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. Katzung BG , White PF . Local anesthetics . In: Katzung BG , Masters SB , Trevor AJ , ed . Basic and Clinical Pharmacology. 11th ed . New York, NY : McGraw-Hill Companies Inc ; 2009 . 3. Goodson JM , Moore PA . Life-threatening reactions after pedodontic sedation: an assessment of narcotic, local anesthetic and

the provider to understand the pharmacology of antidepressant medications and herbal supplements with alleged antidepressant/antianxiety properties, their adverse effects, and potential perioperative drug-drug interactions, effects on bleeding, and interactions with various adrenergic agonists used in local anesthetics and anesthesiology practice. In part I of this series, antidepressant pharmacology and interactions with adrenergic agonists will be discussed. In part II, other anesthetic drug interactions and serotonin syndrome will be discussed

, sympathomimetic drugs, and adrenergic receptor antagonists. In: Hardman , J. G. , L. E. Limbird , and A. G. Gilman . eds. Goodman and Gilman’s The Pharmacological Basis of Therapeutics , 10th ed. . New York, NY McGraw-Hill . 2001 . 19 Lawson , N. W. and D. J. Meyer . Autonomic nervous system physiology and pharmacology. In: Barash , P. G. , B. F. Cullen , and R. K. Stoelting . eds. Clinical Anesthesia , 3rd ed. . Philadelphia, Pa

psychological health and, in turn, the patient's ability to cope with daily pain. Depression and anxiety are common and can profoundly affect pain perception; hence, the use of psychotropic medication is common. This article will review pharmacologic management of chronic pain, but the reader should not presume that medication management is the primary treatment modality. For many patients who suffer with chronic pain, psychological therapies are at least as, and sometimes more, important than sound pharmacologic and interventional measures. Many different medication

large amount of research has been added, clarifying a number of issues about the actions of N 2 O. A Medline search for research manuscripts on the pharmacology of N 2 O revealed 2439 articles between 1940 and 1980; a similar search conducted recently uncovered 5801 articles between 1981 and 2006. This timely review will update readers on the current state of knowledge of the pharmacokinetic and pharmacodynamic aspects of N 2 O. The relevant clinical uses of N 2 O as an analgesic, anxiolytic, and anesthetic drug will be explored. ANALGESIA

diabetic patient. It is also of utmost importance that anesthesia providers understand the pharmacokinetics and pharmacodynamics of the many different types of oral and injectable antidiabetic drugs that patients with the disease often utilize. Regimens of the various time-sensitive insulin therapies must also be understood. This second installment of this 2-part series on the anesthetic management of type 2 diabetes has addressed the pharmacology of the various medications used to treat the disorder and has reviewed the most recent guidelines for blood glucose

Part I of this series discussed antidepressant pharmacology and interactions with adrenergic agonists. In part II, we will focus on Sedation and General Anesthetic Drug Interactions, Serotonin Syndrome, and other anesthetic concerns with antidepressants. SEDATION AND GENERAL ANESTHETIC DRUG INTERACTIONS Tricyclic Antidepressants (TCAs) and Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs) As noted in part I, both the TCAs and the SNRIs inhibit the reuptake of both serotonin and

The extent to which autonomic pharmacology impacts clinical practice is often unappreciated. Drugs that imitate and inhibit autonomic nerves are used extensively in medicine for managing cardiovascular, respiratory, urinary tract, and gastrointestinal disorders. In dental practice, the use of autonomic drugs is more limited, but sympathomimetics are used extensively as vasoconstrictors to potentiate local anesthetics, and the cholinergic agonists and antagonists are used to influence salivation. Equally important, however, is that side

instruction, to create a more clinically relevant curriculum, to prepare pre-doctoral dental students who can manage medically complex conditions, to incorporate active and interactive learning, and to develop critical thinking skills. In few areas of dental education is the need for advanced education in complex patient management more applicable than in anesthesia, therapeutics, and pain control. Clinical experiences in anesthesia allow the best application of a student's didactic knowledge of behavioral science, clinical medicine, anatomy, physiology, pharmacology, and

. As cortisol is consumed, its serum levels diminish and inhibition of the axis wanes. This allows production of cortisol to commence again. This pattern of function is called circadian or diurnal rhythm and occurs at a normal basal rate unless the axis is excited by other factors such as hypoglycemia, trauma, or stress. Glucocorticoids produce an impressive number of physiological effects. When supraphysiologic doses are administered, the subsequent pharmacological effects consist essentially of exaggerated physiologic effects. These doses will also impart a