Pharmacology

This article is a review of the current recommendations relating to this group of patients and outlines the approach to management of acute pain in the opioid tolerant patient by anaesthetists in the hospital setting.Acute pain management for opioid tolerant patients – October 28, 2011

Atropine a naturally occurring alkaloid of Atropa belladonna, is a competitive antagonist of muscarinic cholinergic receptors. It’s pharmacological properties are described here.
Atropine – June 1, 1996

A balance exists between sympathetic and parasympathetic outflow. Many common pathologies and surgical procedures can affect this balance, leading to disturbances in the function of organ systems. Drugs can contribute to autonomic disturbance, but drugs can also be used to redress the balance. Autonomic Nervous System Pharmacology – December 1, 2008

The subject of cardiovascular pharmacology is diverse, and this article concentrates on areas relevant to the anaesthetist. The pathophysiology of common diseases of the heart and circulation is discussed before considering the drugs used for treatment.
Cardiovascular Pharmacology for Anaesthetists – June 1, 2000

Halothane and diethyl ether, the two anaesthetics most commonly used in developing countries, have the unusual property that they form an azeotrope when mixed in the ratio of about 2 parts halothane to 1 part ether. This aazeotrope behaves physically as though it were a single compound.Halothane-Ether Azeotrope – June 1, 2004

Download – Induction Drugs in Anaesthesia The agents available for induction of anaesthesia are described, with discussion of the advantages and disadvantages of each. Personal preference and familiarity of the practitioner largely determines the choice of agent, but it is important to maintain a broad knowledge of all available agents, for situations when the choice […]Induction Drugs in Anaesthesia – December 1, 2008

This article describes the pharmacology and actions of the commonly-used inhalation anaesthetic agents.Inhalational Anaesthetic Agents – December 1, 2008

This article describes the way in which vasoactive drugs are used in critically ill patients. Typical clinical scenarios are used to demonstrate why we choose certain drugs in certain conditions. The safety aspects of running infusions of highly potent drugs are.Inotropes and vasopressors in critical care (Update 28, 2012) – December 21, 2012

Ketamine is frequently described as a “unique drug” because it has hypnotic (sleep producing), analgesic (pain relieving) and amnesic (short term memory loss) effects – no other drug used in clinical practice combines these three important features.Ketamine (Update 4) – June 1, 1994

Ketamine is the only anaesthetic available which has analgesic (pain relieving), hypnotic (sleep producing) and amnesic (short term memory loss) effects. When used correctly it is a very useful and versatile drug.Ketamine in Anaesthetic Practice – June 1, 2006

Ketamine provides dissociative anaesthesia – a combination of profound analgesia with superficial sleep. This state is characterised by spontaneous ventilation, relative preservation of airway reflexes and haemodynamic stability, and explains why ketmaine has remained the anaesthetic drug of choice in the developing world and for mass casualties in the field.Ketamine, A Review (Update 20) – June 1, 2005

Levobupivacaine contains only the levorotatory isomer present in the commercial preparations of bupivacaine. The risk for cardiac and neurotoxicity may be less than with the racemic bupivacaine but with similar clinical effects.Levobupivacaine – June 1, 2002

Toxic side effects of local anaesthetic drugs occur when excessive blood levels occur. The causes and treatment are discussed.Local Anaesthetic Drug Toxicity – June 1, 1999

This article focuses on the basic structure and function of local anaesthetics. Learning will be improved by trying to answer the questions posed in the text before moving on. More detail can be found in the “Further reading” section at the end.Local Anaesthetic Pharmacology – December 1, 2008

The purpose of this review is to suggest methods of relieving acute postoperative pain. It will discuss how the use of peripherally-acting drugs (such as the non-steroidal anti-inflammatory drugs, centrally-acting agents (such as opioids) and local anaesthetics can achieve this. Guidelines are offered for pain relief in children and the elderly.Management of Postoperative Pain – June 1, 1997

Morphine is obtained from opium, the juice secreted by the seeds of the poppy. It works on several types of receptors, widely found in nervous tissue. “Opioids” is a term used for all drugs that act on these receptors. These other opioids may be natural occurring substances, such as morphine, or made in the laboratory such as pethidine.Morphine – June 1, 1993

Postoperative residual curarization occurs even after administration of intermediate-acting non-depolarizing neuromuscular blocking drugs, for example, atracurium or vecuronium. Satisfactory recovery from neuromuscular block has not occurred until the train-of-four ratio is >0.9. Quantitative methods of measuring evoked responses, for the example, acceleromyography or mechanomyography, are necessary to ensure adequate recovery from block.Neuromuscular Block Monitoring – June 1, 2009

This article describes the pharmacology of neuromuscular blockers and the drugs used to reverse their effects.Neuromuscular Blocking Drugs and Anticholinesterases – December 1, 2008

Reviewing new pharmacological agents and their effects on the brain has been a considerable challenge. Over recent years a number of new agents, both inhalational and intravenous have been introduced. Their advantages and disadvantages are debated, their availability is not uniform, but their costs are undisputedly increased.Neuropharmacology, Intracranial Pressure and Cerebral Blood Flow – December 1, 1998

NSAIDs are effective analgesics used almost universally to reduce perioperative and long term pain, especially when associated with inflammatory conditions. The side effects however, are numerous and clinically important, possibly having far greater impact than we imagine. The future may herald tighter regulation of this class of drug.Non-steroidal Anti-inflammatory Drugs – December 1, 2008

Opioid drugs are widely used as moderate to strong analgesic agents. The pharmacokinetic properties of different agents determine their analgesic and side effect profiles. Many agents that have fallen from favour in more developed countries are still widely used in poorly-resourced settings and so knowledge of their advantages and disadvantages is essential.Opioid Pharmacology – December 1, 2008

This article compares the efficacy and cost of the oral, rectal and intravenous formulations of paracetamol.Paracetamol – A Review of Three Routes of Administration – December 1, 2008

Pentazocine, an opioid agonist-antagonist, is widely used around the world despite its considerable side-effects and tendency to cause dependency. It still has a useful function to play in the management of moderate to severe pain when used intravenously or intramuscularly, but should not replace morphine or pethidine if available.Pentazocine – June 1, 2008

Antiplatelet drugs, such as aspirin and clopidogrel, are widely used in primary and secondary care and are very commonly encountered in the perioperative setting. In this article we explore the specific uses of antiplatelet drugs, their mechanisms of action and possible consequences of their discontinuation. Perioperative Management of Antiplatelet Drugs – December 1, 2010

Pharmacodynamics illustrates what a drug does to the body, with drugs acting on ‘targets’ by binding. Receptors are a special type of target, involved in the body’s normal signalling processes and the different aspects of the interaction between drugs and receptors are described.Pharmacodynamics and Receptor Physiology – December 1, 2008

Pharmacokinetics is the study of the way the body deals with any drugs that are given to it. Simply put “what the body does to a drug”. In pharmacokinetics we study the processes of absorption, distribution, and elimination, either by metabolism or excretion, of drugs.Pharmacokinetics (Update 15) – December 1, 2002

This article explains the internationally recognised formats for describing drugs, their dosage and dilutions, with commonly-used examples. Pharmacology and Drug Doses – An Introduction – December 1, 2008

A ‘vasopressor’ causes vasoconstriction and an ‘inotrope’ increases the force of cardiac contraction. Vasopressors and inotropes work via the Autonomic Nervous System.Pharmacology of Vasopressors and Inotropes – June 1, 1999

This clear article by Fred Roberts explains the essentials of pharmacokinetics in anaesthesia.Pharmokinetics and Anaesthesia – December 1, 2008

This article summarises the pahrmacological properties and clinical uses of suxamethonium.
Suxamethonium – June 1, 1992