Mechanisms of drug action
and penicillamine are both used in lead poisoning; penicillamine is also of use in copper and mercury poisoning. Cyclodextrins are bucket-shaped oligosaccharides produced from starch. α-Cyclodextrins are formed of six,…
ANESTHESIA
Local anaesthetic agents
Figure 33.1 Chemical structure of an ester (procaine) and an amide (lidocaine) Local anaesthetic agents exist in two states, acid (protonated) and basic (non-ionised) in equilibrium according to their pKa…
Special patient circumstances
Figure 5.1 Innervation of the birth canal Figure 5.2 Methods of pain relief in labour Psychological Antenatal educationPleasant environment Complementary TENSAromatherapyReflexologyAcupuncture Systemic analgesia Nitrous oxideInhalationalIM opioids (pethidine)PCA (remifentanil) Epidural Bolus…
Cardiovascular pharmacology
Figure 36.1 Sites of action of antiarrhythmic drugs Figure 36.2 Antiarrhythmic drugs by class Class I IA Quinidine Procainamide Disopyramide Cibenzoline IB Lidocaine Phenytoin Mexiletine Tocainide Ethmozine IC Flecainide Lorcainide…
Intravenous fluids
Extracellular waterIntravascular (blood) volumeProvision of metabolic substratesElectrolytesCarbohydrateAmino acids and proteinFatty acidsManipulation of acid–base balanceForced acid or alkaline diuresisCoagulopathy correctionPlateletsClotting factorsImproving oxygen carriageDiluent for drugsIf causticIf low solubilityOsmotic effectsManipulation of blood…
Analgesic drugs
Figure 31.3 Chemical structure of opioids The presence of the tertiary nitrogen and its distance from the aromatic ring (4.55 Å for morphine and the related semisynthetic compounds) is considered…
Major trauma
and elastase. This inflammatory response plays a key role in the development of acute respiratory distress syndrome (ARDS) and MODS. The metabolic response to severe trauma is biphasic. SIRS occurs…
Anaesthetic gases and vapours
Figure 29.1 Wash-in curves for volatile anaesthetic agents Partial pressure of volatile agent in the pulmonary artery The rate of uptake of volatile agent from each alveolus is dependent on…
Antimicrobial therapy
CefaclorModerately stableModerate32ndCefuroximeCephamandoleResistanceModerate43rdCefotaximeCeftriaxoneStablePotent: especially Gram-negatives53rdCefiximeCefpodoximeStablePotent: especially Gram-negatives63rdCeftazidimeCefsulodinStablePotent: especially Gram-negatives and Pseudomonas74thCefpiromeStableEnterobacteriaceae Cephalexin Cephalexin is active against most Gram-positive cocci, except fecal streptococci and MRSA. It is also moderately active against some…
Pharmacology of haemostasis
Figure 41.2 Effect of drugs on the coagulation pathway Anticoagulants Anticoagulants are drugs that interfere with the process of fibrin plug formation, to reduce or prevent coagulation. This effect is…
