Pharmacology for Dentistry

(Ben Green) #1

(Mode of Action of Drugs)


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Chapter


1.4


Chapter


2.1


General


Anaesthetics


General


Anaesthetics


General anaesthetics are the group of
drugs which bring about a reversible loss of
pain sensation and consciousness. The depth
of anaesthesia appropriate for the conduct
of surgical procedures can be achieved by a
wide variety of drugs, either alone or by a
combination of drugs, each drug for a spe-
cific purpose. General anaesthetics can be
administered by a variety of routes, but in-
tra-venous or inhalation administration is
preferred, because the effective dose and the
time course of action are more predictable
when these techniques are used.


The general anaesthetics are divided into
two main groups (table 2.1.1).


INHALATIONAL ANAESTHETICS

NITROUS OXIDE (N 2 O)


It is a colourless, odourless, noninflammable
gas which is approx. 1½ times heavier than
air. It is non-irritating with a sweet taste.


Nitrous oxide is used for induction and
maintenance of anaesthesia. It is widely
used as carrier gas for other volatile agents
in general anaesthesia. The usual concentra-


tion used is 70 percent N 2 O + 30 percent O 2
along with some muscle relaxants or other
potent anaesthetics. Nitrous oxide, if admin-
istered along with air, it produces a stage of
excitement and delirium and also produce
amnesia. Hence, the name ‘laughing gas.’
It is eliminated unchanged from the
body, via the lungs. Despite its high fat solu-
bility, it is rapidly eliminated through lungs
within 2 to 5 minutes after its withdrawal.
Nitrous oxide, due to its analgesic action
in subanaesthetic concentration, is employed
for minor operation like tooth extraction, for
obstetrical analysis, painful procedures such
as changing dressing of burns. It is cheap and
very commonly used.
Prolonged administration of nitrous ox-
ide as in cases of tetanus, may cause bone
marrow depression and agranulocytosis.

CYCLOPROPANE
It is a colourless gas with sweet odour and
taste, available as liquid under pressure. It
produces analgesia without loss of conscious-
ness in 1 to 2 percent concentration, in 6 to 8
percent it produces loss of consciousness while
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