This book is designed to assist in the preparation for sitting the pharmacology component of the primary examination of the Australian and New Zealand College of Anaesthetists. The main aim is not to offer yet another heavy-duty textbook but to organise the material that you would normally highlight in those texts into a practical and concise source of information.

lgrsnf/Essential Pharmacology For The - Petkov, V.pdf

Title page
Contents
Preface
Abbreviations
Basic principles of pharmacology
Fick’s law of diffusion
Mechanism of drug transfer across cell membranes
Ionisation of drugs
Ion trapping
Protein binding
Mechanisms of drug action
Receptors
Nicotinic acetylcholine receptors
Gamma aminobutyric acid receptors
N-methyl D-aspartate receptor
G-protein coupled receptors
Theories of mechanism of action of general anaesthetic agents
Receptor down-regulation
Receptor up-regulation
Tachyphylaxis
Tolerance
Dependence
Drug addiction
Affinity
Intrinsic Activity
Efficacy
Potency
Graded dose-response curve
Quantal (all-or-nothing) dose-response curve
Log dose-response curve
Therapeutic index
Agonism
Antagonism
Allosteric modulator
Mixed agonist-antagonist
Spare receptors
Drug interactions
Isobologram
Adverse drug reactions
Hypersensitivity reactions
Latex allergy
Management of anaphylaxis
Malignant hyperthermia
Management of malignant hyperthermia
Dantrolene
Porphyrias
Disorders of plasma cholinesterase concentration and activity
Dibucaine
Basic pharmacokinetic processes
Factors that affect systemic absorption through the gastrointestinal tract
Oral bioavailability
First-pass metabolism
Extraction ratio (ER)
Oral route of drug administration
Sublingual route of drug administration
Rectal route of drug administration
Intramuscular route of drug administration
Subcutaneous route of drug administration
Intravenous route of drug administration
Inhalational route of drug administration
Transdermal route of drug administration
Factors that affect distribution and tissue uptake of drugs
Volume of distribution (Vd)
Metabolism (biotransformation)
Cytochrome P450 enzyme superfamily
Plasma esterases
Factors that affect hepatic metabolism of drugs
Kinetics of drug elimination
Clearance (Cl)
Renal clearance
Hepatic clearance
Compartmental models
One-compartment model
Two-compartment model
Three-compartment model
Non-compartmental models
Half-life (t1/2)
Elimination half-life (t1/2β)
Effect-site equilibration time (ESET)
Context-sensitive half-time (CSHT)
Decrement time
Total intravenous anaesthesia (TIVA)
Target-controlled infusion (TCI)
Isomers
Structural isomers
Stereoisomers
Alteration to drug response due to liver disease
Alteration to drug response due to renal disease
Alteration to drug response due to cardiac failure
Alteration to drug response in the elderly
Alteration to drug response in neonates and infants
Alteration to drug response due to pregnancy
Alteration to drug response in obese patients
Pharmaceutics
Shelf-life
Expiry date
Processes of degradation of drugs
Drug additives
Inhalational anaesthetic agents
Definitions
The ideal properties of inhalational anaesthetic agents
Classification of inhalational anaesthetic agents
Structure of some inhalational anaesthetic agents
Structure-activity relationships of inhalational anaesthetic agents
Factors that affect onset of action of inhalational anaesthetic agents
Wash-in curves of inhalational anaesthetic agents
Factors that affect recovery from anaesthesia
Elimination (washout) curves of inhalational anaesthetic agents
Metabolism of some inhalational anaesthetic agents
Hepatic toxicity of halothane
Nephrotoxicity of inhalational anaesthetic agents
Sevoflurane toxicity
Minimum alveolar concentration (MAC)
MAC-95
MAC-awake
MAC-BAR (Block Adrenergic Response)
MAC-hr
Factors that affect MAC
Physicochemical properties of some inhalational anaesthetic agents
Nitrous oxide (N2O)
Central nervous system effects of inhalational anaesthetic agents
Cardiovascular system effects of inhalational anaesthetic agents
Respiratory system effects of inhalational anaesthetic agents
Miscellaneous effects of inhalational anaesthetic agents
Oxygen (O2)
Xenon (Xe)
Nitric oxide (NO)
CO2 absorbents
Intravenous anaesthetic agents
The ideal properties of intravenous anaesthetic agents
Classification of intravenous anaesthetic agents
Pharmacokinetic properties of some intravenous anaesthetic agents
Structure-activity relationships of barbiturates
Thiopental
Effects of thiopental
Methohexital
Propofol presentation
Pharmacokinetics of propofol
Mechanism of action of propofol
Effects of propofol
Ketamine
Effects of ketamine
Etomidate
Midazolam
Diazepam
Pharmacodynamics of benzodiazepines
Flumazenil
α2-adrenoreceptor agonists
Recommended doses of some intravenous anaesthetic agents
Neuromuscular blocking agents and reversal agents
Acetylcholine
Acetylcholinesterase
Non-depolarising block
Depolarising block (phase I block)
Phase II block
Desensitisation block
Measurement of neuromuscular blockade
Single twitch
Train-of-four (TOF)
Tetanic stimulation
Post-tetanic potentiation and count
Double-burst stimulation (DBS)
Response of different muscle groups to neuromuscular blocking agents
The ideal properties of neuromuscular blocking agents
Clinical classification of neuromuscular blocking agents
Succinylcholine (Suxamethonium)
Pharmacokinetics of succinylcholine
Side effects of succinylcholine
Non-depolarising muscle relaxants
Factors that affect onset of action of NDMRs
Factors that affect duration of action of NDMRs
The use of muscle relaxants in patients with neuromuscular diseases
Pancuronium
Vecuronium
Rocuronium
Atracurium
Cisatracurium
Mivacurium
Anticholinesterases
Sugammadex
Analgesics
Opioids
Classification of opioids according to structure
Classification of opioids according to activity
Classification of opioid receptors
Mechanism of action of opioid agonists
Structure-activity relationships of opioids
Pharmacokinetic properties of some opioids
Equianalgesic doses of some opioids (mg)
Indications for opioids
Effects of opioids
Morphine
Pethidine
Fentanyl
Alfentanil
Sufentanil
Remifentanil
Codeine
Oxycodone
Hydromorphone
Methadone
Tramadol
Buprenorphine
Naloxone
Intrathecal opioids
Non-steroidal anti-inflammatory drugs
Synthesis of prostaglandins
Effects of non-steroidal anti-inflammatory drugs
Pharmacokinetics of non-steroidal anti-inflammatory drugs
Pharmacokinetics of paracetamol
Pharmacodynamics of paracetamol
Paracetamol overdose
Pharmacokinetics of aspirin
Pharmacodynamics of aspirin
Aspirin overdose
Specific COX-2 inhibitors
Parecoxi
Local anaesthetics
The ideal properties of local anaesthetics
Classification of local anaesthetics based on the chemical structure of their intermediate linkage chain
Mechanism of action of local anaesthetics
Minimum effective concentration of local anaesthetic (Cm)
Structure-activity relationships of local anaesthetics
Factors that affect onset of action of local anaesthetics
Factors that affect duration of action of local anaesthetics
Factors that affect potency of local anaesthetics
Pharmacokinetics of local anaesthetics
Pharmaceutics of local anaesthetics
Lignocaine
Bupivacaine
Levobupivacaine
Ropivacaine
Prilocaine
Topical local anaesthetics
Factors that affect topical penetration of local anaesthetics
Adverse effects of local anaesthetics
Central nervous system toxicity
Cardiovascular system toxicity
CC:CNS ratio
Factors predisposing to local anaesthetic toxicity
Prevention of local anaesthetic toxicity
Management of local anaesthetic toxicity
Cocaine toxicit
Cardiovascular drugs
Autonomic nervous system
Adrenoreceptors
Drugs acting on the sympathetic nervous system
Drugs acting on the parasympathetic nervous system
Structure-activity relationships of sympathomimetics
Synthesis of catecholamines
Adrenaline
Noradrenaline
Dopamine
Dobutamine
Salbutamol
Phenylephrine
Ephedrine
Metaraminol
Inotropes
Non-selective phospho-diesterase inhibitors
Selective phospho-diesterase inhibitors
α-adrenoreceptor antagonists
β-adrenoreceptor antagonists
Indications for β-adrenoreceptor antagonists
Isomerism of β-adrenoreceptor antagonists
Effects of β-adrenoreceptor antagonists
Pharmacokinetic properties of some β-adrenoreceptor antagonists
Anticholinergics
Mechanism of action of anticholinergics
Effects of anticholinergics
Atropine
Hyoscine
Glycopyrrolate
Antiarrhythmic drugs (Vaughan-Williams classification)
Digoxin
Digoxin toxicity
Adenosine
Amiodarone
Magnesium sulphate
Classification of vasodilators
Glyceryl trinitrate (GTN)
Hydralazine
Sodium nitroprusside
Sodium nitroprusside toxicity
Calcium channel blockers
Angiotensin-converting enzyme inhibitors
Angiotensin II (ATII)
Angiotensin II receptor antagonists
Diuretics
Sites of action of diuretics
Thiazides
Loop diuretics
Potassium-sparing diuretics
Aldosterone antagonists
Osmotic diuretics
Carbonic anhydrase inhibitors
Antihypertensive drugs
Drugs used to manage myocardial ischaemia
Drugs used to manage cardiac failure
Drugs used to manage cardiac arrest
Central nervous system drugs
Antidepressants
Tricyclic antidepressants
Selective serotonin reuptake inhibitors
Monoamine oxidase inhibitors 2
Phenothiazines
Butyrophenones
Neuroleptic malignant syndrome
Anticonvulsants
Sodium valproate
Phenytoin
Carbamazepine
Gabapentine
Pregabalin
Lamotrigine
Antiparkinsonian drugs
Drugs used to treat migraine
Drugs acting via effects on serotonin or serotonin receptors
Miscellaneous drugs
Antiplatelet drugs
Anticoagulants
Pharmacodynamics of unfractionated heparin
Effects of unfractionated heparin
Pharmacokinetics of unfractionated heparin
Low molecular weight heparins
Monitoring of heparin therapy
Protamine
Synthetic pentasaccharide derivatives
Warfarin
Dabigatran etexilate
Rivaroxaban
Antifibrinolytics
Recombinant FVIIa (Novoseven)
Prothrombinex
Cryoprecipitate
Physiology of nausea and vomiting
Antiemetics
Metoclopramide
Ondansetron
Granisetron
Antacids
Drugs used for reduction of gastric acid production
H2 receptor antagonists
Proton pump inhibitors
Misoprostol
Sucralfate
Prokinetics
Laxatives
H1 receptor antagonists
Antiasthma drugs
Drugs used to treat pulmonary hypertension
Insulin
Physiological effects of insulin
Side effects of injectable insulin
Insulin preparations
Oral hypoglycaemic drugs
Sulphonylureas
Biguanides
Meglitinides
Glucocorticoids
Perioperative steroid supplementation
Vasopressin (ADH)
Desmopressin (DDAVP)
Antimicrobial drugs
Mechanism of action of antimicrobial drugs
Principles of surgical antibiotic prophylaxis
Principles of bacterial endocarditis prophylaxis
Antifungal drugs
Antiviral drugs
Cancer chemotherapeutic drugs
Side effects of cancer chemotherapeutic drugs
Recombinant DNA drug
Intravenous fluids
Crystalloids
Assumptions used for analysis of infusions of different IV fluids
Infusion of 1000ml of 0.9% NaCl
Infusion of 1000ml of 5% Dextrose
Colloids
The properties of an ideal colloid
Pharmacology of pregnancy
Placental drug transfer
Oxytocic drugs
Tocolytic drugs
Succinylcholine and pregnancy

2024-07-03