My Blog

poet often describe love as an emotion we cannot control, one that overwhems logic and common sense. that’s what it was like for me. i didnt plan on falling in love with you and i douth if you planned on falling in love with me. but once we me, it was clear that neither of us could control what was happening to us. we fell in love, despite our differences, and once we did, something rare and beautiful was created. for me love like that has happened only once, and thats why every minute we spend together has been seared in my memory. Ill never forget a single moment of it. i love you beh’ and i will always do.

i am nothing special; of dis i am sure. i am a common man wid commom thoughts, & i’ve led a common life. there r no monuments ddcated 2 me & my name will soon b 4goten, but I’ve lived another wid ol my heart & soul & 2 me dis has always been enough

Local anesthetics Surface (topical or mucosal) anesthetics • Bezocaine (Americaine, Anbesol, Chloraseptic, Num-Zit, Orajel) • Butamben (Butensin) • Cocaine • Dibucaine (Nupercainal) • Dyclonine (Dyclone, Sucrets) • Pramoxine (Anusol, Prame-Jel, ProctoFoam, Tronolane, Tronothane) • Proparacaine (Alcaine, Ocu-Caine, Ophthaine) Parenteral anesthetics • Articaine (Astracaine, Ultrcaine) • Bupivacaine (Marcaine, Sensorcaine) • Chloroprocaine (Nesacaine) • Etidocaine (Duranest) • Levobupivacaine (Chirocaine) • Lidocaine (Xylocaine, Dalcaine, Dilocaine , L-Caine, Octocaine) • Mepivacaine (Carbocaine, Polocaine) • Prilocaine (Citanest) • Procaine (Novocain) • Proparqacaine (Ophthaine, Alcaine) • Ropivacaine (Naropin) • Tetracaine (Pontocaine) Mechanism of action Works by blocking fast sodium channels in peripheral sensory nerve fibers and thereby preventing the pain-producing signals-or any sensory information from the affected are-from reaching the brain Surface anesthesia Applied as drops, sprays, lotions creams or ointment Used to eliminate gag reflex Local anesthetics administer by injection Infiltration anesthesia Refers to the superficial application of a local anesthetics Intravenous regional anesthesia (Bier’s Block) Used in surgery of the forearm and hand or foot and distal leg Nerve block anesthesia The injection of a local anesthesia along a nerve before it reaches the surgical site • Epidural anesthesia – administered outside the dura mater • Caudal anesthesia – for of epidural anesthesia achieve by administering local anesthetic into the base of the spine • Spinal anesthesia – achieved by injecting local anesthetics into the subarachnoid spaces between the arachnoid and pia mater membranes in the lumbar area • Saddle block – used principally in obstetrics for vaginal delivery Pharmacokinetics Enter systemic circulation and affects other organs, especially excitable tissues such as the brain and the heart Adverse reaction • Euphoria, anxiety, tingling (paresthesia), tremors and ringing in the ears (tinnitus) • Profound hypotension resulting to coma • Life cardiac threatening arrhythmia • Skin rashes (contact dermatitis) Inhaled anesthetics • Desflurane (Suprane) • Enflurane (Ethrane) • Halothane (Fluothane) • Isoflurane (Florane) • Nitrous oxide • Sevoflurane (Ultane) Mechanism of action Mechanism is still unknown, but believed that they effect on receptors of the inhibitory neurotransmitters GABA, produce classic state which includes analgesia, hypnosis, amnesia and depression of reflexes. Pharmacokinetics Inhaled anesthesia is a mixture of volatile liquids or gas and oxygen. When inhaled drugs are administered by mask, the gases flow into the mask through finely calibrated vaporizers. The amount of vapor the patient receives determines the depth of anesthesia. The distribution of the anesthetics is determined by the blood flow; thus the brain, liver and kidney reaches equilibrium first excretion is largely though the lungs. Emergence is the time during which the patient regains consciousness after the anesthetic has been discontinued Adverse reaction • Halothane and enflurane – reduces B/P as will as cardiac output • Desflurane and isoflurane - lower B/P but little effects on cardiac output • Respiratory depression, decrease ventilatory response to hypoxia, increase bleeding during D&C • Nitrous oxide –can cause blockage to the middle ear, pneumothorax loops of twisted intestine, renal cysts and the skull Intravenous anesthetics Barbiturate • Methohexital (Brevital) • Thiopental (penthothal) Benzodiazepines • Diazepam (valium) • Midazolam (versed) Opioids • Alfentail (alfenta) • Fentanyl (sublimaze) • Remifentanil (ultiva) • Sufentanil(sufenta) Others • Droperidol (inapsine) • Etomidate amidate) • Ketamine (ketalar) • Propofol (diprivan) Mechanism of action • Except for ketamine and the opioids are thought to produce an anesthetic-likestate primariry by increasing the effect of GABA – potential to depress vital functions conrolled by the brain. • Ketamine works by interfering with the action of glutamate which acts as an excitatory neurotransmitter. • Opioid actby stimulating receptors for opiates and opioid peptides in the CNS • It ca provoke profound analgesia but not actually anesthetic drug. Uses Primarily use for these drugs is in the induction of the anesthetic state, usually in short surgical procedures or where inhaled anesthetics will be employed for maintenance. Pharmacokinetics • The brain has a very high blood flow; a drug placed directly in the bloodstream will go first to the brain in high concentration • These drugs are very lipophilic so they easily cross the blood-brain barrier and enters the CNS Neuromuscular blocker Nondepolarizing • Antracurrium (tracrium) • Cisatracurium (nimbex) • Doxacurium (nuromax) • Mivacurium (mivacron) • Pancuronium (pavulon) • Pipecuronium (arduan) • Rocuronium (zemuron) • d-tubocurarine (turbarine) • vecuronium (norcuron) Depolarizing • Succinylcholine (anectine, quelicin, sucostrin) Mechanism of action Acts primarily as competitive antagonist at these receptors, thus preventing muscle contraction in response to motor nerve activity Uses Neuromuscular-blocking drugs provide muscle relaxation, particularly of the abdominal muscles, during surgery Also permits the use of a lower concentration of inhaled anesthetic, thereby reducing cardiovascular depression Pharmacokinetics Paralyzed patient must remain on artificial ventilation as long as a neuromuscular blocker is effective Adverse reaction • Triggers the release of histamines from mast cell • Alter cardiovascular function is by acting • At other cholinergic receptors found in the parasympathetic nervous system

You’re my everything

You’re my everything
The sun that shines above you makes the blue bird sing
The stars that twinkle way up
in the sky tell me I’m in love

Chorus
When I hold you tight there’s nothing That can harm you In the lonely night
I’ll come to you
And keep you safe and warm
It’s so strong, my love

Friend of Mine

I’ve known you for so long
You are a friend of mine
But is this all we’d ever be?
I’ve loved you ever since
You are a friend of mine
And babe is this all we ever could be?

You tell me things I’ve never known
I shown you love you’ve never shown
But then again, when you cry
I’m always at your side
You tell me ’bout the love you’ve had
I listen very eagerly
But deep inside you’ll never see
This feeling of emptiness
It makes me feel sad
But then again
Then again
Then again I’m glad

Means of ABC For A FRIEND
A Friend….
(A)ccepts you as you are
(B)elieves in "you"
(C)alls you just to say "HI"
(D)oesn’t give up on you
(E)nvisions the whole of you (even the unfinished parts)
(F)orgives your mistakes
(G)ives unconditionally
(H)elps you
(I)nvites you over
(J)ust "be" with you
(K)eeps you close at heart
(L)oves you for who you are
(M)akes a difference in your life
(N)ever Judges
(O)ffer support
(P)icks you up
(Q)uiets your fears
(R)aises your spirits
(S)ays nice things about you
(T)ells you the truth when you need to hear it
(U)nderstands you
(V)alues you
(W)alks beside you
(X)plains thing you don’t understand
(Y)ells when you won’t listen and
(Z)aps you back to reality

When youre down and troubled
And you need a helping hand
And nothing, whoa nothing is going right.
Close your eyes and think of me
And soon I will be there
To brighten up even your darkest nights.

You just call out my name,
And you know whereever I am
Ill come running, oh yeah baby
To see you again.
Winter, spring, summer, or fall,
All you have to do is call
And Ill be there, yeah, yeah, yeah.
Youve got a friend.

If the sky above you
Should turn dark and full of clouds
And that old north wind should begin to blow
Keep your head together and call my name out loud
And soon I will be knocking upon your door.
You just call out my name and you know where ever I am
Ill come running to see you again.
Winter, spring, summer or fall
All you got to do is call
And Ill be there, yeah, yeah, yeah.

Hey, aint it good to know that youve got a friend?
People can be so cold.
Theyll hurt you and desert you.
Well theyll take your soul if you let them.
Oh yeah, but dont you let them.

You just call out my name and you know wherever I am
Ill come running to see you again.
Oh babe, dont you know that,
Winter spring summer or fall,
Hey now, all youve got to do is call.
Lord, Ill be there, yes I will.
Youve got a friend.
Youve got a friend.
Aint it good to know youve got a friend.
Aint it good to know youve got a friend.
Youve got a friend.

Phantom Of The Opera - All I Ask Of You Lyrics

No more talk of darkness,forget these wide-eyed fears;I'm here, nothing can harm you,my words will warm
and calm you.Let me be your freedom,let daylight dry
your tears;I'm here, with you, beside you,to
guard you and to guide you.

ChristineSay
you'll love me ev'ry waking moment;turn my head
with talk of summertime.Say you need me with you now and
always;promise me that all you say is true,that's all I ask of you.

RaoulLet me be
your shelter,let me be your light;you're safe,
no one will find you,your fears are far behind you.

ChristineAll I want is freedom,a world with
no more night;and you, always beside me,to hold me
and to hide me.

RaoulThen say you'll share
with me one love, one lifetime;let me lead you from you
solitude.Say you need me with you, here beside you,anywhere you go, let me go too,that's all I ask of
you.

ChristineSay you'll share with me one
love, one lifetime.Say the word and I will follow you.

TogetherShare each day with me, each night, each
morning.

ChristineSay you love me...

RaoulYou know I do.

TogetherLove me,
that's all I ask of you.

Anywhere you go let me
go too

Love me...that's all I ask of
you.

We see people in different sides, We anticipate what we believe it should be a person is, In our ideal ways. Our impressions to a person marks our Thoughts to somebody that we believed. We perceived people differently, We perceived person on our ideal way, We perceived someone more that its body parts. So it was in friendship. The more you know a person, And understands them, The more your ties are bonded stronger. Friendship is more than what we Know on somebody’s physical and social parts, But dig deeper on someone’s heart, On how more we understand and how more we are there In moments, more than what we did not expect. You’ve been a good friend to me ma’am Meg, Not just ordinary but very special, Your kindness counts to everyone. Ill never forget such a person who shape my whole being

A mile with me

O who will walk a mile with me
Along life’s merry way?
A comrade blithe and full of glee,
Who dares to laugh out loud and free,
And let his frolic fancy play,
Like a happy child, through the flowers gay
That fill the field and fringe the way
Where he walks a mile with me.

And who will walk a mile with me
Along life’s weary way?
A friend whose heart has eyes to see
The stars shine out o’er the darkening lea,
And the quiet rest at the end o’ the day,—
A friend who knows, and dares to say,
The brave, sweet words that cheer the way
Where he walks a mile with me.

With such a comrade, such a friend,
I fain would walk till journeys end,
Through summer sunshine, winter rain,
And then?—Farewell, we shall meet again!