Pharmacology For Nurse Anesthesiology

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More About This Textbook

Overview

Pharmacology for Nurse Anesthesiology provides appropriate chemical, biological, and physical information of the actions, interactions, and reactions of medication, particularly as they apply and impact the practice of nurse anesthesia. Written by CRNAs for CRNAs, the information about various drugs is based on theoretical aspects based in chemistry, biochemistry, biology, and physics/biophysics and practical aspects straight from actual CRNAs who administer and deal with the medications on a case-by-case, daily basis. The perfect resource for both practicing professionals and students in CRNA programs!
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Product Details

  • ISBN-13: 9780763786076
  • Publisher: Jones & Bartlett Learning
  • Publication date: 5/27/2010
  • Edition description: 1E
  • Pages: 544
  • Sales rank: 666,642
  • Product dimensions: 8.50 (w) x 10.80 (h) x 1.20 (d)

Table of Contents

Foreword: Pharmacology for the Nurse Anesthetist

Contributors

SECTION I General Pharmacologic Concepts 1

Chapter 1 Pharmacokinetics: The Study of Drug Disposition 3

Objectives 3

Introduction 3

Pharmacokinetics 3

Routes of Administration 3

Solubility 5

Absorption, Distribution, Metabolism, and Elimination 7

Mathematical Modeling 10

Dosing Calculations 14

Key Points 15

Chapter Questions 15

References 15

Chapter 2 Pharmacodynamics: Study of Drug Action 17

Objectives 17

Introduction 17

Receptor Theory 17

Receptor Interactions 19

Receptor Regulation 22

Receptor Types 23

Non-Receptor-Mediated Effects 25

Mechanisms of General Anesthesia 25

Key Points 26

Chapter Questions 26

References 26

Chapter 3 Cultural, Environmental, and Genetic Influences on Drug Therapy 27

Objectives 27

Introduction 27

Historic Perspective 27

Cultural and Environmental Influences 28

Genetic Influences 33

Conclusion 35

Key Points 35

Chapter Questions 35

References 35

SECTION II Pharmacology of Anesthetic Practice 39

Chapter 4 Anesthetic Induction Agents 41

Objectives 41

Introduction 41

Barbiturates 41

Etomidate 44

Ketamine 45

Propofol 48

Key Points 50

Chapter Questions 50

References 50

Chapter 5 Benzodiazepines 53

Objectives 53

Introduction 53

Mechanism of Action 53

Clinical Pharmacology 53

Clinical Uses and Indications 55

Side Effects and Contraindications 55

Drug Interactions, Guidelines, and Precautions 56

Dosages, Administration, and Practical Aspects 57

Key Points 58

Chapter Questions 59

References 59

Chapter 6 Opioid Agonists, Antagonists, and Agonist-Antagonists 61

Objectives 61

Introduction 61

History of the Use of Opioids 61

Mechanisms of Action 61

Clinical Pharmacology 62

Clinical Uses and Indications 64

Comparative Pharmacology of Other Drugs in Class 65

Adverse Effects and Contraindications 69

Drug Interactions 70

Guidelines and Precautions 70

Practical Aspects of Drug Administration (Applications in the Operating Room) 72

Key Points 73

Chapter Questions 73

References 74

Chapter 7 Nonopioid Analgesics and Their Role in Anesthesia Practice 77

Objectives 77

Introduction 77

Epidemiology and Etiology 77

Pathophysiology 77

Mechanisms of Pain 78

Cyclooxygenase Inhibitors 78

Cyclooxygenase Enzymes 79

Classification of NSAIDs 79

Side Effects of Nonselective and COX-2 NSAIDs 86

Ketamine 87

Dextromethorphan 89

Centrally Acting a2 Agonists 89

Key Points 91

Chapter Questions 91

References 91

Chapter 8 Neuromuscular Blocking Drugs 95

Objectives 95

Introduction 95

Mechanisms of Action 95

Clinical Pharmacology (Prototype: Rocuronium) 99

Metabolism 101

Elimination 103

Clinical Uses and Indications 103

Side Effects and Contraindications 106

Drug Interactions 110

Guidelines and Precautions 111

Dosage and Administration 112

Practical Aspects of Drug Administration 113

Key Points 114

Chapter Questions 114

References 114

Chapter 9 Pharmacology of Local Analgesics 119

Objectives 119

Introduction 119

Mechanisms of Action 119

Clinical Pharmacology 121

Commonly Used Local Anesthetic Agents 125

Systemic Administration 128

Toxicity 129

Systemic Local Anesthetic Toxicity 130

Summary 133

Key Points 133

Chapter Questions 133

References 133

Chapter 10 Anticholinergics 139

Objectives 139

Introduction 139

Parasympathetic Mechanism of Action 139

Muscarinic Receptors 139

Muscarinic Receptor Antagonists 142

Key Points 146

Chapter Questions 146

References 147

Chapter 11 Anticholinesterases 149

Objectives 149

Introduction 149

Mechanism of Action 149

Myasthenia Gravis 150

Alzheimer's Dementia 150

Clinical Pharmacology 151

On the Horizon 156

Train-of-Four 156

Key Points 157

Chapter Questions 157

References 157

Chapter 12 Inhalation Anesthesia 159

Objectives 159

Introduction 159

Historical Context of Inhalation Anesthetics 159

Pharmacokinetic Issues: Uptake and Distribution 164

Uptake of Inhaled Anesthetics 166

Pharmacodynamics and Inhaled Anesthetics 169

Modern Inhaled Anesthetics 171

Impact of Inhaled Anesthetics by System 173

Other Issues Related to Inhaled Anesthetics 180

Key Points 181

Chapter Questions 182

References 182

SECTION III General Pharmacology 191

Chapter 13 Antibiotics 193

Objectives 193

Introduction 193

General Principles 193

Pharmacokinetic and Pharmacodynamic Principles 194

Antibiotic Selection and Specific Antibiotic Classes 195

β-Lactam Compounds 196

Aminoglycosides 201

Macrolides 203

Tetracyclines 205

Clindamycin 206

Vancomycin 207

Fluoroquinolones 208

Metronidazole 208

Practical Aspects of Antibiotic Use 209

Key Points 213

Chapter Questions 214

References 214

Chapter 14 Antiemetic Drugs and Therapies 215

Objectives 215

Introduction 215

Physiology of Emesis 216

Selective Serotonin Receptor Antagonists 216

Corticosteroids 219

Butyrophenones 219

Benzamides 220

Phenothiazines 220

Antihistamines (H1 Receptor Antagonists) 221

Anticholinergics 223

Neurokinin-1 Receptor Antagonists 223

Miscellaneous Drugs and Therapies 224

Anesthetic Techniques for Preventing PONV 225

Conclusion 226

Key Points 226

Chapter Questions 227

References 227

Chapter 15 Prophylaxis for Aspiration Pneumonitis 231

Objectives 231

Introduction 231

Interventions for the Prevention of AP 236

Summary and Anesthesia Implications 252

Conclusions 252

Key Points 253

Chapter Questions 253

Answers and Discussion 254

Acknowledgments 254

References 254

Chapter 16 Diuretics 257

Objectives 257

Introduction 257

Anatomy and Physiology Associated with Urine Formation 257

Diuretic Agents 258

Anesthetic Implications 265

Key Points 266

Chapter Questions 266

References 266

Chapter 17 Antihypertensive Drugs 269

Objectives 269

Introduction 269

Mechanisms of Action of Antihypertensive Drugs 269

Anesthetic Management of Acute Perioperative Hypertension 294

Key Points 299

Chapter Questions 299

References 299

Chapter 18 Steroids 303

Objectives 303

Introduction 303

Clinical Pharmacology 304

Side Effects and Contraindications 305

Drug Interactions 306

Practical Aspects of Drug Administration 306

Clinical Uses and Indications 307

Comparative Pharmacology of Other Drugs in Class 308

Dosage and Administration 309

Key Points 311

Chapter Questions 311

Answers and Discussion 312

References 312

Chapter 19 Herbal and Dietary Supplements 315

Objectives 315

Introduction 315

Historical Perspective 315

Legislative Intervention 315

Anesthesia Implications 316

Preoperative Assessment 316

Commonly Used Dietary Supplements 316

Summary 321

Key Points 321

Chapter Questions 322

References 322

Chapter 20 α-and β-Adrenergic Receptor Agonists and Antagonists 323

Objectives 323

Introduction 323

Catecholamines 323

Types of Adrenergic Receptors 324

Caution in α-and β-Adrenergic Drug Usage in Geriatric Populations 340

Key Points 340

Chapter Questions 342

References 342

Chapter 21 Drug Therapy Associated with Autocoids 347

Objectives 347

Introduction 347

Histamine Agonists and Antagonists 347

Bradykinin Agonists and Antagonist 353

Serotonin Agonist and Antagonist 354

Prostaglandins 356

Conclusion 361

Key Points 361

Chapter Questions 362

References 362

Chapter 22 Anticoagulants and Their Reversal 367

Objectives 367

Introduction 367

Cascade Model of Coagulation 367

Cell-Based Model of Coagulation 368

Direct and Indirect Thrombin Inhibitors 369

Conclusion 383

Key Points 383

Chapter Questions 383

References 383

Chapter 23 Antiarrhythmics 385

Objectives 385

Introduction 385

Muscarinic Receptor Antagonists 386

β-Adrenergic Receptor Antagonists 388

Calcium Channel Antagonists 390

Sodium Channel Blockers 391

Amiodarone (Cordarone, Pacerone) 393

Adenosine (Adenocard) 396

Vasopressin (Antidiuretic Hormone, Arginine Vasopressin) 397

Magnesium 397

Summary 398

Key Points 398

Chapter Questions 398

Answers and Discussion 399

References 399

SECTION IV Pharmacologic Management of Disease: Anesthetic Considerations 403

Chapter 24 Malignant Hyperthermia: Dantrolene 405

Objectives 405

Malignant Hyperthermia 405

Conditions and Disorders in the Differential Diagnosis of MH 407

Tests for Diagnosing MH Susceptibility 407

Anesthesia for the MH-Susceptible Individual 408

Pharmacologic Intervention 408

Summary 413

Key Points 413

Chapter Questions 413

References 414

Chapter 25 Pharmacology of Asthma: Anesthesia Implications 417

Objectives 417

Introduction 417

Origins 417

Incidence 418

Pathophysiology 418

Signs and Symptoms: Preanesthesia Evaluation 420

Differential Diagnosis 422

Pharmacologic Intervention: Management and Control of Disease 422

Practical Aspects: Surgery and Asthma 428

Summary 432

Key Points 432

Chapter Questions 433

References 433

Chapter 26 Immune System and Anesthesia: Pharmacologic Implications 437

Objectives 437

Introduction 437

Review of Normal Immune Function 437

Drugs Used in the Perioperative Setting 438

Anesthetic Technique and Immune System Responses 441

Summary 441

Key Points 442

Chapter Questions 442

References 442

Chapter 27 Pharmacologic Considerations in Obstetric Anesthesia Practice 445

Objectives 445

Introduction 445

Physiologic Changes of Pregnancy 445

Pathophysiologic Conditions in Pregnancy and Postpartum 446

Pharmacology of Drugs Used in Obstetric Anesthesia Practice 448

Key Points 452

Chapter Questions 453

References 453

Chapter 28 Psychiatric Disorders and Their Pharmacologic Management 457

Objectives 457

Introduction 457

Etiology and Pathophysiology of Common Psychiatric Disorders 457

Pharmacologic Management of Psychiatric Disorders 460

Anesthesia Considerations in the Patient Treated for Mental Illness 475

Anesthesia Considerations in Patients Having ECT 476

Key Points 477

Chapter Questions 477

References 478

Chapter 29 Pharmacology of Congestive Heart Failure 481

Objectives 481

Epidemiology 481

Etiology and Pathophysiology 481

Classification 482

Treatment 483

Anesthesia Implications 493

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