Lidocain ppt

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  • Animated spinning picture(Intermediate)Tip: Some shape effects on this slide are created with the Combine Shapes commands. To access this command, you must add it to the Quick Access Toolbar, located above the File tab. To customize the Quick Access Toolbar, do the following:Click the arrow next to the Quick Access Toolbar, and then under CustomizeQuickAccessToolbar click MoreCommands.In the PowerPointOptions dialog box, in the Choose commands from list, select All Commands. In the list of commands, click CombineShapes, and then click Add.To reproduce the shape effect on this slide, do the following:On the Home tab, in the Slides group, click Layout, and then click Blank.Also on the Home tab, in the Drawing group, click Shapes, and then under Basic Shapes click Oval (first row).On the slide, drag to draw an oval.Select the oval. Under DrawingTools, on the Format tab, in the Size group, enter 6” in the Height box and 6” in the Width box.Also on the Format shape, in the ShapeStyles group, click ShapeOutline, and then click NoOutline.On the Home tab, in the Drawing group, click Shapes, and then under BasicShapes click Pie (second row).On the slide, drag to draw a pie.Select the pie. Drag the yellow diamond adjustment handle to create a wedge shape.Under DrawingTools, on the Format tab, in the Size group, enter 5.7” in the Height box and 5.7” in the Width box.Press and hold CTRL, select the oval, and then select the pie. On the Home tab, in the Drawing group, click Arrange, point to Align, and then do the following:Click Align to Slide.Click Align Center.Click Align Middle.Press and hold CTRL, and then select the oval and then the pie shape. On the Quick Access Toolbar, click Combine Shapes, and then click ShapeSubtract.Select the new shape. Under DrawingTools, on the Format tab, in the ShapeStyle group, click the FormatShape dialog box launcher. In the FormatShape dialog box, click Fill in the left pane, in the Fill pane, click Pictureor texture fill, and then click the button next to Texture and click RecycledPaper (third row). Also in the FormatShape dialog box, click PictureColor in the left pane, in the PictureColor pane, under Recolor, click the button next to Presets, and then click Grayscale (first row). Also in the FormatShape dialog box, click PictureCorrections in the left pane, in the PictureCorrections pane, under Brightness and Contrast, in the Contrast box, enter 20%. Also in the FormatShape dialog box, click Shadow in the left pane, in the Shadow pane, click the Presets button, and then under Outer, click Offset Diagonal Bottom Left.Also in the Shadow pane, in the Blur box, enter 10 pt. To reproduce the picture effects on this slide, do the following:On the Insert tab, in the Images group, click Picture. In the Insert Picture dialog box, select a picture and then click Insert.Select the picture. Under PictureTools, on the Format tab, in the Size group, click the Size and Position dialog box launcher. In the Format Picture dialog box, resize or crop the image so that the height is set to 5.8” and the widthis set to 5.8”. To crop the picture, click Crop in the left pane, and in the right pane, under Crop position, enter values into the Height, Width, Left, and Top boxes. To resize the picture, click Size in the left pane, and in the right pane, under Size and rotate, enter values into the Height and Width boxes.Under Picture Tools, on the Format tab, in the Size group, click the down arrow under Crop, and then click Crop to Shape. Under Basic Shapes, click Oval (first row, first option from the left).Also under PictureTools, on the Format tab, in the Arrange group, click SendBackward.To reproduce the other shapes on this slide, do the following:Also on the Home tab, in the Drawing group, click Shapes, and then under BasicShapes click Oval (first row). On the slide, drag to draw an oval.Select the oval. Under DrawingsTools, on the Format tab, in the Size group, enter 0.17” in the Height box and 0.17” in the Width box. Also on the Format tab, in the ShapeStyles group, click ShapeFill, and then under ThemeColors, click Black, Text 1, Lighter 25% (fourth row). Also on the Format tab, in the ShapeStyles group, click ShapeOutline, and then click No Line. On the Home tab, in the Drawing group, click Shapes, and then under BasicShapes click Donut.On the slide, drag to draw a donut.Select the donut. Under Drawing Tools, on the Format tab in the Size group, enter 0.25” in the Height box and 0.25” in the Width box.Also on the Format tab, in the ShapeStyles group, click the FormatShape dialog box launcher. In the FormatShape dialog box, click Fill in the left pane, in the Fill pane, click Gradientfill, and then click the button next to Preset colors and click Silver (fifth row). Also in the FormatShape dialog box, click LineColor in the left pane, in the LineColor pane, click No line.Also in the FormatShape dialog box, click 3-DFormat in the left pane, in the 3-DFormat pane, under Bevel, click the button next to Top, and then click Circle (first row).Press and hold CTRL, and then select the freeform shape, the picture, the small circle, and the donut. On the Home tab, in the Drawing group, click Arrange, point to Align, and the do the following:Click Align to Slide.Click Align Center.Click Align Middle.Also on the Home tab, in the Drawing group, click Shapes, and then under BasicShapes click Oval.On the slide, drag to draw an oval.Select the oval. Under DrawingTools, on the Format tab, in the Size group, enter 0.65” in the Height box and 0.65” in the Width box. Also on the Format tab, in the ShapeStyles group, click the FormatShape dialog box launcher. In the FormatShape dialog box, click Fill in the left pane, in the Fill pane, click Picture or texture fill, and then click the button next to Texture and then click Recycled Paper (fourth row). Select the freeform shape. On the Home tab, in the Clipboard group, click Format Painter, and then click the new oval. Position this circle over the top edge of the freeform shape. On the Home tab, in the Drawing group, click Arrange, and then do the following:Under OrderObjects, click Send to Back.Point to Align, and then click Align Center.To reproduce the animation effects on this slide, do the following:Select the picture. On the Animations tab, in the AdvancedAnimation group, click AddAnimation, and then under EmphasisEffects, click Spin.Also on the Animations tab, in the Animation group, click the Show Additional Effects Options dialog box launcher. In the Spin dialog box, on the Effect tab, do the following:In the Smoothstart box, enter 5 sec.In the Smooth end box, enter 5 sec.Also in the Spin dialog box, click the Timing tab, and then do the following:In the Start list, select WithPrevious.In the Duration box, enter 20 sec.Select the small oval at the top edge of the freeform shape. On the Animations tab, in the AdvancedAnimation group, click AddAnimation, under Motion Paths, click Shapes.On the slide, drag the bottom, left, and right sides of the motion path so that it matches the inside edge of the freeform shape.Also on the Animations tab, in the Animation group, click the Show Additional Effects Options dialog box launcher. In the Circle dialog box, on the Effect tab, do the following:In the Smoothstart box, enter 5 sec.In the Smooth end box, enter 5 sec.Also in the Spin dialog box, click the Timing tab, and then do the following:In the Start list, select WithPrevious.In the Duration box, enter 20 sec.To reproduce the background effects on this slide, do the following:On the Design tab, in the Background group, click BackgroundStyles, and then click Style9.
  • Ambulatory –able to walk;not confined to bed
  • Lidocain ppt

    1. 1. THE GOLD STANDARD DRUG PRESENTED BYVANDITA SINGH
    2. 2. Lidocaine Lidocaine, the first amino amide-type local anesthetic, was first synthesized under the name Xylocaine by Swedish chemist Nils Löfgren in 1943. FDA Approved-November 1948
    3. 3. Indications  Rapid acting local anesthetic for procedures ranging from infiltration to regional nerve block  Antiarrhythmic in the treatment of vent. arrhythmias  Treatment of status epilepticus (INVESTIGATIONAL)  Treatment of pain Operative Neuropathic pain
    4. 4. Pharmacology  Half life: 1.6 hrs(~90 min)  Distribution: Lipo-philic, widely distributed into body  pH of plain solution-6.5  pH of vasoconstrictor containing solution-5.0-5.5  Onset of action –rapid  Pregnancy clissification-B  Effective dental concentration-2%  Protein binding: 60-80 %
    5. 5. MAXIMUM RECOMMENDED DOSE  The max. manufactures recommended dose of lidocaine with epinephrine is 7.0mg/kg body weight for adult patient,not to exeed dose of 500mg.  4.4mg/kg body weight dose of lidocaine without a vasoconstrictor
    6. 6. ACTIONS ON CNS ON CVS (i) Blocks conduction around a nerve Heart Anaesthesia (ii) Initially causes drowsiness & lethargy (iii) Higher doses cause excitation followed by depression Abbreviates Effective Refractory Period Blood vessels Vasodilatation in the injected area
    7. 7. MECHANISM OF ACTION  Alters depolarization in neurons by blocking the fast voltage gated sodium (Na+) channels in the cell membrane.  With sufficient blockade, the membrane of the presynaptic neuron will not depolarize and so fail to transmit an action potential, leading to its anaesthetic effects
    8. 8. PHARMACOKINETICS  Absorption: Absorbed rapidly after parenteral administration & from GIT & Respiratory Tract  Metabolism: Metabolized in the liver  Excretion: Metabolites and unchanged drug are excreted by the kidneys in the urine
    9. 9. ROUTES OF ADMINISTRATION  Intravenous injection (sometimes combined with epinephrine)  Dermal patch (sometimes combined with prilocaine)  Nasal instillation/spray (combined with phenylephrine)  Topical gel
    10. 10. DIFFERENT FORMS OF LIDOCAINE 2% WITHOUT VASOCONSTRICTOR (LIDOCAIN PLAIN) Its vasodilating effect limits pulpal anesthesia to only 5-10min. This leads to higher blood levels& increased risk of adverse reaction 2% WITH EPINEPHRINE 1:50,000 2% WITH EPINEPHRINE 1:100,000 The inclusion of epinephrine produces a decrease in blood flow leading to decrease in bleeding at the site of injection. Decreases blood flow . Increases duration of action~60min of pulpal anesthesia. Increased duration-~60min of pulpal anesthesia The duration &depth obtained with both lidocaine-epinephrine solution are equivalent although not the same level of hemostasis.{2%lidocaine with 1:50,000 epinephrine is recommended because it decrease bleeding by 50% as compared with 1:100,000 epinephrene dilution}
    11. 11. Intravenous Lidocaine for Ambulatory Anesthesia Christopher L. Wu, MD ,Inter Anes Research Society,Dec. 2009 Using 1.5–3 mg kg h lidocaine significantly reduced the incidence of nausea and vomiting (32% vs 52%), Marginally reduced pain scores .
    12. 12. ADVERSE EFFECTS
    13. 13. OVERDOSE
    14. 14. CONTRAINDICATIONS
    15. 15. EUTECTIC MIXTURE OF LOCAL ANESTHETICS (EMLA)- LIDOCAINE & PRILOCAINE  Eutectic mixture refers to lowering of melting point of two solids when they are mixed  Lidocaine+Prilocaine at 25oC Oil emulsified into water to form a cream
    16. 16. CLINICAL USES/ INDICATIONS  Dermal anaesthesia, specifically applied to prevent pain associated with intravenous catheter insertion, blood sampling, superficial surgical procedures on intact skin & mucous membranes  Topical anaesthesia for cleansing or debridement of ulcers, to numb the skin before tattooing as well as laser hair removal

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