Chapter
Ionotropic purinergic receptors
Production of intermediate messengers
G-protein coupled receptors (GPCRs) and G-proteins
Regulation of gene transcription
Dynamics of drug–receptor binding
Types of drug–receptor interaction
Non-competitive antagonists
Allosteric modulation of receptor binding
Tachyphylaxis, desensitization and tolerance
Mixtures of multiple isomers
6 Pharmacokinetic modelling
Calculus: differentiation
The one-compartment model
Measurement of pharmacokinetic parameters
Examples of using logarithms
Adding and subtracting logarithms
Logarithms of numbers with exponential terms
Conversion of logarithms from one base to another
A semi-logarithmic plot of concentration against time
Relationship between half-life and time constant
7 Applied pharmacokinetic models
Ideal drugs for intravenous use in anaesthesia
Total intravenous anaesthesia
Manual TIVA: the Bristol model
Target-controlled infusion
Context-sensitive half-time
Safety of TIVA and TCI in clinical practice
Building blocks: amino acids, nucleic acids and sugars
Nucleic acids, nucleosides and nucleotides
Drugs and their structures
Catecholamines and derivatives
Non-depolarizing muscle relaxants
Bis-benzylisoquinoliniums
Medicinal chemistry mini-dictionary
Section II Core drugs in anaesthetic practice
9 General anaesthetic agents
Mechanisms of general anaesthetic action
Anatomical sites of action
Protein site(s) of action
Intravenous anaesthetic agents
The ideal intravenous anaesthetic agent
Inhaled anaesthetic agents
Minimum alveolar concentration
The ideal inhaled anaesthetic agent
Kinetics of inhaled anaesthetic agents
Blood:gas partition coefficient
Concentration and second gas effect
Pharmacology of inhaled anaesthetic agents
Concentration effect, second gas effect and diffusion hypoxia
Non-anaesthetic medical gases
Physiochemical properties
UK guidelines for the use of inhaled NO in adult intensive care units
Physiochemical properties
Carbon dioxide absorbents
Opioids and related drugs
Combination preparations – Targinact
Non-steroidal anti-inflammatory drugs
Non-specific COX inhibitors
Features of aspirin overdose
Features of paracetamol overdose
Preferential COX-2 inhibitors
Specific COX-2 inhibitors
The resting membrane potential
Physiochemical characteristics
Metabolism and elimination
Intravenous regional anaesthesia
Eutectic mixture of local anaesthetic (EMLA)
12 Muscle relaxants and reversal agents
Monitoring neuromuscular block
Single twitch stimulation
Post-tetanic potentiation and count
Depolarizing muscle relaxants
Prolonged block (succinylcholine apnoea)
Non-depolarizing muscle relaxants
Easily reversible inhibition
Formation of a carbamylated enzyme complex
Organophosphorous compounds
Uses and mechanism of action
Section III Cardiovascular drugs
Parasympathetic nervous system
Sympathetic nervous system
Naturally occurring catecholamines
Non-selective phosphodiesterase inhibitors
Selective phosphodiesterase inhibitors
14 Adrenoceptor antagonists
α-Adrenoceptor antagonists
ß-Adrenoceptor antagonists
Intrinsic sympathomimetic activity – partial agonist activity
Membrane stabilizing activity
Combined α- and β-adrenoceptor antagonists
Classification of anti-arrhythmics
Supraventricular tachyarrhythmias
Treatment of digoxin toxicity
Ventricular tachyarrhythmias
Both: supraventricular and ventricular tachyarrhythmias
Isosorbide dinitrate and isosorbide mononitrate
Potassium channel activators
Calcium channel antagonists
Renin–angiotensin–aldosterone system
Angiotensin-converting enzyme inhibitors
Angiotensin II receptor antagonists (ARAs)
Comparing ARAs to ACE inhibitors
Adrenergic neurone blockade
Section IV Other important drugs
18 Central nervous system
Hypnotics and anxiolytics
Non-benzodiazepine hypnotics (the Z drugs)
Tricyclics – TCAs (amitriptyline, nortriptyline, imipramine, dothiepin)
Selective serotonin re-uptake inhibitors (fluoxetine, paroxetine, sertraline, venlafaxine)
Monoamine oxidase inhibitors
Non-selective irreversible MAOIs (phenelzine, isocarboxazid, tranylcypromine)
Selective reversible MAOIs – RIMA (moclobemide)
MAOIs and general anaesthesia
19 Antiemetics and related drugs
Neurokinin 1 (NK1) receptor antagonists
Aprepitant and fosaprepitant
20 Drugs acting on the gut
Aluminium- and magnesium-containing antacids
Sodium bicarbonate and sodium citrate
Drugs influencing gastric secretion
Drugs influencing gastric motility
21 Intravenous fluids and minerals
Thiazides (bendroflumethiazide, chlorothiazide, metolazone)
Loop diuretics (furosemide, bumetanide)
Potassium sparing (amiloride)
Aldosterone antagonists (spironolactone)
Carbonic anhydrase inhibitors (acetazolamide)
Antibiotics attacking the cell wall
Mechanisms of resistance to penicillins
Side effects: teicoplanin
Antibiotics interfering with DNA and transcription to RNA
Antibiotics interfering with peptide synthesis
Patients on renal replacement therapy
24 Drugs affecting coagulation
Cyclo-oxygenase I inhibition
Platelet phosphodiesterase inhibition
Inhibition of ADP binding
Glycoprotein IIb/IIIa-receptor antagonists
Epoprostenol (prostacyclin – PGI2)
Low-molecular-weight heparins (LMWHs)
Enoxaparin, dalteparin, tinzaparin
Monitoring heparin therapy
Monitoring warfarin therapy
Direct thrombin inhibitors
Direct factor Xa inhibitors
Chosing between dabigatran, rivaroxaban and apixaban
Neuraxial anaesthesia and oral anticoagulants
Drugs affecting the fibrinolytic system
25 Drugs used in diabetes
Repaglinide and metiglinide
Peri-operative care of the diabetic patient
26 Corticosteroids and other hormone preparations
Anti-inflammatory effects
Immunosuppressive effects
Peri-operative steroid supplementation
Drugs used in thyroid disease
Drugs used in the treatment of hyperthyroidism
Hormone replacement therapy
Pharmacology for Anaesthesia and Intensive Care
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