Amiodarone (Pacerone) is an antiarrhythmic that works by prolonging the myocardium’s refractory period through potassium channel, sodium channel, calcium channel, and beta-blockade. Its side effects can be remembered by their effects on “PFTs, TFTs, and LFTs” (pulmonary, thyroid, and liver testing, respectively) in addition to corneal, neurological, and skin changes.
Labetalol (Trandate) is one of my favorite anti-hypertensive medications in the perioperative and ICU settings! It’s a “mixed” beta blocker courtesy of dual alpha and beta adrenergic antagonism conferred by different stereoisomers of the drug in the traditional racemic formulation. The beta blockade to alpha blockade ratio is often cited…
Etomidate (Amidate) is an intravenous hypnotic agent most commonly used as an induction agent for general anesthesia. Similar to propofol, it works by potentiating GABA, one of the primary inhibitory neurotransmitters in the central nervous system, to hyperpolarize post-synaptic neurons. From a molecular standpoint, etomidate has more in common with…
Lactated Ringer’s (LR) is a balanced crystalloid solution created by Dr. Sydney Ringer in the 1880s using ex-vivo frog hearts. It contains sodium, chloride, lactate, potassium, and calcium, yielding an osmolarity of 273 mOsm/L (human plasma is ~ 290 mOsm/L). In the OR and ICU, I preferentially use balanced crystalloids…
Ketamine (Ketalar) is my FAVORITE medication in perioperative and critical care medicine! It’s a unique dissociative amnestic, an almost complete anesthetic in itself, has tremendous versatility in terms of routes of administration (IV, IM, oral, subcutaneous, intranasal, sublingual, rectal, epidural, transdermal), and unique properties as an analgesic and antidepressant!
Normal saline (NS) is one of the most widely used therapies in medicine. One liter of solution contains 154 mEq of sodium and 154 mEq of chloride with a pH ~ 5.5. The fact that the solution is acidic is actually UNRELATED to how it CAUSES non-anion gap acidosis in…
Phenylephrine is a selective α1 receptor agonist used in various settings for its vasoconstrictive properties. Whether this is as a decongestant (constricting vessels in the nasal/sinus mucosa) or a mydriatic to perform a fundoscopic exam, this medication’s selectivity gives me an idea of the expected response and potential side effects.
Kcentra (human prothrombin complex concentrate) is a medication derived from human plasma that contains unactivated factors II, VII, IX, X, protein C, protein S, antithrombin III, and heparin. In 2013, it gained FDA approval for the urgent reversal of acquired factor deficiency from vitamin K antagonism (ie, Coumadin) in the…
