.......................................... 2 Local Anaesthetics .............................................................................. 3 Side Effects.......................................................................................... 3 Pharmacodynamics ............................................................................. 4 Pharmacokinetics ................................................................................ 5 Legal Aspects ...................................................................................... 6 Conclusion .......................................................................................... 6 References .......................................................................................... 7 Table 1. Effects of CNS depression associated with increasing plasma concentrations of lidocaine................................................................. 4 1 Summary This report discusses the intended uses and advantages of two types of analgesic drugs, opioids and local anaesthetics. The severity of the side effects for each category of analgesia are assessed. Methadone is an opioid that is regularly used in veterinary medicine, the pharmacodynamics and pharmacokinetics of this opioid are compared against that of the common local anaesthetic, lidocaine. Opioids are classed as either schedule 2, 3 or 5 controlled drugs, due to the potential for abuse. Local anaesthetics are only classed as POM-VPS medicines and have a...
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...about a critical incident that happenned during my practice as an anaesthetic nurse trainee, based on the Gibbs reflective model (1988), which is the model that suits better in health-care settings. This critical incident fits perfectly on the description made by Benner (1984) in a way that promotes the nursing care with a substancially difference on the patient outcome. In accordance with the 2015 Nursing and Midwifery Council, confidentiality has been maintained with the use of pseudonyms. Description: This scenario referes to a 27 years old female patient, who required surgery for multiple teeth extraction under general anaesthesia. On arrival, Mrs. Jo asked for all the needles...
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...S DR. NICHOLAS BURNS, DDS w 907D07 Eleni Mitsis prepared this case under the supervision of Professor John Haywood-Farmer solely to provide material for class discussion. The authors do not intend to illustrate either effective or ineffective handling of a managerial situation. The authors might have disguised certain names and other identifying information to protect confidentiality. Ivey Management Services prohibits any form of reproduction, storage or transmittal of this material without its written permission. Reproduction of this material is not covered under authorization by any reproduction rights organization. To order copies or request permission to reproduce materials, contact Ivey Publishing, Ivey Management Services, c/o Richard Ivey School of Business, The University of Western Ontario, London, Ontario, Canada, N6A 3K7; phone (519) 661-3208; fax (519) 661-3882; e-mail cases@ivey.uwo.ca. Copyright © 2007, Ivey Management Services Version: (A) 2007-03-12 One Friday afternoon in September 2005, Dr. Nicholas Burns, a sole practitioner dentist from Busby, Ontario, was driving home from a continuing education course on gum disease. At the course, he had overheard two dentists discussing Waterlase®, the new dental laser that allowed dentists to perform dental treatments without anaesthesia. One of the two was purchasing this technology. Burns had seen an increasing number of journal articles about the laser in recent years. Although he had wondered whether he...
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...supplies an active and vast floor zone for medicinal absorption. The large floor field of the anal canal and lower rectum is additionally porous to non-ionized drugs. Suppositories formulations are accessible within the assortment of more than a few ingredients to provide retention and bring down complications. Suppositories are available in different configurations and dimensions, which encourages their insertion and maintenance within the rectal cavity. Adult rectal suppositories weigh somewhere around one or two grammes while those for children are about half that weight. They're available with varieties of compositions either in separate or mixed formulations. The traditionally utilised ones include-- Suppositories containing local anaesthetics...
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...Checking of an anaesthetic machine prior to use. On the morning of this particular learning experience I had already pre-informed the student of the event so we could start promptly. The student arrived on time as I did. We went straight to the operating theatre where we were going to be working for the day. On arriving in that theatre I discovered it had been used prior and was left in an untidy state so I had to tidy it up before we could proceed. Had I have thought before hand I could have checked the day before to ensure this was not the case. I started by showing the student the anaesthetic machine we were going to use, explained the different parts and how they function. The student looked a bit perplexed at the terminology I used so I tried more simple terminology and explanations and that seemed to help. After the brief explanation of how the anaesthetic machine worked I described The checks we were going to carry out. I showed the student the 2012 guide to checking the machine produced by the College of Anaesthetists which is the one we currently use. We started to check the machine going through the guide step by step as described. It took quiet a while to complete the check. Afterwards I asked the student if they followed what we had done, the student commented it was a bit too much to go through in one session. I think looking back that I should have broken down the process into perhaps two or more sessions allowing the student time to take in and question...
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...context. | | |People, patients or population - who are you asking the question about? | |Intervention - what intervention are you interested in? | |Control or comparison - what are you comparing the intervention to? | |Outcome - what outcome are you interested in measuring? | Table 1: PICO criterion People or population of personal interest means the intended study subjects, for example, Post qualifying nursing students studying Anaesthetic Practice. Intervention generally means the aspect of the people or population that is the main...
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...Immediate Post Operative Care 2 The following essay will use a systematic approach to critically evaluate the care and treatment delivered to a non-elective paediatric orthopaedic patient within the Post Anaesthetic Care Unit (PACU) by a student Operating Department Practitioner at a local trust hospital. The assessment and management of the patients care will be examined and rationale provided for strategies employed during delivery of individualised patient care. In accordance with Health and Care Professional Council’s standards of conduct, performance and ethics (HCPC, 2012) the confidentiality of the service user will be up held at all times. The service user shall be referred to as “Daisy” to protect her confidentiality. Daisy was received to the PACU after surgical stabilisation of her left fibula and tibia with flexible intramedullary nails following a fall. A specified paediatric bay was utilised enabling the patient to be cared for separately from the adults in the PACU (RCOA, 2013). Anaesthetic and surgical handover was received (RCOA, 2013) which detailed that she was 14 years old with no known allergies. She had no significant medical history. She had a general anaesthetic with 140mfg of Propofol used on induction followed by Sevoflurane as a maintenance agent. 30mg of Atricurium, 4mg Dexamethasone, 4mg Ondansatron, 10mg Morphine and 1g Paracetemol had been administered intraoperatively. 1 litre of Hartmanns solution had been administered during surgery and...
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...| | Prepared by: SHRUTI GULATI | | | | | | DEXELEX To assess the existing clinical practice of INTENSIVISTS & ANAESTHESIOLOGISTS for the management of sedation and analgesia while taken into consideration “dexmedetomidine” ACKNOWLEDGEMENT I would like to express my sincere gratitude towards RANBAXY Laboratories Limited, Mumbai for selecting me as a summer trainee and giving me an opportunity to work on this project and also for providing a good working ambience for successful completion of this project. I also thank the MARKETING RESEARCH TEAM for giving me an opportunity to conduct market research for DEXELEX belonging to INTENSIVA division of RANBAXY. I would like to express my special gratitude towards my guide Mr. Shoreb Khanduri, who throughout my project has been teacher and supporter for me showing me the right direction during my project. I am highly grateful to all summer interns and friends for their support and cooperation, owing to which I have successfully completed and compiled this report Last but not least, I would like to express my sincere thanks to my institute NIPER for providing me all kind of support in my summer project placement at RANBAXY Laboratories Limited. Shruti Gulati Certificate This is to certify that the dissertation submitted in partial fulfillment for the degree of M.B.A. in Pharmaceutical Management of National Institute of Pharmaceutical Education and Research (NIPER) is a result of the bonafide research work...
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...ASSIGNMENT GUIDANCE – NRSG258 ASSESSMENT 1: CASE STUDY Dear students here are some guidelines to assist you in writing Assessment 1: Case Study. If, after reading through these, you still have questions please post on the relevant forum. If you are still unsure then please contact your campus specific lecturer to arrange to discuss your assignment. We ask that you bring these guidelines to any meeting and highlight the areas about which you are still unsure. In this case study you do not need an introduction or conclusion for this case study of 1500 WORDS ± 10% due by midnight 8th April Turnitin. Just answer the questions. Turnitin is located in your campus specific block. Although we suggest you do your background reading in the current textbooks for basic information, the case study also requires you to find current literature/research/articles to support your discussion throughout the case study. Do NOT use Better Health Channel, WedMed, dictionaries, encyclopaedias etc. These are NOT suitable academic sources. If you use these you will not meet the criteria for this question and you will lose marks. You must follow the APA referencing format as directed by ACU in your case study and in your reference list. The Library website has examples of how to do this referencing and you can find the correct format at the end of your lectures and tutorials as well as in the free Student Study Guide. This essay should have approximately 10 relevant sources. Textbooks...
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...decreased requirement of thiopentone for induction. In 1992, Jakola ML et al.(36) studied the effects of a single intravenous dose of dexmedetomidine on intraocular pressure, haemodynamic and sympathoadrenal responses to laryngoscopy and tracheal intubation and on anaesthetic requirements in a randomly allocated 30 ASA I-II patients undergoing cataract surgery. Authors concluded that a single intravenous dose of dexmedetomidine 0.6µg/kg reduced intraocular pressure and attenuated sympathoadrenal responses associated with laryngoscopy and intubation. It also reduced the requirements for thiopentone, opioid and inhalational anaesthetic agents. In 2006, Yildiz et al.(37), studied the effect of single preinduction intravenous dose of dexmedetomidine 1µg/kg body weight on cardiovascular response resulting from laryngoscopy and endotracheal intubation, need for anaesthetic agent and perioperative haemodynamic stability in fifty patients undergoing elective minor surgery under general endotracheal anaesthesia and concluded that Preoperative administration of single dose of dexmedetomidine resulted in progressive increase in sedation, blunted the haemodynamic responses during laryngoscopy and reduced opioid and anaesthetic requirements without affecting the recovery time after the surgery.In 2008, Mowafi et al.,(38) conducted a double blind randomized controlled study in 40 patients undergoing elective non-ophthalmic surgery under general endotracheal anaesthesia, to investigate the...
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...What is the role of the anaesthetist? Anaesthetists play a very important role in surgery. In addition to the administration and monitoring of anaesthetics and sedation, they have a responsibility to keep the patient comfortable and in a stable condition. The anaesthetist has a role in the pre, peri and postoperative stages. Including: Preoperative- Gaining consent from the patient and choosing the most suitable anaesthetic/s Perioperative- Monitoring the patient (most important, the patient’s airway) Postoperative- Continue monitoring the patient, documentation of anaesthetics given and the patient’s state throughout the pre, peri and postoperative stages. (State Government of Victoria, 2011) Outside of theatre, anaesthetists can assist with pain relief and management in a wide variety of areas. State Government of Victoria (2011, February 12). Anaethetist. Pick Vic! Retrieved March 6, 2014, http://pickvic.ssa.vic.gov.au/jobs/healthcare-medical-and-community/medical-and-nursing/anaesthetist Sterile Field A sterile field is created to provide a surgically aseptic workspace. It should be considered a restricted area. Asterile drape may be used to establish a sterile field or to extend the sterile working area. The sterile drape should be waterproof on one side, with that side placed down on the work surface. After establishing the sterile field, other sterile items needed, including solutions, are added. Sterile items and sterile gloved hands are the only...
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...Propofol is an approved synthetically derived hypnotic agent used in the induction and maintenance of anaesthesia or sedation. After its approval, it replaced thiopental as the anaesthetic of choice by hospitals. It was estimated in the year 2010 that propofol accounted for at least 75% of anesthetics given in the U.S. Pharmacology Propofol is a small strongly lipophilic molecule which is usually housed in an oil-in-water emulsion. It is administrated through intravenous infusion at a strength of 10mg/100ml, and due to its lack of analgesic potency and may be injected with an analgesic drug.Propofol in the blood plasma is highly protein bound (97-99%) by serum albumin and hemoglobin. The onset of action is usually rapid and unconsciousness can be induced within 15-40sec of administration on average. This is mostly due to the molecules large volumes of distribution and fast distribution from plasma to CNS. Propofol induces hypnosis by significantly increasing the activity of GABAA (β3, β2) receptors and consequently decreasing neuronal activity. Induction of GABAA β3 receptors is theorized to lead to immobility,...
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...Ateneo de Zamboanga University College of Nursing Nursing Skills Output (NSO) Biopsy Report no.___ I. Description: A biopsy is a medical test commonly performed by a surgeon, interventional radiologist, or an interventional cardiologist involving sampling of cells or tissues for examination. It is the medical removal of tissue from a living subject to determine the presence or extent of a disease. The tissue is generally examined under a microscope by a pathologist, and can also be analyzed chemically. When an entire lump or suspicious area is removed, the procedure is called an excisional biopsy. When only a sample of tissue is removed with preservation of the histological architecture of the tissue’s cells, the procedure is called an incisional biopsy or core biopsy. When a sample of tissue or fluid is removed with a needle in such a way that cells are removed without preserving the histological architecture of the tissue cells, the procedure is called a needle aspiration biopsy. Biopsies are most commonly performed for insight into possible cancerous and inflammatory conditions. II. Materials/ Equipment Needed: Clean Gloves Anesthesia (surgical biopsy) Mdication (antianxiety) Sterile eye dressing (pad), as needed, and paper eye tape to secure it Clean Gloves Anesthesia (surgical biopsy) Mdication (antianxiety) Sterile eye dressing (pad), as needed, and paper eye tape to secure it Procedures: III. Procedure Prepare the site where the biopsy is to be...
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...theatre department and I work mainly in anaesthetics and the post anaesthetic care unit or (PACU). The innovation I plan to introduce is the implementation of the National Early Warning Score (NEWS) documentation into the PACU. The PACU is the last clinical area in the hospital to implement the NEWS documentation. This summer I spent three months working in the hospital's High Dependency Unit (HDU) which had already implemented the NEWS. While there I took part in the hospital's sepsis study day and learnt how to apply the scoring system in practice. When I returned to the theatre department I was asked by my manager to lead the implementation of the...
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...Why the population in Britain grew so quickly after 1750 Monday 21st June 2010 Essay By Christopher Herbert 9X During the 1750’s the population rocketed upwards. Why was this? Well in this essay I will describe the reasons why this happened to the population in Britain. Before this time they measured the number of people using church records, but not everyone used the registries as it was time consuming and frankly a waste of time. So they used a census which is a form compulsory for the public to fill in. This measured what people owned and who was living within the household. Now days this is still used and happens every ten years. There was a massive increase from 7 million to 37 million and with this explosion in the growth of the amount of people in Britain and for sure there must be solid reasons behind this. Was it because of the birth rate? The factories? Or even simple things such as fresh fruit and vegetables or putting tax on alcohol. In this essay I have learnt a great amount about population increase and I hope it will do the same for you My first reason is that of the fruit and vegetable increase. With farmers having more land they were therefore allowed to produce more fruit and vegetables and with much of too much for them and their family they decided to sell the fruit and vegetables to the willing to pay public. This gave many towns people a much improved healthy lifestyle to live with. Many people now beginning to buy all of the products they would...
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