History Pharmacology is characterized by detailed descriptions of the actions of individual drugs. In the case of anesthesia, no single drug has been found to be universally satisfactory and indeed general anesthesia is now regarded as a set of desirable…
Anesthesiologists frequently care for patients at the extremes of age and size. These patient groups have unique features that require special consideration when formulating an anesthetic plan. The purpose of this chapter is to highlight alterations in physiology associated with…
Evolutionary Perspective The biotransformation of foreign substances is based on ancient evolutionary defense mechanisms. Hundreds of millions of years ago, animals evolved to terrestrial life and began ingesting new varieties of plant life with nutrient and toxic potential. These early…
Historical Perspective The discovery of drugs with anesthetic properties was a landmark event in the history of pharmacology, medicine, and even civilization, in that it made otherwise painful surgical treatments of disease possible. Without a means of providing anesthesia, it…
The science broadly referred to as clinical pharmacology is the foundation on which anesthesiologists base their therapeutic decisions, including the rational selection of anesthetics and the formulation of safe and effective dosage regimens. Focusing exclusively on intravenous anesthetics, this chapter…
Understanding the basic principles of pharmacology is fundamental to the practice of medicine in general, but is perhaps most relevant to the practice of anesthesiology. It is now widely accepted that cells contain a host of specific receptors that mediate…
Clinical Presentation The vagus nerve is the largest cranial nerve. It extends from medulla to colon, extensively supplying sensory and autonomic innervation to various thoracic and abdominal viscera. It is involved in the cardiac, pulmonary, immune, gastrointestinal, and endocrine systems.…
Introduction Clinical presentation In 2013, 1.7% of the US population, or 5.4 million people, were living with paralysis. The leading causes of paralysis were stroke and spinal cord injury (SCI). Limitations brought on by any degree of paralysis significantly impact…
Clinical Presentation Gastric stimulation is a treatment option typically reserved for refractory cases of gastroparesis. Estimates from Minnesota in 2007 suggest that the prevalence of confirmed gastroparesis per 100,000 people is 37.8 for women and 9.8 for men. However, estimates…
Introduction The purpose of this chapter is to provide an overview of peripheral nerve stimulation for the treatment of overactive bladder (OAB) syndrome. OAB is common among adults worldwide, with a substantial psychological and economic burden on society. Symptoms typically…