The occurrence of deleterious or even fatal drug-drug interactions (DDIs) in the perioperative period is no longer a theoretical concern but a harrowing reality. A Case Approach to Perioperative Drug-Drug Interactions addresses the complex realm of pharmacokinetic drug interactions in an easy-to-read volume that functions as both a comprehensive clinical reference and a casebook. The book presents a summary of the core concepts of drug interactions; an organized, annotated presentation of the drug interactions most relevant to the perioperative clinician; and approximately 200 case scenarios that highlight specific drug interactions. This book fills a real void in the clinical literature and is invaluable to anesthesiologists and surgeons, as well as trainees in both specialties; intensive care staff, including physicians, physician’s assistants, and nurses; and nurse practitioners who staff preoperative evaluation clinics.
Essential at-a-glance guidance whenever and wherever it's needed. Previously published as the Anesthesia Drug Manual, this handy guide, now entitled Perioperative Drugs, once again concisely reviews the essential pharmacokinetic and pharmacodynamic properties of more than 400 drugs in 36 drug classes to give readers an informed basis for sound decision-making. It enables clinicians to quickly review the pharmacologic properties of all of the drugs a patient might be taking, and to anticipate interactions between these medications and anesthetics. The concisely organized, templated format facilitates quick reference, and a PDA version makes it accessible any setting. Describes the drugs a surgical patient might be taking for other medical conditions, and how these drugs interact with anesthetics. Details approximately 400 drugs in 36 different drugs classes, including drugs recently approved by the FDA. Uses a concise, bulleted format to present-generic and trade name - pharmacokinetics - indications - pharmaco-dynamics involving the central nervous, cardiovascular, pulmonary, hepatic, renal, gastrointestinal, and musculoskeletal systems - dosages/concentrations for adults and children - specific contraindications - and interactions/allergic responses-for each drug. Includes a "key point" for every drug entry that summarizes the clinical implications of the drug for the patient's perioperative course. Is meticulously updated throughout to incorporate all of the latest information. Features new sections on transplant drugs as well as alternative and herbal medications, and offers expanded coverage of blood substitutes.
This user-friendly resource offers complete and comprehensive coverage of the difficult challenges posed by drug-drug interactions. Over 170 case vignettes illustrate a variety of interactions (DDIs) to provide an unintimidating -- even entertaining -- approach to understanding these issues. Drug-Drug Interaction Primer builds on the author's earlier work, Drug Interactions Casebook: The Cytochrome P450 System and Beyond, and features updated references throughout and 29 new cases that provide such clinical examples as: a patient diagnosed with schizoaffective disorder transitions from haloperidol to aripiprazole with disastrous results; an AIDS patient's trimethoprim-sulfamethoxazole is replaced with warfarin following atrial fibrillation, resulting in ischemic stroke; and a delusional patient on risperidone is placed on phenytoin following seizures, and delusions return. Previous cases have been revised to enhance clarity. An introduction to core concepts, which includes brief reviews of each enzyme system, brings the reader up to speed on how to think about DDIs and begin to grapple with what might seem like an imposing subject. The vignettes that follow each include a case presentation and an explanation of the mechanism by which the interaction(s) occurred, and each derives from sound clinical evidence -- not merely extrapolations from drug characteristics -- to offer a more realistic understanding of DDIs. Most of the interactions described involve the cytochrome P450 enzyme system; others involve alterations in phase II metabolism and P-glycoprotein functioning, as well as plasma protein displacement effects. The appendices detail most drug-drug interactions between psychotropic agents and contain metabolic pathways and inhibitory and inductive profiles for antidepressants, antipsychotics, and mood stabilizing agents -- as well as tables that detail all known and clinically significant DDIs between pairings of any two agents from these drug classes. An extensive index allows quick reference. Among the book's other features: Reorganization by medical subspecialty -- psychiatry, internal medicine, neurology, surgery/anesthesia, and gynecology, oncology, and dermatology -- better facilitates clinical application. Comprehensive tables detail substrates, inhibitors, and inducers for P450, phase II, and P-glycoprotein. DDIs involving select nonpsychotropic agents such as tobacco, ethinylestradiol, and statins. Exploration of the paradigm of plasma protein binding mediated DDIs in detail, with cases conveniently indexed. These cases bring DDIs alive in a way that drier descriptions cannot, and this volume introduces more original material than will be found in other sources. Drug-Drug Interaction Primer is brimming with material that can be put to immediate use, offering insights that will improve any practitioner's skills.
This book is designed to guide the practitioner in the medical and anesthetic management of the maxillofacial surgery patient, serving as a comprehensive, up-to-date resource that will assist in patient work-up and response to any medical problem. It is divided into four sections that provide an overview of general and basic topics relevant to perioperative assessment, explain the assessment and management of diverse medical issues and co-morbidities, discuss the perioperative, pharmacological, and supportive management of maxillofacial treatment, and identify potential complications and their management. All of the authors have been carefully selected for their expertise in the topics that they discuss. While the book will be especially valuable for oral and maxillofacial surgeons, it will also be highly relevant for multiple other health care providers, including dentists, dental specialists, dental hygienists, otolaryngologists, plastic and reconstructive surgeons, medical residents, nurses, and physician assistants.
Our four studies highlight the importance of potential drug-drug interactions as a contributing factor in drug safety. Thus, this book contains these studies starting with the evaluation of drug interaction screening programs, continuing with the prevalence of drug-drug interactions during hospitalization and the pharmacist intervention study and ending with a case-control study about risk factors for gastrointestinal bleeding. We conclude, that improvements regarding the awareness of potential drug-drug interactions and a strict management should be implemented. Prescribing drugs with a low risk for potential drug-drug interactions as well as careful monitoring for adverse drug reactions are important measures in the prevention of harm associated with potential drug-drug interactions.
This new definitive resource addresses the fundamental principles of anaesthesia, underpinning sciences and the full spectrum of clinical anaesthetic practice. An international team of experts provide trustworthy, effective, and evidence-based guidance enabling clinicians to provide the very best clinical care to patients.
In recent years our understanding of molecular mechanisms of drug action and interindividual variability in drug response has grown enormously. Meanwhile, the practice of anesthesiology has expanded to the preoperative environment and numerous locations outside the OR. Anesthetic Pharmacology: Basic Principles and Clinical Practice, 2nd edition, is an outstanding therapeutic resource in anesthesia and critical care: Section 1 introduces the principles of drug action, Section 2 presents the molecular, cellular and integrated physiology of the target organ/functional system and Section 3 reviews the pharmacology and toxicology of anesthetic drugs. The new Section 4, Therapeutics of Clinical Practice, provides integrated and comparative pharmacology and the practical application of drugs in daily clinical practice. Edited by three highly acclaimed academic anesthetic pharmacologists, with contributions from an international team of experts, and illustrated in full colour, this is a sophisticated, user-friendly resource for all practitioners providing care in the perioperative period.
Today we witness an eventful time in which the powerful new forces of genomics, information technology and economics are rapidly changing the science and art of medicine. This will require more specialization than ever before. However, there is also an increasing demand for an integrated approach, which is provided by the discipline of Clinical Pharmacology (CP). CP pursues a scientific goal by studying drug action in patients and volunteers, a clinical goal by administering appropriate drug therapy and a regulatory goal by assessing the risk/benefit ratio of drug candidates in drug development and reimbursement. This introduction to current topics of CP covers traditional topics of clinical drug research and trial methodology but also provides insight in current topics like genomics, imaging technology and issues in drug reimbursement. A number of concrete case studies in clinical drug research and development help to give a better understanding of the general principles of CP.
