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anesthetic pharmacology

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https://www.readbyqxmd.com/read/28538623/impact-of-a-novel-pi3-kinase-inhibitor-in-preventing-mitochondrial-dna-damage-and-damage-associated-molecular-pattern-accumulation-results-from-the-biochronicity-project
#1
George E Black, Kyle K Sokol, Donald M Moe, Jon Simmons, David Muscat, Victor Pastukh, Gina Capley, Olena Gorodnya, Mykhalo Ruchko, Mark B Roth, Mark Gillespie, Matthew J Martin
BACKGROUND: Despite improvements in the management of severely injured patients, development of multiple organ dysfunction syndrome (MODS) remains a morbid complication of traumatic shock. One of the key attributes of MODS is a profound bioenergetics crisis, for which the mediators and mechanisms are poorly understood. We hypothesized that metabolic uncoupling using an experimental PI3-kinase inhibitor, LY294002 (LY), may prevent mitochondrial abnormalities that lead to the generation of mitochondrial DNA (mtDNA) damage and the release of mtDNA damage associated molecular patterns (DAMPs) METHODS: 16 swine were studied using LY294002 (LY), a non-selective PI3-KI: Animals were assigned to Trauma only (TO, N=3); LY drug only (LYO, N=3); and Experimental (N=10), trauma + drug (LY+T) groups...
May 22, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28535859/uses-and-doses-of-local-anesthetics-in-fish-amphibians-and-reptiles
#2
Frederic Chatigny, Collins Kamunde, Catherine M Creighton, E Don Stevens
Local anesthetics are an integral part of routine pain management in mammals, yet their use is relatively limited in fish, amphibians and reptiles. These animals frequently undergo potentially painful surgical procedures and therefore could possibly benefit from those drugs. Some recommendations are currently available in the literature concerning analgesic use in these animals. However the pharmacological properties, safety and often efficacy of local anesthetic drugs have not been investigated yet in fish, amphibians, or reptiles...
May 1, 2017: Journal of the American Association for Laboratory Animal Science: JAALAS
https://www.readbyqxmd.com/read/28526163/new-hypnotic-drug-development-and-pharmacologic-considerations-for-clinical-anesthesia
#3
REVIEW
Mariah Kincaid Tanious, Sascha S Beutler, Alan D Kaye, Richard D Urman
Since the public demonstration of ether as a novel, viable anesthetic for surgery in 1846, the field of anesthesia has continually sought the ideal anesthetic-rapid onset, potent sedation-hypnosis with a high therapeutic ratio of toxic dose to minimally effective dose, predictable clearance to inactive metabolites, and minimal side effects. This article aims to review current progress of novel induction agent development and provide an update on the most promising drugs poised to enter clinical practice. In addition, the authors describe trends in novel agent development, implications for health care costs, and implications for perioperative care...
June 2017: Anesthesiology Clinics
https://www.readbyqxmd.com/read/28526162/pharmacologic-considerations-of-anesthetic-agents-in-pediatric-patients-a-comprehensive-review
#4
REVIEW
Alan D Kaye, Charles J Fox, Ira W Padnos, Ken P Ehrhardt, James H Diaz, Elyse M Cornett, Debbie Chandler, Sudipta Sen, Shilpadevi Patil
Acute pain in the pediatric population has important differences in terms of biology, intrapopulation variation, and epidemiology. Discussion as to the pharmacologic considerations of anesthetic agents, such as induction agents, neuromuscular blockers, opioids, local anesthetics, and adjuvant agents, is presented in this article. Special considerations and concerns, such as risk for propofol infusion syndrome and adverse potential side effects of anesthesia agents, are discussed. Anesthesiologists managing pediatric patients need to have a firm understanding of physiologic and pharmacologic differences compared with the adult population...
June 2017: Anesthesiology Clinics
https://www.readbyqxmd.com/read/28526152/pharmacologic-properties-of-novel-local-anesthetic-agents-in-anesthesia-practice
#5
REVIEW
Chih H King, Sascha S Beutler, Alan D Kaye, Richard D Urman
Therapeutic duration of traditional local anesthetics when used in peripheral nerve blocks is normally limited. This article describes novel approaches to extend the duration of peripheral nerve blocks currently available or in development. Three newer approaches on extending the duration of peripheral nerve blocks include site-1 sodium channel blockers, novel local anesthetics delivery systems, and novel adjuvants of local anesthetics. Compared with plain amide-based and ester-based local anesthetics, alternative approaches show significant promise in decreasing postoperative pain, rescue opioid requirement, hospital length-of-stay, and overall health care cost, without compromising the established safety profile of traditional local anesthetics...
June 2017: Anesthesiology Clinics
https://www.readbyqxmd.com/read/28526151/novel-anticoagulant-agents-in-the-perioperative-setting
#6
REVIEW
Allyson Lemay, Alan D Kaye, Richard D Urman
An increasing number of oral anticoagulants have become available over the past decade. Each of these agents has differing implications on both regional and neuraxial anesthetic techniques. This article describes the pharmacology, pharmacokinetics, and pharmacodynamics of the most commonly used novel oral anticoagulants (NOACs). It also outlines recent guidelines for the use of NOACs in the perioperative setting, especially with regard to neuraxial anesthesia.
June 2017: Anesthesiology Clinics
https://www.readbyqxmd.com/read/28526147/pharmacologic-considerations-of-anesthetic-agents-in-geriatric-patients
#7
REVIEW
Maunak V Rana, Lara K Bonasera, Gregory J Bordelon
Aging is a natural process of declining organ function and reserve. Census data show that the geriatric population is expected to grow to nearly 30%. More than half of geriatric patients have 1 or more surgical procedures in their lifetimes. Moreover, this is the population at greatest risk of morbidity and mortality with any given complication. There is remarkable variability in health across the age spectrum, from fit to frail and compromised. This variability requires a unique approach to anesthetic delivery and drug dosing on an individual basis to avoid complications such as postoperative cognitive dysfunction and delirium...
June 2017: Anesthesiology Clinics
https://www.readbyqxmd.com/read/28526146/perioperative-pharmacologic-considerations-in-obesity
#8
REVIEW
Simon Willis, Gregory J Bordelon, Maunak V Rana
Obesity has increased in incidence worldwide. Along with the increased number of obese patients, comorbid conditions are also more prevalent in this population. Obesity leads to changes in the physiology of patients along with an altered response to pharmacologic therapy. Vigilant perioperative physicians must be aware of the unique characteristics of administered agents in order to appropriately provide anesthetic care for obese patients. Because of the variability in tissue content in obese patients and changes in pharmacokinetic modeling, a one-size-fits-all approach is not justified and a more sophisticated and prudent approach is indicated...
June 2017: Anesthesiology Clinics
https://www.readbyqxmd.com/read/28524911/cancer-related-acute-pain-a-systematic-review-of-evidence-based-interventions-for-putting-evidence-into-practice
#9
Thiruppavai Sundaramurthi, Natalie Gallagher, Bethany Sterling
BACKGROUND: Identifying and implementing evidence-based interventions for cancer-related acute pain can decrease adverse effects and improve quality of life. 
. OBJECTIVES: This article presents current evidence supporting interventions to reduce cancer-related acute pain. 
. METHODS: PubMed and CINAHL® databases were searched to identify studies addressing interventions to manage acute pain in patients with cancer. The interventions are categorized according to the Putting Evidence Into Practice classification schema...
June 1, 2017: Clinical Journal of Oncology Nursing
https://www.readbyqxmd.com/read/28513099/syntheses-analytical-and-pharmacological-characterizations-of-the-legal-high-4-1-3-methoxyphenyl-cyclohexyl-morpholine-3-meo-pcmo-and-analogues
#10
Tristan Colestock, Jason Wallach, Matt Mansi, Nadine Filemban, Hamilton Morris, Simon P Elliott, Folker Westphal, Simon D Brandt, Adeboye Adejare
New psychoactive substances (NPS) are commonly referred to as "research chemicals", "designer drugs" or "legal highs." One NPS class is represented by dissociative anesthetics, which include analogues of the arylcyclohexylamine phencyclidine (PCP), ketamine, and diphenidine. A recent addition to the NPS market was 4-[1-(3-methoxyphenyl)cyclohexyl]morpholine (3-MeO-PCMo), a morpholine analogue of 3-MeO-PCP. Although suspected to have dissociative effects in users, information about its pharmacological profile is not available...
May 16, 2017: Drug Testing and Analysis
https://www.readbyqxmd.com/read/28505538/synthesis-and-pharmacological-evaluation-of-neurosteroid-photoaffinity-ligands
#11
Pavel Y Savechenkov, David C Chiara, Rooma Desai, Alexander T Stern, Xiaojuan Zhou, Alexis M Ziemba, Andrea L Szabo, Yinghui Zhang, Jonathan B Cohen, Stuart A Forman, Keith W Miller, Karol S Bruzik
Neuroactive steroids are potent positive allosteric modulators of GABAA receptors (GABAAR), but the locations of their GABAAR binding sites remain poorly defined. To discover these sites, we synthesized two photoreactive analogs of alphaxalone, an anesthetic neurosteroid targeting GABAAR, 11β-(4-azido-2,3,5,6-tetrafluorobenzoyloxy)allopregnanolone, (F4N3Bzoxy-AP) and 11-aziallopregnanolone (11-AziAP). Both photoprobes acted with equal or higher potency than alphaxalone as general anesthetics and potentiators of GABAAR responses, left-shifting the GABA concentration - response curve for human α1β3γ2 GABAARs expressed in Xenopus oocytes, and enhancing [(3)H]muscimol binding to α1β3γ2 GABAARs expressed in HEK293 cells...
April 21, 2017: European Journal of Medicinal Chemistry
https://www.readbyqxmd.com/read/28498499/heterogeneous-extracellular-dopamine-regulation-in-the-subregions-of-the-olfactory-tubercle
#12
Jinwoo Park, Ken T Wakabayashi, Caitlin Szalkowski, Rohan V Bhimani
Recent studies show that dense dopamine (DA) innervation from the ventral tegmental area (VTA) to the olfactory tubercle (OT) may play an important role in processing multisensory information pertaining to arousal and reward, yet little is known about DA regulation in the OT. This is mainly due to the anatomical limitations of conventional methods of determining DA dynamics in small heterogeneous OT subregions located in the ventral most part of the brain. Additionally, there is increasing awareness that anteromedial and anterolateral subregions of the OT have distinct functional roles in natural and psychostimulant drug reinforcement as well as in regulating other types of behavioral responses, such as aversion...
May 12, 2017: Journal of Neurochemistry
https://www.readbyqxmd.com/read/28495013/the-acttion-aps-aapm-pain-taxonomy-aaapt-multidimensional-approach-to-classifying-acute-pain-conditions
#13
Michael L Kent, Patrick J Tighe, Inna Belfer, Timothy J Brennan, Stephen Bruehl, Chad M Brummett, Chester C Buckenmaier, Asokumar Buvanendran, Robert I Cohen, Paul Desjardins, David Edwards, Roger Fillingim, Jennifer Gewandter, Debra B Gordon, Robert W Hurley, Henrik Kehlet, John D Loeser, Sean Mackey, Samuel A McLean, Rosemary Polomano, Siamak Rahman, Srinivasa Raja, Michael Rowbotham, Santhanam Suresh, Bernard Schachtel, Kristin Schreiber, Mark Schumacher, Brett Stacey, Steven Stanos, Knox Todd, Dennis C Turk, Steven J Weisman, Christopher Wu, Daniel B Carr, Robert H Dworkin, Gregory Terman
OBJECTIVE: With the increasing societal awareness of the prevalence and impact of acute pain, there is a need to develop an acute pain classification system that both reflects contemporary mechanistic insights and helps guide future research and treatment. Existing classifications of acute pain conditions are limiting, with a predominant focus on the sensory experience (eg, pain intensity) and pharmacologic consumption. Consequently, there is a need to more broadly characterize and classify the multidimensional experience of acute pain...
May 2017: Journal of Pain: Official Journal of the American Pain Society
https://www.readbyqxmd.com/read/28490900/complex-management-of-a-patient-with-refractory-primary-erythromelalgia-lacking-a-scn9a-mutation
#14
Sarah A Low, Wendye Robbins, Vivianne L Tawfik
A 41-year-old woman presented with burning and erythema in her extremities triggered by warmth and activity, which was relieved by applying ice. Extensive workup was consistent with adult-onset primary erythromelalgia (EM). Several pharmacological treatments were tried including local anesthetics, capsaicin, ziconotide, and dantrolene, all providing 24-48 hours of relief followed by symptom flare. Interventional therapies, including peripheral and sympathetic ganglion blocks, also failed. Thus far, clonidine and ketamine have been the only effective agents for our patient...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28482098/the-acttion-aps-aapm-pain-taxonomy-aaapt-multidimensional-approach-to-classifying-acute-pain-conditions
#15
Michael L Kent, Patrick J Tighe, Inna Belfer, Timothy J Brennan, Stephen Bruehl, Chad M Brummett, Chester C Buckenmaier, Asokumar Buvanendran, Robert I Cohen, Paul Desjardins, David Edwards, Roger Fillingim, Jennifer Gewandter, Debra B Gordon, Robert W Hurley, Henrik Kehlet, John D Loeser, Sean Mackey, Samuel A McLean, Rosemary Polomano, Siamak Rahman, Srinivasa Raja, Michael Rowbotham, Santhanam Suresh, Bernard Schachtel, Kristin Schreiber, Mark Schumacher, Brett Stacey, Steven Stanos, Knox Todd, Dennis C Turk, Steven J Weisman, Christopher Wu, Daniel B Carr, Robert H Dworkin, Gregory Terman
Objective: With the increasing societal awareness of the prevalence and impact of acute pain, there is a need to develop an acute pain classification system that both reflects contemporary mechanistic insights and helps guide future research and treatment. Existing classifications of acute pain conditions are limiting, with a predominant focus on the sensory experience (e.g., pain intensity) and pharmacologic consumption. Consequently, there is a need to more broadly characterize and classify the multidimensional experience of acute pain...
May 1, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28472037/state-dependent-intrinsic-predictability-of-cortical-network-dynamics
#16
Leila Fakhraei, Shree Hari Gautam, Woodrow L Shew
The information encoded in cortical circuit dynamics is fleeting, changing from moment to moment as new input arrives and ongoing intracortical interactions progress. A combination of deterministic and stochastic biophysical mechanisms governs how cortical dynamics at one moment evolve from cortical dynamics in recently preceding moments. Such temporal continuity of cortical dynamics is fundamental to many aspects of cortex function but is not well understood. Here we study temporal continuity by attempting to predict cortical population dynamics (multisite local field potential) based on its own recent history in somatosensory cortex of anesthetized rats and in a computational network-level model...
2017: PloS One
https://www.readbyqxmd.com/read/28456484/hypersensitivity-reactions-in-patients-receiving-hemodialysis
#17
REVIEW
Lavjay Butani, Gianfranco Calogiuri
OBJECTIVE: To describe hypersensitivity reactions in patients receiving maintenance hemodialysis. DATA SOURCES: PubMed search of articles published during the past 30 years with an emphasis on publications in the past decade. STUDY SELECTIONS: Case reports and review articles describing hypersensitivity reactions in the context of hemodialysis. RESULTS: Pharmacologic agents are the most common identifiable cause of hypersensitivity reactions in patients receiving hemodialysis...
April 26, 2017: Annals of Allergy, Asthma & Immunology
https://www.readbyqxmd.com/read/28455892/psychotic-symptoms-as-a-complication-of-electroconvulsive-therapy-a-case-report
#18
Anna Antosik-Wójcińska, Magdalena Chojnacka, Łukasz Święcicki
We report a patient who experienced atypical symptoms in the course of electroconvulsive therapy (ECT). During ECT treatment patient experienced psychotic symptoms which should be differentiated with prolonged delirium and nonconvulsive status epilepticus. 46-year-old female was referred to hospital with a diagnosis of major depressive disorder with no psychotic features in the course of recurrent depression. Despite several changes of pharmacological treatment no improvement was achieved, therefore it was decided to initiate ECT...
February 26, 2017: Psychiatria Polska
https://www.readbyqxmd.com/read/28438761/improved-skeletal-muscle-ca-2-regulation-in-vivo-following-contractions-in-mice-overexpressing-pgc-1%C3%AE
#19
Hiroaki Eshima, Shinji Miura, Nanami Senoo, Koji Hatakeyama, David C Poole, Yutaka Kano
In skeletal muscle, resting intracellular Ca(2+) concentration ([Ca(2+)]i) homeostasis is exquisitely regulated by Ca(2+) transport across the sarcolemmal, mitochondrial and sarcoplasmic reticulum (SR) membranes. Of these three systems, the relative importance of the mitochondria in [Ca(2+)]i regulation remains poorly understood in in vivo skeletal muscle. We tested the hypothesis that the capacity for Ca(2+) uptake by mitochondria is a primary factor in determining [Ca(2+)]i regulation in muscle at rest and following contractions...
April 24, 2017: American Journal of Physiology. Regulatory, Integrative and Comparative Physiology
https://www.readbyqxmd.com/read/28436705/pharmacologically-increasing-collateral-perfusion-during-acute-stroke-using-a-carboxyhemoglobin-gas-transfer-agent-sanguinate%C3%A2-in-spontaneously-hypertensive-rats
#20
Marilyn J Cipolla, Italo Linfante, Abe Abuchowski, Ronald Jubin, Siu-Lung Chan
Similar to patients with chronic hypertension, spontaneously hypertensive rats (SHR) develop fast core progression during middle cerebral artery occlusion (MCAO) resulting in large final infarct volumes. We investigated the effect of Sanguinate™ (SG), a PEGylated carboxyhemoglobin (COHb) gas transfer agent, on changes in collateral and reperfusion cerebral blood flow and brain injury in SHR during 2 h of MCAO. SG (8 mL/kg) or vehicle ( n = 6-8/group) was infused i.v. after 30 or 90 min of ischemia with 2 h reperfusion...
January 1, 2017: Journal of Cerebral Blood Flow and Metabolism
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