吸入麻 醉 药的临床药理学（英文）.pptVIP

Department of Anesthesiology Clinical Pharmacology of Inhaled Anesthetics Department of Anesthesiology University of Ottawa Core Program Lecture Series September 2003 A note for those at the lecture Those I was able to keep awake might notice that I’ve added/modified a couple of the slides to better reflect the information in the latest versions of your text books. Much the material on CV and RS effects can be annoyingly inconsistent between texts and editions For those who asked about “protection” and volatile anesthesia I’ve appended a couple of recent articles “for your interest” “FYI” means that I won’t examine you on this stuff but the Royal College might! This stuff is relatively new and part of a broader area of research in ischemic preconditioning – you know, rat stuff Thanks for attending! Objectives I Chemical structure Structure - function relationships Physiochemical properties Mechanism of action Pharmacokinetics of Inhaled Agents Uptake and Distribution Fa/Fi curves, and factors which affect them Metabolism of Inhalation Anesthetics Objectives II Definition of MAC Factors which affect MAC Cardiovascular effects Pulmonary effects CNS effects Neuromuscular effects Hepatic effects Renal effects Uterine effects Marrow effects The reality There’s an awful lot of stuff here - none of it is “new” All of it is in the textbooks Barash 4th Edition Chapter 15. Inhalation Anesthesia. 377-417. Miller 5th Edition Chapter 3. Mechanisms of Action. 48-73 Chapter 4. Uptake and Distribution. 74-95 Chapter 5a. Cardiovascular Pharmacology. 96-124 Chapter 5b. Pulmonary Pharmacology. 125-146 Chapter 6. Metabolism and Toxicity. 147-173 Much of it requires rote memorization Some of it useful - all of it “test-able” I can’t cover all of it in 3 hours Greg’s goals for this lecture Inflict my view of what you should know Put this in a clinical (read: useful) context Explain that which needs explaining Leave the memory work to you Be back on my porch, beer in hand, by 17