Essence of Anesthesia Practice

Marijuana

Acknowledgment The authors would like to acknowledge the contributions of Drs. Joshua W. Sappenfield and Christopher T. Stephens to this chapter in the previous edition. Uses Antiemetic Appetite stimulation Analgesia Recreational Epilepsy Glaucoma Mood disorders Spastic disorders Perioperative Risks Cross-tolerance…

Magnesium Sulfate

Acknowledgment The author would like to acknowledge the contributions of Drs. Subramanian Sathishkumar and Sanjib Adhikary to this chapter in the previous edition. Uses Treatment of hypomagnesemia and magnesium deficiency in critically ill pts Treatment of torsade de pointes, atrial…

Lithium Carbonate (Lithobid)

Uses For treatment of manic episodes of bipolar disorder and some schizoaffective disorders. Approved for maintenance therapy to help prevent episodes of mania or depression. As an augmenting agent for antidepressants. Has also been used to treat aggression, PTSD, and…

Leukotriene Antagonists

Uses Include the leukotriene receptor antagonists montelukast, zafirlukast, and pranlukast (not available in USA) as well as the 5-lipoxygenase (5-LO) inhibitor zileuton. Montelukast is the most commonly used drug of this class in USA. Montelukast is a once-daily oral drug…

Insulin

Uses Treatment of pts with insulin-dependent DM, hyperglycemia, DKA, and hyperkalemia Overview/Pharmacology Produced by the beta cells of the pancreatic islets of Langerhans. Proteolytic cleavage of the connecting peptide from proinsulin produces the C-peptide and insulin (peptides A and B),…

Inhaled Bronchodilators

Uses Reversal of airflow limitation via relaxation of airway smooth muscle tissue Long-acting formulations used for chronic therapy and short-acting formulations for acute symptom relief. Diagnosis of COPD: FEV 1 /FVC <0.70 after bronchodilator treatment. Overview/Pharmacology Two classes: Beta 2…

Hormone Replacement Therapy

Uses Prevention or alleviation of moderate to severe menopausal signs and symptoms such as vasomotor effects, depressive mood changes, vaginal dryness, urogenital atrophy, osteoporosis, cardiovascular disease, and cognitive dysfunction Treatment of physiologic and physical manifestations of primary ovarian insufficiency Perioperative…

Gold (Auranofin, Aurothioglucose, Aurothiomalate)

Uses Rheumatoid arthritis treatment for patients without sufficient response to initial treatment with NSAIDs, steroids, or other DMARDs. May have efficacy in pemphigus vulgaris, psoriatic arthritis, and palindromic rheumatism but lacks trials is and rarely used due to availability of…

Glucocorticoids

Uses Used to treat a wide range of illnesses including but not limited to autoimmune disorders, postop nausea and vomiting, and chronic pain Overview/Pharmacology Adrenal cortex produces and releases two different types of corticosteroids: Mineralocorticoids (maintain salt and fluid balance)…

Folic Acid

Uses Prevention of folic acid deficiency Treatment of megaloblastic anemia Experimental treatment for major depressive disorder Treatment of folic acid deficiency caused by anorexia, chronic use of oral contraceptive and some antiepileptic drugs, alcoholism, malabsorption diseases (e.g., sprue), bowel resection,…