Month January 2019
CCC Critical Care compendium 340

Morphine

Morphine: opioid analgesic; mu and kappa receptor agonist; increase intracellular Ca2+ -> increased K+ conductance -> hyperpolarisation of excitable cell membranes -> decrease in pre & post synaptic responses; reversed by naloxone

CCC Critical Care compendium 340

N-acetylcysteine

N-acetylcysteine (NAC): glutathione supplementation ? protects the liver by maintaining and restoring glutathione levels or by acting as an alternate substrate for conjugation with -> detoxification of reactive metabolites.

CCC Critical Care compendium 340

Naloxone

Naloxone: opioid receptor antagonist; competitive antagonism at mu, kappa and delta receptors -> prevention of binding to endogenous and exogenous opiate receptors.

CCC Critical Care compendium 340

Noradrenaline

Noradrenaline (norepinephrine) hypotension refractory to fluid resuscitation (primarily distributive shock such as septic shock, neurogenic shock, post-bypass vasoplegia and drug-induced)

CCC Critical Care compendium 340

NSAIDs

NSAIDS: Nonsteroidal anti-inflammatory drugs; non-selective COX inhibitors

CCC Critical Care compendium 340

Octreotide

Octreotide: somatostatin analogue; reduces portal hypertension; antidote to sulfonylureas; reduces GI secretions

CCC Critical Care compendium 340

Omeprazole

Omeprazole: proton pump inhibitor; inhibits Na-H+ exchanger in parietal cell membrane

CCC Critical Care compendium 340

Opioids

An opioid is any psychoactive chemical that resembles opiates in their pharmacological effects by binding opioid receptors. They may be endogenous or exogenous compounds, and may be naturally occurring or synthetic

CCC Critical Care compendium 340

Paracetamol

Paracetamol (acetaminophen): simple analgesic and antipyretic - not an NSAID as it lacks significant anti-inflammatory effects

CCC Critical Care compendium 340

Physostigmine

Physostigmine: anticholinesterase; inhibition of anticholinesterase -> increase in cholinergic tone

CCC Critical Care compendium 340

Quorum sensing

Quorum sensing is the capacity of micro-organisms to detect extracellular, small-molecule signals and to alter gene expression in response to microbial population densities