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Premedications (a2 Agonists (Features (Sedation, Analgesia, Muscle…
Premedications
a2 Agonists
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MOA
Binds pre-synaptic a2 receptors, causing negative feedback loop of NAdr.
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Diazepam
Features
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Little CVS effects, good for geriatrics and neonates
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Opioids
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MOA
Bind to mu, kappa and delta receptors.
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Ketamine
MOA
Noncompetitive antagonist at the NMDA receptor, preventing glutamate (excitatory NT) from binding.
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Produces cataleptic, dissociated state.
Features
Palpebral, pharyngeal/laryngeal reflexes intact
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CVS well maintained, may have indirect sympathomimetic action, increasing HR
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2-5 mg/kg IV, IM, SC, sublingual
Induction Agents
Propofol
Suspended in glycerol, egg phosphatide, soya bean oil. Milky white emulsion.
MOA
Prevents GABA from dissociating from its receptors, thereby inhibiting postsynaptic neurons
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Phenol 2,6- diisopropylphenol
Alfaxalone
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MOA
Binds to GABA receptors, increases Ca influx into cells, causing hyperpolarisation and inhibiting neural impulses.
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Features
Causes respiratory depression, requires ventilatory support
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Non-linear pharmoacokinetics, elimination variable
No drug interactions, safe
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Barbituates
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Thiopentone
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Short acting, DOA 10-15 min
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