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By S M Yentis; Nicholas Hirsch; James K Ip; G B Smith

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Bradycardia and hypotension may occur. May cause inflammation of peripheral veins. The dose should be reduced after 1–2 days. ● Side effects: prolonged administration commonly results in corneal microdeposits (reversible, and rarely affecting vision), and may cause photosensitivity, peripheral neuropathy, hyper- or hypothyroidism, hepatitis and pulmonary fibrosis. Amitriptyline hydrochloride. Tricyclic antidepressant drug. Competitively blocks neuronal uptake of noradrenaline and serotonin. Also has anticholinergic and antihistaminergic properties; thus has marked sedative effects and is well suited for patients with agitated depression.

Alveolar air equation. g. when determining alveolar–arterial O2 difference and shunt fractions. The equation also illustrates how hypercapnia may be associated with a lower PAO2. Another form of the equation allows for differences between inspired and expired gas volumes, and is unaffected by inert gas exchange:  P O − PEO 2  alveolar PO2 = PIO2 − PA CO 2 −  I 2  PECO 2  where PEO2 = mixed expired PO2 PECO2 = mixed expired PCO2 Alveolar–arterial oxygen difference (A–adO2). Alveolar PO2 minus arterial PO2.

Anaesthesia for patients with airway obstruction: ◗ preoperatively: - preoperative assessment for the above features and management as above. - useful pre-induction investigations include: - radiography, including tomograms, thoracic inlet views and CT scanning. - flexible nasendoscopy images. - arterial blood gas interpretation. - flow–volume loops. - premedication may aid smooth induction of anaesthesia but excessive sedation should be avoided. g. tracheostomy under local anaesthesia or awake fibreoptic intubation).

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