A seasoned anesthesiologist, Dr. Edwin Perez, MD, summarizes a lecture on regional anesthesia pharmacology and therapeutics, when to use them, the risk and benefits, and other important information about anesthesia.
This presentation deals with the in-depth analysis of various cardiac stimulants & depressants both directly & indirectly acting on frog's heart. Also, includes a nice quiz, a good exercise for the grey cells of the brain at the end of the presentation.
Prehospital Ketamine – Is there anything it can’t do?SMACC Conference
PHARM Physician, Per Bredmose, provides an indepth look at Ketamine in the prehospital setting. Per discusses the uses, benefits and potential complications of Ketamine, providing tips and tricks from his wealth of experience.
A Practical Approach to Ionotropes and vasopressors Aneesh Bhandary
Vasopressors are a powerful class of drugs that induce vasoconstriction and Inotropes increase cardiac contractility. Choice of an agent should be based upon the suspected underlying etiology of shock.
This presentation deals with the practical issues and controversies surrounding the use of these agents
This presentation deals with the in-depth analysis of various cardiac stimulants & depressants both directly & indirectly acting on frog's heart. Also, includes a nice quiz, a good exercise for the grey cells of the brain at the end of the presentation.
Prehospital Ketamine – Is there anything it can’t do?SMACC Conference
PHARM Physician, Per Bredmose, provides an indepth look at Ketamine in the prehospital setting. Per discusses the uses, benefits and potential complications of Ketamine, providing tips and tricks from his wealth of experience.
A Practical Approach to Ionotropes and vasopressors Aneesh Bhandary
Vasopressors are a powerful class of drugs that induce vasoconstriction and Inotropes increase cardiac contractility. Choice of an agent should be based upon the suspected underlying etiology of shock.
This presentation deals with the practical issues and controversies surrounding the use of these agents
This presentation contains drugs which blocks the adrenergic system e.g receptor blockers like alpha and beta receptor antagonists, adrenergic neuron blocking agents in details.various animated pictures are also included to make the presentation interesting as well as i have used various diagrams and tables to have better understanding of the topic. Thank you.
Also called Atrial natriuretic peptide, Atrial natriuretic factor, Atrial natriuretic hormone, or atriopeptin. They are protein hormones secreted by heart muscle cells.
The protein hormones secreted by the heart muscle cells are called atrial peptides. This presentation gives a detailed information about the structure, production and pharmacological effects of atrial natriuretic peptides.
Cresar (Generic Telmisartan Tablets) is used for the treatment of hypertension, to lower blood pressure. Lowering blood pressure reduces the risk of fatal and nonfatal cardiovascular events, primarily strokes and myocardial infarctions.
Cresar tablets are also used for reduction of the risk of myocardial infarction, stroke, or death from cardiovascular causes in patients 55 years of age or older at high risk developing major cardiovascular events who are unable to take ACE inhibitors.
Awareness and assessment of the pain in
postoperative children is important
Remember the different pharmacology in
neonates, infants and children
Multi-modal approach to preventing and treating
pain to minimize adverse effects
Regional analgesia must be considered unless
contraindicated
This presentation contains drugs which blocks the adrenergic system e.g receptor blockers like alpha and beta receptor antagonists, adrenergic neuron blocking agents in details.various animated pictures are also included to make the presentation interesting as well as i have used various diagrams and tables to have better understanding of the topic. Thank you.
Also called Atrial natriuretic peptide, Atrial natriuretic factor, Atrial natriuretic hormone, or atriopeptin. They are protein hormones secreted by heart muscle cells.
The protein hormones secreted by the heart muscle cells are called atrial peptides. This presentation gives a detailed information about the structure, production and pharmacological effects of atrial natriuretic peptides.
Cresar (Generic Telmisartan Tablets) is used for the treatment of hypertension, to lower blood pressure. Lowering blood pressure reduces the risk of fatal and nonfatal cardiovascular events, primarily strokes and myocardial infarctions.
Cresar tablets are also used for reduction of the risk of myocardial infarction, stroke, or death from cardiovascular causes in patients 55 years of age or older at high risk developing major cardiovascular events who are unable to take ACE inhibitors.
Awareness and assessment of the pain in
postoperative children is important
Remember the different pharmacology in
neonates, infants and children
Multi-modal approach to preventing and treating
pain to minimize adverse effects
Regional analgesia must be considered unless
contraindicated
The perfect introduction to Bali's fascinating culture and handicrafts, picturesque rice paddy fields, traditional villages and a spectacular lake and volcano. A traditional dance that portrays the eternal struggle between good and evil, the religious and the profane and with a dramatic ending.
Videos should be used on your landing pages whenever possible,because it is a passive engagement medium where visitors can experience your message with very little effort.
Kati graham life tec presentation don't stop doing the things you love kgLifeTec
LifeTec is a social enterprise that exists to enable people and their communities to achieve their goals through the correct application of assistive technology.
We provide everyone with everyday solutions to everyday activities.
The Grand Blossoms It is Chennai's only full moon party destination!
THE Grand Blossoms rewrites the philosophy of ultimate leisure with The Grand Blossoms Red Hills. Bringing in carefully designed spaces on the shores of a wide and tranquil lake. To give you the best of family recreation and splendid isolation. Forget your cares. Forget yourself. Enjoy.
inotropic drugs and vassopressors drugs.pptxAhmed638947
this presentation is toalking about the Sympathomimetic drugs which are agents which in general mimic responses due to stimulation of sympathetic nerves.
These agents are able to directly activate adrenergic receptors or to indirectly activate them by increasing norepinephrine and epinephrine (mediators of the sympathoadrenal system) levels.
These drugs are used clinically to treat glaucoma, anaphylactic shock, chronic obstructive pulmonary disease, hypotension, hypertension, heart failure, nasal congestion, premature labor, attention-deficit/hyperactivity disorder, narcolepsy, and acute or chronic asthma. The α or β adrenergic antagonists block or attenuate the effect of sympathomimetics on α or β receptors. Alpha blockers are used clinically to treat hypertension and benign prostatic hyperplasia. Beta blockers are used clinically to treat ischemic heart disease, essential hypertension, cardiac arrhythmias, congestive heart failure, glaucoma, hyperthyroidism, surgical removal of pheochromocytoma, nonparkinsonian tremor, migraine headache (prophylaxis), and a wide variety of anxiety situations.
A slideshow presentation by Dr. Edwin Perez, anesthesiologist, pain management specialist, and life coach. Questions to ask of yourself and your potential life coach in your search, with tips for finding the right life coach for your goals, personality, and budget.
See dredwinperez.net and supportanger.com for more info!
Neuro-lingiustic programming is often underused as a method in life coaching. At Support Anger, life coach Dr. Edwin Perez believes just the opposite. He uses this presentation to talk about what, exactly, NLP is, and how it can benefit you and your life coach!
A presentation given by Dr. Edwin Perez during his time as a Pain Fellow at the University of Washington, detailing the diagnostics and clinical markers in complex regional pain syndrome (CRPS)
Need a life coach? Want to learn more about what they do? Learn more about Edwin Perez and his life coaching practice. Also, don't forget to visit his site listed above.
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Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
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- WOMEN’S HEALTH: FERTILITY PRESERVATION
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- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
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The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
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
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
3. Objectives
key points about all blocks in general
when to use them
risks/benefits
ultrasound versus landmark/stim technique
LAST
4. Amides And Esters
All local Anesthetics (LA) have a hydrocarbon
chain connected to a lipophilic portion. This is
done by either an ester (-CO-) bond or amine (-
HNC-) bond.
amides are metabolized in liver
esters are metabolized in plasma by
pseudocholinesterase
6. Do you have any
allergies?
Extremely unlikely-1% of ADR are caused by
Local anesthetics
Most likely seeing systemic toxicity
esters are the culprit more than amides-think
PABA
when linked to amides usually due to
preservative-methylparaben
7. Max single-shot dose
Esters-
procaine-1000mg in 70kg male
chloroprocaine-800mg in 70kg male
1000mg in 70kg male w/epi
tetracaine-20mg in 70kg male
Amides
Lidocaine- 3 or 5mg/kg depending on epi
Bupivacaine/Ropivacaine 3mg/kg
9. Pharmacology 101:its
gotta get inside
LA bind to sodium channels on the inside of
the channel
They also obstruct the outside
maintains them in inactivated-closed state
10. Pharmacokinetics
pKa of local anesthetics makes them such
that only 0.5% is already in a nonionized form.
It must be nonionized to cross (abscess)
Intrinsic vasodilator-lidocaine
esters safer except in pseudocholinesterase
deficiency
11. Toxicity
1) #1 casue is accidental intravascular
placement
2) Then from absorption
intercostal>caudal>epidural> sciatic
12. CNS
Scale of effects
A) Analgesia
B) Lightheadedness, tinnitus, numb tongue
C) Seizures
D) Coma
E) Then cardiovascular depression
15. Why Blocks
Significant improvement in analgesia
Significant improvement in patient
satisfaction
Sometimes decreased LOS
Decreased opioid requirements by 50% or
more
16. Blocks
Chronic vs Acute Pain Blocks (diag vs ther)
contraindications
peripheral blocks only work on periphery
block effect times
nerve sparing and the compartment syndrome
situation
adjuvant therapy (fem/sciatic controversy)
how long do blocks actually last
18. Checklist for Treatment of Local Anesthetic
Systemic Toxicity
The Pharmacologic Treatment of Local Anesthetic Systemic Toxicity (LAST) is Different from
Other Cardiac Arrest Scenarios
❑ Get Help ❑ Initial Focus
❑ Airway management: ventilate with 100% oxygen ❑ Seizures uppression: benzodiazepines
are preferred; AVOID propofol
in patients having signs of cardiovascular instability ❑ Alert the nearest facility having
cardiopulmonary bypass capability
❑ Management of Cardiac Arrhythmias ❑ Basic and Advanced Cardiac Life Support
(ACLS) will require
adjustment of medications and perhaps prolonged effort
❑ AVOID vasopressin, calcium channel blockers, beta blockers, or local anesthetic
❑ REDUCE individual epinephrine doses to <1 mcg/kg ❑ Lipid Emulsion (20%)
Therapy (values in parenthesis are for 70kg patient)
❑ Bolus 1.5 mL/kg (lean body mass) intravenously over 1 minute (~100mL)
❑ Continuous infusion 0.25 mL/kg/min (~18 mL/min; adjust by roller clamp)
❑ Repeat bolus once or twice for persistent cardiovascular collapse
❑ Double the infusion rate to 0.5 mL/kg/min if blood pressure remains low
❑ Continue infusion for at least10 minutes after attaining circulatory stability
❑ Recommended upper limit: Approximately 10 mL/kg lipid emulsion over the first 30 minutes
❑ Post LAST events at www.lipidrescue.org and report use of lipid to www.lipidregistry.org
19. Bibliography
Dang, Charles;The value of adding sciatic block to continuous femoral
block for analgesia after total knee replacement;
Regional Anesthesia and Pain Medicine; Volume 30, Issue 2, March–
April 2005, Pages 128–133
Benzon, Honorio, Essentials of Pain Medicine and Regional
Anesthesia, 2005
Neal, Joseph;ASRA Practice Advisory on Local Anesthetic Systemic
Toxicity; Regional Anesthesia & Pain Medicine; March/April 2010; Vol
35 Issue 2; pp152-161
Stoelting, Robert; Basics of Anesthesia; 2000