A Case Approach to Perioperative Drug-Drug Interactions

The occurrence of deleterious or even fatal drug-drug interactions (DDIs) in the perioperative period is no longer a theoretical concern but a harrowing reality. A Case Approach to Perioperative Drug-Drug Interactions addresses the complex realm of pharmacokinetic drug interactions in an easy-to-read volume that functions as both a comprehensive clinical reference and a casebook.  The book presents a summary of the core concepts of drug interactions; an organized, annotated presentation of the drug interactions most relevant to the perioperative clinician; and approximately 200 case scenarios that highlight specific drug interactions. This book fills a real void in the clinical literature and is invaluable to anesthesiologists and surgeons, as well as trainees  in both specialties; intensive care staff, including physicians, physician’s assistants, and nurses; and nurse practitioners who staff preoperative evaluation clinics. 

Part I. Introduction to Drug-Drug Interactions.- 1. Let’s Start at the Very Beginning: Overcoming Fear and Gaining Mastery of Drug-Drug Interactions.- 2. Pharmacodynamic Interactions:  Core Concepts.- 3. Pharmacokinetic Interactions:  Core Concepts.- 4. A Brief Treatise On The Area Under The Curve.- Part II. Introduction to Drug-Drug Interactions:  Brief Review of CYP450 Enzymes, UGTs, and Transporters.- 5. CYP2D6:  Where It All Began.- 6. CYP2E1:  The Anesthesia Enzyme.- 7. CYP3A4:  The Workhorse.- 8. CYP1A2:  The Switch-hitter.- 9. CYP2B:   2B or Not 2B?- 10. CYP2C9:  The Support Crew I.- 11. CYP2C19:   The Support Crew II.- 12. UGTs:  Conjugating Cousins.- 13. The Cytochrome P450 System In Disease States—A Brief Review.- PART III. Drug-Drug Interactions:  Paradigms and Core Concepts.- 14. P-glycoprotein and OATP Transporters.- 15. The  “Fatal” Forty.- 16. The Six Patterns of Pharmacokinetic Drug-Drug Interactions.- 17. The Problem with the Drug-Drug Interaction Software: A Procrustean Dilemma.- 18. Pharmacogenomics.- 19. The Pharmacoepidemiology of Drug Interactions: Why and How They Are Important.- 20. The Lawyers Can Read, Too:  Case Presentations from the Courtroom.- Part IV. Drug-Drug Interactions Involving Inhalational Anesthetic Agents.- 21. Introduction.- 22. That Sums It Up.- 23. 1+1+1+1=?.- 24. A Delayed Surgeon Is A “Dismayed” Surgeon?.- 25. Relax, It’s Only Gentamicin.- 26. Jaundice After Surgery.- 27. Everybody Clear?.- 28. The Hemodynamic Hole.- 29. Alpha-2 To The Rescue But Beware Bradycardia.- 30. Hot Stuff!.- Part V. Drug-Drug Interactions Involving Intravenous Anesthetic Agents.- 31. Introduction.- 32. How to Successfully Occlude an Intravenous Line.- 33. A Curious Cause of Seizures.- 34. Magnesium Mama And The Mad Dad.- 35. Dexy’s Midnight Spinal.- Part VI. Drug-Drug Interactions Involving Local Anesthetics.- 36. Introduction.- 37. Comfortably Numb.- 38. Naturally Occurring And Nasty.- 39. LOL-LOL:  Little Old Lady—Lots of Lido.- 40. The Spinal Countdown.- 41.  Are Drug-Drug Interactions The Smoking Guns of Local Anesthetic Toxicity?  Smoking Gun I.- 42. Are Drug-Drug Interactions The Smoking Guns of Local Anesthetic Toxicity?  Smoking Gun II.- 43. A Perfect Storm?.- 44. Shake Rattle and Roll.- 45. Hello, We Have A Patient With Acute Delirium and We Need An Urgent Psych Consult.- 46. Fatal Pain Relief.- 47. Lipid Lifesaver.- Part VII. Drug-Drug Interactions Involving Opioids.- 48. Introduction.- 49. No ‘Subs’titute for Sobriety.- 50. A Needle And The Damage Done.- 51. Dad’s Not Having Much Pain.- 52. Royal Flush.- 53. The Worry That’s Always With Us:  Afternoon Nap.- 54. The Bawling Baby.- 55. Sleeping Beauty.- 56. Codeine Can’t Do It.- 57. A Shuddering Interaction.- 58. Double Indemnity.- 59. Breaking the Codeine .- 60. The Ultimate Ultram Primer I:  My Mood Is Better, But Boy Do I Hurt!.- 61. The Ultimate Ultram Primer II: I “Haight” Narcotics But I Hate Seizures Worse.- 62. The Ultimate Ultram Primer III:  Tremor-dol Trigger in Serotonin Syndrome.- 63. Too Much of A Good Thing.- Part VIII. Drug-Drug Interactions Involving Non-opioid Pain Medications.- 64. Introduction.- 65. Pining For Pete In The Pain Clinic.- 66. You Do Not Look Well Today, Mon Ami.- 67. My Headache is Gone, But My Leg Now Hurts.- 68. Special ‘K’ase.- 69. Not Manic About NSAIDs.- 70. Keep It Capped!.- 71. The ACE Is Not Always High.- 72. When The Smoke Clears, Relaxation Disappears.- 73. Befuddled by Aspirin.- 74. You Can’t Trick Us!.- Part IX. Drug-Drug Interactions Involving Benzodiazepines and Other Sedatives.- 75. Introduction.- 76. The Worry That’s Always With Us:  Now I’m Depressed.- 77. The Worry That’s Always With Us: Tragic But Not Rare.- 78. Lack of Sedation.- 79. A Cold Isn’t Going to Slow Me Down.- 80. Her Patients Never Wake Up On Time.- 81. When Enough Is Now Too Much.- 82. The Distressed Daughter.- 83. Check Check and Double Check.- 84. Doggone It—The Case is Cancelled.- 85. Noct’ Out.- 86. Predisposed to Doze.- 87. Synergistic Sedation.- Part X. Drug-Drug Interactions Involving Neuromuscular Blockade Agents.- 88. Introduction.- 89. Blocked Again.- 90. Irreversibility Sux.- 91. Keep An “Ion” The Twitches.- 92. A Reversal of Misfortune.- 93. Stop Moving.- 94. There’s Just Not Enough Roc In The World.- 95. Slow Sux I:  A Lengthy Wake-Up Period After Electroconvulsive Therapy.- 96. Slow Sux II:  I Remember Reviewing This For The Boards.- 97. Slow Sux III:  Where Did the Twitches Go?.- 98. Weakened All Weekend.- 99. The Patient Who Could Not Raise Her Head.- 100. An Unexpected Wait.- 101. Diabolical Cough Syrup.- Part XI. Drug-Drug Interactions Involving Antibiotics and Antifungals.- 102. Introduction.- 103. Full Stop.- 104. Flummoxed by the FLOX.- 105. Tales of Terror.- 106. Too Low To Go.- 107. A Fungal Story.- 108. Rejection Protection Turned Kidney Killer.- 109. Can’t Get Well.- 110. Linezolid (I): Be VREy Careful.- 111. Linezolid (II):  Hyper and Hot.- 112. Not Sweet At All.- 113. Where Did All The Sugar Go?.- 114. Exposed! (Part 1).- 115. Exposed! (Part 2).- 116. Seizures on 5 West.- Part XII. Drug-Drug Interactions Involving Cardiovascular Medications.- 117. Introduction.- 118. Riding The Rollercoaster.- 119. A Pressing Need For Vasopressin!.- 120. Too Young To Die.- 121. A Widening Gyre.- 122. Misusing Mom’s Meds.- 123. If the Patient Has No Renal Failure, Why is Her Potassium So High?.- 124. Prazosin and the PTSD Paratrooper.- 125. Nicardipine Notes.- 126. Hypotension Harry.- 127. Too Slow to Flow.- 128. Better Sleep But Slower Heart.- 129. Extreme Blood Pressure After Ephedrine:  Should We Rule Out Pheochromocytoma?.- 130. Heart-Stopping Treatment.- 131. Induction Crashes:  Are There Clues In the Ashes?.- 132. The Wakeup Call: 2AM Trauma.- 133.  Falling Down.- 134. A Hidden Drug.- 135. I’m Listening, I’m Listening.- 136. Jump Start My Heart.- 137. The Statin Trilogy (I): ‘Statin’ From The Beginning.- 138. The Statin Trilogy (II): Tripped And Fell At The Train ‘Statin’.- 139. The Statin Trilogy (III): Welcome To The United ‘Statins’ Of America.- 140. Be Still, My Beating Heart.- 141. The Nice Niece.- 142. Cyclo Killer: Qu’est-ce que c’est?.- 143. Blurry-Eyed With Rapid Heart Beats.- Part XIII. Drug-Drug Interactions Involving Coagulation Modifiers.- 144. Introduction.- 145. Seize the Day.- 146. The Third and Final Complication.- 147. An Interaction With the Furniture.- 148. Macrolide Mishap for Little Miss Muffett.- 149. From Asymptomatic to Symptomatic:  a Cause of Nosebleed.- 150. The Consequences of Not Following A Cardiac Diet.- 151. Clopidogrel (I):  Bagel Brunch.- 152. Clopidogrel (II):  Conferring Over The Kung Pao.- Part XIV. Drug-Drug Interactions Involving Immunosuppressants, Antiemetics, and Chemotherapy.- 153. Introduction.- 154. Beaned.- 155. Addisonian Adjustment.- 156. Tea Time.- 157.  No Fits at Uffizi.- 158. Quit Steroids Quit Kidneys.- 159. The Fall Guy (I).- 160. The Fall Guy (2).- 161. The Topic of the Day.- 162. Bounce Back.- 163. Call The Cath Lab!.- 164. The Imatinib Inquiry:  A Theoretical Case (For Now).- 165. A HAART-Breaking Tale.- Part XV. Drug-Drug Interactions Involving Neuropsychiatric Drugs.- 166. Introduction.- 167. Phenytoin (I): Going Crazy!.- 168. Phenytoin (II):  The Wrong Drug for the Schizophrenic.- 169. Dizzy and Depressed.- 170. The Funeral Is On Monday.- 171. This Antacid Is Making Me Sick!.- 172. Young at Heart.- 173. Shiver Yes, Die No.- 174. Clip and Dip.- 175. Blue Fog.- 176. Confiscated Contraceptives.- 177. Gotta Love Derm.- 178. Desperate for A Drink.- Part XVI. Drug-Drug Interactions Involving QT Prolonging DDIs.- 179. Introduction.- 180. Delusion At Heart.- 181. At Long Last.- 182. Metha-don’t!.- 183. Flash Fire.- 184. I Am Dizzy When I Stand Up.- Part XVII. Drug-Drug Interactions Involving Foods and Nutrition.- 185. Introduction.- 186. High Fat Diet (I): No Juice For The Ketotic Kid.- 187. Protein Huffing and Puffing.- 188. Salty Sam.- 189. A Peak Potassium Problem.- 190. Awake?.- 191. Tropical Punch Packing a Real Knockout.- 192. When The Fire Won’t Go Out.- 193. Peppermint Patty.- 194. From Bleeding Gums to Green Thumbs- A True Story.- 195. Delicious but Malicious.- 196. I Just Can’t Lick This Problem.- 197. Sommelier’s Surprise.- 198. Dairy Carefully.- 199. Cold And Sick, Sick And Cold.- 200. TPN (I):  A Review and Two Interactions.- 201. TPN (II):  A Traumatic Case of Increased Metabolism.- 202. Skin and Bones.- 203. Enough to Make You Sick.- 204. Determined and Desperate to Diet.- Part XVIII. Drug-Drug Interactions Involving Spices and Supplements.- 205. Introduction.- 206. Caffeine Crash.- 207. Sad Sequelae.- 208. The Scary Side of Ginkgo Biloba Is No Match For An Anesthesia Superstar: Seizures.- 209. The Scary Side of Ginkgo Biloba Is No Match For An Anesthesia Superstar:  Sugar.- 210. The Scary Side of Ginkgo Biloba Is No Match For An Anesthesia Superstar: Subdural.- 211. “Khat” Unawares.- 212. Pain on the Plane.- 213. Ca va, c’est Kava.- 214. Summertime and the Herbals are Hot.- 215. Garlic I:  More Than Just Bad Breath.- 216. Garlic II:  A Girl Named Allicin.- 217. “Danshen” the Night Away.- 218. Caught Yellow-Handed.- 219. St. John:  Not Such A Saint.- 220. Hearing the News.