The Pharmacological Basis of Therapeutics A Textbook of Pharmacology, Toxicology and Therapeutics for Physicians and Medical Students. By Prof. Louis Goodman and Prof. Alfred Gilman. Pp. xiii + 1383. (New York: The Macmillan Company, 1941.) 50s. net.

The Pharmacological Basis of Therapeutics

羟氨苄青霉素引起大疱性类天疱疮样疹

Experimental Neurology By Prof Paul Glees Pp xii + 532 (Oxford: Clarendon Press; London: Oxford University Press, 1961) 75s net

The Nervous System

Objective To attempt to determine the relative value of preclinical cardiac electrophysiology data (in vitro and in vivo) for predicting risk of torsade de pointes (TdP) in clinical use. Methods Published data on hERG (or I(Kr)) activity, cardiac action potential duration (at 90% repolarisation; APD(90)), and QT prolongation in dogs were compared against QT effects and reports of TdP in humans for 100 drugs. These data were set against the free plasma concentrations attained during clinical use (effective therapeutic plasma concentrations; ETPC(unbound)). The drugs were divided into five categories: (1) Class Ia and III antiarrhythmics; (2) Withdrawn from market due to TdP; (3) Measurable incidence/numerous reports of TdP in humans; (4) Isolated reports of TdP in humans; (5) No reports of TdP in humans. Results Data from hERG (or I(Kr)) assays in addition to ETPC(unbound) data were available for 52 drugs. For Category 1 drugs, data for hERG/I(Kr) IC(50), APD(90), QTc in animals and QTc in humans were generally close to or superimposed on the ETPC(unbound) values. This relationship was uncoupled in the other categories, with more complex relationships between the data. In Category 1 (except amiodarone), the ratios between hERG/I(Kr) IC(50) and ETPC(unbound) (max) ranged from 0.1- to 31-fold. Similar ranges were obtained for drugs in Category 2 (0.31- to 13-fold) and Category 3 (0.03- to 35-fold). A large spread was found for Category 4 drugs (0.13- to 35700-fold); this category embraced an assortment of mechanisms ranging from drugs which may well be affecting I(Kr) currents in clinical use (e.g. sparfloxacin) to others such as nifedipine (35700-fold) where channel block is not involved. Finally, for the majority of Category 5 drugs there was a >30-fold separation between hERG/I(Kr) activity and ETPC(unbound) values, with the notable exception of verapamil (1.7-fold), which is free from QT prolongation in man; this is probably explained by its multiple interactions with cardiac ion channels. Conclusions The dataset confirms the widely-held belief that most drugs associated with TdP in humans are also associated with hERG K(+) channel block at concentrations close to or superimposed upon the free plasma concentrations found in clinical use. A 30-fold margin between C(max) and hERG IC(50) may suffice for drugs currently undergoing clinical evaluation, but for future drug discovery programmes, pharmaceutical companies should consider increasing this margin, particularly for drugs aimed at non-debilitating diseases. However, interactions with multiple cardiac ion channels can either mitigate or exacerbate the prolongation of APD and QT that would ensue from block of I(Kr) currents alone, and delay of repolarisation per se is not necessarily torsadogenic. Clearly, an integrated assessment of in vitro and in vivo data is required in order to predict the torsadogenic risk of a new candidate drug in humans.

Relationships between preclinical cardiac electrophysiology, clinical QT interval prolongation and torsade de pointes for a broad range of drugs : Evidence for a provisional safety margin in drug development

1. Clarification: The 2013 Guidelines make a distinction between euthanasia, humane killing, and slaughter, and state that neither slaughter nor humane killing is covered in the document P.68, S6.1.1. Not included among the definitions of these terms are ending the lives of healthy animals or scientific collection of animals. For clarification, whatever the term used, classification of the method, or reason given for killing animals: euthanasia, humane killing, slaughter, harvest, depopulation, scientific collection, or research-related, the Council on Accreditation’s foremost concern, in all situations, is with humane technique. The goal of humane technique is to minimize pain, distress, and the negative effect to the animal. The technique employed should result in rapid loss of consciousness followed by cardiac or respiratory arrest and, ultimately, a loss of brain function. Although complete absence of pain and distress is preferred, it is understood that it cannot always be achieved P7.13.2.

https://works.bepress.com/cheryl_greenacre/14/download/

AVMA Guidelines for the Euthanasia of Animals: 2013 Edition

http://www.uco.es/organiza/departamentos/anatomia-y-anat-patologica/peques/master/juanmorgaz/Muir.pdf

The cardiorespiratory and anesthetic effects of clinical and supraclinical doses of alfaxalone in cats.

Objective To determine the effects of constant rate infusion of morphine, lidocaine, ketamine, and morphine-lidocaine-ketamine (MLK) combination on end-tidal isoflurane concentration (ET-Iso) and minimum alveolar concentration (MAC) in dogs anesthetized with isoflurane and monitor depth of anesthesia by use of the bispectral index (BIS). Animals 6 adult dogs. Procedure Each dog was anesthetized with isoflurane on 5 occasions, separated by a minimum of 7 to 10 days. Individual isoflurane MAC values were determined for each dog. Reduction in isoflurane MAC, induced by administration of morphine (3.3 microg/kg/min), lidocaine (50 microg/kg/min), ketamine (10 microg/kg/min), and MLK, was determined. Heart rate, mean arterial blood pressure, oxygen saturation as measured by pulse oximetry (Spo2), core body temperature, and BIS were monitored. Results Mean +/- SD isoflurane MAC was 1.38 +/- 0.08%. Morphine, lidocaine, ketamine, and MLK significantly lowered isoflurane MAC by 48, 29, 25, and 45%, respectively. The percentage reductions in isoflurane MAC for morphine and MLK were not significantly different but were significantly greater than for lidocaine and ketamine. The Spo2, mean arterial pressure, and core body temperature were not different among groups. Heart rate was significantly decreased at isoflurane MAC during infusion of morphine and MLK. The BIS was inversely related to the ET-Iso and was significantly increased at isoflurane MAC during infusions of morphine and ketamine, compared with isoflurane alone. Conclusions and clinical relevance Low infusion doses of morphine, lidocaine, ketamine, and MLK decreased isoflurane MAC in dogs and were not associated with adverse hemodynamic effects. The BIS can be used to monitor depth of anesthesia.

Effects of morphine, lidocaine, ketamine, and morphine-lidocaine-ketamine drug combination on minimum alveolar concentration in dogs anesthetized with isoflurane.

Introduction to Anesthesia Patient Evaluation and Preparation Drugs used for Preanesthetic Medication Local Anesthetic Drugs and Techniques Local anesthesia in Cattle, Sheep, Goats, and Pigs Loca Anesthesia in Horses Local Anesthesia in Dogs and Cats Acupuncture Analgesia Specific Intravenous Anesthetic Drugs Inhalation Anesthesia Pharmacology of Inhalations Anesthetic Drugs Neuromuscular Blocking Drugs Anesthetic Toxicity, Oxygen Toxicity, Drug Interactions Anesthetic Machines and Breathing Systems Ventilation and Mechanical Assist Devices Patient Monitoring During Anesthesia Acid-Base Balance and Blood Gases Pain Anesthetic Procedures and Techniques in Small Animals Anesthetic Procedures and Techniques in Horses Anesthetic Procedures and Techniques in Ruminants Anesthetic Procedures and Techniques in Swine Anesthesia for Cesarean Section

Handbook of veterinary anesthesia

The cardiovascular effects of medetomidine, detomidine, and xylazine in horses were studied. Fifteen horses, whose right carotid arteries had previously been surgically raised to a subcutaneous position during general anesthesia were used. Five horses each were given the following 8 treatments: an intravenous injection of 4 doses of medetomidine (3, 5, 7.5, and 10 microg/kg), 3 doses of detomidine (10, 20, and 40 microg/kg), and one dose of xylazine (1 mg/kg). Heart rate decreased, but not statistically significant. Atrio-ventricular block was observed following all treatments and prolonged with detomidine. Cardiac index (CI) and stroke volume (SV) were decreased with all treatments. The CI decreased to about 50% of baseline values for 5 min after 7.5 and 10 microg/kg medetomidine and 1 mg/kg xylazine, for 20 min after 20 microg/kg detomidine, and for 50 min after 40 microg/kg detomidine. All treatments produced an initial hypertension within 2 min of drug administration followed by a significant decrease in arterial blood pressure (ABP) in horses administered 3 to 7.5 microg/kg medetomidine and 1 mg/kg xylazine. Hypertension was significantly prolonged in 20 and 40 microg/kg detomidine. The hypotensive phase was not observed in 10 microg/kg medetomidine or detomidine. The changes in ABP were associated with an increase in peripheral vascular resistance. Respiratory rate was decreased for 40 to 120 min in 5, 7.5, and 10 microg/kg medetomidine and detomidine. The partial pressure of arterial oxygen decreased significantly in 10 microg/kg medetomidine and detomidine, while the partial pressure of arterial carbon dioxide did not change significantly. Medetomidine induced dose-dependent cardiovascular depression similar to detomidine. The cardiovascular effects of medetomidine and xylazine were not as prolonged as that of detomidine.

Cardiovascular Effects of Medetomidine, Detomidine and Xylazine in Horses

PART I: PRINCIPLES OF PAIN MANAGEMENT 1. The Ethics of Pain Management 2. Pain and Stress 3. Definitions of Terms Describing Pain PART II: RECOGNITION AND EVALUATION OF PAIN 4. Pain Behavior 5. Objective, Categorical Methods for Assessing Pain and Analgesia PART III: THERAPY FOR THE ALLEVIATION OF PAIN 6. Principles of Drug Therapy 7. Drugs Used to Treat Pain 8. Opioids 9. NSAIDs 10. Alpha-2 Agonists 11. Local Anesthetics 12. Corticosteroids 13. Other Drugs Used to Treat Pain 14. Adjunctive Pain Therapy 15. Local And Regional Anesthetic Techniques For Alleviation Of Perioperative Pain 16. Complementary and Alternative (Integrative) Pain Therapy PART IV: ACUTE AND CHRONIC PAIN MANAGEMENT 17. Choosing And Administering The Right Analgesic Therapy 18. Acute Pain Management 19. Chronic Pain Management 20. Drug Antagonism and Antagonists 21. Cancer Pain Management

William W. Muir

Papers

The cardiorespiratory and anesthetic effects of clinical and supraclinical doses of alfaxalone in cats.

Effects of morphine, lidocaine, ketamine, and morphine-lidocaine-ketamine drug combination on minimum alveolar concentration in dogs anesthetized with isoflurane.

Handbook of veterinary anesthesia

Cardiovascular Effects of Medetomidine, Detomidine and Xylazine in Horses

Handbook of veterinary pain management