Biochemistry for Anesthesiologists and Intensivists

Foreword
Preface
Acknowledgments
Contents
1: Enzymes and Coenzymes (A Brief, Boring but Necessary Preamble)
	References
		Further Reading
2: Anaerobic Glycolysis or Embden–Meyerhof Pathway
	2.1	 The Origins of ATP
	2.2	 What ATP Is for
	References
		Further Reading
3: Tricarboxylic Acids Cycle or Krebs Cycle
	3.1	 The Respiratory Chain
	3.2	 The Cytochromes
		3.2.1	 Cytochrome P-450
	References
		Further Reading
4: Glutamate – GABA Collateral Cycle
	4.1	 Magnesium
	4.2	 Sodium Gamma Hydroxybutyrate
	References
		Further Reading
5: Hexose-Monophosphate Shunt or Horecker Cycle (The Sleep Pathway)
	5.1	 Glucuronic Acid
	5.2	 Vitamin C
	5.3	 Hyaluronic Acid
	5.4	 Sleep
	References
		Further Reading
6: Neurotransmitters
	6.1	 Ionotropic and Metabotropic Receptors
	6.2	 Acetylcholine
		6.2.1	 The Muscarinic Effects of Acetylcholine
		6.2.2	 The Nicotinic Effects of Acetylcholine
	6.3	 Catecholamines
		6.3.1	 The Catecholamine Receptors
	6.4	 Substance P
	6.5	 Glutamate and GABA
	6.6	 Serotonin
	6.7	 Synthesis of Melatonin
	6.8	 Memory
	References
		Further Reading
7: Blood–Brain Barrier
	References
		Further Reading
8: Shock
	8.1	 The Origins
		8.1.1	 Pathogenesis
	8.2	 The Lytic Cocktail
	8.3	 The State of Shock
	8.4	 General Haemodynamic Syndrome
	8.5	 Disturbances of the Microcirculation
	8.6	 Metabolic Disturbances
	8.7	 Free Radicals
	8.8	 Therapy
	8.9	 Plasma Expanders
	8.10	 Cortisones
	8.11	 Catecholamines
	8.12	 Vasodilators
	8.13	 Plasma Filtration
	8.14	 Gram-Positive and Gram-Negative Germs
	8.15	 Gram+ and Gram−
	References
		Further Reading
9: Cerebral Oedema
	9.1	 Pathogenesis
	9.2	 Treatment of Cerebral Oedema
	9.3	 Mannitol
	9.4	 Glycerol
	9.5	 Dihydroxyacetone (DHA) (A molecule deserving of more attention)
	9.6	 Dihydroxyacetone for Intracarotid Infusion
	9.7	 Corticosteroids
	9.8	 Cytidine Diphosphocholine (Citicoline)
	9.9	 Glycerophospholipids
	9.10	 Sphingophospholipids
	9.11	 Hypertonic Saline Solution (HSS)
	9.12	 Barbiturate Coma
	9.13	 Research in the New Millennium
	9.14	 AQP4 Water Channels
	9.15	 Antagonists of Substance P
	9.16	 Conclusions
	References
		Further Reading
10: Pulmonary Surfactant
	Bibliography
11: When the Mind Does Not Work as It Should
	11.1	 Schizophrenia
		11.1.1	 Schizophrenia and…
			11.1.1.1	 …Dopamine
			11.1.1.2	 …Serotonin
			11.1.1.3	 …Glutamate and GABA
			11.1.1.4	 …Acetylcholine
			11.1.1.5	 …Substance P
	11.2	 Depression
		11.2.1	 Serotonin
		11.2.2	 Influence of Substance P
		11.2.3	 Influence of the Pituitary-Adrenal Axis
		11.2.4	 Inhibition of the Action
	References
		Further Reading
12: Thiamine (Vitamin B1)
	12.1	 Mechanism of Action of Vitamin B1 in the Synthesis of Acetylcholine
	12.2	 Thiamine Synaptic Anaesthesia
	12.3	 Mechanism of Action of Thiamine at Elevated Doses
	12.4	 Thiamine Anaesthesia in Clinical Practice
	12.5	 From Anaesthesia to Intensive Therapy
		12.5.1	 Therapeutic Potential of Thiamine in Tetanus
	12.6	 Mechanism of Action of the Oximes
	12.7	 Mechanism of Action of Thiamine
		12.7.1	 Case History
	12.8	 Thiamine Analgesia
		12.8.1	 Rationale for Perineural Application
		12.8.2	 Clinical Cases
	References
		Further Reading
13: Normobaric Oxygen Therapy
(a little used therapeutic system)
	13.1	 Indications
	13.2	 Clinical Application
	References
		Further Reading
14: Acid–Base Equilibrium
(cliche paper yellow)
	14.1	 Definitions
	14.2	 Some Necessary Clarifications
		14.2.1	 Ionization
		14.2.2	 Electrolytic Dissociation Equilibria
		14.2.3	 Dissociation of Water
		14.2.4	 pH
	14.3	 Buffer System
	14.4	 Extracellular Buffers
	14.5	 Henderson–Hasselbalch Equation
	14.6	 What the Henderson–Hasselbalch Equation Is for
	14.7	 Acid–Base Equilibrium in Clinical Practice
	14.8	 Modifications of the Acid–Base Equilibrium
		14.8.1	 Respiratory Acidosis
			14.8.1.1	 Therapy
		14.8.2	 Respiratory Alkalosis
			14.8.2.1	 Therapy
		14.8.3	 Metabolic Acidosis
			14.8.3.1	 Therapy
		14.8.4	 Metabolic Alkalosis
			14.8.4.1	 Therapy
		14.8.5	 Electrolytic Balance (Anion Gap)
	References
		Further Reading
15: Theories of Narcosis
	15.1	 Theory of Protoplasmic Semi-coagulation (Claude Bernard 1878)
	15.2	 Partition Coefficient Theory (Meyer and Overton)
	15.3	 Oxidative Phsphorilation Inhibition Theory (Quastel 1952)
	15.4	 Clathrates
	15.5	 Action on the Multimodal Receptors of Inhalation Anaesthetics
	15.6	 Propane Derivatives (3 Atoms of C)
	References
		Further Reading
16: Local Anaesthetics
	16.1	 Esters
		16.1.1	 Cocaine
		16.1.2	 Procaine
	16.2	 Amides
		16.2.1	 Lidocaine
		16.2.2	 Etidocaine
		16.2.3	 Mepivacaine
		16.2.4	 Bupivacaine
		16.2.5	 Prilocaine
		16.2.6	 Articaine
	16.3	 Mechanism of Action of Local Anaesthetics
	16.4	 Toxicity of Local Anaesthetics
	16.5	 Principal Ingredients of a Lipid Preparation for Total Parenteral Nutrition
	References
		Further Reading
17: Perineural Adjuvants
	17.1	 Introduction
	17.2	 Patients Selection
	17.3	 Epinephrine
	17.4	 Sodium Bicarbonate
	17.5	 Alpha2-Agonists
		17.5.1 Clonidine
		17.5.2	 Dexmedetomidine
	17.6	 Dexamethasone
	17.7	 Midazolam
	17.8	 N-methyl-d-Aspartate (NMDA) Antagonists
	17.9	 Opiates
		17.9.1	 Rationale
		17.9.2	 Buprenorphine
		17.9.3	 Perineural Application
		17.9.4	 Tramadol
		17.9.5	 Perineural Application
	17.10	 Perspectives
		17.10.1 Thiamine
	References
		Further Reading
18: The Grand Design
	18.1	 Photosynthesis
	18.2	 Considerations on the Periodic Table of the Elements
	18.3	 Conclusions
	References
		Further Reading
19: Epilogue and Farewell
	19.1	 Farewell