General anesthetics intravenous agents

HHMC can also be directly activated by agents injected intravenously for therapeutic (general anesthetics, protamine, etc.) or diagnostic purposes (radiocontrast media, etc.), which can cause non-IgE-mediated anaphylactic reactions in vitro [24,... 

Benzodiazepines—including diazepam, lorazepam, and midazolam—are used intravenously in anesthesia (see Chapter 25), often in combination with other agents. Not surprisingly, benzodiazepines given in large doses as adjuncts to general anesthetics may contribute to a persistent postanesthetic respiratory depression. This is probably related to their relatively long half-lives and the formation of active metabolites. However, such depressant actions of the benzodiazepines are usually reversible with flumazenil. 

Table 22-2 summarizes several other important clinical uses of drugs in the sedative-hypnotic class. Drugs used in the management of seizure disorders and as intravenous agents in anesthesia are discussed in Chapter 24 Antiseizure Drugs and Chapter 25 General Anesthetics. 

General anesthetic agents can be broadly categorized as those useful by the inhalation route and those ascful by the intravenous (IV) route. These arc dictated by the physical state of the agents. 

The general anesthetics are classified as either inhalational or intravenous. The inhalational anesthetic agents include ... 

Ensuring an adequate depth of anesthesia depends on achieving a therapeutic concentration of the anesthetic in the CNS. The rate at which an effective brain concentration is achieved (ie, time to induction of general anesthesia) depends on multiple pharmacokinetic factors that influence the brain uptake and tissue distribution of the anesthetic agent. The pharmacokinetic properties of the intravenous anesthetics (Table 25-1) and the physicochemical properties of the inhaled agents (Table 25-2) directly influence the pharmacodynamic effects of these drugs. These factors also influence the rate of recovery when the administration of anesthetic is discontinued. 

Propofol is a short-acting intravenous induction agent, which is dissolved in a mixture of long-chain triglycerides and soya bean emulsion. It is now in general use in daycare anesthesia and is being increasingly used in infusions in intensive care units. Recovery from anesthetic doses compares favorably with that after enflurane and isoflurane (1). 

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