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DRUG AND CLASSIFICATION Generic Name: desflurane Brand Name: Suprane Anaesthetics - Local & General Pregnancy Category B

MECHANISM OF INDICATION ACTION Desflurane is a volatile Induction and halogenated maintenance of anaesthetic. It general anesthesia. depresses the CNS causing loss of consciousness associated with an inability to perceive pain. It is used for induction and maintenance of general anaesthesia.

CONTRAINDICATION Induction of anaesthesia in children. Known or suspected susceptibility to malignant hyperthermia.

SIDE EFFECTS Hypotension, respiratory depression, arrhythmias, nausea and vomiting; may provoke breath holding, apnoea, coughing, increased salivation, laryngospasm; rarely, malignant hyperthermia.

NURSING RESPONSIBILITIES * Caution should be exercised in case of allergies, during pregnancy, elderly and in children * It may cause tiredness, weakness or drowsiness, do not drive a car or operate machinery for 24hours after receiving this medication. * Avoid alcohol consumption.

DRUG AND CLASSIFICATION Generic Name: Isoflurane Brand Name: Forane, Terrell General Anesthetic

MECHANISM OF INDICATION ACTION Isoflurane reduces For induction and pain sensitivity maintenance of (analgesia) and relaxes general anesthesia. muscles.

CONTRAINDICATION Known sensitivity to Isoflurane, USP or to other halogenated agents. Known or suspected genetic susceptibility to malignant hyperthermia.

SIDE EFFECTS Shivering, nausea,  vomiting and ileus have been observed in the postoperative period. Resp depression,  hypotension, arrhythmias, malignant hyperthermia.

NURSING RESPONSIBILITIES Used with caution in patients with coronary artery disease Monitor blood pressure and temperature to detect residual hypotension and the possibility of malignant hyperthermia. Must be given with a licensed anesthesiologist Emergency kit must be made available

DRUG AND CLASSIFICATION Generic Name: sevoflurane Brand Name: Sevorane

General Anesthetics

MECHANISM OF ACTION Induces a state in which the CNS is altered so that varying degrees of pan relief, depression of consciousness, skeletal muscle relaxation and reflex reduction are produced.

INDICATION Induction and maintenance of general anesthesia

CONTRAINDICATION Known or suspected susceptibility to malignant hyperthermia.

SIDE EFFECTS Agitation, dizziness, drowsiness, increased cough, increased saliva, lightheadedness, nausea, shivering, vomiting.

NURSING RESPONSIBILITIES  Check the name of the patient and the time of administration.  Monitor vital signs.  Monitor all the body systems.  Continuous monitoring of pulse oximetry.  Postural BP should be taken.  Take note of that time that the drug has expired.

DRUG AND CLASSIFICATION Generic Name: tetracaine hydrochloride Brand Name: Pontocaine Topical anesthetics Spinal anesthetics

MECHANISM OF ACTION Tetracaine acts by preventing the generation and transmission of impulses along nerve fibres and at nerve endings; depolarisation and ion-exchange are inhibited. In general, loss of pain occurs before loss of sensory, autonomic and motor functions.

INDICATION For spinal anesthesia and topical anesthesia.

CONTRAINDICATION Hypersensitivity to p-aminobenzoic acid or its derivatives, local anesthesia of the ester type.

SIDE EFFECTS Mild erythema at the application site, slight edema or pruritus, blistering of the skin.

NURSING RESPONSIBILITIES  Check the name of the patient and the time of administration.  Check laboratory results for low plasmacholinesterase concentration  Do not administer to inflamed or traumatized surfaces  Do not instill into the middle ear

DRUG AND CLASSIFICATION Generic Name: Lidocaine Brand Name: Xylocaine Local and General Anesthesia

MECHANISM OF ACTION Lidocaine is an amide type local anaesthetic. It stabilises the neuronal membrane and inhibits sodium ion movements, which are necessary for conduction of impulses. In the heart, lidocaine reduces phase 4 depolarisation and automaticity. Duration of action potential and effective refractory period are also reduced.

INDICATION Xylocaine (lidocaine HCl) Injections are indicated for production of local or regional anesthesia by infiltration techniques such as percutaneous injection and intravenous regional anesthesia by peripheral nerve block techniques such as brachial plexus and intercostal and by central neural techniques such as lumbar and caudal epidural blocks, when the accepted procedures for these techniques as described in standard textbooks are observed.

CONTRAINDICATION Hypovolemia; heart block or other conduction disturbances.

NURSING RESPONSIBILITIES Dizziness,  When paraesthesia, administered as an drowsiness, confusion, anesthetic, the respiratory depression numbness of the and convulsions. affected part should be assessed.  Serum Lidocaine levels should be monitored frequently during prolonged use. Therapeutic serum lidocaine levels range from 1.5 to 5 mcg/ml.


DRUG AND CLASSIFICATION Generic Name: Procaine Brand Name: Novicain Local Anesthesia

MECHANISM OF INDICATION ACTION Procaine acts by For local anesthesia. stabilising the neuronal membrane thus preventing the generation and transmission of impulses along nerve fibers and at nerve endings. In general, loss of pain occurs before loss of sensory, autonomic and motor functions. A PABA ester, it does not penetrate intact mucous membranes well making it ineffective against surface application and admin is solely by injection.

CONTRAINDICATION Hypersensitivity, complete heart block. Not to be applied to inflamed or traumatised surfaces, low plasmacholinesterase conc, not to be instilled into the middle ear. Generalised septicaemia. Epidural or spinal block should not be used in patients with cerebrospinal diseases, cardiogenic/hypovolaemic shock or altered coagulation states.

SIDE EFFECTS CNS excitation; dizziness; tinnitus; blurred vision; nausea and vomiting; muscle twitching and tremors; convulsions. Numbness of tongue and perioral region. Bradycardia; arrhythmias. Hypersensitivity; methemoglobinemia; foetal intoxication; corneal damage.

NURSING RESPONSIBILITIES  Use procaine with epinephrine with caution in body areas with limited blood supply (e.g., fingers, toes, ears, nose). If used, inspect particular area for evidence of reduced perfusion (vasospasm): Pale, cold, sensitive skin.  Hypotension is the most important complication of spinal anesthesia. Risk period is during first 30 min after induction and is intensified by changes in position that promote decreased venous return, or by preexisting hypertension, pregnancy, old age, or hypovolemia.

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