Pharmacology and Pathophysiology of the Control of Breathing

Introduction Claude Lenfant

Preface

Foreword Thomas L. Hornbein

Contributors

Abbreviations

NEUROPHARMACOLOGY AND PHYSIOLOGY

Peripheral Chemoreceptors: Sensors of Metabolic Status

Colin A. Nurse

Introduction

Cellular Organization and Innervation of the Carotid Body

Carotid Body Chemoreceptors: O-Sensitive Kþ Channels

What is the O Sensor and How is it Linked to Kþ Channel(s)?

Role of Fast-Acting Neurotransmitters in Chemosensory Processing

Glucose Sensing in the Carotid Body

Neuromodulation in the Carotid Body

Future Directions

Acknowledgments

References

Central Chemoreceptors

Luc J. Teppema and Albert Dahan

Introduction

Location of Central Chemoreceptors

Mechanism of Central Chemoreception

Central Chemoreceptors and Breathing

References

Suprapontine Control of Breathing

Shakeeb H. Moosavi, David Paydarfar, and Steven A. Shea

Introduction

Definitions and Terminology

Volitional Control

Involuntary Emotional Influences

Tonic Excitatory and Inhibitory Drives

Interaction between ‘Behavioral’ and

‘Automatic’ Control

Learned Respiratory Behaviors

Summary

Acknowledgments

References

Measurement of Drug Effects on Ventilatory Control

Denham S. Ward

Introduction

Measurement Techniques

Quantification of Drug Pharmacodynamics

Resting Measurements

Hypercapnic Ventilatory Response

Hypoxic Ventilatory Response

Changes in Airway Pressure

Other Stimuli

References

Response Surface Modeling of Drug Interactions: Model Selection and Multimodel Inference Using

the Bootstrap

Erik Olofsen and Albert Dahan

Introduction

Pharmacodynamic Interaction Models

Model Selection and Multimodel Inference

The Bootstrap

Applications

Conclusions

References

Respiratory Neuroplasticity: Respiratory Gases, Development, and Spinal Injury

David D. Fuller, Gordon S. Mitchell, and Ryan W. Bavis

Introduction

Plasticity Induced by Respiratory Gases in

Adult Mammals

Developmental Plasticity and the Control of Breathing

Sex Hormones

Spinal Cord Injury (SCI) and Respiratory Plasticity

Conclusion

Acknowledgments

References

Airway Reflexes in Humans

Takashi Nishino

Introduction

Central Nervous System

Afferent Innervation of the Upper Airway and Receptors

Reflex Responses from the Upper Airway

Afferent Innervation of the Lower Airway and

Receptors

Integrative Aspects of the Airway Reflexes

Elicited from the Lower Airways

Clinical Problems Associated with Airway Reflexes

Conclusions

Acknowledgments

References

Inheritance and Ventilatory Behavior in Animal Models

Kingman P. Strohl

Introduction

Evidence and Implications for Inheritance of Ventilatory Traits in Humans

Targeting Ventilatory Traits in Small Animals

Evidence for the Inheritance of Ventilatory Traits in Rodents

Estimates of the Strength of Inheritance

Studies of Gene Effects in Rodent Models

A Physiogenetic Map of Ventilatory Behavior

Overview and Future Directions

Acknowledgments

References

PATHOPHYSIOLOGY

Congenital Central Hypoventilation Syndrome: Should We Rename it Congenital Autonomopathy?

David Gozal

Introduction

Definition and Diagnosis

Pathophysiology

Animal Models

Structural Central Nervous System Abnormalities

Physiologic Abnormalities of Ventilatory Control

Autonomic Nervous System Dysfunction

Summary and Conclusions

Acknowledgment

References

Upper Airway Obstruction in Sleep Apnea

Susheel P. Patil, Hartmut Schneider, Philip L. Smith, and Alan R. Schwartz

Introduction

Epidemiologic and Clinical Risk Factors

Pathogenesis of Upper Airway Obstruction

Therapeutic Implications

Summary and Conclusions

References

High Altitude

Frank L. Powell and Philip E. Bickler

Introduction

Ventilatory Response to High Altitude

Time Domains of the HVR

Increases in the Hypercapnic Ventilatory Response (HCVR) with Acclimatization

High Altitude Diseases and Ventilatory Control

References

Obesity and the Control of Breathing

Khalid F. Almoosa and Shahrokh Javaheri

Introduction

Overview of Obesity

Effects of Obesity on the Respiratory System

Disorders of Ventilatory Control Associated with Obesity

Effects of Treatment of Obesity and OSAH on Ventilatory Control and PaCO

Conclusion

References

CLINICAL PHARMACOLOGY

Pain Management and Regional Anesthesia

Peter L. Bailey and Rajbala Thakur

Introduction

Postoperative Respiratory Dysfunction

Other Effects of Pain and Surgical Trauma

Pain Control and Chronic Pain

Effects of Pain and Pain Management on

Respiratory Function

Regional Analgesia

Other Analgesic Agents

Pre-Emptive Analgesia

Perioperative Analgesia and Pulmonary Outcome

Cardiac Surgery

Summary

References

Ventilatory Effects of Medications Used for Moderate and Deep Sedation

Jeffrey B. Gross and Dante A. Cerza

Introduction

Sedatives

Opioids

Drug Combinations

Strategies for Minimizing Respiratory

Risks of Sedation

Conclusion

References

Central Effects of General Anesthesia

Eckehard A.E. Stuth, Edward J. Zuperku, and Astrid G. Stucke

Introduction

General Effects of Anesthetics on Respiration

Anesthetic Effects on Fast Synaptic Neurotransmission

Overview of the Brainstem Respiratory Network

Paradigms of Anesthetic Effects on Respiratory

Neurotransmission

Summary and Outlook

Acknowledgment

References

The Influence of Inhalational Anesthetics on Carotid Body Mediated Ventilatory Responses

Albert Dahan, Raymonda Romberg, Elise Sarton, and Luc J. Teppema

Introduction

Influence of Inhalational Anesthetics on the Ventilatory

Response to Hypoxia and Hypercapnia

Pain and Behavioral Responses

Short-Term Potentiation of Breathing (STP)

Conclusions

References

General Anesthesia and Respiratory Mechanics

David O. Warner

Introduction

Normal Function of the Respiratory Pump

Effects of Anesthesia on Chest Wall Mechanics

Effects of Anesthesia on Upper Airway Mechanics

Effects of Anesthesia on Lung Mechanics

Summary

References

Recovery from Anesthesia

Shiroh Isono and Jacob Rosenberg

Introduction

Impairment and Recovery of Upper Airway Function after Anesthesia

Impairment and Recovery of Chemical Control of Breathing after Anesthesia

Impairment and Recovery of Lung Function after Surgery

Late Postoperative Nocturnal Hypoxemia

References

Neuromuscular Blocking Agents and Ventilation

Lars I. Eriksson

Regulation of Breathing

Respiratory Pump Function and the

Control of the Upper Airways

References

Cardiovascular Drugs and the Control of Breathing

Denham S. Ward and Suzanne Karan

Introduction

Catecholamine Agonists and Antagonists

Renin–Angiotensin System

Calcium Channel Blockers

Purinoceptor Agonists and Antagonists

Other Agents

References

Author Index

Subject Index

Biography

Ward, Denham S.; Dahan, Albert; Teppema, Luc

"…a useful book to have on the bookshelf."
-Books, Films, Tapes & Software

"…[this book] has been creatively conceived and gestated by Drs. Ward, Dahan, and Teppema….one need only reflect on the potency of the tools currently available to our imaginations to realize there is a world of understanding out there waiting to be explored. Within this volume are many enticing next steps."
-Thomas Hornbein