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Anaesthesia pharmacology - Coggle Diagram

- - - - Most widely used IV anaesthetic
      - Not commonly used on neonates
      - MOA: potentiates the inhibitory transmitters glycine and GABA which enhance spinal inhibition
      - Dose
        
        onset: 30 - 60 seconds
        
        Induction: 1.5 - 2.5 mg/kg at rate of 20-40 per 10 seconds till response
        
        Maintenence: 4 - 12 mg/kg/hr
      - Indication
        
        sedation
        
        status epilepticus
        
        Induction + maintenance of general anaesthesia
        
        N+ V treatment in chemo
      - Adverse events
        
        negative intropy
        
        hypotension
        
        bradycardia
        
        propofol infusion syndrome
        
        apnoea
        
        pain on injection
        
        hypertriglyceridemia
    - - MOA: prolong GABA receptor opening duration and can cause direct activation of the channel
      - Indications
        
        Induction of anaesthesia
        
        treatment of status epilepticus
        
        neuroprotection
      - Dose
        
        3 - 7 mg/kg
        
        PR: 1g per 22kg body weight
        
        IV or PR
      - barbituate: hypnotic and anticonvulsant
      - Adverse effects:
        
        metabolism slow
        
        seditive effects can persisit for 24 hours
        
        recovery much slower
      - can be used for short procedures or induction phase of anaesthesia - single dose for around 10 - 15 mins
    - - Dose
        
        IV only
        
        150 - 300 mcg/kg over 30 - 60 seconds
      - MOA: hypnotic agent that is a GABA agonist
      - Adverse effects
        
        can inhibit a patients ability to form stress response
        
        pain on injection
        
        PONV
      - Used for short operative procedures such as dislocated joints,tracheal intubation
    - - MOA: NMDA receptor antagonist: interacts with opioid receptors (mu,delta and kappa) and partial antagonist on muscarinic receptors
      - Indications
        
        procedural sedation
        
        analgesia - pre-operative and chronic pain
        
        induction of anaesthesia and emergency intubation
        
        severe unresponsive asthma (bronchodilator)
        
        refractory status epilepticus
      - Dose
        
        IV - 2mg/kg (30 sec onset)
        
        IM - 10mg/kg (6 min onset)
        
        IV, IM, or PO, extradural, intrethcal, rectal or nasal
        
        analgesic dose 0.1 - 0.3mg/kg
      - Adverse effects
        
        increasing ICP
        
        PONV
        
        salivation
        
        emergence delirium
  - - - Desflurane is a rapid acting volatile liquid anaesthetic; it is reported to have about one-fifth the potency of isoflurane. Emergence and recovery from anaesthesia are particularly rapid because of its low solubility. Desflurane is not recommended for induction of anaesthesia as it is irritant to the upper respiratory tract.
    - - Desflurane is a rapid acting volatile liquid anaesthetic; it is reported to have about one-fifth the potency of isoflurane. Emergence and recovery from anaesthesia are particularly rapid because of its low solubility. Desflurane is not recommended for induction of anaesthesia as it is irritant to the upper respiratory tract.
    - - volotile, halogenated ether anethetic for induction and maintence
      - not commonly inhaled due to pungent odor
      - MOA: enhances inhibitory neurotransmitters (mainly via GABA and glycine), inhibitiing excitory pathways (NMDA) and modulating channels to cause widespread CNS depression