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Intravenous Anesthetics – Anesthetic Drugs

by Pravin Shukle, MD
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    Treatment strategies. We talked about the gases and the volatile liquids, let's now move on to the intravenous agents. We have barbiturates like thiopental, and dissociatives. We have opioids and benzodiazepines. And we have the miscellaneous agents. Let's talk about barbiturates. So, barbiturates include thiopental and others. They are highly lipid soluble. They enter the brain very quickly. And they act through the GABA A receptor. It may decrease circulatory blood flow as well. So that is nice because you can decrease intracranial pressures. So, in cases of head injury or where you're worried about high intracranial pressures, this is a good choice of medication. You can see here how quickly this drug is moving from each of the different tissue compartments. Remember that benzodiazepines and barbiturates work through the GABA A receptor, I keep showing this to you all the time because it's such a beautiful illustration. Midazolam is one of the most commonly used benzodiazepine. It has a slower onset than thiopental. Flumazenil may be used to reverse excess sedation or dosing due to the benzodiazepine. Remember that flumazenil does not reverse barbiturates. The next category of drugs are the dissociatives drugs. Dissociative anesthesia generally involves a conscious patient. It causes marked analgesia and amnesia. These are actually quite fun to view in the operating room because you can have some great conversations with your patients as you're going through surgery. Ketamine is the prototypical agent. It is a cardiovascular stimulant and it may increase intracranial pressure so there are some select patients that we don't want to use this medication on. It is associated with some very interesting postoperative emergence issues, patient are often quite disoriented. They can be quite excitable and they can have hallucinations. Once again, the nurses love these patients because of some really...

    About the Lecture

    The lecture Intravenous Anesthetics – Anesthetic Drugs by Pravin Shukle, MD is from the course CNS - Pharmacology. It contains the following chapters:

    • Barbiturates
    • Benzodiazepenes
    • Dissassociatives
    • Propofol

    Included Quiz Questions

    1. Toxicity is easily treated
    2. Highly lipid soluble
    3. Enters brain quickly
    4. Decreases circulatory blood flow
    5. Acts at GABA receptor
    1. Priapism
    2. Hallucination
    3. Disorientation
    4. Excitation
    5. Cardiovascular stimulation
    1. Propohol
    2. Ketamine
    3. Phenobarbital
    4. Midazolam
    5. Flumazenil

    Author of lecture Intravenous Anesthetics – Anesthetic Drugs

     Pravin Shukle, MD

    Pravin Shukle, MD


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