CAUTION: High concentrations of nitrous oxide may cause cyanosis and asphyxia.
Halothane (Fluothane)
ACTION AND USE.— Halothane can be used for inhalation anesthesia in every known operative procedure in patients of all ages. Use of halothane permits high oxygen concentration and use of cautery. Virtually nontoxic, recovery is rapid and remarkably free of excitement, nausea, and vomiting. It is nonflammable and nonexplosive. It is contraindicated in obstetrics or in patients with hepatic dysfunction.
Ketamine Hydrochloride (Ketalar)
ACTION AND USE.— Ketamine hydrochloride is a rapid general anesthetic agent for procedures that do not require skeletal muscle relaxation or as a preinduction agent. One significant side effect of this agent is when the patient begins to recover from the drug he or she may experience psychological manifestations ranging from pleasant dream-like states to hallucinations to delirium accompanied by confusion or irrational behavior. The effects of these manifestations may be minimized by keeping aural and tactile stimuli to a minimum. It is contraindicated in patients with hypertensive disease.
USUAL DOSE.— No usual dose has been determined; ketamine hydrochloride must be titrated to individual patient response.
Fentanyl and Droperidol (Innovar)
ACTION AND USE.— This is a combination of a narcotic (fentanyl) and a tranquilizer (droperidol). Because of the selfpotentiating combination, it must be used with extreme caution in patients with any respiratory problems.
Local Anesthetics
These drugs produce loss of sensation to pain in a specific area or locality of the body, without loss of consciousness or mental capacity. The majority of these drugs are administered parenterally or topically.
Procaine Hydrochloride (Novocain)
ACTION AND USE.— Administered only by injection, it may be used for most types of local anesthesia including spinal anesthesia. It is available in various solutions for injection.
Lidocaine Hydrochloride (Xylocaine)
ACTION AND USE.— This is the standard to which all other local anesthetics are compared. It may be combined with epinephrine for vasoconstrictive effects and is used for all types of local anesthesia. Lidocaine is also used in the treatment of myocardial infarctions to prevent or suppress preventricular contractions. CAUTION: Total dosage injected in 24 hours should not exceed 0.05 g per patient when used with epinephrine. It is available as an ointment, jelly, solution for injection, solution for gargle, and spray.
Dibucaine Hydrochloride (Nupercaine)
ACTION AND USE.— Dibucaine hydrochloride is used as a topical anesthetic on mucous membranes and is also administered parenterally. It is available as an ointment for topical use or as a solution for injection.
Proparacaine (Ophthetic, Ophthaine)
ACTION AND USE.— This is a topical ophthalmic anesthetic suited for almost every ophthalmic procedure. It is fairly long lasting.
AUTONOMIC DRUGS
The autonomic nervous system, also called the visceral or involuntary nervous system, controls the autonomic functions of the body. Drugs that affect the autonomic nervous system are highly specialized and therefore are classified according to their effect.
Parasympathetic Drugs
These drugs, also called cholinomimetics, stimulate the structures controlled by the parasympathetic nerves. They are either direct acting or indirect acting.
Neostigmine Methylsulfate (Prostigmin)
ACTION AND USE.— Neostigmine methylsulfate is indicated for the symptomatic control of myasthenia gravis.