Inhalational anesthetic induction

Ph: Amin Elkholy
Inhalational induction is common in pediatric patients, and the potent inhaled anesthetic agents are excellent bronchodilators. The only exception is desflurane, which has mild bronchoconstricting activity.
The potent inhaled agents decrease skeletal muscle tone in a dose-dependent fashion, which often improves surgical exposure.

Mode Of Action

Act on GABA-A, glycine, and glutamate receptors.

How to answer Drug Information Request?

How to answer Drug Information Request?
Here is the seven steps you can use in systematic approach for answering a Drug Information Request, if you use these steps you will provide the most evidence answer.

·         Name and profession
·         (physician-pharmacist-nurse-patient)
·         DI Form & DI Answer Form.
·         First question asked by requestor.
·         Requestor demographics
·         Appropriate formulation and delivery  method.
·         Initial question.
Step 1: Secure Demographics of Requestor.
·         Patient specific or academic.
·         Age-Height-Weight-history-current problem-medication-allergies-laboratory information.
·         Question type.
·         Patient background information.
Step 2: Obtain Background Information.
·         Select the suitable question category from the question categories.
·         Locate the references that contain question category (drug oriented-disease oriented)

·         Convert initial question + background information  to the Ultimate question.
·         Categorize the ultimate question.
·         Develop a time line for response.
Step 3: Determine and Categorize the Ultimate Question.
·         Exact resource name.
·         Further search in 2ndry & primary resources.

·         Develop a search strategy and select the recourses.
·         Conduct systematic search.
Step 4: Develop Strategy and Conduct Search.
·         At least two resources confirmation.
·         Perform evaluation and double check of final answer.
·         Clinical opinion is important according to the case.
·         Confirm with other references.
·         Check for final answer, with professional judgment.
·         Check for all medication doses and interactions before answer the question.
Step 5: Perform Evaluation, Analysis, and Synthesis.
·         Ultimate question.
·         The answer.
·         Recommendation.
·         References.
·         Pharmacist.
·         Drug information answer form.
Step 6: Formulate and Provide Response.
·         Ask the requestor if it was helpful and what is the action taken.
·         Store a copy of every DI request in file and on pc.
·         Follow your answer.
·         Save all data.
Step 7: Conduct Follow-Up and Documentation.

Serious and Life-Threatening Cases for use Harvoni and Sovaldi with amiodarone

Serious and Life-Threatening Cases of Symptomatic Bradycardia as well as One Case of Fatal Cardiac Arrest Reported with Coadministration of amiodarone with either Harvoni® (ledipasvir and sofosbuvir fixed-dose combination) or with Sovaldi® (sofosbuvir) in combination with another direct acting antiviral.

The specific changes to the each label are summarized below.

Guidelines for anticoagulant use in mechanical valve pregnant woman

Management of mechanical heart valves in pregnancy is still a clinical dilemma for women and clinician, because of pregnancy itself considers pro thrombotic state and the options available for management of this case still Subject to benefit risk choice.

FDA has approved Bellafill for the treatment of skin condition scars

U.S. Food and Drug Administration (FDA) has approved the dermal filler, Bellafill-polymethylmethacrylate (PMMA) collagen filler-for the treatment of skin condition scars. Bellafill represents a big clinical advancement because the solely filler on the market approved for this disfiguring skin condition. skin condition is that the commonest skin condition within the U.S., poignant 40-50 million people1 and up to ninety fifth of individuals with skin condition could endure to suffer from scarring. 

Bellafill was studied extensively before its office approval and established to be safe and effective for the correction of moderate to severe, atrophic, expansive facial skin condition scars on the cheek in patients over the age of twenty one years.

FDA approved Lynparza for treatment of Advanced Ovarian Cancer

The U.S. Food and Drug Administration nowadays granted accelerated approval to Lynparza (olaparib), a brand new drug treatment for ladies with advanced ovarian cancer related to defective BRCA genes, as detected by associate degree FDA-approved take a look at.

Ovarian cancer forms within the ovary, one in all a try of feminine reproductive glands wherever ova, or eggs, are formed. The National Cancer Institute estimates that 21,980 american girls are going to be diagnosed with and 14,270 can die from ovarian cancer in 2014.

Top FIFA players initiate "11 Against Ebola" campaign

This is the primary emergency health campaign of its kind enforced by FIFA and CAF and is galvanized by the dedication of medical personnel at the front line of the fight against Ebola hemorrhagic fever.

Neymar Jr. (Barcelona/Brazil)The campaign is meant to supply a assuasive, positive message to affected communities with straightforward and clear info which will facilitate to combat the unfold of the Ebola virus.

Through the facility and recognition of soccer, the eleven Against Ebola hemorrhagic fever campaign seeks to succeed in as wide associate audience as attainable within the most affected regions and globally by connexion forces with high international soccer players, the planet Bank, FIFA and CAF member associations, native organizations and also the media.

The “11 Against Ebola” campaign, options World Player of the Year, Real capital of Spain’s Cristiano Ronaldo, Barcelona’s Neymar Jr, Chelsea’s Didier Drogba and Bayern Muenchen’s Philipp Lahm. alternative players concerned at the beginning of the campaign square measure Gareth Bale (Real Madrid/Wales), Raphaël Varane (Real Madrid/France), Neymar Jr. (Barcelona/Brazil), Gerard Piqué (Barcelona/Spain), Xavi (Barcelona/Spain), Jérôme Boateng (Bayern Munich/Germany), John cult Mikel (Chelsea/Nigeria), Saint George Davies (Sierra Leone) and Bayern Muenchen coach spirit Guardiola.

Ebola Virus Complete Fact Sheet

Ebola virusEbola virus disease (EVD), better known in past as viral hemorrhagic fever, could be a severe, typically fatal human disease. The Ebola virus causes an acute, serious illness, which is commonly fatal if untreated. Ebola virus disease (EVD) first appeared in 1976 in a pair of coinciding outbreaks, one in Nzara, Sudan, and the other in Yambuku, Democratic Republic of Congo. The latter occurred in an exceedingly village close to the Ebola river, which it takes its name.

Pharmacology Refresh Cards: Noradrenaline - Norepinephrine

Noradrenaline  -  norepinephrine
Drug name
Sympathomimetic   (Vasopressor)
Stimulates alpha-receptors in arterial and venous beds and beta1 receptors of heart, resulting in peripheral vasoconstriction and stimulation of heart rate and contractility. Coronary vasodilation occurs secondary to enhanced myocardial contractility.
Mechanism of action

Cont. infusion
0.01–0.4 µg/kg/min IV infusion via a central vein         
Septic shock ,with low SVR
Severe hypertension may occur if noradrenaline is given to patients taking tricyclic antidepressants since tricyclics block the uptake of noradrenaline into nerve endings.
Drug interaction
Myocardial ischaemia
peripheral ischaemia
Side effects

Hypovolaemic shock
Acute myocardial ischaemia or MI
Contraindication & precaution
Pregnancy: Category D
Special populations

Norepinephrine may lose potency in normal saline solution
Administer in D5W or 5% dextrose in saline
If extravasation occurs, infiltration with phentolamine
Administration notes
4mg/4ml amp
Availability in pharmacy

Other notes

Calcium Carbonate versus Calcium Acetate as Phosphate binder

Phosphate binder
Ph D: Neven Mohamed
For many years, calcium-containing phosphate binders (calcium acetate and calcium carbonate) were considered the best choice in the treatment of hyperphosphatemia, due to they are effective, possessed only moderate side-effects and suppressed parathormone levels with the intention of counteracting progression of secondary hyperparathyroidism. In two head-to-head observational studies (CARE, ARNOS), calcium-containing binders showed signals of clinical superiority versus the comparator sevelamer-HCl.[1.2] 

Nevertheless, calcium may be absorbed significantly, which may result in a positive calcium balance and actively contribute progressive cardiovascular and soft-tissue calcification in patients at risk.[3]