Medicines

• Ketamine: increase cardiac work, O2 use, secretions, BP. No respiratory depression. Hallucinations
• Methoxyflurane has renal toxicity
• Halothane is hepatotoxic
• Succinylcholine is the only depolarizing agent used; generalized contractions; hyperkalemia in burn patients; fast on/fast off; risk aspiration, glaucoma
• Clindamycin prolongs neuromuscular blockade
• Demerol should be avoided in patients on MAOI's
• Octreotide: long acting somatostatin analog
• Reglan = metoclopromaide: DA blocker, increase LES tone, increase gastric motility
• Omeprazole: mech is blocking H pump (ATPase); associated with enterochromaffin hyperplasia in rats. No evidence for carcinogenesis in humans
• Digoxin: glycosides, inhibits Na-K ATPase to increase Ca in heart. Slows AV conduction. Inotrope, but does not increase O2 consumption. Associated with ischemic gut, decreases splanchnic flow. Avoid hypokalemia
• Amrinone: phosphodiesterase inhibitor; inotrope, increase cardiac output, decrease SVR
• Metyrapone and Aminoglutethimide: 'medical adrenalectomy'
• Leuprolide: 'medical orchiectomy'
• Vasopressin: reduces splanchnic flow, portal flow ~40%. Useful in GI bleeds, give with beta-blocker to avoid angina
• Sodium Nitroprusside relaxes arteries and veins; has cyanide toxicity
• Nitroglycerin primarily relaxes veins
• Aspirin irreversibly binds cyclooxygenase, effective for life of platelet (~7 days)
• Indomethacin blocks PG production, used to close PDA (effective in 70%). Decrease renal blood flow
• Misoprostil replaces PGE2 (cytoprotective) for pt on nsaids, to reduce PUD

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