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Remifentanyl Vs Fentanyl
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Analgesics
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Effects of the sudden and sustained increase in LV Afterload
Dr Swapnil Pawar -
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Remifentanyl Vs Fentanyl Dr Swapnil Pawar
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Empiric Antimicrobials used in Hospital Dr Swapnil Pawar
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Analgesics Dr Swapnil Pawar
Latest Podcast
Empiric Antimicrobials used in Hospital
Emiric Antimicrobials in Hospital Written by – Dr Andrew Lam Penicillins MoA: Beta lactam ring binds to Penicillin Binding Protein (PBP) on cell walls. As a result, they prevent cross-linking and cell wall synthesis leading to cell death Benzylpenicillin – Narrow Spectrum: Streptococcus, Listeria, Syphilis Flucloxacillin – MSSA Addition of further beta lactam inhibitors helps to broaden spectrum of activity: Amoxicillin + Clavulanate (Augmentin) Piperacillin + Tazobactam (Tazocin) Cephalosporins MoA: As per penicillins, but altered beta lactam ring confers resistance to some beta lactamases Cefazolin – Mostly gram positive cover, some gram negative cover -> used for skin infections and […]
Analgesics
Analgesics Written by Dr Andrew Lam ParacetamolMoA: COX inhibition preventing prostaglandin synthesis Prevention of re-uptake of endocannabinoids Enhancement of inhibitory serotonergic pathways Side Effects: Generally well tolerated. Hepatotoxicity in overdose, hypotension with IV administration NSAID’s Non-Selective (i.e. Ibuprofen) MoA: Inhibition of COX 2 +/- COX 1 to decrease prostaglandin synthesis and hence, pain transmission Side Effects: Renal dysfunction, GI ulceration/bleeding, and platelet dysfunction COX-2 Selective (i.e. Celecoxib) MoA: Selective inhibition of COX 2 to decrease prostaglandin synthesis and hence, pain transmission Side Effects: Myocardial infarction, stroke, renal dysfunction Opioids MoA: Primarily μ GPCR agonistic activity but also has some weak […]
ICU Fellowship Snippet – Type 1 Respiratory failure in immunocompramised patient
Written by Dr Madhuri Anupindi 42M admitted to ICU day 4 post induction chemotherapy for APML. The patient was initially treated with idarubicin and all-trans retinoic acid (ATRA). He has become progressively more dyspnoeac in the ward. CXR demonstrates a bilateral, diffuse pulmonary infiltrate. Initial exam reveals RR 40, sats 88% on 10L via face mask, GCS 14 (E4V4M6), temp 38.9, Hr 144, BP 95/50. Full blood count on admission shows Hb 88 WCC 26 and platelets 22 with blasts visible. INR 3.2. Suggest a differential diagnosis. There are multiple potential causes for this gentleman’s respiratory failure, both infective (of […]
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