Clinical Pharmacology for Anesthesiology

Section I: A basic primer (i.e. easy to ready with lots of figures)
1. Pharmacokinetics
2. Pharmacodynamics
3. Biophase
4. Drug interactions
5. Covariates of interest (age, weight, comorbidities, etc).
Section II: For each drug, clincal features of: Pharmacokinetics
(some interesting facts like % protien binding, volume of
distribution, but more importantly, how age, weight, and
comorbidities impact drug concentrations, how drugs behave
when given as a bolus or as a continuous infusion);
Pharmacodynamics; Simulations of onset and duration of effect
for commonly used doses; Common toxicity issues and adverse
features (focus only on those that anesthesia clinicians worry
about); Unique characteristics (i.e. context sensitive half time);
Common preparations (especially for drugs that have to be
dissolved) and dosing regimens (bolus versus continuous
infusion)
6. Analgesics
7. Sedatives
8. Inhalation Agents
9. Muscle Relaxants
10. Reversal Agents
11. Vasoactive Drugs (inotopres, chronotropes, cholinergic and
anticholinergic drugs)
Section III: Drug interactions for commonly used anesthetic drug
combinations: a look at analgesia for moderate and severe
stimuli, sedation, loss of responsiveness, and muscle relaxation.
Section IV: Suggested dosing strategies for unique or challenging
anesthetics. This section would be simulation based and use PK
and combined drug PD interaction models.
12. Drug models
13. Preoperative sedation
14. Moderate sedation for MAC cases
15. Approaches to general anesthesia (conventional TIVA, and
multimodal)
16. Post operative pain (both PACU and inpatient management)
Section V: Cases
17. Moderate sedation cases with more than minimal painful
stimuli in the elderly (i.e.An approach to analgesia for a
retrobulbar block).
18. A quick wake up after general anesthesia yet provide
analgesia for moderate to severe surgical pain
19. An approach to opioid tolerant patients for surgeries
associated with moderate to severe surgical pain
20. An approach to pateints that have lost a considerable amount
of blood
21. A clinician's guide to dosing PCA's especially in opioid
tolerant patients
22. Dosing considerations for obese patients with sleep apnea
23. General anesthsia for patients with poor cardiac function
24. General anesthesia for patient with poor liver function
25.CABG or valve replacement,
26.Liver transplant
27. AAA repair
28. Aneurysm clipping
29. Aortic arch procedures that require cirulatory arrest.