Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-6bf8c574d5-9nwgx Total loading time: 0 Render date: 2025-02-24T12:42:05.376Z Has data issue: false hasContentIssue false

Chapter 8 - General Pharmacology

Published online by Cambridge University Press:  21 February 2025

By
David Convissar ,
Victoria Nguyen ,
Shaji Faisal  and
Ben Toure
Edited by
Dharti Patel ,
Sang J. Kim ,
Himani V. Bhatt  and
Alopi M. Patel
Dharti Patel
Affiliation:
Mount Sinai West and Morningside Hospitals, New York
Sang J. Kim
Affiliation:
Hospital for Special Surgery, New York
Himani V. Bhatt
Affiliation:
Mount Sinai West and Morningside Hospitals, New York
Alopi M. Patel
Affiliation:
Rutgers Robert Wood Johnson Medical School, New Jersey
Get access

Summary

One of the core principles essential to an anesthesiologist’s fund of knowledge is that of general pharmacology. The aim of this chapter is to provide a foundation of key pharmacology principles necessary for the clinical application of anesthesia. The understanding of pharmacokinetics and pharmacodynamics is fundamental to maintaining anesthesia in a safe manner. This chapter will present basic pharmacological principles that govern anesthetic drug behavior, such as absorption, volume of distribution, clearance, metabolism, context sensitive half-time, extrahepatic modes of metabolism, and the impact of liver and renal dysfunction on anesthetic pharmacology.

Keywords

PharmacokineticsPharmacodynamicsVolume of distributionClearanceMetabolismKineticsContext-sensitive half-time
Type
Chapter
Information
BASIC Essentials
A Comprehensive Review for the Anesthesiology BASIC Exam
 , pp. 41 - 44
Publisher: Cambridge University Press
Print publication year: 2025

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Further Reading

Atkinson, AJ, Kushner, W. Clinical pharmacokinetics. Annu Rev Pharmacol Toxicol 1979;19(1):105–127.CrossRefGoogle ScholarPubMed
Bairamian, M. Anesthetic considerations for bariatric surgery. Survey Anesthesiol 2003;47(5):298–299.CrossRefGoogle Scholar
Beem, H, Manger, F, Boxtel, C, Bentem, N. Etomidate anaesthesia in patients with cirrhosis of the liver: pharmacokinetic data. Anaesthesia 1983;38(S1):61–62.CrossRefGoogle ScholarPubMed
Buxton, ILO. The dynamics of drug absorption, distribution, metabolism, and elimination. In Goodman, L, Brunton, L, Gilman, A, Chabner, B, Knollmann, B. Goodman & Gilman’s The Pharmacological Basis of Therapeutics. McGraw-Hill Medical, 2011; chapter 2, pp 17–41.Google Scholar
Carpenter, R, Eger, E, Johnson, B, Unadkat, J, Sheiner, L. The extent of metabolism of inhaled anesthetics in humans. Anesthesiology 1986;65(2):201–205.CrossRefGoogle ScholarPubMed
Craig, RG, Hunter, JM. Neuromuscular blocking drugs and their antagonists in patients with organ disease. Anaesthesia 2009;64:55–65.CrossRefGoogle ScholarPubMed
Gholson, C, Provenza, JM, Bacon, BR. Hepatologic considerations in patients with parenchymal liver disease undergoing surgery. Am J Gastroenterol 1990;85:487–496.Google ScholarPubMed
Hill, S. Pharmacokinetics of drug infusions. Continuing Educ Anaesthes Crit Care Pain 2004;4(3):76–80.CrossRefGoogle Scholar
Ingrande, J, Lemmens, HJM. Anesthetic pharmacology and the morbidly obese patient. Curr Anesthesiol Rep 2012;3(1):10–17.CrossRefGoogle ScholarPubMed
Jensen, F, Viby-Mogensen, J. Plasma cholinesterase and abnormal reaction to succinylcholine: twenty years’ experience with the Danish Cholinesterase Research Unit. Acta Anaesthesiol Scand 1995;39(2):150–156.CrossRefGoogle ScholarPubMed
Prescott, L. Mechanisms of renal excretion of drugs (with special reference to drugs used by anaesthetists). BJA 1972;44(3):246–251.CrossRefGoogle ScholarPubMed
Roberts Freshwater-Turner, D. Pharmacokinetics and anaesthesia. Continuing Educ Anaesthes Crit Care Pain 2007;7(1):25–29.CrossRefGoogle Scholar
Servin, F, Cockshott, ID, Farinotti, R, et al. Pharmacokinetics of propofol infusions in patients with cirrhosis. Br J Anaesth 1990;65(2):177–83.CrossRefGoogle ScholarPubMed
Tegeder, I, Lötsch, J, Geisslinger, G. Pharmacokinetics of opioids in liver disease. Clin Pharmacokinet 1999;37:17–40.CrossRefGoogle ScholarPubMed
Verbeeck, R. Pharmacokinetics and dosage adjustment in patients with hepatic dysfunction. Eur J Clin Pharmacol 2008;64(12):1147–1161.CrossRefGoogle ScholarPubMed
Wastila, W, Maehr, R, Turner, G, et al. Comparative pharmacology of cisatracurium (51W89), atracurium, and five isomers in cats. Anesthesiology 1996;85(1):169–177.CrossRefGoogle ScholarPubMed

Save book to Kindle

To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×