Use new drugs with caution

Beware of new drugs being introduced in the market...The pharmacologist and the drug industry have to criticize the old drugs to replace them with new. They have criticized Thiopentone to make way for their costly drug-Propofol. They highlight the rapid recovery of consciousness, which can be advantageously used for operations for day care surgery. But one has to remember that its use as induction agent for a prolonged surgery has no meaning. Even Thiopentone is metabolised and excreted in that time. The cost of the new drug is very high. The solvent of the drug is Egg white and soya bean oil. One raises a doubt to inject a foreign protein I.V. that may land you with serious anaphylactoid reaction and death. Thus you have to weigh the advantages and disadvantages by discussing with your colleagues and not be misled by the medical representatives.
They are now trying to throw out Scoline by propagating single long acting muscle relaxant with increased initial dose to be used for intubation. They try to highlight the bad effects of Succinylcholine Chloride. But ask yourself a simple question “How many deaths have you heard or seen in clinical practice under Scoline.” Except in cases where the drug is definitely contra indicated with raised serum potassium due to any cause at least in my practice I have not come across a single case with death due to Scoline. The first successful drug Atracurium which was successfully launched to replace Scoline was found later to cause anaphylactoid reaction due to intubating dose. It was abandoned in Europe and was being dumped in India. Luckily better drugs appeared in the market and we in India were prevented from being guinea pigs.