Anticholinesterases For The Anaesthetically Adept
Anticholinesterases for FRCA: mechanism of action, neostigmine pharmacology, muscarinic side effects, organophosphate poisoning, and acetylcholine synthesis at the NMJ.
19 Apr 2026
Podcast
56 episodes
Sugammadex For Anaesthetists
Sugammadex pharmacology for FRCA: mechanism, dosing by block depth, pharmacokinetics, anaphylaxis incidence, and the contraceptive interaction.
1 Apr 2026
Pancuronium For Anaesthetists
Pancuronium bromide: aminosteroid pharmacology, vagolytic cardiovascular effects, and Phase I vs Phase II neuromuscular blockade for FRCA preparation.
22 Mar 2026
Vecuronium For Anaesthetists
Vecuronium: aminosteroid non-depolarising neuromuscular blocker. Pharmacology, dosing, kinetics, cardiovascular profile, and monitoring for FRCA candidates.
26 Feb 2026
Cisatracurium For Anaesthetists
Cisatracurium is the 1R-cis, 1'R-cis isomer of atracurium — three times as potent, 'histamineless', and eliminated by Hofmann degradation regardless of organ function.
18 Feb 2026
Mivacurium For Anaesthetists
Mivacurium: plasma cholinesterase-metabolised NMB. FRCA: isomers, context-insensitive offset, histamine release, and cholinesterase deficiency.
1 Feb 2026
Oxygen for the FRCA Primary
Oxygen pharmacology for FRCA Primary: fractional distillation, cylinder pressures, oxygen toxicity, COPD hypercapnia, and BTS dosing targets.
22 Jan 2026
Nitrous Oxide for the FRCA Primary
Nitrous oxide pharmacology: MAC of 105%, NMDA receptor antagonism, diffusion hypoxia, vitamin B12 oxidation, Entonox, and the concentration effect.
9 Jan 2026
Ether, Enflurane and Explosions “barely for the FRCA”
Di-ethyl ether and enflurane: GABA-A volatile anaesthetic agents with high blood:gas partition coefficients, MAC values, side-effect profiles, and a guide to theatre fires, deflagration, and detonation for the FRCA.
29 Dec 2025
Desflurane for the FRCA and Vapourisers
Desflurane pharmacology for the FRCA: MAC, SVP, boiling point, Tec 6 vaporiser anatomy, temperature compensation, altitude effects, and why the NHS decommissioned it.
11 Dec 2025
Halothane For The 1963 Diploma in Anaesthesia
Halothane: physico-chemical properties, MAC, cardiovascular effects, and the two types of halothane hepatitis with mechanisms + (and fewer explosions).
27 Nov 2025
Ep.46 – Sevoflurane For The FRCA Primary
Sevoflurane pharmacology for the FRCA Primary — physico-chemical properties, MAC (2.0%), pharmacodynamics, gas induction advantages, and Compound A degradation.
12 Nov 2025
Ep.45 – Isoflurane For The FRCA Primary
Isoflurane pharmacology for the FRCA Primary: physico-chemical properties, MAC, blood:gas solubility, pharmacodynamics, pharmacokinetics, and Dalton's Law.
29 Oct 2025
Almost Everything You Need to Know About Opioids for the FRCA Primary Exam
Complete opioid pharmacology series for the FRCA Primary: receptor mechanisms, PK/PD profiles, neuraxial kinetics, and viva decision-making for all major opioids.
4 Aug 2025
Ep.30 – Local Anaesthetic Fundamentals for the FRCA Primary
Local anaesthetics block voltage-gated sodium channels. This episode covers pKa, nerve fibre classification, ester–amide pharmacology, and LAST management.
25 Jun 2025
Ep.29 – Comparing Opioids For the FRCA Primary
Comparing opioids for the FRCA Primary: pharmacokinetics, context-sensitive half-time, neuraxial selection, renal failure prescribing, and receptor pharmacology.
17 Jun 2025
Ep.28 – Remifentanil and the Minto Model
Remifentanil pharmacology for the FRCA: ester hydrolysis, context-sensitive half-time, opioid-induced hyperalgesia, and the Minto TCI model effect-site targets.
9 Jun 2025
Ep 25 – Diamorphine
Diamorphine pharmacology for the FRCA Primary: mechanism of action at mu opioid receptors, pro-drug metabolism to 6-O-acetylmorphine, neuraxial use, and M6G accumulation in renal failure.
29 May 2025
Ep 25 – Oxycodone for the FRCA Primary
Oxycodone: semi-synthetic opioid, 60–87 % oral bioavailability, CYP3A4/2D6 metabolism, and equipotency conversions for FRCA Primary pharmacology.
22 May 2025
Ep 24 – Methadone for the FRCA Primary
Methadone pharmacology for FRCA Primary: µ-opioid agonist, NMDA antagonist, CYP3A4/2D6 metabolism, QT prolongation, and opioid substitution therapy.
10 May 2025
Ep 23 – Tramadol for the FRCA Primary Exam
Tramadol pharmacology for the FRCA Primary: multimodal mechanism (mu-opioid, noradrenaline, serotonin), CYP2D6 metabolism, active metabolite, serotonin syndrome.
7 May 2025
Ep.22 – Alfentanil for the FRCA Primary
Alfentanil is a short-acting μ-opioid receptor agonist used in RSI, ICU sedation, and acute analgesia — FRCA Primary pharmacology examined in full.
28 Apr 2025
Ep.21 – Target Controlled Infusion (TCI) Models for Propofol – Marsh, Schnider & Eleveld
Marsh, Schnider, and Eleveld TCI models for propofol explained for FRCA — pharmacokinetics, compartments, effect-site targeting, and clinical dosing.
24 Apr 2025
VivaCast 16 – 1 Litre Blood Loss, Nerve conduction and pH
VivaCast 16: FRCA Primary physiology viva: acute blood loss physiology, nerve conduction + classification and acid-base balance / anion gap interpretation.
13 Apr 2025
VivaCast 15 – Clinical Case: IV Drug User with an Infected Pseudoaneurysm
Anaesthetic management of an infected pseudoaneurysm in an IVDU: sepsis, opioid tolerance, femoral nerve block, and local anaesthetic systemic toxicity.
3 Apr 2025
VivaCast 14 : Pharmacokinetics, Hypoglycaemics & Clinical Studies
Pharmacokinetics (ADME), hypoglycaemic drug classes, and clinical trial design — core FRCA Primary pharmacology covered in a 20-minute VivaCast.
27 Mar 2025
VivaCast 13 – Ultrasound, Cardiac Output Monitoring and Diathermy | FRCA Primary Viva
Viva-format episode covering ultrasound physics, cardiac output monitoring (non-invasive to Swan-Ganz), and diathermy safety for the FRCA Primary exam.
19 Mar 2025
VivaCast 12, Anti-Emetics, Propofol (again) and Anti-Microbials.
Pharmacology viva covering antiemetic receptor targets (D2, 5-HT3, H1), propofol bolus pharmacokinetics, and antimicrobial prophylaxis — FRCA Primary.
14 Mar 2025
VivaCast 11 – Liver Physiology
Liver physiology for the FRCA Primary: dual blood supply, hepatic acinar zones, CYP450 biotransformation, bilirubin conjugation, and paracetamol toxicity.
5 Mar 2025
Vivacast 10 – Hypoxia Classification, Delivery, Saturations
Tom gets quizzed on what defines hypoxia, how oxygen is delivered to tissues and how the oxyhemoglobin disassociation curve behaves. Oxygen must traverse multiple steps from atmosphere to mitochondria, and issues at any stage results in tissue hypoxia with those inherent consequences. Understanding
26 Feb 2025
Vivacast 09 – The Cardiac Cycle, Coronary Perfusion, + Flow & Resistance
Cardiac cycle phases, coronary perfusion pressure, Hagen-Poiseuille equation, and Reynolds number — FRCA Primary cardiovascular physiology VivaCast.
21 Feb 2025
VivaCast 8 – Oxygen Storage – Wheatstone Bridge – Art Lines – Fibre Optics – Lasers
FRCA Primary viva: oxygen storage, vacuum insulated evaporators, Wheatstone bridge, arterial line damping, fibre optics, and lasers.
16 Feb 2025
Vivacast 7 – Adrenoceptors : Local Anaesthetics : Antiarrhythmics
Adrenoceptors, G-protein signalling, local anaesthetic pKa, and Vaughan Williams antiarrhythmic classification — FRCA Primary pharmacology viva practice.
9 Feb 2025
VivaCast 6 – Alveolar Gases, Oxygen Cascade, Partial Pressure Sensing and the Valsalva Manoeuvre
FRCA VivaCast covering the alveolar gas equation, oxygen cascade, shunt, hypoxic pulmonary vasoconstriction, and the Valsalva manoeuvre — with debrief.
4 Feb 2025
VivaCast 5 – Clinical Station – Onco-Laparotomy
Emergency laparotomy FRCA clinical viva: Tom walks through a structured approach to an elderly oncology patient with bowel perforation, covering pre-op assessment, RSI, intra-operative monitoring, and post-op critical care.
27 Jan 2025
Ep 18 – Poly-Compartmental Madness – Part Two
Multi-compartmental pharmacokinetic models, context-sensitive half time, and the effect site explained for FRCA Primary candidates.
20 Jan 2025
VivaCast 4 – FRCA Physics: Gas Laws, Heat, Humidity and Vapourisers
FRCA Primary physics: gas laws, saturated vapour pressure, humidity, Entonox, Kelvin, and desflurane vs sevoflurane vaporiser function.
15 Jan 2025
Ep 17 – Multi-Compartmental Model – Part One: Half-Life, Time Constant and Bi-Exponential Decay
Pharmacokinetic compartment models for FRCA: half-life, time constant, bi-exponential decay, and Fick's Law — the foundation of TCI dosing.
8 Jan 2025
VivaCast 03 – NMJ inhibiting agents – Suxamethonium vs Rocuronium – Reversal
FRCA viva: suxamethonium vs rocuronium mechanisms, malignant hyperthermia, suxamethonium apnoea, and reversal with sugammadex and neostigmine.
23 Dec 2024
Vivacast 02 – CO2 Transport – Intra-Cranial Pressure – Neonatal Physiology
FRCA Primary physiology viva: CO₂ transport from tissues to lungs, determinants of intracranial pressure, and neonatal cardiovascular changes at birth.
6 Dec 2024
VivaCast 1 – Cleaning and Sterilisation for the FRCA Primary Exam
Cleaning and sterilisation of medical equipment for the FRCA Primary Viva: autoclaving, Spaulding risk classification, disinfection levels, and glutaraldehyde.
2 Dec 2024
Ep 16 – Suxamethonium for the FRCA Primary Exam
Suxamethonium: depolarising neuromuscular blocker, 30 s onset. FRCA pharmacology — mechanism, side effects, sux apnoea, malignant hyperthermia.
29 Nov 2024
Ep 15 – Morphine for the FRCA Primary Exam
Morphine for the FRCA Primary: mu-opioid receptor mechanism, pharmacokinetics, M3G/M6G metabolites, and intrathecal delayed respiratory depression.
22 Nov 2024
Ep 14 – Ketamine for the FRCA
Ketamine pharmacology for the FRCA Primary: NMDA receptor antagonism, dissociative anaesthesia, dosing, pharmacokinetics, and cardiovascular effects.
17 Nov 2024
Ep 12 – Comparing Volatiles for the FRCA
Compare sevoflurane, isoflurane and desflurane for the FRCA: MAC values, blood:gas and oil:gas partition coefficients, SVP, boiling points, and global warming potential.
11 Nov 2024
Ep 9 – Atracurium For The FRCA Primary
Atracurium: benzylisoquinolinium NMB with Hofmann elimination. Organ-independent clearance, dosing, side effects, and laudanosine — FRCA Primary pharmacology.
9 Nov 2024
Ep 11 – Minimum Alveolar Concentration (MAC) and Partition Coefficients
Minimum alveolar concentration (MAC), blood:gas and oil:gas partition coefficients, wash-in curves, and MAC variants explained for FRCA Primary candidates.
9 Nov 2024
Ep 10 – Michaelis-Menten Enzyme Kinetics & Law of Mass action
Michaelis-Menten kinetics explain enzyme saturation, Km, Vmax, and the transition between first-order and zero-order kinetics — core FRCA Primary pharmacology.
9 Nov 2024
Ep 8 – Thiopentone For The FRCA Primary
Thiopentone pharmacology for FRCA Primary: GABA-A mechanism, tautomerism, zero-order kinetics, cardiovascular and CNS effects, contraindications, and RSI use.
9 Nov 2024
Ep 7 – Compartmentalised Volatiles and a brief jaunt with Sevoflurane
Sevoflurane pharmacokinetics for FRCA: wash-in, wash-out, compartmental distribution, blood-gas partition coefficient, MAC factors, and low-flow technique.
8 Nov 2024
Ep 3 – Fentanyl For The FRCA Primary
Fentanyl pharmacology for FRCA Primary: mu-opioid receptor mechanism, pharmacokinetics, opioid receptor subtypes (MOP/DOP/KOP/NOP), and clinical dosing.
8 Nov 2024
Ep 6 – Hepatic Clearance For The FRCA Primary
Hepatic clearance, extraction ratio, and intrinsic clearance explained for the FRCA Primary — how hepatic blood flow and protein binding govern drug elimination.
8 Nov 2024
Ep 2 – Propofol for the FRCA Primary
Propofol pharmacology for FRCA: GABA-A mechanism, three-compartment kinetics, propofol infusion syndrome (PRIS), and TIVA dosing.
8 Nov 2024
Ep 1 – Rocuronium For The FRCA Primary
Rocuronium pharmacology for FRCA Primary: mechanism of action, dosing, pharmacokinetics, sugammadex reversal, and neuromuscular junction.
8 Nov 2024
Ep 4 – Volume of Distribution For The FRCA Primary
Volume of distribution (Vd) is a core FRCA pharmacokinetic concept — a theoretical apparent volume explaining why drugs distribute differently across patients and tissues.
8 Nov 2024
Ep 5 – pKa For The FRCA Primary
pKa is the pH at which a drug is 50% ionised and 50% unionised. Governing onset speed, membrane crossing, and local anaesthetic behaviour. Essential for the FRCA Primary.
8 Nov 2024