Some machines can deliver air and CO3. The gas passes through a rotameter. This is a specially constructed cylindrical tube containing a bobbin that relates flow to radius and pressure. so that the exact amount of gas passing through the rotameter is indicated by the top of the rotating bobbin. Each cylinder (rotameter) is specific for a gas. The bobbin is made to rotate so that one can be sure there is gas flow and the bobbin has not become stuck.
The knob used for oxygen flow is always easily identifiable. The pressure in the gas cylinders or pipes is above atmospheric pressure. Certain machines have reducing valves to drop this pressure to that of the atmosphere. In those machines that do not have reducing valves the pressure is reduced due to the resistance at the rotameter and vaporizer. In some cases, a Hip Replacement Physio is needed.
The vaporizer is attached distal to the rotameter and is designed to deliver a set quantity of inhalational anaesthetic agent. There are many types of vaporizers. In essence they consist of an entry port for the gas. which may vary in size. a chamber in which the anaesthetic liquid is vaporized and an exit port which again may vary in size.
As the gas passes through the vaporizing chamber it becomes saturated with the anaesthetic agent. The actual concentration reaching the patient is determined by the amount of gas bypassing the vapour chamber and the amount being fully saturated.
Bromoeriptine is an orally administered dopamine agonist. It is used to suppress lactation in doses which are much lower than those required to alleviate Parkinson’s disease. Patients treated with bromocriptine or bromocriptine plus levodopa seem less inclined to develop the on-off syndrome described for levodopa.
Visual and auditory hallucinations and hypotension are more prevalent in patients using bromocriptine than those using levodopa. Both levodopa and bromocriptine can cause CNS arousal which appears to be of value in treating comatose patients with hepatic encephalopathy. Bromoeriptine is an expensive drug. However, the Hip Replacement Physio is affordable.
Amantadine was introduced as an antiviral agent. It has been found to release dopamine from intact dopaminergic nerve endings and to enhance dopaminergic transmission by other mechanisms. When not overdosed, amantadine does not appear to cause serious side-effects. CNS effects such as sedation. slurred speech. nightmares, hallucinations and sleep disturbances may occur.
Prevention of further absorption (emesis. gastric lavage followed by activated charcoal). Administration of a glutathione replenisher. e.g. Lthionine. I.–cysteine. N-acetylcysteine. L” e form of an intravenous injection. Parvolex. This should be administered in a 5% dextrose infusion as follows: Over 15 minutes, 150 mg/kg body mass of Parvolex in 200 ml of 5% dextrose.
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