Pharmacological Basis of Acute Care

266 Pages·2015·6.38 MB·English

by  Yoo Kuen Chan

Yoo Kuen Chan · Kwee Peng Ng
Debra Si Mui Sim Editors
Pharmacological
Basis of
Acute Care
Pharmacological Basis of Acute Care

Yoo Kuen Chan (cid:129) Kwee Peng Ng
Debra Si Mui Sim
Editors
Pharmacological Basis
of Acute Care
Editors
YooKuenChan KweePengNg
DepartmentofAnesthesiology SubangJayaMedicalCentre
FacultyofMedicine SubangJaya,Malaysia
UniversityofMalaya
KualaLumpur,Malaysia
DebraSiMuiSim
DepartmentofPharmacology
FacultyofMedicine
UniversityofMalaysia
KualaLumpur,Malaysia
ISBN978-3-319-10385-3 ISBN978-3-319-10386-0(eBook)
DOI10.1007/978-3-319-10386-0
SpringerChamHeidelbergNewYorkDordrechtLondon
LibraryofCongressControlNumber:2014955359
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LokeLee,HsuiHanandHsuiYang,thankyou
for not only giving me the time and space to
find myself in every endeavor I am involved
in, but the boundless energy and creativity to
enjoy the process... Yoo Kuen
Possible because of a family that enabled
me to achieve whatever I want and a friend
who never gave up...Kwee Peng
TomylateMum,MadamGohGheeKiam–
an ordinary womanwith an extraordinary
heart, whogave me the opportunity of a
lifetime to further my study overseas so thatI
canbe where Iam now... Debra

Foreword
Physicians and others, practicing ‘healing arts’ have sought ways of curing
symptoms and diseases by the administration of some form of ‘potion’ since the
dawnofman.Theapplicationofherbs,animalpartsandothernaturallyoccurring
substances has been a process of trial and error which improved as early
prescriptionswerewrittendownandcompared.
The drugs available for use are now very varied and knowledge of their exact
pharmacologicalactionandinteractioncontinuestodeveloprapidly.Allphysicians
struggletokeepuptodateandtheappearanceofanewandhelpfultextbooktoaid
themismostwelcome.
Anaesthesiologistspridethemselvesinbeingexpertclinicalpharmacologistsin
thehospitalsetting.Thisexpertisehasbeenacquiredthroughyearsofacuteclinical
practicefoundedonasoundgroundinginpharmacologywhichhasalwaysbeenat
the forefront of our discipline. In anaesthesia, as in many fields of acute care, the
needsofthepatientareconstantlychanging.Ifweareabletomeetthischallenging
task of acceding to their varying pharmacology/physiological demands, we have
reachedaveryhighlevelofpracticewithpharmacology.
Thisbookrepresentsthecollectiveeffortofasetofanaesthesiologiststogether
withtheirpharmacologycolleaguestobringthesevaluableconceptstothosewho
trulyneedtheminasimpletounderstandway.
WorldFederationofSocietiesofAnaesthesiologists DavidJWilkinson
London,UK
vii

Preface
Pharmacology as taught to medical students and junior frontline providers has
always been considered a subject difficult to grasp. Pharmacology textbooks and
formulariesareusuallydrug-centred.Whileclinicaltextbooksandtreatmentguide-
lines are disease-centred and provide treatment recommendations, they seldom
discuss why these treatments are chosen. In addition, the nature and extent of the
subject makes it difficult to be captured into a single book to meet the needs of
providers. Gaps in knowledge occur in frontline providers as a result and this
translatesintogapsincare.
Thecontributorsofthisbookrealizetheimportanceofclosingthisgap.Wehave
focused on the pharmacological principles as they apply in the different clinical
situations and highlight how they are best utilized in managing the ill patient.
Whilst information about drugs is relevant in every pharmacology book, we have
decidedtopareitdowntotheminimumhere,sothatreaderswillnotbedistracted
fromthemainpurposeofthisbook.Wehopetomakethemunderstandthatwhile
drugs administered are always with the aim of correcting or improving a physio-
logical process in the body, the physiological changes and pathology in patients,
particularly the acutely ill ones, can alter the effects of drugs and the body’s
responses to these drugs, sometimes dangerously. Ultimately, frontline providers
should be able to use knowledge of pharmacology to provide maximum benefit
and minimum harm to our acutely ill patients, who are most at risk of adverse
drugevents.
Aspharmacologyissecondnaturetoallthe authors,themajorityofwhomare
practicingclinicians, we hope toshareour wealth of experience tomakethis vast
knowledgeavailabletoprovidersinawaythatisasrealisticandclinicallyrelevant
aspossible.Thiswillhopefullyshortenthelearningcurvesofthosewhostrivetodo
their best in the most difficult of conditions, i.e. to master the proper use of
medicationanddrugresourcestoallowthebodytoheal.
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