Pharmacology for Anaesthesia and Intensive Care

Transcription

1 Pharmacology for Anaesthesia and Intensive Care Fourth Edition

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3 Pharmacology for Anaesthesia and Intensive Care Fourth Edition T. E. Peck Consultant Anaesthetist, Royal Hampshire County Hospital, Winchester; Honorary Consultant, University Hospital Southampton, UK S. A. Hill Consultant Neuroanaesthetist, University Hospital Southampton, UK

4 University Printing House, Cambridge CB2 8BS, United Kingdom Cambridge University Press is part of the University of Cambridge. It furthers the University s mission by disseminating knowledge in the pursuit of education, learning and research at the highest international levels of excellence. Information on this title: / This publication is in copyright. Subject to statutory exception and to the provisions of relevant collective licensing agreements, no reproduction of any part may take place without the written permission of Cambridge University Press. First published 2000 Second edition 2003 Third edition 2008 Fourth edition 2014 Printed in the United Kingdom by Clays, St Ives plc A catalogue record for this publication is available from the British Library Library of Congress Cataloguing in Publication data Peck, T. E., author. Pharmacology for anaesthesia and intensive care / T. E. Peck, S. A. Hill. Fourth edition. p. ; cm. Includes bibliographical references and index. ISBN (hbk.) I. Hill, S. A. (Sue A.), author. II. Title. [DNLM: 1. Anesthetics pharmacology. 2. Cardiovascular Agents pharmacology. 3. Central Nervous System Agents pharmacology. 4. Intensive Care. 5. Peripheral Nervous System Agents pharmacology. QV 81] RD dc ISBN Hardback Cambridge University Press has no responsibility for the persistence or accuracy of URLs for external or third-party internet websites referred to in this publication, and does not guarantee that any content on such websites is, or will remain, accurate or appropriate. Every effort has been made in preparing this book to provide accurate and up-to-date information which is in accord with accepted standards and practice at the time of publication. Although case histories are drawn from actual cases, every effort has been made to disguise the identities of the individuals involved. Nevertheless, the authors, editors and publishers can make no warranties that the information contained herein is totally free from error, not least because clinical standards are constantly changing through research and regulation. The authors, editors and publishers therefore disclaim all liability for direct or consequential damages resulting from the use of material contained in this book. Readers are strongly advised to pay careful attention to information provided by the manufacturer of any drugs or equipment that they plan to use.

5 Contents Preface Foreword by Zeev Goldik page vii viii Section I Basic principles 1 1 Drug passage across the cell membrane 1 2 Absorption, distribution, metabolism and excretion 9 3 Drug action 25 4 Drug interaction 40 5 Isomerism 45 6 Pharmacokinetic modelling 50 7 Applied pharmacokinetic models 71 8 Medicinal chemistry 80 Section II Core drugs in anaesthetic practice 93 9 General anaesthetic agents Analgesics Local anaesthetics Muscle relaxants and reversal agents 166 Section III Cardiovascular drugs Sympathomimetics Adrenoceptor antagonists Anti-arrhythmics Vasodilators Antihypertensives 247 Section IV Other important drugs Central nervous system Antiemetics and related drugs Drugs acting on the gut Intravenous fluids and minerals Diuretics Antimicrobials 298 v

6 vi Contents 24 Drugs affecting coagulation Drugs used in diabetes Corticosteroids and other hormone preparations 336 Index 344

7 Preface The style of this fourth edition has remained largely unchanged, as it has proved successful in giving easy access to the contents. In order to keep the overall size similar to previous editions we have culled some of the drugs that had provided a historical perspective and reduced the space given to drugs used less commonly. Drugs that had been discontinued or withdrawn, but more recently been reinstated, are now included in order to remain current. A wide range of drugs that did not exist or were in the trial phase of their development are now included and further add to the breadth of this book. Section 1 has been developed further with a chapter for applied pharmacokinetic models as the use of total intravenous anaesthesia becomes more widespread. We trust that this book will continue to provide current and useful information to the wide readership that it has attracted thus far in its evolution. vii

8 Foreword The art of anaesthesia includes many different facets deeply rooted in medical behaviour: listening and talking to the patient, evaluating, diagnosing and taking the right decisions. Drugs are central to patient care in many areas of medical practice and the anaesthetist as well as all healthcare practitioners need to have a clear understanding of therapeutics. However, competence in anaesthetic management during the whole perioperative management of our patients implies good knowledge of pharmacology; it is the bread and butter of our profession. The dynamic nature of drug development in this field compels a continuous updating of the characteristics of drugs that form such an essential part of our armamentarium. Pharmacology for Anaesthesia and Intensive Care, edited by T.E. Peck and S.A. Hill, provides a novel-classic approach to pharmacology. Drawing on the experience of the authors, who are involved in clinical practice, postgraduate training and assessments, not only in the United Kingdom but with a pan-european view, the changes and improvements introduced in this fourth edition make this textbook an appropriate guide not only for trainees at all stages of their training but also for consultants. Designed as a refresher textbook, this work is suitable as a reference for daily use as well as in preparing for various medical assessments and examinations. Its content is fitted to anaesthesia training programmes in pharmacology in many countries. It covers the pharmacology requirements of the new syllabus in anaesthesia and intensive care produced by the European Board of Anaesthesiology of the UEMS (Union of European Medical Specialties) as well that of the Royal College of Anaesthetists. As for the previous editions, this textbook is part of the recommended bibliography for examination preparation for the European Diploma in Anaesthesiology and Intensive Care (EDAIC). I know that readers will find this book to be a valuable resource for both examination preparation and clinical use as a practical guide to pharmacology for anaesthesia and intensive care. Zeev Goldik MD MPH Chairman, Examinations Committee European Diploma in Anaesthesiology and Intensive Care President Elect, European Society of Anaesthesiology Head of Post Anaesthesia Care Unit and Consultant Anaesthetist, Lady Davis Carmel Medical Centre, Haifa, Israel viii