Opioid Agonists and Antagonists

Dec 11, 2016 by in ANESTHESIA Comments Off on Opioid Agonists and Antagonists

Chemical Structure of Opium Alkaloids The active components of opium can be divided into two distinct chemical classes: phenanthrenes and benzylisoquinolines. The principal phenanthrene alkaloids present in opium are morphine,…

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Local Anesthetics

Dec 11, 2016 by in ANESTHESIA Comments Off on Local Anesthetics

Local anesthetics are poorly soluble in water and therefore are marketed most often as water-soluble hydrochloride salts. These hydrochloride salt solutions are acidic (pH 6), contributing to the stability of…

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Sympatholytics

Dec 11, 2016 by in ANESTHESIA Comments Off on Sympatholytics

Clinical Uses The principal use of phentolamine is the treatment of acute hypertensive emergencies, as may accompany intraoperative manipulation of a pheochromocytoma or autonomic nervous system hyperreflexia. Administration of phentolamine,…

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Metabolism

Dec 11, 2016 by in ANESTHESIA Comments Off on Metabolism

For adults, total energy expenditure averages 39 kcal/kg in males and 34 kcal/kg in females. Approximately 20 kcal/kg is expended as basal metabolism necessary to maintain integrity of the cell…

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Normal Endocrine Function

Dec 11, 2016 by in ANESTHESIA Comments Off on Normal Endocrine Function

The pituitary gland lies in the sella turcica at the base of the brain and is connected to the hypothalamus by the pituitary stalk. Physiologically, the gland is outside the…

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Gastrointestinal Physiology

Dec 11, 2016 by in ANESTHESIA Comments Off on Gastrointestinal Physiology

Anatomy The liver is divided into four lobes consisting of 50,000 to 100,000 individual hepatic lobules (Fig. 32-1). Blood flows past hepatocytes via sinusoids from branches of the portal vein…

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Gastrointestinal Motility Drugs

Dec 11, 2016 by in ANESTHESIA Comments Off on Gastrointestinal Motility Drugs

Pharmacokinetics H1-receptor antagonists are well absorbed after oral administration, often reaching peak plasma concentrations within 2 hours (see Table 35-1).19,20 Many are highly protein bound, with ranges from 78% to…

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Renal Physiology

Dec 11, 2016 by in ANESTHESIA Comments Off on Renal Physiology

The Glomerulus Structure and Function of the Glomerulus Glomeruli are found in the renal cortex and consist of a tuft of capillaries surrounded by Bowman’s capsule, the dilated blind end…

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Sympathomimetic Drugs

Dec 11, 2016 by in ANESTHESIA Comments Off on Sympathomimetic Drugs

Epinephrine Epinephrine is the prototype sympathomimetic. It is a circulating hormone synthesized, stored, and released from the adrenal medulla. Its natural functions upon release into the circulation include regulation of…

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Physiology and Pharmacology of the Elderly

Dec 11, 2016 by in ANESTHESIA Comments Off on Physiology and Pharmacology of the Elderly

Heart The heart increases in size during aging as a result of concentric ventricular hypertrophy. This occurs in response to the increase in left ventricular afterload. This increase in afterload…

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