NEET MDS Lessons
Pharmacology
Midazolam -Intravenous Anesthetics
Midazolam is a benzodiazepine used for preoperative sedation, induction of anesthesia, or maintenance of anesthesia in short procedures.
Ciclopirox:Ciclopirox is a synthetic antifungal agent for topical dermatologic use.
Ketamine
- Causes a dissociative anesthesia.
- Is similar to but less potent than phencyclidine.
- Induces amnesia, analgesia, catalepsy and anesthesia, but does not induce convulsions.
- The principal disadvantage of ketamine is its adverse psychic effects during emergence from anesthesia. These include: hallucinations, changes in mood and body image.
- During anesthesia, many of the protective reflexes are maintained, such as laryngeal, pharyngeal, eyelid and corneal reflexes.
- Muscle relaxation is poor.
- It is not indicated for intracranial operations because it increases cerebrospinal fluid pressure.
- Respiration is well maintained.
- Arterial blood pressure, cardiac output, and heart rate are all elevated.
Pharmacokinetics
Pharmacokinetics is the way that the body deals with a drug - how that drug moves throughout the body, and how the body metabolizes and excretes it. The factors and processes involved in pharmacokinetics must be considered when choosing the most effective dose, route and schedule for a drug's use.
The four processes involved in pharmacokinetics are:
Absorption: The movement of a drug from its site of administration into the blood.
Several factors influence a drug's absorption:
- Rate of Dissolution: the faster a drug dissolves the faster it can be absorbed, and the faster the effects will begin.
- Surface Area: Larger surface area = faster absorption.
- Blood Flow: Greater blood flow at the site of drug administration = faster absorption.
- Lipid Solubility: High lipid solubility = faster absorption
- pH Partitioning: A drug that will ionize in the blood and not at the site of administration will absorb more quickly.
Distribution: The movement of drugs throughout the body.
Metabolism: (Biotransformation) The enzymatic alteration of drug structure.
Excretion: The removal of drugs from the body.
As a drug moves through the body, it must cross membranes. Some important factors to consider here then are:
Body's cells are surrounded by a bilayer of phospholipids (cell membrane).
There are three ways that a substance can cross cell membranes:
- Passing through channels and pores: only very small molecules can cross cell membranes this way.
- Transport Systems: Selective carriers that may or may not use ATP.
- Direct Penetration of the Cell Membrane:
Drugs used to induce vomiting
In case of poisoning with noncorrosive agents, and assuming incomplete absorption of the poison has taken place, induction of vomiting can be carried out. One of the drugs used for this purpose is emetine which causes irritation of the upper gut and, on absorption, it also acts on CTZ.
Chemotherapeutic agents (or their metabolites) can directly activate the medullary chemoreceptor trigger zone or vomiting center; several neuroreceptors, including dopamine receptor Type 2 and serotonin Type 3 (5-HT3) from cell damage(GIT and pharynx) play roles in vomiting.
Classification
I) Esters
1. Formed from an aromatic acid and an amino alcohol.
2. Examples of ester type local anesthetics:
Procaine
Chloroprocaine
Tetracaine
Cocaine
Benzocaine- topical applications only
2) Amides
1. Formed from an aromatic amine and an amino acid.
2. Examples of amide type local anesthetics:
Articaine
Mepivacaine
Bupivacaine
Prilocaine
Etidocaine
Ropivacaine
Lidocaine
VITAMIN -K
- Group of lipophilic, hydrophobic vitamins.
- Needed for the post-translational modification of coagulation proteins.
- Phylloquinone (vitamin K1) is the major dietary form of vitamin K.
- Vitamin K2 (menaquinone, menatetrenone) is produced by bacteria in the intestines.