GENERAL APPROACH Emergency or Elective End-organ damage Complications– brain injury– spinal cord ischaemia– ileus– MI– lower limb ischaemia– compartment syndromes– renal injury INTRODUCTION CUBICLE dialysis INFUSIONS vasoactives fluid boluses sedation analgesia transpyloric feeding: ileus, ischaemia TPN VENTILATOR mode level of…
Clopidogrel: anti-platelet agent; inhibition of the ADP platelet receptor and subsequent ADP-mediated activation of the glycoprotein IIb/IIIa complex -> inhibits platelet aggregation
Selective COX-2 inhibitors developed to try and inhibit prostacyclin synthesis by the COX-2 isoenzyme induced at sites of inflammation without affecting the action of the constitutively active COX-1 isoenzyme found in gastic mucosa, platelets & kidney.
Delivery of Beta-2-Agonists in Intubated Patients. Need to consider: dose; side effect profile; effectiveness; cost
Dexmedetomidine: alpha 2 agonist; sedoanalgesia;
Dipyridamole: anti-platelet + vasodilator. Potentiates the effect of prostacyclin or by inhibiting phosphodiesterase enzyme activity -> increase intracellular cAMP; inhibits cellular uptake of adenosine -> more available to act on coronary vessels -> vasodilation
OVERVIEW RISK FACTORS CAUSES Anaesthetic Surgical INVESTIGATIONS MANAGEMENT Resuscitate Electrolytes and Acid-base Specific Therapy Underlying Cause References and Links
Posterior reversible encephalopathy syndrome (PRES) is a syndrome of 'cephalgia, convulsions, confusion, and vision loss' (CCCV) typically in the context of severe hypertension
Dobutamine: synthetic isoprenaline derivative; adrenergic agonist; racemic mixture: -> inotropy with some vasodilation
Dopamine: naturally occurring catecholamine; dopamine and adrenoreceptor agonist; immediate precursor to noradrenaline
Epidural Complications: Catheter related; or drug related
Flumazenil: benzodiazepine antagonist; competitive antagonist that act on the benzodiazepine receptor