Stoelting's Pharmacology & Physiology in Anesthetic Practice

Höfundar: Pamela Flood; James P. Rathmell; Richard D. Urman (Útgáfa: 6)
Stoelting's Pharmacology & Physiology in Anesthetic Practice

Kaup valmöguleikar

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.

Nánar um bókina

Útgefandi
Wolters Kluwer Health
ISBN
9781975126926
Print ISBN
9781975126896
Format
ePub
Útgáfa
6
Höfundar
Pamela Flood; James P. Rathmell; Richard D. Urman
Tungumál
English
Útgefið
2021-03-31
Prent takmörkun á líftíma
10
Prent takmörkun
2
Afritunar takmörkun
2

Kaflar

  • Cover
  • Title Page
  • Copyright
  • Dedication
  • Contributors
  • Foreword to the Sixth Edition
  • Preface to the Sixth Edition
  • 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