[Verse 1]
Propofol drips into the vein, a white emulsion smooth,
Lipid soluble, high clearance — watch it redistribute and move,
Context-sensitive half-time climbs when infusions run too long,
GABA-A receptor agonist, hypnosis short and strong,
Apnea, hypotension, pain on injection — know the cost,
Without a titrated hand, the patient's airway can be lost
[Chorus]
Pharmacokinetics: absorption, distribution, metabolism, elimination
Pharmacodynamics: the receptor interaction, the clinical sensation
Volume of distribution tells you where the molecule goes to hide,
Clearance drives the half-life — let those four letters be your guide
Absorption, distribution, metabolism, elimination — A-D-M-E
Protein binding, hepatic extraction, renal filtration — that's the key
[Verse 2]
Opioids bind mu receptors, analgesia is the aim,
Fentanyl's lipophilic — rapid onset, potent frame,
Morphine glucuronidation yields active metabolites,
Remifentanil is ester-cleaved — context half-time never bites,
Respiratory depression, pruritis, delayed gastric drain,
Tolerance shifts the dose-response — you're titrating against pain
[Chorus]
Pharmacokinetics: absorption, distribution, metabolism, elimination
Pharmacodynamics: the receptor interaction, the clinical sensation
Volume of distribution tells you where the molecule goes to hide,
Clearance drives the half-life — let those four letters be your guide
Absorption, distribution, metabolism, elimination — A-D-M-E
Protein binding, hepatic extraction, renal filtration — that's the key
[Verse 3]
Neuromuscular blockers — depolarizing versus non,
Succinylcholine mimics ACh, then the fasciculations come,
Pseudocholinesterase deficiency prolongs the block for hours,
Rocuronium, vecuronium — aminosteroids with competitive powers,
Sugammadex chelates and wraps them, reversal quick and clean,
Monitoring train-of-four — don't extubate on residual curaremia
[Bridge]
Drug interactions thread through every case,
CYP enzymes induct or inhibit — metabolic race,
Volatile agents potentiate the block, MAC reduction too,
Polypharmacy demands you calculate the pharmacologic queue,
Therapeutic index narrow — ketamine dissociates the mind,
Dexmedetomidine at alpha-two: sedation, no respiratory bind,
Vasopressors, reversal agents, local anesthetics — each one a pharmacologic art,
Sodium channel blockade, bupivacaine cardiotoxic — lipid emulsion, restart
[Verse 4]
Benzodiazepines potentiate GABA chloride flow,
Midazolam water-soluble, becomes lipid once it hits below,
Neostigmine inhibits acetylcholinesterase — muscarinic side effects rise,
Pair it with glycopyrrolate — anticholinergic counters, that's the wise,
Adjuncts layer depth: ketamine, dexamethasone, regional nerve block,
Multimodal analgesia — you're building pharmacology around the clock