PPT-Mechanism of Action of Methadone and concerns over effects on Cardiac Conduction

Clinical Scenario Case 1 76 year old man with head and neck cancer sp Radical dissection with PMH of Chronic Renal Failure and patient stated morphine allergy in 1010 pain Case 2 25 year old woman with long standing history of narcotic use for chronic back pain presenting to clinic requesting cheaper medication for pain control. Cardiac Conduction Effects Laboratory studies, both in vivo and in vitro, have demonstrated that methadone inhibits cardiac potassium channels and prolongs the QT interval. Cases of QT interval prolo General Properties and Utility. Learning Objective. Identify the unique pharmacological properties of methadone that distinguish it from other opioids. Learn . key properties of methadone . lending itself to . Methadone is prescribed to relieve moderate to severe pain that has not been relieved by non-narcotic pain relievers. . Methadone is also prescribed to prevent withdrawal symptoms in patients who were addicted to opiates. . Melissa Hemphill MD. 4/17/2015. OAFP Spring Conference. Disclosures & Scope. No disclosures. Scope is . Herbs that are commonly . used, . safe. . and accessible to . patients & maybe . a couple you haven’t heard . DRUG THERAPY . Bradycardia. Atropine. Dopamine infusion. Epinephrine infusion. Atropine. Mechanism of Action. Inhibits the actions of . acetycholine. on structures innervated by postganglionic sites (smooth/cardiac muscle, SA/AV nodes). ARRHYTHMIA. 2. 2. CLINICAL INCIDENCE. 80% cardiac arrhythmia → after M.I. 50% cardiac arrhythmia → during anesthesia. 25% cardiac arrhythmia → treatment with digitalis . Cardiac arrhythmia need to be treated when serious haemodynamic derangement expected. Primary Teaching . 2015 viva – Draw and label the membrane potential of normal pacemaker tissue.. 2015 viva – What mechanisms can . tachyarrythmias. be generated?. Physiology. Cardiac action potential . Dr. Syed Md. . Basheeruddin. . Asdaq. Learning outcomes . At the end of lecture, students should be able to:. Enlist . the agents used as antiemetic and pro kinetic. Discuss the clinical uses, mechanism of action and adverse effects of 5HT3 Antagonist, D2 Antagonists, . POISONOUS PLANTS. The active principles in most of these plants are alkaloids but glycosides (. digitales. ) and resinous materials, as cannabis also exist.. The plant poisons have mainly remote action after their absorption. The route of poisoning is usually the oral one, so gastric lavage is indicated . each plant poison has its specific physiological antidote.. 2 3 septum (Fig. and Supplementary Figs and ). ese regions, previously described as paranodal, could also be dierentiated from the working myocardium in the micro-CT data, appearing as lower atten Cardiac arrest after spinal anesthesia. in Orthopedic surgery. พญ.โสภิต เหล่าชัย. 5 . มิ.ย.58. Hypotension. Severe . bradycardia. Cardiac arrest. Problems. Cardiac Arrest During Spinal Anesthesia: Common Mechanisms and Strategies for Prevention. Shari L. Targum, MD, MPH, FACC. Medical Officer. U.S. Food and Drug Administration. Detecting cardiac safety signals. Common, drug-related. : can detect in placebo-controlled, clinical trials, compare to background rate. Cardiac arrhythmias are the most common cause of death in patients with a myocardial infarction or terminal heart failure. . Normal sinus rhythm is dependent on generation of an impulse in the normal sinoatrial (SA) node pacemaker and its conduction through the atrial muscle, through the atrioventricular (AV) node, through the Purkinje conduction system, to the ventricular muscle. LIDOCANE. AMIODARONE. CALCIUM GLUCONATE. FRUSEMIDE. ATROINE . DOPAMINE . NORADRENALINE. ADENOSINE. METEPROLOL. DOBUTAMINE . CHLORPHENARAMINE. DEXAMETHASONE. HYDROCORTISONE. MIDAZOLAM. TRAMADOL.