Tag: Pharmacology Articles

  • Ep.43 –Clonidine For The FRCA Primary

    Ep.43 –Clonidine For The FRCA Primary

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    James
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    Introduction Clonidine is alpha-2 adrenoceptor agonist. Progressively overshadowed by newer agents, its unique pharmacological profile—combining sedation, analgesia, and sympatholysis—makes it handy for intensive care sedation, regional anaesthesia augmentation, and perioperative blood pressure management. Understanding clonidine’s mechanism as a partial agonist, its biphasic cardiovascular effects, and its metabolic pathways is essential for safe clinical application and…

  • Ep.42– Dexmedetomidine For The FRCA Primary

    Ep.42– Dexmedetomidine For The FRCA Primary

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    James
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    Introducing Dexdor! Dexmedetomidine unlike traditional sedatives produces a distinctive sleep-like state that preserves patient arousability and respiratory drive. Unlike GABA modulating agents that create a general depression of consciousness. This GasGasGas episode explores the comprehensive pharmacology of this alpha-2 receptor agonist, its clinical applications, and practical considerations for the FRCA primary exam. Key Clinical Question: How…

  • Ep.41 –Midazolam For The FRCA Primary

    Ep.41 –Midazolam For The FRCA Primary

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    James
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    Midazolam Midazolam represents the cornerstone benzodiazepine in perioperative medicine, offering rapid onset sedation, anxiolysis, and amnesia with predictable pharmacokinetics. Understanding its mechanism, dosing strategies, and clinical applications is fundamental for safe anaesthetic practice and optimal patient care. Key Clinical Question: How can we optimise midazolam’s therapeutic benefits while minimising risks, particularly in vulnerable populations and…

  • Ep.40 –Etomidate For The FRCA Primary

    Ep.40 –Etomidate For The FRCA Primary

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    James
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    Etomidate: The Cardiovascularly Stable Hypnotic with a Cortisol Problem Understanding Etomidate for the frca exam needs to be somewhere on your list of things to learn, but not too near the top folks… It represents one of anaesthesia’s most intriguing paradoxes – a hypnotic agent with exceptional cardiovascular stability that’s been largely abandoned due to…

  • Ep.39 – Classifying Isomers For The FRCA Primary

    Ep.39 – Classifying Isomers For The FRCA Primary

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    James
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    Introduction to the Episode Understanding the concepts of stereochemistry and classifying isomers is fundamental to modern anaesthetic practice. The three-dimensional arrangement of atoms within drug molecules directly impacts their pharmacological properties, with some arrangements being therapeutically beneficial while others may be inactive or even harmful. This episode explores the critical concept of isomerism in anaesthetic…

  • Everything! Your brain needs to know about Local Anaesthetics For The FRCA Primary

    Everything! Your brain needs to know about Local Anaesthetics For The FRCA Primary

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    by

    James
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    Welcome to the comprehensive GasGasGas collection of knowledge regarding local anaesthetics for the FRCA Primary Exam. This full series covers every major local anaesthetic you’ll encounter in uk anaesthetic practice, handles the fundamentals of sodium channel pharmacology and onset mechanics of test agents to advanced clinical decision-making and emergency management. What You’ll Master Core Pharmacology:…

  • Ep.38–Peri-Neural Adjuncts to Local Anaesthetics – For The FRCA Primary

    Ep.38–Peri-Neural Adjuncts to Local Anaesthetics – For The FRCA Primary

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    James
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    Introducing Regional anaesthesia is becoming progressively more ingrained in clinical practice, yet block duration remains limited by the maximum safe dose of local anaesthetic that can be administered. This creates a clinical gap where adjunct agents could potentially enhance block quality and duration. However, the use of peri-neural adjuncts presents a complex risk-benefit analysis involving…

  • Ep37.2 – Local Anaesthetic Quiz For The FRCA Primary

    Ep37.2 – Local Anaesthetic Quiz For The FRCA Primary

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    James
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    Herein lies the ‘lets get down to Quiz-ness’ local anaesthetic pharmacology quiz’ You opened a chest at the end of a D&D dungeon complex and happen to find, Dr Gas’ excellent Local Anaesthetic Quiz How exciting, mayhap it will help you learn everything you need to know for the FRCA primary when it boils down…

  • Ep37.1 –Comparing Local Anaesthetics For The FRCA Primary

    Ep37.1 –Comparing Local Anaesthetics For The FRCA Primary

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    James
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    Comparing Local Anaesthetics Comparing local anaesthetics and selecting for specific indication is core anaesthetic work! Its also examined in the in the FRCA Primary Exam. From simple cannulation to emergency caesarean sections they are ubiquitous. This comprehensive guide summarizes the pharmacological properties of the major local anaesthetic agents covered in the Gas Gas Gas podcast…

  • Ep.36: Local Anaesthetic Systemic Toxicity (LAST) For the FRCA Primary

    Ep.36: Local Anaesthetic Systemic Toxicity (LAST) For the FRCA Primary

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    James
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    Introduction Local Anaesthetic Systemic Toxicity (LAST) represents one of the most clinically significant complications in regional anaesthesia practice. This episode explores the pathophysiology, recognition, and management of LAST with particular emphasis on emergency management protocols and risk mitigation strategies. Understanding LAST is crucial for safe regional anaesthesia practice, as it can occur with any local…

  • Ep.35 – Ropivacaine For The FRCA Primary

    Ep.35 – Ropivacaine For The FRCA Primary

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    by

    James
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    Episode Introduction Welcome to another essential episode of Gas Gas Gas, where we dive deep into the pharmacology that could make or break your FRCA primary exam. Today we’re exploring ropivacaine – the local anaesthetic you might not see every day, but absolutely need to understand when bupivacaine is in short supply or when examiners want to…

  • Ep.34 – Lidocaine For The FRCA Primary

    Ep.34 – Lidocaine For The FRCA Primary

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    by

    James
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    Introduction Welcome to lidocaine – the ubiquitous local anaesthetic that’s everywhere in clinical practice but comes with some important caveats. Whether you’re preparing for your primary FRCA exams or just starting your anaesthesia rotations, understanding lidocaine’s extensive clinical applications, antiarrhythmic properties, and the growing role of IV infusions for pain management is essential. This guide…

  • Ep.33 – Prilocaine For The FRCA Primary

    Ep.33 – Prilocaine For The FRCA Primary

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    James
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    Introduction Welcome to the prilocaine episode – the local anaesthetic that’s often overshadowed by Bupivacaine but deserves a place in your clinical toolkit. Whether you’re preparing and studying up on Prilocaine For The FRCA Primary exams or just starting your anaesthesia rotations, understanding prilocaine’s unique properties will help you tailor anaesthesia to patient and surgery…

  • Ep.32 – Cocaine For the FRCA Primary

    Ep.32 – Cocaine For the FRCA Primary

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    by

    James
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    Cocaine For the FRCA Primary If you like a story about extensive testicular traction and hammering shins then this is the episode for you.  This FRCA Primary Podcast episode explores cocaine and the exposure patients have to it in the clinical environment, chiefly courtesy of the ENT surgeons. The episode explores mechanism, side effects, onset,…

  • Ep.31 – Bupivacaine for the FRCA Primary Exam

    Ep.31 – Bupivacaine for the FRCA Primary Exam

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    James
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    Bupivacaine for the FRCA Primary In this episode, we dive deep into bupivacaine, exploring its friends (additives), mechanisms of action, and clinical applications. We’ll also cover the key differences between neuronal and cardiac action potentials, and discuss why levobupivacaine has become the preferred choice in many clinical scenarios. Bupivacaine Classification Appearance & Preparations Pharmacodynamics of…

  • Ep.30 – Local Anaesthetics, the Fundamentals

    Ep.30 – Local Anaesthetics, the Fundamentals

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    James
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    Local anaesthetics are fundamental to anaesthetic practice and A key element in the FRCA Primary Exam. From simple cannulation to emergency caesarean sections they are ubiquitous. This episode establishes the scientific foundation you need to understand how these drugs work, why they behave differently, and how to use them safely. By the end, you’ll understand…

  • Ep.29 – Comparing Opioids For the FRCA Primary

    Ep.29 – Comparing Opioids For the FRCA Primary

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    James
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    Opioids are a significant cornerstone of anaesthetic practice (and the primary FRCA exam), forming part of the triad of anaesthesia with their analgesic properties. Hence why Comparing Opioids For the FRCA Primary exam is out final opioid episode! We utilise these analgesic properties not just because “surgery hurts,” but also because our interventions cause discomfort…

  • Ep.28 – Remifentanil and the Minto Model

    Ep.28 – Remifentanil and the Minto Model

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    James
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    Remifentanil is a dream: ultra-short acting, reliably titratable, and deeply potent. This episode takes a dual-pronged approach—covering both the FRCA-relevant pharmacology of remifentanil and introducing the Minto target-controlled infusion (TCI) model. You absolutely should have a grip of a drug and a model that you are using every day. This is why Ep.28 Remifentanil and…

  • Ep.26 – Neuraxial Opiate Kinetics

    Ep.26 – Neuraxial Opiate Kinetics

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    James
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    Introduction In this explainer episode of GasGasGas, James delves into the joyful complexities of neuraxial opiate pharmacology. Why do we bother putting opiates into this space at all? What governs their journey, how do they behave once administered, and what clinical pearls can be drawn from their behaviour? This episode follows the journey of a…

  • Ep 25 – DiaMorphine

    Ep 25 – DiaMorphine

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    James
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    Diamorphine for the FRCA Primary In this episode of Gas, Gas, Gas, we dive deep into the pharmacology of diamorphine — also known by its more notorious street name, heroin. Diamorphine is a synthetic diacetylated derivative of morphine, and this episode details its mechanism of action, clinical applications, pharmacokinetics, pharmacodynamics, and side effect profile. The…

  • Ep 25 – Oxycodone

    Ep 25 – Oxycodone

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    James
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    1. Introduction Oxycodone is a semi‑synthetic opioid widely used for moderate‑to‑severe acute and cancer‑related pain. Its higher oral bio‑availability and potency relative to morphine make it a common choice in peri‑operative analgesia, patient‑controlled analgesia (PCA) and palliative care—topics examined in both the FRCA Primary (opioid pharmacology) and Final (peri‑operative pain management) curricula. 2. Classification 3.…

  • Ep 24 – Methadone

    Ep 24 – Methadone

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    James
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    In this episode of the GasGasGas Primary FRCA podcast, we explore methadone—its pharmacology, diverse receptor activity, and relevance in both chronic pain and addiction management. While traditionally associated with managing opioid dependency, methadone’s unique pharmacodynamics and potential utility may have been overlooked given its other uses… Medicine is plagued with Dogma and Sterotyping after all,…

  • Ep 23 – Tramadol for the FRCA Primary Exam

    Ep 23 – Tramadol for the FRCA Primary Exam

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    James
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    1. Introduction In this episode of GasGasGas, primary FRCA podcast, we dissect Tramadol, a somewhat controversial yet commonly encountered analgesic. While some clinicians appreciate its multimodal action, others question its efficacy. Understanding its nuanced pharmacology is crucial for FRCA candidates and in its clinical application. Certainly not one to forget, and the withdrawal of tramadol…

  • Ep.22 – Alfentanil

    Ep.22 – Alfentanil

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    James
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    Introduction In this episode of GasGasGas, we explore Alfentanil, a short-acting μ-opioid receptor agonist pivotal for anaesthetic practice. Discovered in 1976 by Janssen Pharmaceuticals, Alfentanil remains a valuable agent, especially for (modified) rapid-sequence induction and acute pain management. Content: What is Alfentanil? Alfentanil is a fast onset, fast offset, potent opioid receptor agonist. It is…

  • Ep 21 – Target-Controlled Infusion (TCI) Models: Marsh, Schneider & Eleveld

    Ep 21 – Target-Controlled Infusion (TCI) Models: Marsh, Schneider & Eleveld

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    James
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    Introduction to TIVA Models for propofol Welcome back to Gas, Gas, Gas—the podcast that breaks complex anaesthesia concepts into digestible, high-yield episodes. Today, we’re doing a deep dive into the TIVA Models for Propofol particularly the: Marsh, Schneider, and Eleveld TCI models. This isn’t just academic—understanding the underpinnings of these models means you can dose…

  • VivaCast 14 : Pharmacokinetics, Hypoglycaemics & Clinical Studies

    VivaCast 14 : Pharmacokinetics, Hypoglycaemics & Clinical Studies

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    James
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    In this episode of GasGasGas, we dive into the essential principles of pharmacokinetics, focusing on how drugs are processed by the body. We also explore the mechanisms and clinical implications of hypoglycaemic medications and discuss the fundamentals of clinical trials. Whether you’re a medical professional or an interested listener, this discussion is packed with keywords,…

  • VivaCast 12, Anti-Emetics, Propofol (again) and Anti-Microbials.

    VivaCast 12, Anti-Emetics, Propofol (again) and Anti-Microbials.

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    James
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    Tom’s exam inches ever closer to reality, here he gets caught out on Droperidol, nails the Journey a Propofol Bolus Takes and handles Anti-Microbial Surgical Prophylaxis. How does Droperidol function as an anti-emetic? Droperidol acts as a dopamine D2 receptor antagonist in the chemoreceptor trigger zone, reducing nausea and vomiting. It also has sedative properties…

  • Vivacast 7 – Adrenoceptors : Local Anaesthetics : Antiarrythmics

    Vivacast 7 – Adrenoceptors : Local Anaesthetics : Antiarrythmics

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    James
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    This Vivacast wanders into the realms of Adrenoceptors, Local Anaesthetics + PKAs and gets all caught up in classifying anti-arrythmics. We open up this episode a bit more, to show the reality of practicing for the exam, no one is perfect, if you get something wrong, or fumble it and spaff out disorganised madness –…

  • Ep 18 – Poly-Compartmental Model Madness – Part Two

    Ep 18 – Poly-Compartmental Model Madness – Part Two

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    James
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    Poly-Compartmental Confabulations, The Rubber Ducky Effect Site and more. This episode and post pairing will have you talking multi compartmental model pharmacokinetics like a champion in no time. How do compartment models explain drug distribution? Compartment models simulate how drugs distribute and eliminate in the body, using mathematical representations to predict concentration over time in…

  • Ep 17 – Poly Compartmental Madness – Part One

    Ep 17 – Poly Compartmental Madness – Part One

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    James
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    This FRCA podcast series will cover the multi-compartmental model We shall cover half-time, time constant, natural logs, Bi-Exponential Decay and Ficks Law of Diffusion. This is the build up to compartmentalising humans for TCI – these compartments are distinct but not necessarily anatomic or truly, physiologically defined elements, they are pharmaceutically convenient divisions of a human.…

  • Ep 16 – Suxamethonium for the FRCA Primary Exam

    Ep 16 – Suxamethonium for the FRCA Primary Exam

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    James
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    Suxamethonium, aka Sux.   A very speedy onset depolarising muscle relaxant.  It gets a bad rap, some people call it a horrible and mean drug, and I’m personally sure every time it gets used a panda expires. Used less and less as the familiarity of rocuronium climbs, perhaps suggamadex was the final death blow across the…

  • Ep 15 – Morphine for the FRCA Primary Exam

    Ep 15 – Morphine for the FRCA Primary Exam

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    James
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    Morphine for the FRCA Primary Exam This FRCA Primary Exam Podcast analyses Morphine, particularly the opiate receptors, mechanisms, pharmacokinetics and pharmacodynamics finishing up with clinical use. I appreciate that everyone is very familiar with Morphine, this creates two issues: So, I’ve been on the hunt for some GREAT facts to make it less boring! What…

  • Ep 14 – Ketamine for the FRCA

    Ep 14 – Ketamine for the FRCA

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    James
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    Ketamine  This episode is going to explore Ketamine and the knowledge you need for the FRCA primary. Chiefly, its properties, clinical uses, metabolism / clearance and we will spend some time on the NMDA receptor complex and what it gets up to! I want to stress right now that it is not a ‘get out…

  • Ep 12 – Comparing Volatiles for the FRCA

    Ep 12 – Comparing Volatiles for the FRCA

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    James
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    This episode focuses on drawing comparisons between the different volatile anaesthetic agents. There is every chance that you’ll be asked to compare and contrast a panel of drugs which yield similar clinical effects, like the opiates, hypnotics, volatiles or neuromuscular blocking agents. It’s very easy to get bogged down listing out information, so practicing this…

  • Ep 11 – MAC and the Partition Co-Efficients

    Ep 11 – MAC and the Partition Co-Efficients

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    James
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    This episode covers MAC (minimum alveolar concentration) and the concepts of blood:gas and oil:gas coefficients. We will explore the different MAC’s that are sometimes spoken of and make sure we are all on the same page about how volatile agents get in and the ratios they distribute themselves around in a human. For the real…

  • Ep 10 – Michaelis-Menten Enzyme Kinetics & Law of Mass action

    Ep 10 – Michaelis-Menten Enzyme Kinetics & Law of Mass action

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    James
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    Michaelis-Menten enzyme kinetics are a corner stone of hepatic clearance, enzyme activity and directly relate to the concepts of receptor binding and receptor affinity. It graphically represents the effects or partial vs complete agonism/antagonism. And this introduction to logarithmic graphs displaying concentration changes in a non-linear manner will ground you for volatile wash in curves,…

  • Ep 9 – Atracurium For The FRCA Primary

    Ep 9 – Atracurium For The FRCA Primary

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    James
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    Atracurium Is a oft used drug for muscle relaxation in anaesthesia given its very predictable offset, equally used in the critical care environment when paralysis for ventilation in critical ARDS is required. Check out the other episodes on suxamethonium and rocuronium, as well as the VIVAcast thinking about neuromuscular blockade. What is Atracurium? (Brand Name:…

  • Ep 8 – Thiopentone For The FRCA Primary

    Ep 8 – Thiopentone For The FRCA Primary

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    James
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    This episode covered Thiopentone For the FRCA Primary, it is a classic induction agent and considered a bit more BP stable when compared to propofol. Dr Gas conducted his first ever (modified)RSI with Thio, but went off recipe and added in some alfentanil at the start too. What is Thiopentone? Thiopentone is a barbiturate used…

  • Ep 7 – Compartmentalised Volatiles and a brief jaunt with Sevoflurane

    Ep 7 – Compartmentalised Volatiles and a brief jaunt with Sevoflurane

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    James
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    Compartmentalised Volatiles by this I am talking about the behaviours governing respective anaesthetic and patient compartment as they equilibrate with volatile agents, in this case Sevoflurane is our example. Sevoflurane is the most commonly used volatile / inhalational anaesthetic agent in UK practice, its friends isoflurane (cheaper, longer to get to wear off) Desflurane pricey,…

  • Ep 6 – Hepatic Clearance For The FRCA Primary

    Ep 6 – Hepatic Clearance For The FRCA Primary

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    James
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    This episode explores Hepatic Clearance of drugs and moves on to First and Zero Order Kinetics, these concepts are the building blocks for exponential decay that occurs in pharmacokinetic systems, check out Michaelis-menten enzyme kinetics and the multi compartmental madness / sevoflurane jaunt episodes for more. Clearance is a pharmacological concept used to consider the…

  • Ep 5 – pKa For The FRCA Primary

    Ep 5 – pKa For The FRCA Primary

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    James
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    pKA to script it more accurately. What is pKa and why does it matter? pKa is the association/disassociation constant It’s a number used to specify the balance of ionised and unionised molecules in a system, it is pH dependent. This is critical to the function of a drug – as the unionised quantity is the…

  • Ep 4 – Volume of Distribution For The FRCA Primary

    Ep 4 – Volume of Distribution For The FRCA Primary

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    James
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    This Episode Cracks on with a make believe…. concept! Volume of Distribution is an important concept to understand as it is a building block to thinking about multi-compartmental pharmacokinetics. Check out the multi-compartmental madness episodes if you want to jump ahead Madness Part 1 – Madness Part 2 It bears relevance when thinking about drugs…

  • Ep 3 – Fentanyl For The FRCA Primary

    Ep 3 – Fentanyl For The FRCA Primary

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    James
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    We’re talking the core fentanyl waffle, and a jump into the opiate GPCRs. Closing up with some talk on using fentanyl in day to day practice. Very commonly used opiate, chief uses include as a co-induction agent for anaesthesia, perioperative pain control, post op pain control and as an element of sedation for procedures /…

  • Ep 2 – Propofol for the FRCA Primary

    Ep 2 – Propofol for the FRCA Primary

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    James
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    Propofol is the most commonly used anaesthetic induction agent in UK healthcare For induction of anaesthesia, maintenance of anaesthesia, procedural sedation in theatre and in other hospital areas (ED) and also to maintain sedation on critical care. You will already be or will soon be very familiar with it. What is Propofol? Propofol is a…

  • Answering FRCA Pharmacology Questions

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    James
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    The – Model Answer To – ‘tell me about drug X‘ Name Class Chemical name Colour / appearance Additives Concentration Mac/BG/OG coefficients Dose route and amount Pharmacodynamics             Mechanism             Actions             Onset and Offset times             Side effects Pharmacokinetics             Absorption –             Distribution – VOD / protein binding             Metabolism –             Elimination…

  • Ep 1 – Rocuronium For The FRCA Primary

    Ep 1 – Rocuronium For The FRCA Primary

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    James
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    The first ever episode of Gas Gas Gas, Begins with Rocuronium, We talk pharmacologic data, mechanism of action and the neuromuscular junction. We crack out a model answer of the ‘classic approach’ to answering a what is drug X? type questions. The Concept Roc (rocuronium) is a commonly used muscle relaxant, convenient because it is…