Anesthesia, parenteral

Aminopyrine, 234 Aminotetradine, 265 2-Aminothiazole, 247 2-Aminothiazole synthesis, 126 Amisotetradine, 266 Amobarbital, 268 Amopyroquine, 342 Amoxycillin, 414 Amphetamine, 37, 70 Ampicillin, 413 Amprolium, 264 Amytriptylene, 141, 404 Anabolic effects, 169 Androgens, discovery, 155 Androstanolone, 173 Androstenedione, 158, 176 Anesthesia, parenteral, 56 Angst, 363 Anileridine, 300 Aniline, metabolism. 111 Anisindandione, 147 Anovlar , 186 Antagonists, 20, 65 Antazoline, 242 Antibodies, 41... 

Lidocaine Blockade of sodium channels Slows, then blocks action potential propagation Short-duration procedures epidural, spinal anesthesia Parenteral duration 30-60 min 2-6 h with epinephrine Toxicity CNS excitation... 

The answer is c. (Hardman, p 323.) Induction of anesthesia by parenteral administration of thiopental sodium and other barbiturates is... 

Parenteral - For preoperative medication, support of anesthesia and obstetrical analgesia. 

OXYMORPHONE HYDROCHLORIDE Relief of moderate to severe pain. Parenterally for preoperative medication, support of anesthesia, obstetrical analgesia, and for relief of anxiety in patients with dyspnea associated with pulmonary edema secondary to acute left ventricular dysfunction. 

Parenteral For preoperative or preanesthetic medication supplement to surgical anesthesia. 

Parenteral Immediately before induction of anesthesia, or postoperatively if the patient experiences nausea or vomiting shortly after surgery, administer 4 mg undiluted IV in not less than 30 seconds, preferably over 2 to 5 minutes. Alternatively, 4 mg undiluted may be administered IM as a single injection in adults. In patients who do not achieve adequate control, administration of a second IV dose of 4 mg ondansetron postoperatively does not provide additional control of nausea and vomiting. 

The neurotoxicity of streptomycin can result in respiratory paralysis from neuromuscular blockage, especially when the drug is given soon after the use of anesthesia or muscle relaxants. Reserve the administration of streptomycin in parenteral form for patients where adequate laboratory and audiometric testing facilities are available during therapy. 

Amide-type agents include articaine, lidocaine, bupivacaine, prilocaine, mepivacain and ropiva-caine. These are metabolized in the liver by microsomal enzymes with amidase activity. The amide group is preferred for parenteral and local use. If by accident rapidly administered intravascularly these agents, especially bupivacaine but also lidocaine, can produce serious and potentially lethal adverse effects including convulsions and cardiac arrest. They can more easily accumulate after multiple administrations. Intravenous lidocaine is sometimes used for regional anesthesia, for infiltration procedures, for the induction of nerve blockade and for epidural anesthesia. However, it is also used as an antiarrhythmic. Bupivacaine is a long-acting local anesthetic used for peripheral nerve blocks and epidural anesthesia. 

Midazolam (Versed), diazepam (Valium), and lo-razepam (Ativan) are benzodiazepine derivatives that are useful in anesthesia. Midazolam is the most popular of these agents for the induction of anesthesia. Its popularity is related to its aqueous solubility and to its short duration of action, which permits a prompt return of psychomotor competence. Unlike midazolam, lor-azepam and diazepam are not water soluble and must be formulated in propylene glycol the latter is irritating to the vasculature on parenteral administration. 

Diazepam, lorazepam, and midazolam are used for preanesthetic medication and as adjuvants during surgical procedures performed under local anesthesia. As a result of their sedative, anxiolytic, and amnestic properties, and their ability to control acute agitation, these compounds are considered to be the drugs of choice for premedication. (The basic pharmacology of benzodiazepines is discussed in Chapter 22.) Diazepam and lorazepam are not water-soluble, and their intravenous use necessitates nonaqueous vehicles, which cause pain and local irritation. Midazolam is water-soluble and is the benzodiazepine of choice for parenteral administration. It is important that the drug becomes lipid-soluble at physiologic pH and can readily cross the blood-brain barrier to produce its central effects. 

Parenteral powder to reconstitute 20, 25 mg/mL for IV injection See Chapter 31 for formulations of opioid agents used in anesthesia. 

Parenteral 1% for injection 0.2, 0.3% with 6% dextrose for spinal anesthesia... 

The lungs are important for the excretion of volatile drugs. As a result of reduced respiratory capacity (Figure 60-1) and the increased incidence of active pulmonary disease in the elderly, the use of inhalation anesthesia is less common and parenteral agents more common in this age group. (See Chapter 25.)... 

MeO-pyr-T, we are far away from any vocabulary of psychedelics. How is it different from, say, what one might expect from a Fentanyl analogue Here is a collection of trials that describe parenteral administration, and the quick development of an anesthesia. This compound may not be the new Fentanyl because of the nausea during what would be the recovery period. But what are the chances that, perhaps not with this compound, but with any of the obvious analogues that are screaming to be assayed, there just might be a useful clinical tool ... 

Dosages and routes of administration Alfentanil is only used parenterally. Because of strong respiratory depression administration under spontaneous respiration has to be confined to a dose range up to 200 pg/h. Higher doses as used in anesthesia need assisted ventilation. 

Dosages and routes of administration Sufentanil is mostly given parenterally as an intravenous bolus or as brief injection or infusion during anesthesia. For pain treatment, intravenous or epidural on-demand procedures are in use. Doses up to 8 pg/kg are adequate for pain treatment and higher doses up to 30 pg/kg for surgery (Grass, 1992). 

Subcutaneous. Injecting medications directly beneath the skin is used when a local response is desired, such as in certain situations requiring local anesthesia. Also, a slower, more prolonged release of the medication into the systemic circulation can be achieved in situations where this is the desired effect. A primary example is insulin injection in a patient with diabetes mellitus. Subcutaneous administration provides a relatively easy route of parenteral injection that can be performed by patients themselves, providing they are properly trained. 

DOT CLASSIFICATION Forbidden SAFETY PROFILE A human poison by ingestion and possibly other routes. Poison experimentally by ingestion, intraperitoneal, intravenous, subcutaneous, and parenteral routes. Human central nervous system effects by ingestion and possibly other routes general anesthesia, hallucinations or distorted perceptions, and convulsions. An eye irritant. A widely abused, controlled substance. Abuse leads to habituation or addiction. In medicine, it is used as a local narcotic anesthetic applied topically to mucous membranes. The free base is soluble... 

In 40 patients undergoing prostatectomy with spinal anesthesia with lidocaine 5 % (75 mg) intrathecally, either alone or co-administered with pethidine 0.15 or 0.30 mg/ kg, the higher dose of pethidine reduced the requirement for parenteral analgesics with a non-significant incidence of pethidine-related adverse effects (22). 

In patients taking oral or parenteral tetracyclines who undergo methoxyflurane anesthesia, renal insufficiency and oxalate crystal formation in renal tissue was attributed to an interaction between these drugs (185-187). Tetracyclines are therefore not recommended preoperatively. 

Parenteral products containing up to 50% of alcohol (ethanol 95 or 96% v/v) have been formulated. However, such concentrations can produce pain on intramuscular injection and lower concentrations such as 5-10% v/v are preferred. Subcutaneous injection of alcohol (ethanol 95% v/v) similarly causes considerable pain followed by anesthesia. If injections are made close to nerves, neuritis and nerve degeneration may occur. This effect is used therapeutically to cause anesthesia in cases of severe pain, although the practice of using alcohol in nerve blocks is controversial. Doses of 1 mL of absolute alcohol have been used for this purpose. ... 

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