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  • Lack of judgement leads to a manic person becoming, for example overgenerous and reckless.
  • Premedication and adjuncts to general anaesthesia are discussed further on page Induction is most likely to be achieved using an intravenous anaesthetic, which produces unconsciousness within seconds.
  • Conversely, the elimination of basic drugs such as amfetamine, antihistamines, morphine and tricyclic antidepressants can be increased by making tubular filtrate more acidic by administration of ammonium chloride.
  • This type of allergic reaction is possible in response to local anaesthetics.
  • Excretion occurs via the kidneys but only a small percentage of the drug appears in the urine in its original form.

Enkephalin reduces the release of substance P at the sensory neuron terminals in the spinal cord. It is also released in areas of the midbrain and medulla where it enhances the descending inhibitory pathways, which terminate in the spinal cord.

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This has proved particularly useful in certain situations. For example PGDs are used for the provision of medicines to counter the side effects of contrast agents used in diagnostic radiography.

Authored by Dr. Todd T Maltese, DO


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Anaesthesia and analgesia both mean loss of sensation; general anaesthesia leads to loss of consciousness as well, local anaesthesia means loss of sensation in part of the body and analgesia means absence of pain specifically.

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Other factors to take into consideration are whether sedation is required and how susceptible the individual is to Parkinsonian side effects.

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However, this is not the complete explanation as, for example phenobarbital is far more effective as an anticonvulsant than other barbiturates with the same enhancing effects on GABA.

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