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Duphaston

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General Information about Duphaston

The central compartment is the volume in which initial mixing of the drug occurs, and thus can be thought to include the vascular system (blood volume) and for some drugs the interstitial fluid. The fast peripheral compartment represents a compartment of the body that absorbs drug rapidly from the central compartment, and thus can be thought of as comprising tissues of the body that are well-perfused (such as muscles and vital organs). Finally the slow peripheral compartment is used to mathematically represent a compartment into which re-distribution occurs more slowly, and thus can be thought of as including tissues with a poor blood supply (such as adipose tissue). The drug is infused in central compartment and then distributed to the slow and fast compartment and eliminated trough metabolism. Defining the drug concentration variable of the i-th compartment as Ci, the propofol distribution can be described as: C1 V 1  V 2C2()tk21  V 3C3()tk31  V 1C1()t(k10  k12  k13) u()t (1) t C 2 V 2  V 1C1()tk12  V 2C2()tk21 (2) t C3 V 3  V 1C1()tk13  V 3C3()tk31 (3) t C e  C1()tke0  Ce()tke0 (4) t where u(t) represents the drug infusion rate in the central compartment and Vi is the volume of the i-th compartment. The dynamics of the compartmental model is defined by the following diffusion constants: k10 (rate constant for drug metabolism), k12 (rate constant for re-distribution of drug from central to fast peripheral compartment), k21 (rate constant for re- distribution of drug from fast to central compartment), k13 (rate constant for redistribution of drug from central to slow compartment) and k31 (rate constant for redistribution of drug from slow to central compartment). From the point of view of hypnosis control, the variable of interest is not the blood concentration but the concentration in the place where the effect on the controlled variable is produced (effect site concentration). Thus, when there is a simultaneous measure of the drug concentration in blood and its effect on the brain, drug latency can be observed that produces a temporal displacement between the peak of blood concentration and the drug effect. Closed-Loop Control of Anaesthetic Effect 457 To include this dynamics in the model a fourth compartment is added. It is assumed that this compartment is attached to the central compartment and has negligible volume. This parameter can be seen as index that measures the degree of nonlinearity of the model. According to the response observed through his vital signs the drug rates can be modified (the anaesthetist is the controller). The main idea in closed-loop control is to use information of the state of the patient to automatically adjust the drug dosing. Many efforts have been made to provide the anaesthetist with more reliable methods for monitoring this state. Thus, it can be used as a feedback system to the controller in order to compute the adequate infusion rate, as can be seen in figure 4. The controller algorithm used for anaesthesia control can be based on signals or in models.

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The latter ac- Propranolol decreases Purkinje fiber membrane re- tion, especially at high clinically employed doses, may sponsiveness and reduces action potential amplitude. These which enhanced -receptor stimulation does not play a changes result in a decrease in His-Purkinje conduction significant role in the genesis of the rhythm disturbance. However, these electrophysiological alter- ations are observed at propranolol concentrations in Sinoatrial Node excess of those normally used in therapy. The most Propranolol slows the spontaneous firing rate of striking electrophysiological property of propranolol nodal cells by decreasing the slope of phase 4 depolar- at usual therapeutic concentrations is a depression of ization. Blockade of -receptors Individual Antiarrhythmic prolongs systolic ejection periods at rest and during ex- Drugs ercise. However, these alterations are Drugs Therapeutic Uses offset by factors that tend to reduce oxygen consump- tion, such as decreased heart rate and decreased force Acebutolol Ventricular arrhythmias, ventricular ectopy of contraction. The decrease in oxygen demand pro- Adenosine Supraventricular tachycardia duced by a decrease in heart rate and a decrease in Wolff-Parkinson-White syndrome force of contraction is usually greater than the increase Amiodarone Hemodynamically unstable ventricular in oxygen demand that results from increased heart size tachycardia and increased ejection time. The net result is that oxy- Ventricular fibrillation Bretylium Ventricular arrhythmias after cardiac gen demand is decreased. In se- Procainamide Atrial tachycardia, ventricular lected cases of sinus tachycardia caused by anxiety, tachycardia Premature ventricular contractions pheochromocytoma, or thyrotoxicosis, -blockade will Propafenone Atrial fibrillation, ventricular reduce the spontaneous heart rate. Patients with Postoperative ventricular arrhythmias Wolff-Parkinson-White syndrome supraventricular extrasystoles and intermittent parox- Quinidine Atrial arrhythmias, ventricular ysms of atrial fibrillation may benefit from -receptor tachycardia blockade with propranolol. An increase in circulating catecholamines also has been observed in patients with acute myo- cardial infarction and has been correlated with the de- velopment of arrhythmias. Although propranolol is highly effective in the treatment of digitalis-induced arrhyth- Hemodynamic Effects mias, phenytoin and lidocaine are preferred. However, the effect of -adrenoceptor blockade on the A-V node will decrease the ventricular response to the atrial tachyarrhythmia. Atrial flutter/tachycardia -Adrenoceptor blockers will reduce the ventricular rate by inhibition of transmission through the A-V node as a result of inhibition of adrenergic influences. Ventricular arrhythmias Premature ventricular complexes Effective in mitral valve prolapse, hypertrophic cardiomyopathy, digitalis-related ectopic activity, and ventricular complexes associated with exercise or induced by ischemia. Ventricular tachycardia Most effective against arrhythmias associated with digitalis toxicity and exercise, particularly if the latter is related to ischemia.

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Duphaston
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Total customer reviews: 324