Stoelting's Pharmacology & Physiology in Anesthetic Practice

 

Description:

Comprehensive, readable, and clinically oriented, Stoelting’s Pharmacology & Physiology in Anesthetic Practice, Sixth Edition, covers all aspects of pharmacology and physiology that are relevant either directly or indirectly to the anesthetic practice—a  challenging topic that is foundational to the practice of anesthesia and essential to master. This systems-based, bestselling text has been thoroughly updated by experts in the field, giving you the detailed information needed to make the most informed clinical decisions about the care of your patients. 

 

Table of Contents:

PART I Basic Principles of Physiology and Pharmacology

CHAPTER 1: Basic Principles of Physiology

Body Composition

Blood Volume

Constituents of Body Fluid Compartments

Osmosis

Tonicity of Fluids

Fluid Management

Dehydration

Cell Structure and Function

Cell Anatomy

Cell Membrane

Transfer of Molecules Through Cell Membranes

Nucleus

Structure and Function of DNA and RNA

Cytoplasm

Mitochondria

Endoplasmic Reticulum

Lysosomes

Golgi Apparatus

References

CHAPTER 2: Basic Principles of Pharmacology

Receptor Theory

Receptor Action

Receptor Types

Pharmacokinetics

Distribution

Protein Binding

Metabolism

Pathways of Metabolism

Phase I Enzymes

Phase II Enzymes

Hepatic Clearance

Renal Clearance

Absorption

Ionization

Determinants of Degree of Ionization

Ion Trapping

Route of Administration and Systemic Absorption of Drugs

Oral Administration

Sublingual, Buccal, and Nasal Administration

Transdermal Administration

Rectal Administration

Pharmacokinetic Models

Zero- and First-Order Processes

Physiologic Pharmacokinetic Models

Compartmental Pharmacokinetic Models

One-Compartment Model

Multicompartment Models

The Time Course of Drug Effect

Dose Calculations

Bolus Dosing

Maintenance Infusion Rate

Context-Sensitive Half-time

Pharmacodynamics

Concentration Versus Response Relationships

Potency and Efficacy

Effective Dose and Lethal Dose

Drug Interactions

Actions at Different Receptors

Stereochemistry

Clinical Aspects of Chirality

Individual Variability

Elderly Patients

Enzyme Activity

Genetic Disorders

Drug Interactions

References

PART II Neurologic System

CHAPTER 3: Neurophysiology*

How Nerves Work

Neurons

Classification of Afferent Nerve Fibers

Evaluation of Peripheral Nerve Function

The Action Potential

Propagation of Action Potentials

Ion Channel Evaluation

Abnormal Action Potentials

Neurotransmitters and Receptors

Ion Channels

Receptor Concentration

Receptor Diseases

The Synapse

Structure

Synaptic Fatigue

Posttetanic Facilitation

Factors That Influence Neuron Responsiveness

Central Nervous System

Cerebral Hemispheres

Anatomy of the Cerebral Cortex

Dominant Versus Nondominant Hemisphere

Memory

Awareness and Recall During Anesthesia

Postoperative Cognitive Dysfunction

Brainstem

Limbic System and Hypothalamus

Basal Ganglia

Reticular Activating System

Cerebellum

Spinal Cord

Gray Matter

White Matter

Pyramidal and Extrapyramidal Tracts

Thalamocortical System

Spinal Nerve

Central Nervous System Membranes

Autonomic Reflexes

Spinal Shock

Imaging of the Nervous System

Cerebral Blood Flow

Autoregulation

Electroencephalogram

Classification of Brain Waves

Clinical Uses

Brain Wave Monitors

Epilepsy

Evoked Potentials

Somatosensory Evoked Potentials

Motor Evoked Potentials

Auditory Evoked Potentials

Visual Evoked Potentials

Cerebrospinal Fluid

Formation

Reabsorption

Intracerebral Circulation

Hydrocephalus

Intracranial Pressure

Papilledema

Blood–Brain Barrier

Vision

Intraocular Pressure

Retina

Visual Pathway

Field of Vision

Muscular Control of Eye Movements

Innervation of the Eye

Horner Syndrome

Hearing

Perioperative Hearing Impairment

Taste

Smell

Nausea and Vomiting

Peripheral Nervous System

Pathways for Peripheral Sensory Impulses

Pathways for Peripheral Motor Responses

Autonomic Nervous System

Anatomy of the Sympathetic Nervous System

Anatomy of the Parasympathetic Nervous System

Physiology of the Autonomic Nervous System

Norepinephrine as a Neurotransmitter

Acetylcholine as a Neurotransmitter

Residual Autonomic Nervous System Tone

Determination of Autonomic Nervous System Function

Adrenal Medulla

Synthesis

Release

Thermoregulation

Heat Loss

Regulation of Body Temperature

Nonshivering Thermogenesis

Shivering

Causes of Increased Body Temperature

Perioperative Temperature Changes

Sequence of Temperature Changes During Anesthesia

Beneficial Effects of Perioperative Hypothermia

Adverse Consequences of Perioperative Hypothermia

Perioperative Temperature Measurement

Prevention of Perioperative Hypothermia

References

CHAPTER 4: Inhaled Anesthetics

History

Inhaled Anesthetics for the Present and Future

Cost Considerations

Current Clinically Useful Inhaled Anesthetics

Nitrous Oxide

Halothane

Enflurane

Isoflurane

Desflurane

Intraoperative Diagnosis of Carbon Monoxide Poisoning

Sevoflurane

Xenon

Pharmacokinetics of Inhaled Anesthetics

Determinants of Alveolar Partial Pressure

Inhaled Partial Pressure

Alveolar Ventilation

Anesthetic Breathing System

Solubility

Blood:Gas Partition Coefficients

Tissue:Blood Partition Coefficients

Oil:Gas Partition Coefficients

Nitrous Oxide Transfer to Closed Gas Spaces

Cardiopulmonary Bypass

Cardiac Output

Impact of a Shunt

Alveolar-to-Venous Partial Pressure Differences

Recovery From Anesthesia

Context-Sensitive Half-Time

Diffusion Hypoxia

Pharmacodynamics of Inhaled Anesthetics

Minimal Alveolar Concentration

Factors That Alter Minimal Alveolar Concentration

Mechanisms of Anesthetic Action

Meyer-Overton Theory (Critical Volume Hypothesis)

Stereoselectivity

Potential Mediators of Anesthetic Action

Mechanism of Immobility

Mechanism of Anesthesia-Induced Unconsciousness

Comparative Pharmacology of Gaseous Anesthetic Drugs

Central Nervous System Effects

Electroencephalogram

Seizure Activity

Evoked Potentials

Mental Function and Awareness

Cerebral Blood Flow

Cerebral Metabolic Oxygen Requirements

Cerebral Protection

Intracranial Pressure

Cerebrospinal Fluid Production

Circulatory Effects

Mean Arterial Pressure

Heart Rate

Cardiac Output and Stroke Volume

Right Atrial Pressure

Systemic Vascular Resistance

Pulmonary Vascular Resistance

Cardiac Dysrhythmias

Spontaneous Breathing

Coronary Blood Flow

Neurocirculatory Responses

Preexisting Diseases and Drug Therapy

Mechanisms of Circulatory Effects

Cardiac Protection (Anesthetic Preconditioning)

Ventilation Effects

Pattern of Breathing

Ventilatory Response to Carbon Dioxide

Surgical Stimulation

Duration of Administration

Mechanism of Depression

Management of Ventilatory Depression

Ventilatory Response to Hypoxemia

Airway Resistance and Irritability

Neurologic Effects

Hepatic Effects

Hepatic Blood Flow

Drug Clearance

Liver Function Tests

Hepatotoxicity

Renal Effects

Fluoride-Induced Nephrotoxicity

Skeletal Muscle Effects

Neuromuscular Junction

Malignant Hyperthermia

Obstetric Effects

Resistance to Infection

Genetic Effects

Bone Marrow Function

Peripheral Neuropathy

Total Body Oxygen Requirements

Metabolism

Environmental Impact of Inhaled Anesthetics

References

CHAPTER 5: Intravenous Sedatives and Hypnotics*

Overview

γ-Aminobutyric Acid Agonists

Propofol

Commercial Preparations

Mechanism of Action

Pharmacokinetics

Clinical Uses

Effects on Organ Systems

Other Side Effects

Miscellaneous Effects

Etomidate

Commercial Preparation

Mechanism of Action

Pharmacokinetics

Clinical Uses

Side Effects

Benzodiazepines

Mechanism of Action

Nucleoside Transporter Systems

Electroencephalogram

Side Effects

Drug Interactions

Hypothalamic-Pituitary-Adrenal Axis

Dependence

Aging

Platelet Aggregation

Midazolam

Commercial Preparation

Pharmacokinetics

Effects on Organ Systems

Clinical Uses

Diazepam

Commercial Preparation

Effects on Organ Systems

Overdose

Clinical Uses

Lorazepam

Pharmacokinetics

Clinical Uses

Temazepam

Remimazolam

Flumazenil

Dose and Administration

Side Effects

Short-Acting Nonbenzodiazepine Benzodiazepines

Barbiturates

Barbiturates’ Use in Anesthesia

Mechanism of Action

Pharmacokinetics

Pharmacodynamics and Clinical Applications

Side Effects

Other Effects

Non–γ-Aminobutyric Acid Sedatives and Hypnotics

Ketamine

Structure–Activity Relationships

Mechanism of Action

Pharmacokinetics

Clinical Uses

Side Effects

Drug Interactions

Dextromethorphan

Dexmedetomidine

Pharmacokinetics

Clinical Uses

Effects on the Control of Breathing

References

CHAPTER 6: Pain Physiology

Social Impact

Neurobiology of Pain

Peripheral Nerve Physiology of Pain

Nociceptors (Pain Receptors)

Sensitization of Nociceptor

Primary Hyperalgesia and Secondary Hyperalgesia

Central Nervous System Physiology

The Dorsal Horn: The Relay Center for Nociception

Gate Theory

Central Sensitization of Dorsal Horn Neurons

Ascending Pathway for Pain Transmission

Supraspinal Modulation of Nociception

Descending Pathway for Pain Modulation

Transition From Acute Pain to Chronic Pain

Psychobiology of Pain

Some Specific Types of Pain

Neuropathic Pain

Visceral Pain

Complex Regional Pain Syndromes

Pain in Neonate and Infant

Embryologic Origin and Localization of Pain

References

CHAPTER 7: Opioid Agonists and Antagonists

Chemical Structure of Opium Alkaloids

Semisynthetic Opioids

Synthetic Opioids

Opioid Receptors

Endogenous Pain-Modulating Mechanisms

Common Opioid Side Effects

Cardiovascular System

Ventilation

Cough Suppression

Central Nervous System

Rigidity

Sedation

Biliary Tract

Gastrointestinal Tract

Nausea and Vomiting

Genitourinary System

Cutaneous Changes

Placental Transfer

Drug Interactions

Hormonal Changes

Overdose

Provocation of Coughing

Pharmacodynamic Tolerance and Physical Dependence

Opioid Agonists

Morphine

Pharmacokinetics

Side Effects

Meperidine

Pharmacokinetics

Clinical Uses

Side Effects

Fentanyl

Pharmacokinetics

Clinical Uses

Side Effects

Sufentanil

Pharmacokinetics

Clinical Uses

Alfentanil

Pharmacokinetics

Clinical Uses

Remifentanil

Ventilation

Pharmacokinetics

Clinical Uses

Side Effects

Opioids With Oral Bioavailability

Codeine

Hydromorphone

Oxymorphone

Oxycodone

Hydrocodone

Methadone

Opioid Withdrawal

Treatment of Chronic Pain

Tramadol

Heroin

Opioid Agonist-Antagonists

Pentazocine

Clinical Uses

Side Effects

Butorphanol

Side Effects

Nalbuphine

Buprenorphine

Side Effects

Opioid Antagonists

Naloxone

Side Effects

Role in Treatment of Shock

Antagonism of General Anesthesia

Naltrexone

Methylnaltrexone

Alvimopan

Naloxegol

Tamper- or Abuse-Resistant Opioids

Opioid Allergy

Opioid Immune Modulation

Anesthetic Requirements

Patient-Controlled Analgesia

Neuraxial Opioids

Pharmacokinetics

Side Effects

Pruritus

Urinary Retention

Depression of Ventilation

Sedation

Central Nervous System Excitation

Viral Reactivation

Neonatal Morbidity

Miscellaneous Side Effects

Opioid Safety Issues

Obstructive Sleep Apnea

Practical Issues

The “Opioid Crisis”

References

CHAPTER 8: Centrally Acting Nonopioid Analgesics*

α2-Adrenergic Agonists

Clonidine

Dexmedetomidine

Neostigmine

Ketamine

Tramadol

Droperidol

Conopeptides

Ziconotide

Other Investigational Conopeptides

CGX-1160

Octreotide

Baclofen

Cyclooxygenase Inhibitors

Ketorolac

Magnesium Sulfate

Conclusion

References

CHAPTER 9: Peripherally Acting Analgesics*

Nonsteroidal Antiinflammatory Drugs

Less Selective Nonsteroidal Antiinflammatory Drugs

Side Effects of Nonsteroidal Antiinflammatory Drugs

Platelet Function

Gastrointestinal Side Effects

Cardiovascular Side Effects

Renal Side Effects

Liver Side Effects

Pulmonary Side Effects

Hypersensitivity Reactions

Idiosyncratic Adverse Effects

Drug-Drug Interactions With Nonsteroidal Antiinflammatory Drugs

Acetaminophen

Acetylsalicylic Acid (Aspirin)

Overdose

Steroids

Systemic Local Anesthetics

Topical Application of 5% Lidocaine

Capsaicin

Ketamine

Clonidine

Dexmedetomidine

Opioids

References

CHAPTER 10: Local Anesthetics

Molecular Structure

Structure-Activity Relationships

Racemic Mixtures or Pure Isomers

Mechanism of Action

Sodium Channels

Frequency-Dependent Blockade

Other Site of Action Targets

Minimum Effective Concentration

Differential Conduction Blockade

Pharmacokinetics

Absorption and Distribution

Lung Extraction

Changes During Pregnancy (see also Chapter 45)

Placental Transfer

Renal Elimination and Clearance

Metabolism of Amide Local Anesthetics

Lidocaine

Prilocaine

Mepivacaine

Bupivacaine

Ropivacaine

Dibucaine

Metabolism of Ester Local Anesthetics

Procaine

Chloroprocaine

Tetracaine

Benzocaine

Cocaine

Alkalinization of Local Anesthetic Solutions

Adjuvant Mixed With Local Anesthetics

Combinations of Local Anesthetics

Use of Vasoconstrictors

Adverse Effects of Local Anesthetics

Allergic Reactions

Cross-Sensitivity

Documentation of Allergy

Local Anesthetic Systemic Toxicity

Central Nervous System Effects

Cardiovascular System Effects

Treatment of Local Anesthetic Systemic Toxicity

Neural Tissue Toxicity (Neurotoxicity)

Transient Neurologic Symptoms

Cauda Equina Syndrome

Anterior Spinal Artery Syndrome

Methemoglobinemia

Ventilatory Response to Hypoxia

Hepatotoxicity

Uses of Local Anesthetics

Regional Anesthesia

Topical Anesthesia

Local Infiltration

Peripheral Nerve Block Anesthesia

Continuous Peripheral Nerve Blocks

Intravenous Regional Anesthesia (Bier Block)

Epidural Anesthesia

Spinal Anesthesia

Liposomal Local Anesthetics

Tumescent Liposuction

Cocaine Toxicity

Pharmacokinetics

Adverse Physiologic Effects

Treatment

References

CHAPTER 11: Neuromuscular Physiology

Muscle Types

Motor Units

The Neuromuscular Junction

Presynaptic Region

Synaptic Vesicles

Synaptic Cleft

The Nicotinic Acetylcholine Receptor at the Neuromuscular Junction

Neuromuscular Transmission and Excitation-Contraction Coupling

Blood Flow

Smooth Muscle

Mechanism of Contraction

Uterine Smooth Muscle

References

CHAPTER 12: Neuromuscular-Blocking Drugs and Reversal Agents

Principles of Action of Neuromuscular-Blocking Drugs at the Neuromuscular Junction

Pharmacology of Succinylcholine

Structure-Activity Relationships for Succinylcholine

Pharmacokinetics, Pharmacodynamics, and Pharmacogenomics of Succinylcholine

Factors Affecting Butyrylcholinesterase Activity

Genetic Variants of Butyrylcholinesterase

Side Effects of Succinylcholine

Cardiovascular Effects

Hyperkalemia

Myoglobinuria

Increased Intraocular Pressure

Increased Intragastric Pressure

Increased Intracranial Pressure

Myalgias

Masseter Spasm

Pharmacology of Nondepolarizing Neuromuscular-Blocking Drugs

Benzylisoquinolinium Compounds

Atracurium

Cisatracurium

Mivacurium

Steroidal Compounds

Pancuronium

Vecuronium

Rocuronium

Potency of Nondepolarizing Neuromuscular-Blocking Drugs

Effect of Drug Potency on Speed of Onset

Factors That Increase the Potency of Nondepolarizing Neuromuscular-Blocking Drugs

Factors That Decrease the Potency of Nondepolarizing Neuromuscular-Blocking Drugs

Adverse Effects of Nondepolarizing Neuromuscular-Blocking Drugs

Autonomic Effects

Histamine Release

Allergic Reactions

Drugs for Reversal of Nondepolarizing Neuromuscular Blockade

Acetylcholinesterase at the Neuromuscular Junction

Mechanisms of Action of Acetylcholinesterase Inhibitors

Clinical Pharmacology

Limitations of Acetylcholinesterase Inhibitors

Sugammadex: A Selective Relaxant Binding Agent

References

CHAPTER 13: Neurologically Active Drugs

Antiepileptic Drugs

Pharmacokinetics

Drug Interactions Related to Protein Binding

Drug Interactions Related to Accelerated Metabolism

Principles of Dosing

Plasma Concentrations and Laboratory Testing

Mechanism of Seizure Activity

Mechanism of Drug Action

Major Antiepileptic Drugs

Adverse Side Effects

Carbamazepine

Eslicarbazepine

Ethosuximide

Felbamate

Gabapentin

Lacosamide

Lamotrigine

Levetiracetam

Oxcarbazepine

Perampanel

Phenobarbital

Phenytoin

Primidone

Rufinamide

Stiripentol

Tiagabine

Topiramate

Valproic Acid

Vigabatrin

Zonisamide

Benzodiazepines

Status Epilepticus

Treatment

Drugs Used for Treatment of Parkinson Disease

Levodopa

Metabolism

Side Effects

Laboratory Measurements

Drug Interactions

Peripheral Decarboxylase Inhibitors

Catechol-O-methyltransferase Inhibitors

Side Effects

Synthetic Dopamine Agonists

Side Effects

Anticholinergic Drugs

Amantadine

Monoamine Oxidase Type B Enzyme Inhibitors

Nonpharmacologic Treatment

Central Nervous System Stimulants

Amphetamine

Doxapram

Clinical Uses

Methylphenidate

Methylxanthines

Mechanism of Action

Clinical Uses

Toxicity

Drug Interactions

Caffeine

Almitrine

Modafinil

Centrally Acting Muscle Relaxants

Baclofen

Benzodiazepines

Botulinum Toxin

Tizanidine

Dantrolene

References

PART III Circulatory System

CHAPTER 14: Circulatory Physiology*

Systemic Circulation

Endothelial Function

Endothelial Function and Regulation of Vascular Tone

Components of the Systemic Circulation

Arteries

Arterioles

Capillaries

Venules and Veins

Physical Characteristics of the Systemic Circulation

Measurement of Systemic Blood Pressure

Direct Measurement of Blood Pressure With an Intravascular Catheter

Progressive Declines in Systemic Blood Pressure

Pulse Pressure in Arteries

The Venous Circulation

Right Atrial Pressure

Measuring Central Venous Pressure

Effect of Hydrostatic Pressure

Venous Valves and the Pump Mechanism

Blood Viscosity

Determinants of Tissue Blood Flow

Vascular Distensibility

Vascular Compliance

Control of Tissue Blood Flow

Local Control of Blood Flow

Autoregulation of Blood Flow

Long-Term Control of Blood Flow

Autonomic Nervous System Control of Blood Flow

Hormone Control of Blood Flow

Regulation of Systemic Blood Pressure

Rapid-Acting Mechanisms for the Regulation of Systemic Blood Pressure

Moderately Rapid-Acting Mechanisms for the Regulation of Systemic Blood Pressure

Long-Term Mechanisms for the Regulation of Systemic Blood Pressure

Regulation of Cardiac Output and Venous Return

Determinants of Cardiac Output

Ventricular Function Curves

Pressure-Volume Loops

Shock Syndromes

Measurement of Cardiac Output

Microcirculation

Anatomy of the Microcirculation

Blood Flow in Capillaries

Vasoactive Role of the Capillary Endothelium

Fluid Movement Between the Capillary Lumen and the Interstitium

Lymphatics

Anatomy

Formation and Flow of Lymph

Edema

Pulmonary Circulation

Anatomy

Bronchial Circulation

Pulmonary Lymph Vessels

Pulmonary Vascular Pressure

Measurement of Left Atrial Pressure

Interstitial Fluid Space

Pulmonary Blood Volume

Pulmonary Blood Flow and Distribution

Endothelial Regulation of Pulmonary Blood Flow

Hypoxic Pulmonary Vasoconstriction

Effect of Breathing

Regional Blood Flow in the Lungs

Pulmonary Circulatory Pathology

Pulmonary Edema

Pulmonary Embolism

Pulmonary Hypertension

References

CHAPTER 15: Cardiac Physiology*

Cardiac Anatomy

Pericardium

Heart

The Coronary Circulation

The Cardiac Conduction System

Cardiac Physiology

Myocardium

Cardiac Action Potential

Excitation-Contraction Coupling

Control of Cardiac Function

Cardiac Cycle

Electrical and Mechanical Events

Myocardial Performance, Preload, and Afterload

Hemodynamic Calculations

Pathophysiology

Ischemic Heart Disease

Heart Failure

Valvular Heart Disease

Aortic Stenosis

Aortic Insufficiency

Mitral Stenosis

Mitral Regurgitation

Cardiac Dysrhythmias

Etiology

Mechanisms of Arrhythmia

Types of Dysrhythmias

References

CHAPTER 16: Renal Physiology*

Kidney Structure and Function

Basic Anatomy of the Kidney

The Glomerulus

The Renal Tubule

Renal Blood Flow

Renal Cortex Blood Flow: Glomerular and Peritubular Capillaries

Renal Medulla Blood Flow: The Vasa Recta

Autoregulation of Renal Blood Flow

Juxtaglomerular Apparatus

Regulation of Body Fluid

Blood and Extracellular Fluid Volume

Atrial and Renal Natriuretic Factors

Osmolarity of Body Fluids

Osmoreceptor–Arginine Vasopressin Hormone

Thirst Reflex

Plasma Concentration of Ions and Urea

Sodium

Potassium

Acid-Base Balance

Calcium and Magnesium

Urea

Measuring Kidney Function

Acute Kidney Injury

Classification

Prerenal Azotemia

Intrinsic Causes of Acute Kidney Injury

Postrenal Obstructive Nephropathy

Acute Kidney Injury Diagnosis

Diagnostic Criteria

Anesthesia and the Kidneys

Anesthesia and Renal Blood Flow

Perioperative Risk Assessment

Intraoperative Management

References

CHAPTER 17: Intravenous Fluids and Electrolytes*

Total Body Fluid Composition

Intravenous Fluid Types

Crystalloids

Colloids

Albumin (4%-5%)

Semisynthetic Colloid Solutions

Assessing Fluid Responsiveness

Important Fluid Constituents

Magnesium

Role of Magnesium

Hypomagnesemia

Hypermagnesemia

Preeclampsia

Cardiac Dysrhythmias

Analgesia

Asthma

Pheochromocytoma

Calcium

Role of Calcium

Hypocalcemia

Hypercalcemia

Bone Composition

Denosumab

Potassium

Role of Potassium

Drugs Causing Hypokalemia

Drugs Causing Hyperkalemia

Hypokalemia

Hyperkalemia

Phosphate

Iron

Iron Deficiency

Copper

Zinc

Chromium

Selenium

Manganese

Molybdenum

References

CHAPTER 18: Sympathomimetic Drugs*

Naturally Occurring Catecholamines

Epinephrine

Clinical Uses

Cardiovascular Effects

Airway Smooth Muscle

Metabolic Effects

Electrolytes

Ocular Effects

Gastrointestinal and Genitourinary Effects

Norepinephrine

Clinical Uses

Side Effects

Dopamine

Clinical Uses

Renal-Dose Dopamine

Cardiovascular Effects

Gastrointestinal Effects

Endocrine and Immunologic Effects

Respiratory Effects

Intraocular Pressure

Synthetic Catecholamines

Isoproterenol

Clinical Uses

Adverse Effects

Dobutamine

Clinical Uses

Adverse Effects

Synthetic Noncatecholamines

Ephedrine

Clinical Uses

Cardiovascular Effects

Phenylephrine

Clinical Uses

Cardiovascular Effects

Treatment of Overdose

Selective β2-Adrenergic Agonists

Clinical Uses

Route of Administration

Side Effects

Albuterol

Metaproterenol

Terbutaline

Cardiac Glycosides

Digoxin

Pharmacokinetics

Mechanism of Action

Toxicity

Drug Interactions

Selective Phosphodiesterase Inhibitors

Milrinone

Clinical Uses

Side Effects

Calcium

Calcium Measurement

Calcium Sensitizers

Levosimendan

References

CHAPTER 19: Sympatholytics

α- and β-Adrenergic Receptor Antagonists

α-Adrenergic Receptor Antagonists

Mechanism of Action

Phentolamine

Phenoxybenzamine

Yohimbine

Doxazosin

Prazosin

Terazosin

Tamsulosin

Alfuzosin

Sildosin

Tolazoline

α2-Adrenergic Receptor Agonists

Mechanism of Action

Clonidine

Dexmedetomidine

β-Adrenergic Receptor Antagonists

Mechanism of Action

Structure-Activity Relationships

Classification

Pharmacokinetics

Propranolol

Nadolol and Pindolol

Timolol

Metoprolol

Atenolol

Betaxolol

Bisoprolol

Nebivolol

Esmolol

Combined α- and β-Adrenergic Receptor Antagonists

Labetalol

Carvedilol

Calcium Channel Blockers

Mechanism of Action

Pharmacologic Effects

Phenylalkylamines

Verapamil

Dihydropyridines

Nifedipine

Nicardipine

Clevidipine

Nimodipine

Amlodipine

Benzothiazepines

Diltiazem

Drug Interactions

Anesthetic Drugs

Neuromuscular Blocking Drugs

Potassium-Containing Solutions

Platelet Function

Digoxin

H2 Antagonists

Cytoprotection

References

CHAPTER 20: Vasodilators*

Introduction

Systemic Hypertension

Specific Antihypertensive Drugs and Anesthesia

β-Adrenergic Blockers

Mechanism of Action

Side Effects

Intravenous β Blockers

α1 Receptor Blockers

Pharmacokinetics

Cardiovascular Effects

Side Effects

α2 Agonists

Mechanism of Action

Pharmacokinetics

Cardiovascular Effects

Side Effects

Rebound Hypertension

Other Clinical Uses

Angiotensin-Converting Enzyme Inhibitors and Angiotensin II Receptor Blockers

Mechanism of Action

Side Effects

Preoperative Management

Specific Agents

Calcium Channel Blocking Drugs

Phosphodiesterase Inhibitors

Nitric Oxide and Nitrovasodilators

Nitric Oxide

Nitric Oxide as a Pulmonary Vasodilator

Toxicity

Nitrodilators

Sodium Nitroprusside

Nitrates

Isosorbide Dinitrate

Hydralazine

Fenoldopam

Diuretics

Drugs Not Discussed

References

CHAPTER 21: Antiarrhythmic Drugs*

Mechanism of Action

Classification

Class I Drugs

Class IA Drugs

Class IB Drugs

Class IC Drugs

Class II Drugs

Class III Drugs

Class IV Drugs

Class 0 Drugs

Proarrhythmic Effects

Torsades de Pointes

Incessant Ventricular Tachycardia

Wide Complex Ventricular Rhythm

Efficacy and Results of Treatment With Cardiac Antiarrhythmic Drugs

Prophylactic Antiarrhythmic Drug Therapy

Decision to Treat Cardiac Arrhythmias

Antiarrhythmic Drug Pharmacology

Quinidine

Mechanism of Action

Metabolism and Excretion

Side Effects

Procainamide

Mechanism of Action

Metabolism and Excretion

Side Effects

Disopyramide

Side Effects

Moricizine

Side Effects

Lidocaine

Mechanism of Action

Metabolism and Excretion

Side Effects

Mexiletine

Side Effects

Tocainide

Phenytoin

Mechanism of Action

Metabolism and Excretion

Side Effects

Flecainide

Metabolism and Excretion

Side Effects

Propafenone

Side Effects

β-Adrenergic Antagonists

Mechanism of Action

Metabolism and Excretion

Side Effects

Amiodarone

Mechanism of Action

Metabolism and Excretion

Side Effects

Pharmacokinetic

Dronedarone

Mechanism of Action

Metabolism and Excretion

Side Effects

Sotalol

Side Effects

Ibutilide

Dofetilide

Verapamil and Diltiazem

Mechanism of Action

Metabolism and Excretion

Side Effects

Other Cardiac Antiarrhythmic Drugs

Digitalis

Adenosine

Mechanism of Action

Side Effects

Ranolazine

References

CHAPTER 22: Diuretics*

Carbonic Anhydrase Inhibitors

Pharmacokinetics and Pharmacodynamics

Clinical Uses

Side Effects

Loop Diuretics

Pharmacokinetics and Pharmacodynamics

Ethacrynic Acid

Furosemide

Bumetanide and Torsemide

Clinical Uses

Side Effects

Thiazide Diuretics

Pharmacokinetics and Pharmacodynamics

Clinical Uses

Side Effects

Osmotic Diuretics

Mannitol

Pharmacokinetics and Pharmacodynamics

Clinical Uses

Side Effects

Potassium-Sparing Diuretics

Pharmacokinetics and Pharmacodynamics

Clinical Uses

Side Effects

Aldosterone Antagonists

Pharmacokinetics and Pharmacodynamics

Clinical Uses

Side Effects

Dopamine Receptor Agonists

Pharmacokinetics and Pharmacodynamics

Clinical Uses

Natriuretic Peptides

Vasopressin Receptor Antagonists

Pharmacokinetics and Pharmacodynamics

Clinical Uses

Side Effects

Aquaporin Modulators

References

CHAPTER 23: Lipid-Lowering Drugs*

Lipoprotein Metabolism

Exogenous Pathway

Endogenous Pathway

Lipid Disorders

Drugs for Treatment of Hyperlipidemia

Statins

Pharmacokinetics

Side Effects

Proprotein Convertase Subtilisin/Kexin Type 9 Inhibitors

Pharmacokinetics

Side Effects

Bile Acid Resins

Side Effects

Niacin

Pharmacokinetics

Side Effects

Fibrates

Pharmacokinetics

Side Effects

Ezetimibe

Side Effects

Omega-3 Fatty Acids (Fish Oil)

Other Agents

References

PART IV Pulmonary System

CHAPTER 24: Gas Exchange

Functional Anatomy

Upper Airway Anatomy and Gas Flow

Oropharynx and Nasopharynx

Larynx

Pharyngeal Innervation

Upper Airway Gas Flow

Tracheal and Bronchial Structure

Respiratory Airways and Alveoli

Pulmonary Circulation

Thorax and Muscles of Respiration

Inspiration

Expiration

Respiratory Mechanical Function

Lung Volumes and Spirometry

Closing Capacity and Closing Volume

Compliance

Resistance

The Equal Pressure Point

Work of Breathing

Respiratory Fatigue

Physiology of Ventilation and Perfusion

Pulmonary Circulation

Pulmonary Hemodynamics

Distribution of Perfusion

Matching of Ventilation and Perfusion

Dead Space

Measurement of Dead Space

Shunt

Alveolar-Arterial Oxygen Difference (A-aDO2)

Hypoxic Pulmonary Vasoconstriction

Movement of Gas

Oxygen Transport

Shifts of the Oxyhemoglobin Dissociation Curve

Carbon Dioxide Transport

Control of Respiration

Central Nervous System

Peripheral Chemoreceptors

Other Neural Connections to the Medullary Respiratory Centers

Abnormal Breathing Patterns

Altered Physiologic Conditions

Anesthesia

Position

Obesity

Sleep-Disordered Breathing

Exercise

Altered Barometric Pressures

Age

Infants and Children

The Elderly

Chronic Respiratory Disease

One-Lung Ventilation

Extracorporeal Ventilatory Support

References

CHAPTER 25: Respiratory Pharmacology

Pharmacology of the Airways

Influence of the Autonomic Nervous System on the Airways

Inhaled Adrenergic Agonists

Systemic Adrenergic Agonists

Inhaled Cholinergic Antagonists

Systemic Cholinergic Antagonists

Influence of Inflammation on the Airway

Inhaled Corticosteroids

Systemic Corticosteroids

Leukotriene Modifiers

Mast Cell Stabilizers

Methylxanthines

Combined Pharmacologic Therapy of Asthma

Influence of Anesthetics on the Airways

Volatile Anesthetics

Intravenous Anesthetics

Local Anesthetics

Influence of Adjunctive Agents on the Airway

Pharmacology of the Pulmonary Circulation

Anesthetic Drugs

Ketamine

Propofol

Etomidate

Opioids

Volatile Anesthetics

Neuromuscular Blockers

Magnesium

Regional Analgesia

Vasopressors and Inotropes

Pulmonary Vasodilators

Nitric Oxide

Prostaglandins

Phosphodiesterase Inhibitors

Hypoxic Pulmonary Vasoconstriction

Intrinsic Pharmacologic Effects of the Lungs

Exogenous Substances

Drugs

Opioids

Local Anesthetics

Hypnotics

Endogenous Substances

Angiotensin-Converting Enzyme

Biogenic Amines

Arachidonic Acid Metabolites

References

CHAPTER 26: Acid–Base Disorders

Mechanisms for Regulation of Hydrogen Ion Concentration

Buffer Systems

Bicarbonate Buffering System

Hemoglobin Buffering System

Protein Buffering System

Phosphate Buffering System

Intracellular pH Regulation

Ventilatory Responses

Renal Responses

Classification of Acid–Base Disturbances

Respiratory Acidosis

Respiratory Alkalosis

Metabolic Acidosis

Lactic Acidosis

Dilutional Acidosis

Other Causes of Metabolic Acidosis

Differential Diagnosis of Metabolic Acidosis

Base Excess

Anion Gap

Strong Ion Gap

Simplified Approach to Metabolic Acidosis of Uncertain Etiology

Metabolic Alkalosis

Compensation for Acid–Base Disturbances

Effects of Temperature on Acid–Base Status

pH-Stat Management

α-Stat Management

References

PART V Blood and Hemostasis

CHAPTER 27: Physiology of Blood and Hemostasis

Hemostasis and History

Initiation of Coagulation

Propagation of Coagulation

Tissue Factor, Thrombin, and Fibrin(ogen) in Clot Formation and Stability

Endothelial Regulation of Coagulation

Antithrombin and Proteins C and S

Inflammation and Coagulation: An Important Link

Coagulation Testing

Perioperative Changes in Coagulation

Hemostatic Therapy

Postoperative Hypercoagulability

Disseminated Intravascular Coagulation

Conclusion

References

CHAPTER 28: Blood Products and Blood Components

Transfusion Therapy for Bleeding

Red Blood Cells

Red Blood Cell Storage Lesions

Red Blood Cell Storage and Tissue Oxygenation Parameters

Plasma/Fresh Frozen Plasma

Solvent/Detergent-Treated Plasma

Cryoprecipitate

Platelet Concentrates

Alloimmunization

Leukoreduction

Graft Versus Host Disease

Indications for Platelet Transfusions and Transfusion Triggers

Purified Factor Concentrates

Fibrinogen Concentrates

Prothrombin Complex Concentrates

von Willebrand Factor

Hereditary Angioedema and C1 Esterase Inhibitor Concentrates

Adverse Effects of Transfusions

Transfusion as an Inflammatory Response

Transfusion-Associated Circulatory Overload

Transfusion-Related Acute Lung Injury

Clinical History of Transfusion-Related Acute Lung Injury

Multiple Factors Influence Transfusion-Related Acute Lung Injury

Acute Pulmonary Edema and Management

Decreasing the Incidence of Transfusion-Related Acute Lung Injury

Plasma From Male Donors

Transfusion-Related Acute Inflammatory Responses and Immunomodulation

Role of Neutrophils and Other Inflammatory Cells

Summary

References

CHAPTER 29: Procoagulants

Antifibrinolytic Agents: Lysine Analogs

Antifibrinolytic Agents: Aprotinin

Protamine

Desmopressin

Fibrinogen

Recombinant Coagulation Products and Factor Concentrates

Recombinant Activated Factor VIIa

Factor XIII

Prothrombin Complex Concentrates

Topical Hemostatic Agents

Summary

References

CHAPTER 30: Anticoagulants

Heparin

Pharmacokinetics

Laboratory Evaluation of Coagulation

Activated Partial Thromboplastin Time and Anti-Factor Xa

Activated Clotting Time

Clinical Uses

Heparin-Induced Thrombocytopenia

Allergic Reactions

Reversal of Heparin-Induced Anticoagulation With Protamine

Low-Molecular-Weight Heparins

Spinal and Epidural Hematomas

Fondaparinux

Danaparoid

Prophylaxis Against Venous Thromboembolism

Direct Thrombin Inhibitors: Parenteral Agents

Bivalirudin

Argatroban

Lepirudin and Desirudin

Oral Anticoagulants

Vitamin K Antagonists—Warfarin

Mechanism of Action

Pharmacokinetics

Laboratory Evaluation

Clinical Uses

Management Before Elective Surgery

Direct-Acting Non–vitamin K Oral Anticoagulants

Direct Factor Xa Inhibitors

Direct Thrombin Inhibitors

Perioperative Management of the Direct-Acting Non–vitamin K Oral Anticoagulants

Platelet Inhibitors

Aspirin

Thienopyridines: Clopidogrel, Prasugrel, and Ticagrelor

Cangrelor

Dipyridamole

Dextran

Platelet Glycoprotein IIb/IIIa Antagonists

Perioperative Management of Patients on Platelet Inhibitors

Thrombolytic Drugs

References

CHAPTER 31: Physiology and Management of Massive Transfusion

Pathophysiology of Hemostatic Abnormalities Associated With Trauma

Trauma and Endothelial Dysfunction

Massive Transfusion

Therapeutic Approaches for Massive Transfusion and Coagulopathy

Adverse Effects of Transfusions

Hemostatic Changes Associated With Massive Transfusion Coagulopathy

Perioperative Hemostatic Changes

Massive Transfusion Coagulopathy

Role of Red Blood Cells and Anemia

Causes of Bleeding in the Setting of Massive Transfusion Coagulopathy

Hypothermia, Acidosis, and Coagulopathy

Dilutional Coagulopathy

Fibrinolysis

Hypofibrinogenemia

Monitoring Hemostasis During Massive Transfusion

Treatment of Coagulopathy During Massive Transfusion

Plasma/Fresh Frozen Plasma

Platelet Administration

Antifibrinolytic Agents

Procoagulants

Goal-Directed Management

Postpartum Hemorrhage

Multimodal Resuscitation: Damage Control Resuscitation

Summary

References

PART VI Gastrointestinal System and Metabolism

CHAPTER 32: Gastrointestinal Physiology

Liver

Anatomy

Hepatic Blood Flow

Control of Hepatic Blood Flow

Reservoir Function

Bile Secretion

Bile Salts

Bilirubin

Cholesterol

Metabolic Functions

Carbohydrates

Lipids

Proteins

Gastrointestinal Tract

Anatomy

Blood Flow

Portal Venous Pressure

Splenic Circulation

Innervation

Motility

Ileus

Salivary Glands

Esophagus

Lower Esophageal Sphincter

Gastroesophageal Reflux Disease

Hiatal Hernia

Achalasia

Stomach

Gastric Secretions

Parietal Cells

Chief Cells

G Cells

Gastric Fluid Volume and Rate of Gastric Emptying

Gastric Emptying Prior to Elective Surgery

Opioid-Induced Slowing of Gastric Emptying

Measurement of the Rate of Gastric Emptying

Vomiting

Small Intestine

Secretions of the Small Intestine

Absorption From the Small Intestine

Colon

Secretions of the Colon

Pancreas

Regulation of Pancreatic Secretions

References

CHAPTER 33: Metabolism

Carbohydrate Metabolism

Glycogen

Gluconeogenesis

Energy Release From Glucose

Anaerobic Glycolysis

Lipid Metabolism

Protein Metabolism

Storage of Amino Acids

Plasma Proteins

Albumin

Coagulation Factors

Use of Proteins for Energy

Effects of Stress on Metabolism

Obesity

Pharmacologic Treatment

References

CHAPTER 34: Antiemetics*

Definition

Incidence

Pathophysiology

Prophylaxis

Patient Factors

Surgical Factors

Anesthetic Factors

Pharmacologic Interventions

5-HT3 Receptor Antagonists

Clinical Uses

Comparison With Other Antiemetics

Pharmacokinetics

Anticholinergics

Scopolamine

Central Anticholinergic Syndrome

Overdose

Decreased Barrier Pressure

Histamine Receptor Antagonists

Corticosteroids

Dopamine Receptor Antagonists

Benzamides

Butyrophenones

Neurokinin-1 Antagonists

Midazolam

Cannabinoids

Summary

References

CHAPTER 35: Antacids and Gastrointestinal Motility Drugs*

Oral Antacids

Complications of Antacid Therapy

Drug Interactions

Histamine-Receptor Antagonists

H1-Receptor Antagonists

Pharmacokinetics

Clinical Uses

Side Effects

H2-Receptor Antagonists

Mechanism of Action

Pharmacokinetics

Clinical Uses

Side Effects

Drug Interactions

Proton Pump Inhibitors

Choice of PPI

Omeprazole

Esomeprazole

Pantoprazole

Gastrointestinal Prokinetics

Dopamine Blockers

Domperidone

Metoclopramide

Macrolides

5-HT4–Receptor Agonists

Serotonin Agonists

References

CHAPTER 36: Nutrition

Definitions

Malnutrition

Nutrition Support

Enteral Nutrition

Enteral Tube Feeding

Side Effects

Parenteral Nutrition

Short-Term Parenteral Therapy

Long-Term Total Parenteral Nutrition

Side Effects

Monitoring During TPN

Preparation of TPN Solutions

Immunonutrition

Vitamins, Dietary Supplements, and Herbal Remedies

Vitamins

Water-Soluble Vitamins

Fat-Soluble Vitamins

Dietary Supplements

Adverse Effects and Drug Interactions

References

PART VII Endocrine System

CHAPTER 37: Normal Endocrine Function

Mechanism of Hormone Action

Hypothalamus and Pituitary Gland

Anterior Pituitary

Growth Hormone (Somatotropin)

Prolactin

Gonadotropins

Adrenocorticotrophic Hormone

Thyroid-Stimulating Hormone

Posterior Pituitary

Arginine Vasopressin

Oxytocin

Thyroid Gland

Mechanism of Action

Calcitonin

Parathyroid Glands

Adrenal Cortex

Mineralocorticoids: Aldosterone

Physiologic Effects

Mechanism of Action

Regulation of Secretion

Glucocorticoids: Cortisol

Physiologic Effects

Mechanism of Action

Regulation of Secretion

Effect of Anesthesia and Surgery

Reproductive Glands

Testes

Ovaries

Estrogens

Progesterone

Menstruation

Pregnancy

Menopause

Pancreas

Insulin

Regulation of Secretion

Physiologic Effects

Glucagon

Somatostatin

Pancreatic Polypeptide

References

CHAPTER 38: Drugs that Alter Glucose Regulation

Diabetes Mellitus

Insulin

Pharmacokinetics

Insulin Preparations and Delivery

Lispro

Insulin Aspart and Glulisine

Regular Insulin (Crystalline Zinc Insulin)

Neutral Protamine Hagedorn

Glargine, Detemir, and Degludec

Side Effects

Hypoglycemia

Allergic Reactions

Lipodystrophy

Insulin Resistance

Drug Interactions

Other Glucose Regulators

Metformin

Pharmacokinetics

Mechanism of Action

Side Effects

Sulfonylureas

Mechanism of Action

Pharmacokinetics

Side Effects

Glyburide

Glipizide

Glimepiride

Thiazolidinediones

Glucagon-like Peptide-1 Receptor Agonists

Side Effects

Pharmacokinetics

Sodium-Glucose Cotransporter 2 Inhibitors

Side Effects

Dipeptidyl-Peptidase-4 Inhibitors

Other Medications

Combination Therapy

References

CHAPTER 39: Drugs for the Treatment of Hypothyroidism and Hyperthyroidism

Hypothyroidism

Synthetic Thyroxine (Levothyroxine)

Triiodothyronine Formulations (Liothyronine)

Hyperthyroidism

Thionamides (Methimazole, Propylthiouracil, Carbimazole)

Side Effects

Iodine (Saturated Potassium Iodide Solutions, Potassium Iodide-Iodine [Lugol Solution])

Radioactive Iodine

Thyroid Storm

References

CHAPTER 40: Other Endocrine Drugs

Corticosteroids

Structure-Activity Relationships

Mechanism of Action

Maintenance of Homeostasis

Permissive Actions

Protective Actions

Pharmacokinetics

Synthetic Corticosteroids

Prednisolone

Prednisone

Methylprednisolone

Betamethasone

Dexamethasone

Triamcinolone

Clinical Uses

Deficiency States

Allergic Therapy

Asthma

Antiemetic Effect

Postoperative Analgesia

Cerebral Edema

Aspiration Pneumonitis

Lumbar Disc Disease

Immunosuppression

Arthritis

Collagen Diseases

Ocular Inflammation

Cutaneous Disorders

Postintubation Laryngeal Edema

Ulcerative Colitis

Myasthenia Gravis

Respiratory Distress Syndrome

Leukemia

Cardiac Arrest

Septic Shock

Side Effects

Corticosteroid Supplementation in the Perioperative Period

Electrolyte and Metabolic Changes and Weight Gain

Osteoporosis

Peptic Ulcer Disease

Skeletal Muscle Myopathy

Central Nervous System Dysfunction

Peripheral Blood Changes

Inhibition of Normal Growth

Inhibitors of Corticosteroid Synthesis

Metyrapone

Mitotane

Drugs That Regulate Calcium

Hypercalcemia

Bisphosphonates

Glucocorticoids

Hypocalcemia

Drugs for Pituitary Function

Anterior Pituitary Hormones

Growth Hormone

Gonadotropins

Adrenocorticotrophic Hormone

Melatonin

Posterior Pituitary Hormones

Arginine Vasopressin

Diabetes Insipidus

Hypotension During Anesthesia

Septic Shock

Refractory Cardiac Arrest

Esophageal Varices

Side Effects

Oxytocin

Side Effects

Drugs for Reproductive Regulation

Ovarian Hormones

Estrogens

Antiestrogens

Tissue-Specific Estrogens

Progesterone

Antiprogestins

Oral Contraceptives

Androgens

Route of Administration

Side Effects

Danazol

Finasteride

References

PART VIII Miscellaneous

CHAPTER 41: Antimicrobials, Antiseptics, Disinfectants, and Management of Perioperative Infection

Introduction

Antimicrobial Prophylaxis for Surgical Procedures

Antimicrobial Selection

Nosocomial Infections

Special Patient Groups

Parturients

Elderly Patients

Human Immunodeficiency Virus–Infected Patients

Antibacterial Drugs Commonly Used in the Perioperative Period

Penicillins

Clinical Indications

Excretion

Duration of Action

Penicillinase-Resistant Penicillins

Penicillinase-Susceptible Broad-Spectrum Penicillins (Second-Generation Penicillins)

Ampicillin

Amoxicillin

Extended-Spectrum Carboxypenicillins (Third-Generation Penicillins)

Carbenicillin

Extended-Spectrum Acylaminopenicillins (Fourth-Generation Penicillins)

Penicillin β-Lactamase Inhibitor Combinations

Cephalosporins

Cephalosporins and Allergy to Penicillins

Cross-reactivity

Classification

Other β-Lactam Antimicrobials

Aztreonam

Aminoglycoside Antimicrobials

Side Effects

Macrolides

Erythromycin

Azithromycin

Clindamycin

Side Effects

Vancomycin

Side Effects

Linezolid

Side Effects

Bacitracins

Metronidazole

Fluoroquinolones

Ciprofloxacin

Moxifloxacin

Antiseptic and Disinfectant Prophylaxis for Surgical Procedures

Topical Antiseptics

Alcohols

Chlorhexidine

Iodine

Quaternary Ammonium Compounds

Hexachlorophene

Methods for Sterilization of Instruments

Formaldehyde

Glutaraldehyde

Pasteurization

Cresol

Silver Nitrate

Ethylene Oxide

References

CHAPTER 42: Chemotherapeutic Drugs*

Drug Resistance

Classification

Toxicities

Alkylating Agents

Side Effects

Nitrogen Mustards

Mechlorethamine

Cyclophosphamide

Melphalan

Chlorambucil

Alkyl Sulfonates

Side Effects

Nitrosoureas

Carmustine

Lomustine and Semustine

Streptozocin

Mitomycin

Platinating Drugs

Cisplatin

Side Effects

Antimetabolites

Folate Analogues

Methotrexate

Pyrimidine Analogues

Fluorouracil

Capecitabine

Pemetrexed

Cytarabine

Gemcitabine

Purine Analogues

Mercaptopurine

Thioguanine

Pentostatin and Cladribine

Hydroxyurea

Topoisomerase Inhibitors

Doxorubicin and Daunorubicin

Clinical Uses

Side Effects

Dactinomycin

Clinical Uses

Side Effects

Bleomycin

Clinical Uses

Side Effects

Tubulin-Binding Drugs

Vinca Alkaloids

Side Effects

Taxanes

Side Effects

Estramustine

Signal Transduction Modulators

Progestins

Estrogens and Androgens

Antiestrogens

Antiandrogens

Aromatase Inhibitors

Monoclonal Antibodies

Other Targeted Therapies

Vaccines

Immunomodulatory Drugs

Cancer Immunotherapies

Adoptive Cellular Therapy

Chimeric Antigen Receptor T Cells

References

CHAPTER 43: Psychopharmacologic Drugs*

Drugs With Primarily Serotonergic Activity

Mechanisms of Action

Serotonin Receptors

Serotonin Reuptake Inhibitors

Adverse Effects

Selective Serotonin Reuptake Inhibitors

Serotonin-Norepinephrine Reuptake Inhibitors

Tricyclic Serotonin Reuptake Inhibitors

Serotonin Multimodal Drugs

Serotonin Agonist

Serotonin and Norepinephrine Multimodal Drugs

Monoamine Oxidase Inhibitors

Monoamine Oxidase Enzyme System

Mechanisms of Action

Adverse Effects

Dietary Restrictions

Drug Interactions

Overdose

Management of Anesthesia

Drugs With Primarily Noradrenergic Activity

Tricyclic and Related Antidepressants

Mechanisms of Action

Utility in Chronic Pain Syndromes

Adverse Effects

Tolerance

Pharmacokinetics

Drug Interactions

Overdose

Other Norepinephrine Reuptake Inhibitor Drugs

Norepinephrine Agonists

Norepinephrine Dopamine Reuptake Inhibitor

Drugs With Primarily Dopaminergic Activity

Dopamine Norepinephrine Multimodal Drugs

Dopamine Reuptake Inhibitor Drugs

Dopamine Agonists

Dopamine Antagonists

Mechanisms of Action

First-Generation Antipsychotics

Antiemetic Effects

Adverse Effects

Drug Interactions

Dopamine and Serotonin Antagonist Drugs

Clozapine

Olanzapine

Risperidone, Paliperidone, and Iloperidone

Aripiprazole, Brexpiprazole, and Cariprazine

Ziprasidone and Lurasidone

Amisulpride

Long-Acting Injectable Formulations

Dopamine Serotonin Norepinephrine Multimodal Drugs

Drugs With Primarily Glutamatergic Activity

Glutamate Antagonists and Channel Blockers

Valproate, Carbamazepine, and Oxcarbazepine

Lamotrigine

Gabapentin and Pregabalin

Glutamate Antagonist Drugs

Other Glutamate Modulators

Drugs With Primarily Acetylcholinergic Action

Acetylcholinesterase Inhibitors

Anesthetic Considerations

Acetylcholine Receptor Agonist and Multimodal Drugs

Drugs With Primarily γ-Aminobutyric Acid (GABA)-ergic Action

Benzodiazepines

Other GABAA Receptor Modulators

Lithium

Mechanisms of Action

Dosage and Monitoring

Adverse Effects

Renal Effects

Cardiac Effects

Endocrine Effects

Drug Interactions

Anesthetic Considerations

Toxicity

Cannabinoids

Pharmacokinetics

Toxicity

Clinical Uses

Conclusion

References

PART IX Special Populations

CHAPTER 44: Physiology of the Newborn*

Neonatal Physiology

Neonatal Cardiovascular Physiology

Respiratory Physiology of the Newborn

Neonatal Thermoregulation

Neonatal Fluid, Electrolyte, and Renal Physiology

Neonatal Neurophysiology

Neonatal Hepatic Physiology

References

CHAPTER 45: Maternal and Fetal Physiology and Pharmacology

Introduction

Maternal Physiology

Physiologic Changes During Pregnancy and Delivery

Cardiovascular Changes

Intravascular Volumes and Hematology

Cardiac Output

Systemic Vascular Resistance

Aortocaval Compression

Pulmonary Changes

Airway

Minute Ventilation and Oxygenation

Lung Volumes

Gastrointestinal Changes

Renal Changes

Neurologic Changes

Uteroplacental Physiology

Uterine Blood Flow

Oxygen Transfer

Principles of Nonobstetric Surgery During Pregnancy

Fetal Heart Rate Monitoring

Intraoperative Considerations for Nonobstetric Surgery

Postoperative Pain Management

Fetal Physiology

Characteristics of the Fetal Circulation

Drug Transfer

Fetal Liver Function and Drug Metabolism

Anesthetic Toxicity in the Fetus

Fetal Neurophysiology

Fetal Pain

References

CHAPTER 46: Physiology and Pharmacology of the Elderly

Aging and the Cardiovascular System

Heart

Large Vessels

Endothelial Function

Conduction System

Autonomic and Integrated Cardiovascular Responses

Anesthetic and Ischemic Preconditioning in the Aging Heart

Aging and the Respiratory System

Respiratory System Mechanics and Architecture

Lung Volumes and Capacities

Vital Capacity

Residual Volume

Total Lung Capacity

Functional Residual Capacity

Closing Capacity

Expiratory Flow

Diffusing Capacity and Alveolar-to-Arterial Oxygen Gradient

Upper Airway Protective Reflexes

Control of Breathing, Chemoreceptors, and Integrated Responses

Sleep-Disordered Breathing

The Coagulation System in the Elderly

Thermoregulation in the Elderly

Resting Core Temperature

Response to Cold Stress

Gastrointestinal Function in the Elderly

Liver

Gastroesophageal Physiology

Renal Function in the Elderly

Skeletal Muscle Mass and Aging

Neurophysiology of Aging

Pain and Aging

Conclusion

References

CHAPTER 47: Physiology and Pharmacology of Resuscitation

Pathophysiology

Cardiac Arrest

Hemorrhagic Shock

Pulmonary Arrest

Pharmacology

Cardiopulmonary Resuscitation

Epinephrine

Amiodarone

Hemorrhage

Tranexamic Acid

Oxygenation/Ventilation

References

Drug Index

Subject Index

 

 

 

An aparitie	25 Jun. 2021
Autor	Pamela Flood MD, MA, James P. Rathmell MD, Richard D. Urman MD
Dimensiuni	21.59 x 2.54 x 25.4 cm
Editura	LWW
Format	Hardcover
ISBN	9781975126896
Limba	Engleza
Nr pag	984