Therapeutically anesthetics

B. Ketamine. Usual therapeutic anesthetic doses are 1-5 mg/kg IV or 5-10 mg/kg IM. Recreational doses range from 10 to 250 mg nasally, 40 to 450 mg orally or rectally, and 10 to 100 mg IM. The higher recreational doses are purported to achieve a psychic state called the K-hole. ... 

AHopregnanolone and similar A-ring-reduced pregnanes potentiate GABA effects at these receptors. These steroids mimic the effects of the benzodiazepines, changing chloride ion conductance and producing sedative and hypnotic behavioral effects (276,277). Neuroactive steroids can be therapeutically useful as anticonvulsants, anxiolytics, or anesthetics (qv) (see also Hypnotics, sedatives, anticonvulsants, and anxiolytics). 

Morphine has certain undesirable side effects. Among these are respiratory depression, nausea, and vomiting, depression of the cough reflex, cardiovascular depression and hypotension, smooth muscle contraction (constipation), and histamine release (93). Morphine s onset of action, duration, and low therapeutic indices have prompted a search for a more effective opiate iv anesthetic. Extreme simplification of the complex morphine molecule has resulted in anilido —piperidines, the fentanyl class of extremely potent opiate iv anesthetics (118,119). 

Procainamide. Procainamide hydrochloride is a ben2amide, synthesized to prolong the therapeutic effects of the local anesthetic procaine [59-46-1] (13) (see Anesthetics). The dmg is effective in a wide range of supraventricular and ventricular arrhythmias (14). 

Propranolol. Propranolol hydrochloride, considered the prototype of the P-adrenoceptor blocking agents, has been in use since 1964. It is a nonselective, highly Hpid-soluble P-adrenoceptor blocker having no ISA. It is a mixture of (+) and (—) enantiomers, and the (—) enantiomer is the active moiety. The local anesthetic effects of propranolol are equipotent to those of Hdocaine [137-58-6] C 4H22N20, (see Anesthetics). Therapeutic effects include termination of catecholamine-induced arrhythmias, conversion of SA nodal tachycardias (including flutter and fibrillation) and AV nodal tachyarrhythmias to normal sinus rhythm, digitahs-induced arrhythmias, and ventricular arrhythmias (1,2). The dmg also has cardioprotective properties (37,39). 

Therapeutic Function Local anesthetic Chemical Name dl-1-butyl-2, 6 -pipecoloxylidide Common Name —... 

Therapeutic Function Inhalation anesthetic Chemical Name (2,2,2-trlfluoroethoxy)ethene Common Name 2,2,2-trifluoroethyl vinyl ether Structural Formula CF3CH20CH=CH2 Chemical Abstracts Registry No. 406-90-6... 

Therapeutic Function Inhalation anesthetic Chemical Name 2-bromo-2-chloro-1,1,1-trifluoroethane Common Name —... 

Therapeutic Function Local anesthetic, antiarrhythmic Chemical Name 2-(diethylamino)-N-(2,6-dimethylphenyl)acetamide Common Name Lignocaine... 

Price HE, Dripps RD General anesthetics, in The Pharmacological Basis of Therapeutics, 3th Edition. Edited by Goodman LS, Gilman A. New York, Macmillan, 1975, pp 88-96... 

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,... 

Examples abound regarding the role of serendipity in the discovery of new therapeutic approaches, which on closer examination usually turned out to be the result of clinicians paying attention to unexpected clinical effects rather than discounting them. For example, lithium was tried first for hypertension, chlorpro-mazine was initially developed as an anesthetic, and imipramine was originally regarded as an antihistamine and an antipsychotic agent. Without astute clinical observations, these drugs would not have found their niche, nor would clozapine have been revived for the benefit of millions of the most difficult to treat schizophrenic patients. Other examples include the expanded indications of newer... 

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