Nanomedicine

Anaesthesia & critical care

PRESENTED BY
DR.N. GOPAL REDDY, M.D.
Associate professor Anaesthesiology
Kims- -Nkp-Nalgonda.Telangana
objective
To cerate interest, enthusiasm in medical post-
graduates students.

To know updates in medicine and anaesthesia.

 To create more academic interest.

To create research orientation.

What is NanoTechnology
Smallest Technology to be used at cellular,
molecular and atomic level
A nanometer is a billionth of a meter
Use of nano tech in medicine is called
nanomedicine
Nano-robots(Nanobots) are used in this
technology
 Present Medical Challenge
are many
•Aging, Arteriosclerosis
•Artificial Blood and Respiration
•Bacterial ,viral Infections
•Cancer, Heart disease
•Congenital defects
•Cosmetics and Hair Care
•Dental Care
•Diagnosis and Testing
•Emergency Care and Trauma
•Gene Therapy
•Neurological Damage
•Thrombosis

•Answer is-nano technology

Nanotechnology -medicine
Nanotechnology is especially important to medicine
because the medical field deals with things on the
smallest of levels.
Additionally, the small nano devices that are being
developed right now can enter the body and look
around in ways that large humans can only dream of.
 Here are many ways that nanotechnology is
revolutionizing medicine:
 MEDICAL USE-NANO TECH
1.Prevention-diagnosis & 2.Regenerative medicine
Treatment
 Cell repair
 Disease prevention
 Bone repair
 Imaging
 Ageing
 Pre-natal
 Stem cells
 Virtual reality
 Individual medicine  Reproduction of new organs
 Emergency medicine  Heart disease
 Anaesthesia& ICU  Diabetes
 Research  Seizures
 Medical monitoring  Sensory feed back
 Medical records  Limb control
 3. Nano –bio pharmacy  Surgery
 Drug delivery  Dental
 Cancer treatment
 Ophthalmic etc
Nanotechnology-nanobots:
Primary technical tools used in this technique are
nanorobots.
These smallest of robots could be used to perform a
number of functions inside the body and out.
• They could even be programmed to build other nano-
bots.
• The Nano -boats are atomically build structures atom by atom
by nano technology.
• They can perform multiple cellular level functions, including
replacing, repairing DNA that is damaged in the cell as we
age and diseased.
• They are self replicating.

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 Nano -boats
•The Nano -boats are atomically build structures
atom by atom by nano technology.
•They can perform multiple cellular level functions,
including replacing, repairing DNA that is
damaged in the cell as we age and diseased.
•They are self replicating.
 NANOBOTS
They are very small, tiny robots will have built in
power supplies, sensors and on board computers to
direct activities.
Travel through blood stream, even squeeze
narrowest capillaries of the body.
Cure the disease and improve the health.
Medical nanobots can easily repair individual cells.
They are synthetic with biological function at atomic
level and perform programmed task.
We see fruits in late 2020.
 Future- Robotic system
Nano-boats- Types
Single action- nanobots,
Disease specific nanobots
Drug carrier nanobots
Inhaled drugs-nanobots
Chromallocytes
Vasculoids- blood like
Respirocytes-RBC Like
Clottocytes –platelets
Microbiovores-virus, bacteria killers, cancer curers.
Different Nanorobot Species

Respirocytes. (Artificial red cells)

Microbivores (artificial white cells)

Clottocytes (artificial platelets)

Pharmacytes (ideal drug delivery nanorobots)
Dentifrobots (dental nanorobots)

Vasculoid (complete artificial vasculature)

Nonobuilders- (reconstructing nanobots)
Shapes Of Nanobots
Nano bots in work- blood stream
 NANOBOTS -USE
 Repair of damaged tissue
 Gases exchange-o2 and co2
 Carries nutrients and others
 Drug delivery,
 Cancer detection and cure
 Investigation and imaging
 Gene silencing,.
 Anaesthesia
 Critical care,
 heart and lung repair
 Pain –palliative care
Advantages of nano robots
Nano robots are non biological entities– no side
effects.
Being highly specific and target oriented -reduce
morbidity.
Since they reach specific sectors, lesser drug required.
They bind to terminal receptors. No peaks and
troughs in effect.
 They do not follow first order kinetics as other
injectables
Cell repair:
Damaged cells of the body can be very difficult to
repair.
 Cells are incredibly very small.
 But nanotechnology could provide a way to get
around this.
 Small nanobots or other devices could be used to
manipulate molecules and atoms on an individual
level, repair cells- called (repairing nano boats).

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Cell –repair- sickle RBC
 RESPIROCYTES (RBC)
These
nanostructures
transport o2 in
human body similar
to erythrocytes 256
times faster.
Shape- micron in
diameter
Also transport co2
 CLOTTOCYTES

artificial platelets -halt bleeding 100 to 1000 times

faster.
Number required is very less for desired activities.
Specifically programmed motile clottocytes -detect
internal bleeding and spontaneously seal the site.
Giving hope for avoiding emergency surgeries.
 Reduces the ICU mortality.
No bleeding diathesis, no DIC-syndrome.
 CLOTTOCYTES
various stages of clot formation-bleeding control

Image #208 Image #209 Image #210 Image #211

Fibot 1 Fibot 2 Fibot 3 Fibot 4

Image #212 Image #213

Fibot 5 Fibot 6
various stages of clot formation-
bleeding control
Microbivores
Microbivores would mimic white cells and perform phagocytosis of specific bacteria, viruses or fungi.

Microbivores
Microbivores

This alternative version

of artificial white cells
uses retractable
tentacles, encircling
the main body, to
convey the idea of
pathogen capture, in
place of the hundreds
of tiny telescoping
arms that were
employed in Freitas'
original technical

design.
The artist also added intake and exhaust vents for propulsion and
maneuvering. Each nanorobot is about 3 microns in size.
A natural white cell is present in the background to
provide visual scaling. In the lower image, the tentacles
have been fully retracted
 Vasculoids:
A vasculoid is a single, complex, multi-segmented
nanotechnological medical robotic system
 capable of all transport functions of the blood,
including circulation of respiratory gases, glucose,
hormones, ,cytokines, waste products and cellular
components.
This nanorobotic system could substitute the human
vascular system.
Pharmacytes
An ideal nanotechnology-based drug delivery system
is a pharmacyte--a self-powered-
Drug will de delivered at desired sites-useful for nerve
block.
 Pharmacytes
Drug-carrying
nanoparticles may be
targeted to specific cell
types.
Dentifrobots
Dentifrobots: Medical nanobots capable of repairing
the various tissues of the teeth and gums will bring
new dimensions to dental care
Diagnostics-medical lab
nanotechnology-puts-a-medical-lab-in-your-hand..
 with high-powered chip -performs various lab functions.
Rapid testing, potentially in the doctors office - complete
diagnosis and start of treatment immediately-stopping
disease early possibly with less damage to the patient.
CRITICAL-CARE-PROBLEMS
Vitals maintenance
Infection control
Antibiotic resistance
Ventilator dependence
ARDS
Cardiac failure
Pain –palliative care
CILIA CLEANING
Repair of ARDS lung
A single inhaled nanorobot reaches, deeply inspired into the lungs, enters an
alveolar duct and attaches to the tissue surface. A pulmonary alveolar
macrophage slowly crawls along the duct wall in the background and repair
NANO-ATROPINE INHALATION
DRUG-AGRI -FIELD USE
Organo phosphorous poisoning commonly
encountered in ICU
Atropine is primary drug along with others
Nano –atropine in inhalation form can be used in
field conditions also even by lay man when supplied
with pesticide and used in case of accidental
poisoning.
LOCAL ANAESTHESIA
Lidocaine – loaded poly-carpo-lactone – polyethylene
glycol – poly-carpo-lactone (pcl-peg-pcl)
nano particles in hydrogel of size 200 nm.
This is superior in terms of onset of anaesthesia and
efficacy .
Once drug injected-it is directed through Nano-
computers to the specific site where action is required,
kept at that site for wanted time , removed from body
when not required.
GENERAL ANAESTHESIA
With slight modification of pentathol, propofoal ,
other induction agents muscle relaxants and
other drugs by nano technology , we achieve pro-
drugs devoid of draw- backs and improvement in
induction of anaesthesia.
 Once drug injected-it is directed through Nano-
computers to the specific site where action is required,
kept at that site for wanted time , removed from body
when not required.
The process of drug metabolism short circuited
Pain and palliative care
Up coming super sociality of anaesthesialogy
Commonly narcotics are used for chronic pain
Have side effects and addiction potential
Solution-soxitoxin potent anaesthetic bundled with
liposomes
Slow release –nerve blocking losts from days to
months
Non-toxic to nerves and surrounding tissue
Formulation with nano revolutionise the technic.
Drug delivery to nerve endings, neuro –muscular
junction or at required site -anaesthesia use-
for pain control in pain & palliative care
OT –rooms,ICU and other areas
Cell repair:
Damaged cells of the body can be very difficult to
repair.
Small nanobot devices could be used to manipulate
molecules and atoms on an individual cell level, repair
them.
Nanotechnology to repair our cells:
Heart disease:
There is a possibility that nanobots could perform a
number of heart related functions in the body.
The repair of damaged heart tissue is only one
possibility.
Another option is to use nano devices to clean out
arteries, helping unclog those that have buildup due
to cholesterol and other problems.
Chest pain-heart care
 Heart-vessels-toxicology
Nanobots remove plaques from arterial walls , detect
and repair weak areas.
Detect chemicals and toxins and give early warning of
organ failure or tissue rejection.
Also used to take bio-metric measurements,
employed to monitor the general health of an
individual
Ischemia- blocked vessel

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analysis and drug delivary-5 minutes
Nanobots injected-clearing plaques
CLEANING ARTERY
Nano boats-repairing artery
A nanomachine swimming through a capillary attacks a fat deposit
(such as normally may accompany an arteriosclerotic lesion).
Final Shape after cleaning
:
Nanotechnology in Drug Delivery -
Heart Disease
Lab studies in mice have shown that using
nanoparticles to target the delivery of the clot
busting drug tPA can reduce the dosage of tPA
needed, which may reduce possible side affects, such
as internal bleeding.
The clot busting drug was attached to a cluster of
nanoparticles that break apart in regions of
turbulent blood flow, like that found when a blood
flow is restricted by a clot.
Nanotechnology in Drug Delivery -
Heart Disease:

Researchers are developing polymer

nanoparticles that home in on inflamed
tissue such as arterial plaque and dissolve it
by releasing drugs, in the presence of
hydrogen peroxide that is present in the
inflamed tissue.
Nanotechnology in Drug Delivery - Heart
Disease:

Nanoparticles containing iron oxide that

allows the nanoparticles to be directed, by a
magnetic field, to stents.
This could allow drugs to be delivered
directly to stents placed in arteries.
Nanotechnology vs. Heart Disease

The use of nanotechnology to treat heart disease

offers some exciting possibilities, including the
ability to:

1.Treat defective heart valves

2.Detect and treat arterial plaque
3.Understand at a sub-cellular level how heart
tissue functions in both healthy and damaged
organs, which can help researchers design better
treatments
TO NORMAL HEART
Nano-in nerve cell -repair
Brain repair
Brain repair
Nanotechnology for Regenerating
Nerves
Viral –disease diagnosis
Gold nanoparticles that have antibodies attached
can provide quick diagnosis of virus.

 When light is directed on a sample containing

virus particles and the nanoparticles the amount of
light reflected back increases because the
nanoparticles cluster around virus particles,
allowing a much faster test than those currently
used.
Nano-particles for deliver
nitric oxide
Using nano-particles to deliver nitric oxide directly
to cancer cells may reduce the required amount of
chemotherapy drugs.
 Researchers conducting tests on neuroblastoma
cancer cells found that the effectiveness of the
chemotherapy drug was increased 5 times when
nano-particles were used to deliver nitric oxide
directly to the cancer cells.
delivery therapeutic drugs nano-
balloons
Researchers have developed elastic materials
embedded with needle like carbon nanofibers.
The material is intended to be used as balloons
which are inserted next diseased tissue, and then
inflated.
When the balloon is inflated the carbon nanofibers
penetrate diseased cells and delivery therapeutic
drugs.
nano-Collagen production gives
good hair, skin eye,& joints
Nano-carbon tubes are 117 times stronger
than steel-ortho application
Limb control:
Limb control: NanoProsthetics -paralysis is handled.
Nanochips help those who have lost limb control
use ,their minds to send signals to provide for motion.
Diabetes:
•Diabetes: no need to draw blood-
•nano-composite contact lenses actually
change color to indicate blood sugar level.
Nanodiamonds deliver insulin for
wound healing .
Nanotechnology-based encapsulation can be used to get
essential food and drugs-presently used by astronauts.
Nanotechnology could allow medics
to manipulate molecules;
Scarless Surgery
Seizures:
Seizures:
Nanochips -analyze brain signals, and adjust the
brain so that epilepsy could be better controlled.
Sensory feedback:
Sensory feedback: For those who have lost feeling in
their body, it is possible to use nanotechnology to
increase sensory feedback.
Nanochips provide the opportunity for electrical
impulses to be intercepted and interpreted.
Medical monitoring-
Medical monitoring:
Small nanochips implanted in your body could
monitor your health and systems, and then send you
feedback to your computer or other device.
Medical records:
Medical records:
In addition to monitoring your own body systems,
nanotech can be used to send information to your
health care providers, and increase the efficiency of
electronic medical records.
Disease prevention
Disease prevention:
Having a nano device in your body could actually
help prevent diseases-by programming, you avoid
some diseases, repair problems before they become
serious issues.
Disease control&prevention
1) Using nano-robots,
nano-machines or other
methods at the
molecular level to
search and destroy
disease-causing cells
2) Same as above for the
purposes of repairing
damaged cells
3) Using pumps or
similar technology at
the molecular scale as a
means of drug delivery
nanoparticles release "biomarkers",
 The magnetic nanoparticles attach to particles in
the blood stream called micro-vesicles which
originate in brain cancer cells.

Nano Microvesicle Reader is then used to detect

these microvesicle/magnetic nanoparticle clusters,
allowing an early diagnosis.
nanoparticles release "biomarkers

Carbon nanotubes and gold nanoparticles are

being used in a sensor that detects proteins
indicative of oral cancer.
 Tests have shown this sensor to be accurate in
detecting oral cancer and provides results in less
than an hour.
Gold nanoparticles, in combination with
fluorescent protein, is being used in a
system to diagnose which type of cancer is
present.
Anti-cancer drug delivery
 drugs delivery to tumors by using two types of
nanoparticles.
The first type of nanoparticle locates the cancer
tumor
 second type of nanoparticle (carrying the
therapeutic drugs) homes in on a signal generated
by the first type of nanoparticles and destroy cancer
cells.
•Anti-cancer drug delivery
•Perhaps the most publicized use of
nanotechnology in drug delivery is the use of
nanoparticles to deliver drugs to cancer cells.
•Particles are engineered so that they are
attracted to diseased cells, which allows direct
treatment of those cells.
•This technique reduces damage to healthy cells
in the body.
A schematic illustration showing how nanoparticles or
other cancer drugs might be used to treat cancer
Gene therapy:
Nanotechnology would be small enough to enter the
body and even redesign the genome.

This would be a way to alter a number of conditions

and diseases.

Gene -repair
Drug delivery: improvement
Systems that automate drug delivery, medication to
those who need it at the proper time, and without the
human error that comes with forgetting to take
something.
DNA-replication
The Nanomedicine Center for Nucleoprotein Machines is
using a different method to develop the ability to replace
damaged DNA.

 facilitating the precise manipulation of DNA and RNA at the

atomic level."
 Prenatal:
•Nanotechnology can also help potentially repair problems
in the womb.
•Eventually it will be possible to detect preventable
diseases in fetal DNA obtained from the mother's
bloodstream.
Nanorobots in the bloodstream
Nanorobots in the bloodstream

For years, nanotechnology has presented the

possibility of using nanotech devices in treating
diseases. Now, it is time for nanotechnology to live up
to expectations. Nanorobots in the bloodstream could
intervene even before the disease appears. They could
keep tissues safely oxygenated after a heart attack,
specifically target cancer cells, or remove platelets.
sequencing the human genome
As the cost of sequencing the human genome has
been declining and the availability of sequencers has
been rising, accessing our own genome will not only
be cheaper than a routine blood test, but will
eventually be free -- although analysis will still be
expensive. In the future personal genomics can be
applied to patients, meaning they will get drugs and
dosages customized to their own genomic code.
 tackle autoimmune diseases
A method being developed to tackle autoimmune
diseases -use nanoparticles to deliver antigens for a
particular disease into the blood stream.
The antigens reset the immune system, stopping white
blood cells from attacking healthy cells.
 This method has been tested in the lab on mice with a
disease similar to multiple sclerosis with promising
results.
 Medical implants
•Medical implants made of porous plastic, coated with
carbon nanotubes.
•Therapeutic drugs, which are attached to the nanotubes
can be released into the bloodstream, for example, when
a change in the blood chemistry signals a problem.
•NASA is developing these implants, called a
"biocapsule", to protect astronauts from the effects of
radiation however the implants may also be useful for
releasing insulin for diabetes patients or for delivering
chemotherapy drugs directly to tumors.
Stem cells:
•Nanotechnology can actually help adult stem cells
morph into the types of cells that are actually
needed.
sequencing the human genome
In the future personal genomics can be applied to
patients, meaning they will get drugs and dosages
customized to their own genomic code.
New ways in Medicine-DNA construction by
nanobots
Life Extension through
Nanotechnology
There are two ways -to extend our lives.
1. Eradicate life-threatening diseases such as cancer,
2.by repairing damaged cells--a nano version of the
fountain of youth.
Extending Life by Curing Life Threatening Disease
Nano-chip -pt
The wearable laboratory

An era of wearable medical devices is coming.

Spandau- measure basic health parameters.
 AliveCor measures ECG,
Tell spec detects allergens,
Patients bring the data to the doctor on any device
they use, creating a new role of digital health data
analyst.
Advances in progress
Shaping the drugs micelles for drug and
encapsulation to reach desired location.
By oral use.
Emulsion delivery system to the end-
receptors and injectables.
To the implantable drug delivery system .
hormones and insulin.
Self-replicating devices, so that life fashions its
miracles-plants animals and us.
Apple iPod Nano 6 6G 6th
Generation Green Silicone Watch
Strap Skin-iPod

108
Doctor's office in a box
The wearable laboratory

An era of wearable medical devices is coming.

Spandau can measure basic health parameters such as
body temperature or blood pressure by putting it to
the forehead. AliveCor measures ECG, Tell spec
detects allergens, chemicals and nutrients in the food,
tooth-embedded sensors can recognize jaw
movements and even smoking.
Plenty of laboratory methods and procedures will be
available at home which could also mean the
detection of diseases at an early stage, making
intervention more effective. Patients will bring the
data to the doctor on any device they use, creating a
new role of digital health data analyst.
Research:
Research: Nanotechnology is advancing medical
research, providing the tools that can help us learn
more about the body and how it functions, as well as
providing insight into chemistry and physics, which
provide the building blocks for the body.
 The connected global brain
Medical communication affects patients and medical professionals
worldwide, without exception.
Social media, along with connected digital healthcare devices
and services, have the potential to become a huge "digital brain"
making it possible to transmit, share, crowd source and store
medical pieces of information.
In the near future, whether it is medical information, crated
dynamic resources or medical records, the required information
will be available to everyone.
This will be the most important development in the history of
medicine, and this is why we have to train doctors do be ready for
the digital era.
Nano Elctronics,nano-lithography, Nano
Biomaterial For Construction
Used for surgical instrumentation,
Drug delivery,
Diagnosis
Finally healthy man,
Amrutham
No old age
Live long.
Die when technic withdrawn.
Primo 3M+, 3D future physique design whose message reflects the goal of super
longevity for a future body. Designed with functionality in mind, its architecture is
based on nanotechnology.
Healthy man
Conclusion:

With this technology there is no need of ventilators

in critical care units.
 no drug resistant respiratory infections, ARDS cases
will be treated without ventilator and no deaths due
to cardio-respiratory failure.
Human society can live without fear of AIDS, SARS
and Ebola virus infections.
No heart attacks, no lung diseases, no strokes, no
cancers.
Think-smile-research
THANK YOU
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