<b>Dr. Conrad Murray & diprivan on Michael Jackson - A new street drug? Subpoenas issued.</b>

<p><img src="http://anestheticnews.com/wp-content/uploads/2009/07/diprivan1.jpg" alt="diprivan" title="diprivan" width="250" height="151" class="alignleft size-full wp-image-1300" />Diprivan, the most talked-about drug this week was introduced during the early eighties manufactured by a small German pharmaceutical company called Zeneca. It arrived at a time when almost all surgery was done under general anesthesia using halogenated carbons which were vaporized after the mask was fitted. Halothane was the first of this type of drug after we graduated from chloroform and ether. Such drugs were extremely toxic and balancing oxygen saturation was a test for the best of any anesthetist. Recovery from general anesthesia took longer than the actual operation. <p> <p> Although the move to vaporizers was a giant step for doctors and mankind, the price was high on liver damage to patients as well as anesthesiologists. The daily inhalation unfortunately also took its toll on surgeons who spent hours day after day in the OR. It was in the late seventies that we started to see a move to what is now called "day surgery". One would arrive at the hospital for minor surgery and be back home that afternoon. The dawn of a new area of synthetic opioids which were well tolerated and effective, transformed simple albeit skillful surgical procedures.<p> <p> Research Pharmaceutical companies continued to press on with their commitment to reduce the toxic effect of vaporized solutions. There are only two now in use for general anesthesia under the name of desflurane and sevoflurane (fluorinated methyl ethyl ether brand). Though they vaporizes very readily, it is a liquid at room temperature. <a href="http://wikipedia.org/wiki/anaesthetic_machine">Anaesthetic machines</a> are fitted with a specialized anesthetic vaporizer unit that heats liquid desflurane to a constant temperature.<p> <p> Propofol back in the eighties showed tremendous potential as an anesthetic in combination with nitrous oxide, because of its efficacy, rapid onset, low toxicity and a low tolerance index. Any drug which acts on the CNS (central nervous system) as a relaxant have one thing in common. <b>tolerance</b>. This means an increasing dosage to deliver the same pharmacological effect. When synthetic benezodiazapies, Librium and Valium were introduced to the medical market by the Hoffman La Roche company in the sixties it revolutionized the management of neurotic anxiety complaints but tolerance was and still is the down side.<p> <p> Fentanyl is another synthetic opioids which although synthesized by <a href="http://en.wikipedia.org/wiki/paul_janssen">Dr. Paul Janssen</a> in 1959 following the medical inception of organic morphine several years earlier, and based initially on the chemical starting point of opioid activity. The widespread use of fentanyl triggered the production of fentanyl citrate, which entered the clinical practice as a general anesthetic under the trade name <a href="http://en.wikipedia.org/wiki/sublimaze">Sublimaze</a> in the 1960s. However due to the potential street abuse was and still is classified as a Schedule II drug in north America.<p> <p> The point I am making is that as far back as the eighteenth century when The Andean natives discovered the euphoric action of Erythroxylon coco and Albert Niamey isolated cocaine which was endorsed by Sigmund Freud for its physiological effects and In 1890 Halstead used cocaine for infiltration and conduction nerve block for dental use, nothing much has changed in the search for the euphoric effect other than the source being less ad hoc. Synthetic compounds are easily titrated for precise therapeutic efficacy. Whereas the effect of inhaling the fumes from roots or leaves do not have an FDA standard. What could be more poignant than Bob Marley's song "One love" in which he was in a twilight zone over political dogma. Ref. Bob Marley relics.<p> <p> In the mid 1990s, fentanyl saw its first widespread palliative use with the clinical introduction of the <a href="http://en.wikipedia.org/wiki/duragesic">Duragesic</a> patch, followed in the next decade by the introduction of the first quick-acting prescription formations of fentanyl for personal use. Through the delivery method of transdermal patches. Fentanyl is currently the most widely used synthetic opioid in clinical practice. Fentanyl is classified as a Schedule II drug in the United States due to its high potential for abuse.<p> <p> The general anesthetic Diprivan (propofol) is at the top of the headlines this week as more sweeping of Dr. Conrad Murray's gated house in which he lives continues. This scrutiny has resulted in three subpoenas being served on him. Until Michael Jackson's death Dr. Murray owned and managed thee offices; one in Las Vegas and two in Los Angeles. He was also selected as Michael's personal physician as he would travel as part of the team planning for his grand European tour. News reported that when in Los Angeles Dr. Murray lived at Michael's rented house and house keepers said they would see Dr. Murray come down in the morning with what looked like two empty oxygen cylinders, one in each hand. <p> <p> Propofol was never a controlled substance neither was it indicated for insomnia. Researchers also found that six out of 16 residents (about 38 percent) who abused propofol died from it. While these are small numbers, lead author Dr. Paul Wischmeyer, professor of anesthesiology at the University of Colorado, believes this is indicative of a larger problem. The use of propofol in conjunction of other synthetic narcotics along with nitrous oxide has revolutionized day surgery such as colonoscopies and even more complex surgical procedures. We will have to follow this drug to see if it will be classified under a schedule. Propofol (diprivan) however requires too complex an administration process for it to be targeted as a street drug.<p> <p> <p> Comments to <a href="mailto:localanesthetics@yahoo.ca"><span style="font-size: small;">localanesthetics@yahoo.ca</span></a><span style="font-size: small;"> M.Sc. PharmD. CCPE Please visit </span><a href="http://www.anestheticnews.com/"><span style="font-size: small;">WWW.AnestheticNews.com</span></a></span></span></div> <p> <p> <p> <p> </span> <p> <p> <p> <p> <p> <p> <p> <p> <p> <p> <p> <p> <p> <p> <p> <p> <p> <p> <p> <p></p>

Taking A Look At Short Term Disability Insurance

<p>In 2005 alone, there were more than 24 million disabling injuries. That's 2,750 every hour, says the National Safety Council! While all of these incidents did not result in permanent injury or the need for long term disability insurance, they did require some time off and many people were concerned about lost wages and how to cover basic living expenses. <p> Luckily, most working adults pay into a system of disability insurance through their employers, so they'll be covered should they ever need it. Self-employed individuals and contract employees may opt into a similar system to protect their wages as well. <p> One type of short-term disability insurance applies to the states of California, Hawaii, New Jersey, New York and Rhode Island only. These locations offer State Disability Insurance benefits, which may also be referred to as temporary disability insurance. <p> When a person comes down with an illness or non-work-related injury that is expected to last for a short amount of time, they can receive partial wage replacement under this program. These state programs pay maternity disability benefits for pregnancy and childbirth as well. <p> Workers may be able to go back to work -- either with the same employer or a different employer -- and will still receive a certain percentage of their new pay. The money for these programs is paid through automatic payroll deductions, so any non-government employee is eligible, even if they are currently out of work. (However, they will not be eligible for SDI and unemployment insurance at the same time.) <p> Once you apply for short-term disability insurance, you will have to wait to see if you're approved. On average, this can take anywhere from one day to 14 days. If approved, you will receive back-pay for the waiting period. Injuries generally clear much faster than illnesses, for which you will need a medical doctor to provide verification documentation on your disability insurance claims. <p> If you disagree with the rejection of your claim, then you may appeal the determination, file a lawsuit or both. If you intend to appear in court, it's advisable to have an attorney who specializes in disability benefits law. <p> Short-term disability insurance frees you from worrying about how you're going to pay the bills or cover basic daily expenses as you recuperate from a sudden illness or injury. In some cases, you may be quite certain that you're filing for disability long term, but you must first make a claim for short-term benefits and then re-apply for long-term benefits once your temporary disability insurance runs out. <p> In some cases, you will need to apply for social security disability if you are over age 65 or worker's compensation if you were hurt on the job. You aren't mandated to stay at home for the entire time you're rehabilitating; in fact, many employers encourage you to come back to work, even in part-time as you heal. <p> <p></p>