FUROSEMIDE , THIAZIDES & NSAIDs : A FEW FACTS

Furosemide is a loop diuretic

It interferes with the concentrating capacity of the loop of Henle.

It is effective in patients with renal dysfunction, whereas the thiazides are NOT.

It potentiates the nephrotoxic effects of cephalosporins and the ototoxic effects of aminoglycosides.

NSAIDs inhibit renal prostaglandin, causing sodium to be retained, which reduces the diuresis caused by furosemide.

Furosemide is a venous and arteriolar dilator and thus reduces both preload and afterload in a time frame just before the period of onset of a significant diuresis.

DEXAMETHASONE AS AN ANTIEMETIC; THINGS TO BE KEPT IN MIND

Dexamethasone is an extremely effective antiemetic for children.

Usually a one-off dose of 4 mg is given.

This single dose has not been shown to produce significant adverse effects such as immunosuppression and poor wound healing.

Has rescue antiemetic properties

Most effective if given early on in the operation.

An awake patient may complain of an uncomfortable sensation of perineal warmth, when dexamethasone is given

CELLULAR METABOLISM : A FEW NUMBERS

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IMPORTANT FACTORS THAT AFFECT DRUG METABOLISM IN THE ELDERLY

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Antibiotics for infections by Elizabethkingia meningosepticum

Cotrimoxazole
Ciprofloxacin
Rifampin
Minocycline
Novobiocin
Vancomycin (problem is it’s high MIC)

ETOMIDATE BASED ANESTHESIA- FACTS

Etomidate is an imidazole derivative

It has higher incidence of PONV than other induction agents

It causes pain on injection

A potential for triggering porphyric crisis, has been described

The REVERSIBLE BLOCKADE of the adrenocortical enzymes 11β -hydroxylase and 17α-hydroxylase, reduces BOTH corticosteroid and mineralocorticoid synthesis and the effect LASTS FOR 3–6 hours after a bolus dose.

The effect of a bolus of etomidate is terminated by redistribution of drug to peripheral tissues

The standard dose for induction of anaesthesia is 0.3 mg/ kg

VASOACTIVE AGENTS; DO YOU KNOW?

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