By S M Yentis; Nicholas Hirsch; James K Ip; G B Smith
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Extra info for Anaesthesia and intensive care A-Z : an encyclopaedia of principles and practice
Phosphodiesterase inhibitor, a mixture of theophylline and ethylenediamine. Much more soluble than theophylline alone, hence its use iv. Used as a bronchodilator drug (but not as first-line therapy), and as an inotropic drug, especially in paediatrics. Causes bronchodilatation, increased diaphragmatic contractility, vasodilatation, increased cardiac output (direct effect on the heart), diuresis (direct effect on the kidney), and CNS stimulation. ● Dosage: ◗ 100–500 mg orally bd–qds (depending on the preparation), usually as slow-release preparations.
Anesth Analg; 112: 156–64 See also, Blood products; Protein-binding Albuterol, see Salbutamol Alcohol, see Alcohols Alcohol poisoning. Problems, features and management depend on the alcohols ingested: ◗ ethanol: commonly complicates or precipitates acute illness or injury, especially trauma. Results in depressed consciousness (hindering assessment of head injury), potentiation of depressant drugs and disinhibition. Patients are often uncooperative. Other effects of acute intoxication include vasodilatation, tachycardia, arrhythmias, vomiting, reduced lower oesophageal sphincter pressure, gastric irritation, delayed gastric emptying, hypo glycaemia (typically 6–36 h after ingestion, especially in a starved or malnourished individual), metabolic acidosis, dehydration (due to diuretic effect), coma and convulsions.
Sevoflurane in O2) is traditionally advocated, although induction may be slow and difficult. If obstruction worsens, anaesthesia is allowed to lighten. Tracheal intubation is performed without paralysis; lidocaine spray may be useful. ◗ postoperatively: as for difficult intubation (see Intubation, difficult). g. by mediastinal tumours, also employs inhalational induction and anaesthesia. This avoids acute exacerbation of airway obstruction caused by sudden muscle relaxation. 19 20 Airway pressure In the recovery room or casualty department, all unconscious patients should be positioned in the recovery position, to protect them from aspiration and airway obstruction.
Anaesthesia and intensive care A-Z : an encyclopaedia of principles and practice by S M Yentis; Nicholas Hirsch; James K Ip; G B Smith