Pharmacokinetics
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This document discusses several key concepts in pharmacokinetics relevant to anesthesia, including: 1) Routes of drug administration and factors affecting drug absorption such as oral bioavailability and pH. 2) Distribution of drugs in the body based on properties like lipid solubility, protein binding, and volume of distribution. 3) Metabolism of drugs through Phase I and Phase II reactions in the liver and how this can impact drug dosing. 4) Excretion of drugs and clearance from the body through renal and non-renal routes like the bile and lungs. 5) Mathematical models used to describe drug behavior over time including one-compartment and multi-compartment models.
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Here are the key steps to solve this problem:
1) Calculate the elimination rate constant (k) using the two measured concentrations and times:
k = (lnC1 - lnC2) / (t1 - t2)
= (ln5.5 - ln6.5) / (8 - 24) hrs
= -0.05 hr-1
2) Calculate the volume of distribution (Vd) using the infusion rate (I), k, and the first measured concentration:
Vd = I / (k * C1)
= 15 mg/hr / (0.05 hr-1 * 5.5 mg/L)
= 15 L
3
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For More Medicine Free PPT - http://playnever.blogspot.com/
For Health benefits and medicine videos Subscribe youtube channel - https://www.youtube.com/playlist?list=PLKg-H-sMh9G01zEg4YpndngXODW2bq92w
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Here are the key steps to solve this problem:
1) Calculate the elimination rate constant (k) using the two measured concentrations and times:
k = (lnC1 - lnC2) / (t1 - t2)
= (ln5.5 - ln6.5) / (8 - 24) hrs
= -0.05 hr-1
2) Calculate the volume of distribution (Vd) using the infusion rate (I), k, and the first measured concentration:
Vd = I / (k * C1)
= 15 mg/hr / (0.05 hr-1 * 5.5 mg/L)
= 15 L
3
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Drug distribution is the process by which a drug reversibly leaves the bloodstream and enters the interstitium (extracellular fluid) and/or the cells of the tissues.
Kinetika En 2002
- Pharmacokinetics is the study of the absorption, distribution, metabolism, and excretion of drugs in the body over time. It aims to quantitatively account for the amount of drug in the body and the rate it is cleared.
- Distribution of drugs throughout tissues is affected by factors like membrane permeability, blood flow, lipid solubility, pH, and plasma protein binding. The apparent volume of distribution indicates how much volume a drug appears to distribute into based on its concentration in plasma.
- Clearance is the rate of drug elimination from plasma relative to its concentration and depends on hepatic and renal elimination. It is used to calculate maintenance dosing to achieve a target concentration.
Kinetika En 2002
Pharmacokinetics is the study of drug absorption, distribution, metabolism, and excretion in the body. The key pharmacokinetic parameters include volume of distribution (Vd), clearance (CL), and elimination half-life (t1/2). Vd represents the apparent volume needed to contain the total amount of drug at the observed plasma concentration. CL is the volume of plasma cleared of drug per unit time, determined by metabolism and excretion. t1/2 is the time for drug concentration to reduce by half, dependent on Vd and CL. These parameters allow quantification of drug behavior in the body over time.
Pk2
This document discusses clinical pharmacokinetics and pharmacodynamics. It defines pharmacokinetics as how the body affects a drug through absorption, distribution, metabolism and elimination. Factors like age can impact these processes in pediatric patients. It also discusses pharmacodynamics, how drugs act on the body, and how pharmacokinetics and pharmacodynamics together can help individualize drug therapy and decrease adverse effects.
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Pharmacokinetics - drug absorption, drug distribution, drug metabolism, drug ...
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Drug Distribution & Factors Affecting Distribution
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This document discusses the history and principles of bioethics. It begins by explaining how advances in medicine raised new moral issues that ethicists worked to address. Notable cases of unethical human subject research helped establish principles like informed consent and respect for persons. Guidelines like the Nuremberg Code aimed to prevent future abuses. The document then examines key bioethical principles like autonomy, beneficence, nonmaleficence, and justice. It explores how these principles guide issues like informed consent, respecting patient values, avoiding harm, and fair allocation of resources. The challenges of applying principles to complex real-world cases are also discussed.
Physiological Changes In Pregnancy
Physiological changes in pregnancy include changes in the central nervous, respiratory, and cardiovascular systems. The minimum alveolar concentration of anesthetic gases decreases by up to 40% due to hormonal and endogenous changes. Oxygen consumption and minute ventilation increase while functional residual capacity decreases, increasing the risk of desaturation. Blood volume and plasma volume increase substantially, elevating cardiac output and stroke volume and decreasing systemic vascular resistance.
Diabetes Mellitus
The document discusses perioperative management of diabetes mellitus. It covers types of diabetes, complications, preoperative assessment and glycemic control goals. Glycemic control is important to minimize complications from hyperglycemia and hypoglycemia. For major surgery, an intravenous insulin and glucose infusion provides optimal control and prevents fluctuations in blood sugar levels. Frequent monitoring of blood glucose levels is essential in the perioperative period.
Pulmonary Embolism
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- Deep vein thrombosis accounts for over 95% of pulmonary emboli. Risk factors for DVT and thus PE include surgery, trauma, cancer, prolonged immobility, and genetic or acquired hypercoagulable states.
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Shock
Shock is a condition where the cardiovascular system fails to adequately perfuse tissues. It can be caused by an impaired pump (cardiogenic shock), reduced circulating volume (hypovolemic shock), or maldistribution of blood flow (distributive shock). The main effects are cellular hypoxia, impaired metabolism, and organ damage or failure if not treated. Compensatory mechanisms aim to increase perfusion but eventually fail, leading to irreversible cellular damage and death if shock persists.
Role of anesthesiologist in pre-opertive period
The document discusses the role of anesthesiologists in the pre-operative period. It covers the objectives of the pre-operative visit which include obtaining medical history, identifying risk factors, and determining necessary lab tests. The stages of the peri-operative period - pre-operative, intra-operative, and post-operative - are defined. Key aspects of the pre-operative evaluation that are described include assessing patient risk factors, surgical risk stratification, airway evaluation, and guidelines for pre-operative testing based on procedure, disease conditions, and ongoing therapies.
Introduction to Regional
Regional anesthesia involves administering local anesthetics near nerves to block pain signals from specific parts of the body. There are several types including neuraxial blocks like epidurals and spinals that involve the spinal canal, and peripheral nerve blocks that target individual nerves. Regional anesthesia has advantages like reduced blood loss and postoperative complications compared to general anesthesia, though placement can be difficult and side effects like hypotension are possible. Proper technique and monitoring are needed to avoid complications.
General Anesthesia
1. General anesthesia involves inducing a reversible state of unconsciousness through drugs that provide analgesia, amnesia, and muscle relaxation while maintaining vital life functions.
2. Anesthesiologists are responsible for preoperative evaluation and preparation, intraoperative management including general anesthesia and regional techniques, and postoperative care including pain management.
3. This case report describes a patient who developed arterial oxygen desaturation during percutaneous nephrolithotomy surgery under general anesthesia which was treated with corticosteroids, aminophylline, and a bronchodilator inhaler.
Fluids
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2. Transfusion is considered when hemoglobin levels compromise oxygen delivery, depending on patient tolerance. Blood groups and cross-matching guide compatible transfusions to avoid reactions. Component therapy allows targeted treatment with specific blood products.
3. Careful fluid and transfusion management can prevent complications like hypotension, edema, and transfusion reactions from improper products or volumes. Alternatives like autologous donation or blood substitutes aim to reduce donor dependence.
Emergency Medicine
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Patient Monitoring
The document provides an introduction to patient monitoring in anesthesia. It discusses the importance of monitoring to detect potential issues and outlines the key physiological parameters that should be monitored, including circulation, ventilation, oxygenation and temperature. It also describes the various equipment and methods used for monitoring these parameters in both the past and present.
Diagnosis and Management of Shock
This document discusses the diagnosis and management of shock. It defines shock as impaired tissue oxygenation and perfusion that can lead to organ dysfunction and death if left untreated. The document classifies shock into 4 main categories: hypovolemic, cardiogenic, distributive, and obstructive. It then describes the key clinical features, causes, and goals of treatment for each type of shock. The general principles of shock management are also summarized, which include treating the underlying cause, restoring adequate perfusion and tissue oxygen delivery, and reducing oxygen demand through supportive care.
Patient Monitoring
The document provides an introduction to patient monitoring in anesthesia. It discusses the importance of monitoring to detect potential issues and outlines the key physiological parameters that should be monitored, including circulation, ventilation, oxygenation, and temperature. It also describes the various equipment and methods used for monitoring these parameters in both the past and present.
Blood Transfusion
Blood transfusion practices involve determining a patient's blood type and screening for antibodies to reduce risks of transfusion reactions like hemolytic reactions. Key indications for transfusion include maintaining hemoglobin above 6-8 g/dL and allowing blood loss within established volumes. Complications can be minimized through proper blood type matching, leukoreduction, and following guidelines for transfusion thresholds and volumes.
Airway Evaluation and Management
This document discusses airway evaluation, management of intubation, and complications. It outlines indications for intubation including resuscitation, prevention of lung soiling, and respiratory failure. Successful intubation requires a normal mandible, throat, and cervical spine alignment. Proper equipment and gadgets are also needed. Difficult airways can be predicted by history, examination of the face, jaw, and neck, and tests like Mallampatti. Securing the airway awake is recommended for expected difficult airways. Maintaining oxygenation is the primary goal, and backup plans should be in place in case of unexpected difficult intubation.
Medical Literature
This document summarizes a lecture on medical literature, including the basic purpose of research, common study designs, tools for reviewing studies, and principles of writing research manuscripts. The lecture covers estimating the truth, variability in perceptions of research findings, evolving nature of research, basic study designs like randomized trials and observational studies, analytical aspects like measures of association and issues with numerical approaches, standards for assessing research quality like CONSORT and STROBE, and considerations for writing manuscripts like clinical relevance and brevity. An example randomized controlled trial on spironolactone is presented and discussed.
Airway Evaluation and Management
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CVS PSL and Monitoring
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2. It summarizes the pharmacokinetics and pharmacodynamics of opioids like morphine and meperidine, how they work in the body to produce analgesia and other effects.
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Pharmacokinetics
- 21. Context sensitive ½ time
- 23. CSHT
- 26. Target controlled infusion TCI