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i.v anaesthetics [Compatibility Mode]

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24 views16 pages

i.v anaesthetics [Compatibility Mode]

Uploaded by

olivermugambim
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd
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INTRAVENOUS ANAESTHETICS

DR MWANGI CAROLINE
• Aims of general anesthesia???
• Analgesia
• Amnesia (anterograde as opposed to
retrograde)
• Loss of consciousness
• Muscle relaxation/decrease in muscle tone
Qualities of the ideal intravenous
anaesthetic agent?
• Rapid and smooth onset of action
• Short duration of action
• Antiemetic , free from ‘hangover’( headache,
dizziness)
• Ability to decrease cerebral blood flow,
cerebral metabolism, intracranial pressure
and intra-ocular pressure (IOP).
• Minimal cardio-respiratory depression

• Minimal risk of histamine release, allergic


reaction or anaphylaxis.

• Drug compatibility and stability in solution

• Rapid metabolism into inactive metabolites


• Pain-free on injection and

• No tissue necrosis on extravasation(diazepam


commonly causes this)

• High potency (steep dose-response


relationship) with minimal accumulation.
How do intravenous anesthetics act?
• Interaction with gamma aminobutyric acid
(GABA) -an inhibitory neurotransmitter
system
• Interaction with NMDA (N-Methyl-D-
Aspartate) an excitatory neurotransmitter
system.
Classification ?
• Barbiturates: thiopentone, methohexitone,
thiamylal etc.
• Phenol derivatives: propofol
• Imidazole derivatives: etomidate
• Phencyclidine derivatives: ketamine
• Benzodiazepines: diazepam, midazolam,
lorazepam
• Steroids – althesin, eltanolone
• Narcotics – fentanyl, alfentanil, sufentanil,
remifentanil, pethidine, morphine.
• Eugenols – propanidid (sometimes classified as a
steroid)
Clinical Uses of Intravenous
Anaesthetic Agents
• Induction of G.A
• Total Intravenous Anaesthesia
• Monitored Anesthesia Care
• Sedation
• Treatment of status epilepticus
• Neuroleptanalgesia-State of
quiescence,altered awareness,and analgesia
Comparative Pharmacology
Ketamine Vs Thiopental Vs Propofol
- Classification
-Physical properties
-Site of action
-Mechanism of action
-Metabolism
Systemic effects
• Cardiovascular
• Respiratory system
• CNS
QUESTIONS?

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