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.