Essence of Anesthesia Practice

Tacrolimus (FK-506)

Uses Rescue of primary immunosuppressant Rx following liver, lung, heart, pancreas, and limb transplant. Approximate number of candidates: 3000 awaiting liver transplant and 9000 awaiting kidney transplant in USA; 15,000 living liver transplant and 50,000 kidney transplant recipients are chronically…

Statins

Uses Incidence in USA: Estimated 20 million Primary indications include: Hyperlipidemia: HMG-CoA reductase inhibitors (statins) are powerful drugs for lowering LDL cholesterol concentrations, and certain statins—atorvastatin in high doses and rosuvastatin—increase concentrations of healthy HDL cholesterol. Primary and secondary prevention…

Sildenafil Citrate

Uses Treatment of erectile dysfunction (Viagra) Sildenafil (Revatio) is used to improve the ability to exercise in people with pulm arterial Htn Oral sildenafil is used as part of multimodal management of severe periop pulm Htn and right ventricular dysfunction…

Serotonin: Agonists, Antagonists, and Reuptake Inhibitors

Uses Serotonin (5-hydroxytryptophan [5-HT]) not given as a drug; is a neurotransmitter that plays many roles within the body; serotonin levels can be affected by drugs called serotonin agonists and antagonists Partially selective receptor agonists used mostly for Rx of…

Selective Estrogen Receptor Modulators

Uses Critical components in treatment algorithm for invasive and/or in situ breast cancer, breast cancer chemoprevention in high-risk pts, and postmenopausal osteoporosis (raloxifene only) Perioperative Risks VTE, particularly if the pt has a history of recent chemotherapy, prior irradiation, or…

Rifampin

Uses Antibiotic therapy for TB (yearly incidence 2.96:100,000 in USA) and Neisseria meningitidis infection (yearly incidence 0.3:100,000 in USA). Also used to treat Hansen disease (leprosy) and Legionnaires disease and as prophylaxis against Haemophilus influenzae type B. Treatment of opioid-induced…

Pyridostigmine Bromide

Uses Therapy for MG, which is caused by decreased postsynaptic ACh receptors. Antagonism of nondepolarizing NMBDs. Therapy for glaucoma. Therapy for atony of GI and urinary tracts. Perioperative Risks Muscarinic effects on GI, respiratory, and CV systems. Prolonged response to…

Pseudoephedrine

Uses An OTC sympathomimetic commonly used as a nasal decongestant or for opening obstructed eustachian ostia. Used in the symptomatic treatment of reactive airway disease; however, appears to be ineffective as a bronchodilator. Also used for treatment of ejaculatory dysfunction…

Proton Pump Inhibitors

Uses PPIs are used for the prevention and treatment of ulcers in the stomach, esophagus, or duodenum that are caused or exacerbated by stomach acids. People in USA receive approximately 21 million prescriptions annually. Worldwide, $13.6 billion worth of PPIs…

Propylthiouracil—Antithyroid Drugs

Uses RX for hypothyroidism. In USA, 7.5% of pregnant women plus an additional 500,000 people per y develop hyperthyroidism. Rx for goiter associated with hyperthyroidism; second drug to methimazole due to greater side effects with PTU except in pregnancy (methimazole…