration during induction of anesthesia.
- Like the barbiturates, etomidate decreases cerebral blood flow, cerebral metabolic rate and intracranial pressure.
- No changes in hepatic, renal or hematologic function have been reported.
- Myoclonic muscle movements are relatively common.
- Postoperative nausea and vomiting are more common with etomidate than with barbiturates.

Classification Based on

a. Chemical structure

I. Sulphonamidcs.and others - c.g.. sulphadiazine. etc.

2. Beta-lactum ring - e.g.. penicillin

3. Tetracycline - e.g.. Oxytetracycline,.doxycycline.etc.

b. Mechanism of action

1. Inhibits cell-wall synthesis - penicillin. cephalosporin..cycloserine. etc.

2. Cause leakage from cell-membrane – polypeptides (polymyxin,  Bacitracin), polyenes (Nystatin)

3. Inhibit protein synthesis - tetracyclines. chloramphenicols. erythromycin.

4. Cause mis-reading of mRNA code - aminoglycosides

5. Interfere with DNA function - refampicin.. metronidazole

6. Interfere with intermediary metabolism - sulphonamides. ethambutole

c. Type of organism against which it is primarily activate

I. Antibacterial - penicillin.

2. Antifungal - nystatin.

d. Spectrum of activity

1. Broad spectrum - tetracylines .

2. Narrow spectrum - penicillin G (penG). streptomycin.erythromycin

e. Type of action

I. Bacteriostatic - sulphonamides, erythromycin.tertracyclines

2. Bacteriocidal - penicillin. aminoglycoside

f. Source

I. Fungi - penicillin. cephalosporins

2. Bacteria - Polymyxin B

Propofol -Intravenous Anesthetics

- A nonbarbiturate anesthetic
- It is very lipid-soluble, acts rapidly and has a short recovery time.
- It is associated with less nausea and vomiting than some of the other IV anesthetics.
- Propofol is very similar to thiopental in its effects on the cardiorespiratory system.
- It does not have any analgesic properties but lowers the dose of opioid needed when the two agents are used in combination.

- The most significant adverse cardiovascular effect associated with propofol administration is hypotension. It should be used with caution in patients with cardiac disease.

Methods of general anesthesia

CIRCLE SYSTEM

*HIGH-FLOW

FRESH GAS FLOW > 3 l/min.

*LOW-FLOW

FGF ok. 1l/min.

*MINIMAL-FLOW

FGF ok. 0,5 l/min.

Thiopental 

- A barbiturate that is generally used to induce anesthesia.
- The temporal course of effects from induction to recovery depends almost entirely upon progressive redistribution.
- Metabolic degradation or excretion during anesthesia is negligible, except in the case of methohexital.
- The barbiturates produce minimal analgesia.
- Respiratory depression may be pronounced.
- Cardiac output is reduced while total peripheral resistance is increased.
- It does not sensitize the heart to catecholamines.
- It may cause bronchiospasm, especially in asthmatics.
- It is contraindicated in acute intermittent porphyria.