Intravenous Anaesthetics are a group of fast-acting
compounds that are used to induce a state of impaired
awareness of complete sedation.
These are drugs that, when given intravenously in an
appropriate dose, cause a rapid loss of consciousness.
Lecture slides for undergraduates medical (MBBS) Students. Source material for this presentation is Essentials of Pharmacology, KD Tripathi, Katzung and Goodman and Gillman. It deals with Local anaesthetics with their mechanism of action, pharmacokinetics , adverse effects and therapeutic uses.
Classification
Mechanism of action
Duration of action
Absorption and distribution
Mode of action
Theories of action of L.A
Pharmacokinetics of local anaesthetics
Routes of administration
Metabolism or biotransformation
Individual agents
Vasoconstrictors
Systemic effects
Toxicity
Advantages
Disadvantages
Maximum allowable dose
Local anaesthetics in community trust services
Intravenous Anaesthetics are a group of fast-acting
compounds that are used to induce a state of impaired
awareness of complete sedation.
These are drugs that, when given intravenously in an
appropriate dose, cause a rapid loss of consciousness.
Lecture slides for undergraduates medical (MBBS) Students. Source material for this presentation is Essentials of Pharmacology, KD Tripathi, Katzung and Goodman and Gillman. It deals with Local anaesthetics with their mechanism of action, pharmacokinetics , adverse effects and therapeutic uses.
Classification
Mechanism of action
Duration of action
Absorption and distribution
Mode of action
Theories of action of L.A
Pharmacokinetics of local anaesthetics
Routes of administration
Metabolism or biotransformation
Individual agents
Vasoconstrictors
Systemic effects
Toxicity
Advantages
Disadvantages
Maximum allowable dose
Local anaesthetics in community trust services
Agents that produces loss of consciousness are anesthetics.
They induce smooth and rapid effect for limited period. There are five stages of anesthesia. They are classified as INHALATION ANESTHETICS, ULTRA SHORT ACTING BARBITURATES and DISSOCIATIVE ANESTHETICS.
complete and detail study on the topic of general anesthetics by the collaboration of teacher and students for the student , teachers and other health care professionals to learn more on the topics
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
- Video recording of this lecture in English language: https://youtu.be/kqbnxVAZs-0
- Video recording of this lecture in Arabic language: https://youtu.be/SINlygW1Mpc
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
4. General Anesthesia
General anesthesia is a reversible state of central nervous
system (CNS) depression, causing loss of response to and
perception of stimuli.
For patients undergoing surgical or medical procedures,
anesthesia provides five important benefits:
• Sedation and reduced anxiety
• Lack of awareness and amnesia
• Skeletal muscle relaxation
• Suppression of undesirable reflexes
• Analgesia
Because no single agent provides all desirable properties,
several categories of drugs are combined to produce optimal
anesthesia
5. Choosing Proper Anesthetic
Status of organ systems
1. Cardiovascular system: Anesthetic agents suppress
cardiovascular function to varying degrees. This is an
important consideration in patients with Heart and coronary
artery diseases.
• Hypotension may develop during anesthesia, resulting in
reduced perfusion pressure and ischemic injury to tissues.
• Halothane, sensitize the heart to arrhythmogenic effects of
sympathomimetic agents.
2. Respiratory system: Inhaled agents depress respiration but
also act as bronchodilators, These effects may influence the
ability to provide adequate ventilation and oxygenation during
and after surgery.
6. 3. Liver and kidney: The liver and kidneys influence long-term
distribution and clearance of drugs and are also target organs
for toxic effects.
4. Nervous system: The presence of neurologic disorders (for
example, epilepsy, myasthenia gravis, neuromuscular
disease, compromised cerebral circulation) influences the
selection of anesthetic.
5. Pregnancy: Special precautions should be observed when
anesthetics are administered during pregnancy. Effects on fetal
organogenesis are a major concern in early pregnancy.
• Commonly, patients receive one or more of preanesthetic
medications for preventing undesirable anesthetic effects.
7. STAGES OF ANESTHESIA
A. Induction
B. Maintenance of anesthesia
C. Recovery
D. Depth of anesthesia:
• Stage I—Analgesia:
• Stage II—Excitement:
• Stage III—Surgical anesthesia:
• Stage IV—Medullary paralysis:
8. Inhalational Anesthetics
• Inhaled gases are used primarily for maintenance of
anesthesia after administration of an IV agent.
• Inhalational agents have very steep dose–response
curves and very narrow therapeutic indices, so the
difference in concentrations causing surgical anesthesia
and severe cardiac and respiratory depression.
• No antagonists exist.
9.
10. HALOTHANE
• Halothane is the prototype to which newer inhalation anesthetics
are compared.
• When halothane was introduced, its rapid induction and quick
recovery made it an anesthetic of choice.
• Due to adverse effects and the availability of other anesthetics with
fewer complications, halothane has been replaced in most
countries.
------------------------------------------------------------------------------------------
• Chemical and Physical Properties
• Halogenated compound chemically:
2-bromo-2-chloro-1,1,1-tri fluoro ethane
• Volatile, so kept in sealed bottles
• Colorless, Pleasant odor, Non-irritant
• Non-explosive, Non-inflammable
• Light-sensitive
• Corrosive, Interaction – rubber and plastic tubing
11. Solubility in blood
• This is determined by a physical property of the anesthetic
called the :
• blood/gas partition coefficient :
Ratio of
𝑪𝒐𝒏𝒄. 𝒐𝒇 𝒂𝒏𝒆𝒔𝒕𝒉𝒆𝒕𝒊𝒄 𝒊𝒏 𝒃𝒍𝒐𝒐𝒅
𝑪𝒐𝒏𝒄. 𝒐𝒇 𝒂𝒏𝒆𝒔𝒕𝒉𝒆𝒕𝒊𝒄 𝒊𝒏 𝒈𝒂𝒔
when the anesthetic is in
equilibrium between the
two phases.
12. Potency
• Potency is defined(determined)
quantitatively as the minimum alveolar
concentration (MAC),
• MAC: the minimum concentration of
inhaled anesthetic needed to eliminate
movement in 50% of subjects exposed to
it.
• MAC is the median effective dose (ED50)
of the anesthetic, expressed as the
percentage of gas in a mixture required
to achieve that effect.
• Numerically, MAC is small for potent
anesthetics such as Halothane and large
for less potent agents such as nitrous
oxide.
13. Therapeutic uses
• Halothane is a potent anesthetic but a relatively weak
analgesic. Thus, it is usually coadministered with nitrous oxide,
opioids, or local anesthetics.
• It is a potent bronchodilator.
• Halothane relaxes both skeletal and uterine muscles and can
be used in obstetrics when uterine relaxation is indicated.
• Halothane is not hepatotoxic in children (unlike its potential
effect on adults).
• Combined with its pleasant odor, it is suitable in pediatrics for
inhalation induction, although sevoflurane is now the agent of
choice.
14. Pharmacokinetics
Potent general anesthetic
• MAC : 0.75%, thus lower MAC value, more drug potency.
• Blood/Gas Partition Coefficient: 2.4
Produces a smooth and relatively rapid induction.
Metabolism: 20-40% is metabolized in liver by oxidation,
normally excreted in form of trifluoroacetic acid.
Clearance: Around 60-80% is cleared out unchanged by
lungs.
15. Mechanism of Action
• No specific receptor has been identified as the locus of general
anesthetic action –generally-.
• It appears that a variety of molecular mechanisms may
contribute to the activity of general anesthetics.
• Halothane activates GABAA , glycine receptors, 5-HT3and twin-
pore K+ channels .
• It antagonizes NMDA receptor.
• It inhibits nACh(block excitatory postsynaptic currents of nicotinic
receptors) and voltage-gated sodium channels.
-----------------------------------------------------------------------------------------
At clinically effective concentrations, general anesthetics increase
the sensitivity of the γ-aminobutyric acid (GABA-A) receptors to
the inhibitory neurotransmitter GABA. This increases chloride ion
influx and cause
Hyperpolarization Decrease Excitability CNS Depression
17. Disadvantages
• Weak analgesic (thus is usually coadministerd with N2O,
opioids)
• Is a strong respiratory depressant
• Is a strong cardiovascular depressant; halothane is
vagomimetic and cause atropine-sensitive bradycardia.
• Cardiac arrhythmias: serious if hypercapnia develops due
to hypoventilation and an increase in the plasma
concentration of catecholamines(Sensitizes heart to
catecholamines)
• Hypotensive effect (Rx: phenylephrine recommended)
• Hepatotoxic: is oxidatively metabolized in the liver to
tissue-toxic hydrocarbons (e.g., trifluroethanol and
bromide ion), could lead to hepatitis.
18. Disadvantages cont.
Malignant hyperthermia:
• In a very small percentage of susceptible patients, a rare life-threatening
condition.
• MH causes a drastic and uncontrolled increase in skeletal muscle oxidative
metabolism, overwhelming the body’s capacity to supply oxygen, remove
carbon dioxide, and regulate temperature, eventually leading to circulatory
collapse and death if not treated immediately.
• Susceptibility to MH is often inherited as an autosomal dominant disorder.
-----------------------------------------------------------------------------------------------
• Dantrolene is given as the anesthetic mixture is withdrawn, and measures
are taken to rapidly cool the patient.
• Dantrolene blocks release of Ca2+ from the sarcoplasmic reticulum of
muscle cells, reducing heat production and relaxing muscle tone.
19. Contraindications
• Liver dysfunction
• History of unexplained jaundice or pyrexia after a previous
exposure to halothane is an absolute contraindication to its
future use in that patient.
• Halothane is contraindicated in patients with known, or
suspected, genetic predisposition to malignant hyperthermia.
• Hypovolemic