Chapter 11: Anesthetics

Overview General anesthesia is a reversible state of central nervous system (CNS) depression, resulting in loss of response to and perception of external stimuli. For patients undergoing surgical and other medical procedures, anesthesia provides these five important benefits: Sedation and reduction of anxiety Lack of awareness and amnesia Skeletal muscle relaxation Suppression of undesirable reflexes […]

Chapter 12: Antidepressants

Overview The symptoms of depression are intense feelings of sadness, hopelessness, and despair as well as the inability to experience pleasure in usual activities, changes in sleep patterns and appetite, loss of energy, and suicidal thoughts. Mania is characterized by the opposite behavior: enthusiasm, rapid thought and speech patterns, extreme self-confidence, and impaired judgment. [Note: […]

Chapter 13: Antipsychotic Drugs

Overview The antipsychotic drugs (also called neuroleptics or major tranquilizers) are used primarily to treat schizophrenia, but they are also effective in other psychotic states, including manic states with psychotic symptoms such as grandiosity, paranoia, and hallucinations, and delirium. The use of antipsychotic medications involves a difficult trade-off between the benefit of alleviating psychotic symptoms […]

Chapter 14: Opioids

Overview Management of pain is one of clinical medicine’s greatest challenges. Pain is defined as an unpleasant sensation that can be either acute or chronic and is a consequence of complex neurochemical processes in the peripheral and central nervous system (CNS). It is subjective, and the physician must rely on the patient’s perception and description […]

Chapter 15: Epilepsy

Overview Epilepsy affects approximately 3 percent of individuals by the time they are 80 years old. About 10 percent of the population will have at least one seizure in their lifetime. Globally, epilepsy is the third most common neurologic disorder after cerebrovascular and Alzheimer disease. Epilepsy is not a single entity. Instead it is, an […]

Chapter 16: Heart Failure

Overview Heart failure (HF) is a complex, progressive disorder in which the heart is unable to pump sufficient blood to meet the needs of the body. Its cardinal symptoms are dyspnea, fatigue, and fluid retention. HF is due to an impaired ability of the heart to adequately fill with and/or eject blood. It is often […]

Chapter 17: Antiarrhythmics

Overview In contrast to skeletal muscle, which contracts only when it receives a stimulus, the heart contains specialized cells that exhibit automaticity. This means that they can intrinsically generate rhythmic action potentials in the absence of external stimuli. These “pacemaker” cells differ from other myocardial cells in showing a slow, spontaneous depolarization during diastole (Phase […]

Chapter 18: Antianginal Drugs

Overview Atherosclerotic disease of the coronary arteries, also known as coronary artery disease or ischemic heart disease, is the most common cause of mortality around the world. Patients commonly die either from pump failure due to a myocardial infarction (tissue necrosis) or fatal arrhythmias. Coronary artery disease may present in different forms, such as angina […]

Chapter 19: Antihypertensives

Overview Hypertension is defined as either a sustained systolic blood pressure of greater than 140 mm Hg or a sustained diastolic blood pressure of greater than 90 mm Hg. Hypertension results from increased peripheral vascular arteriolar smooth muscle tone, which leads to increased arteriolar resistance and reduced capacitance of the venous system. In most cases, […]

Chapter 20: Blood Drugs

Overview This chapter describes drugs that are useful in treating important dysfunctions of blood: thrombosis, bleeding, circulation problems, and anemia. Thrombosis, the formation of an unwanted clot within a blood vessel, is the most common abnormality of hemostasis. Thrombotic disorders include acute myocardial infarction, deep vein thrombosis, pulmonary embolism, and acute ischemic stroke. These are […]