Clinical Anesthesia Procedures of the Massachusetts General Hospital

1. I. INTRODUCTION - p. 1 2. II. HISTORY - p. 1 3. III. REVIEW OF SYSTEMS - p. 4 4. IV. THE PHYSICAL EXAMINATION - p. 6 5. V. LABORATORY STUDIES - p. 7 6. VI. PREOPERATIVE MEDICAL OPTIMIZATION - p. 9 7. VII. ANESTHETIC ASSESSMENT AND PLAN - p. 11 8. VIII. PATIENT DISCUSSION - p. 11 9. IX. INFORMED CONSENT - p. 13 10. X. DAY OF SURGERY PREMEDICATION - p. 14 11. XI. DELAYING SURGICAL PROCEDURES - p. 14 12. XII. ETHICAL CONSIDERATIONS IN PATIENT CARE - p. 16 13. 2 Basics of Echocardiography - p. 19 14. I. TRANSTHORACIC IMAGE ACQUISITION - p. 19 15. II. TRANSESOPHAGEAL IMAGE ACQUISITION - p. 29 16. III. ECHOCARDIOGRAPHIC ASSESSMENT - p. 37 17. IV. HEMODYNAMIC MEASUREMENTS AND FLUID RESPONSIVENESS - p. 41 18. V. CONCLUSION - p. 45 19. 3 Specific Considerations With Cardiac Disease - p. 47 20. I. GENERAL CONSIDERATIONS - p. 47 21. II. CORONARY ANATOMY - p. 47 22. III. PREOPERATIVE CARDIOVASCULAR EVALUATION FOR NONCARDIAC SURGERY - p. 47 23. IV. PREANESTHETIC CONSIDERATIONS - p. 51 24. V. ISCHEMIC HEART DISEASE - p. 53 25. VI. VALVULAR HEART DISEASE - p. 54 26. VII. CONGESTIVE HEART FAILURE - p. 56 27. VIII. HYPERTROPHIC CARDIOMYOPATHY - p. 58 28. IX. CONGENITAL HEART DISEASE - p. 59 29. X. CARDIAC TRANSPLANT PATIENT - p. 59 30. XI. CARDIAC IMPLANTABLE ELECTRONIC DEVICES: PACEMAKERS AND IMPLANTABLE CARDIOVERTER-DEFIBRILLATORS - p. 61 31. 4 Specific Considerations With Pulmonary Disease - p. 67 32. I. OVERVIEW - p. 67 33. II. PULMONARY FUNCTION - p. 67 34. III. ASTHMA - p. 68 35. IV. CHRONIC OBSTRUCTIVE PULMONARY DISEASE - p. 69 36. V. OBESITY - p. 69 37. VI. ACUTE RESPIRATORY DISTRESS SYNDROME - p. 72 38. 5 Specific Considerations With Renal Disease - p. 77 39. I. GENERAL CONSIDERATIONS - p. 77 40. II. PHYSIOLOGY - p. 77 41. III. RENAL FAILURE - p. 81 42. IV. ANESTHETIC MANAGEMENT - p. 85 43. V. PHARMACOLOGY AND THE KIDNEY - p. 90 44. VI. PHARMACOLOGY AND RENAL FAILURE - p. 92 45. VII. FUTURE CONSIDERATIONS FOR IDENTIFICATION OF PATIENTS AT RISK OF PERIOPERATIVE AKI - p. 95 46. 6 Specific Considerations With Liver Disease - p. 97 47. I. HEPATIC ANATOMY - p. 97 48. II. HEPATIC FUNCTION - p. 97 49. III. METABOLISM OF ANESTHETICS - p. 99 50. IV. LIVER DISEASE - p. 100 51. V. SURGICAL RISK IN PATIENTS WITH LIVER DISEASE - p. 104 52. VI. ANESTHESIA IN PATIENTS WITH LIVER DISEASE - p. 106 53. VII. POSTOPERATIVE LIVER DYSFUNCTION - p. 109 54. 7 Specific Considerations With Endocrine Disease - p. 111 55. I. DIABETES MELLITUS - p. 111 56. II. HYPOGLYCEMIA - p. 119 57. III. THYROID DISEASE - p. 119 58. IV. CALCIUM METABOLISM AND PARATHYROID DISEASE - p. 122 59. V. ADRENAL CORTICAL DISEASE - p. 126 60. VI. ADRENAL MEDULLARY DISEASE - p. 129 61. VII. PITUITARY DISEASE - p. 131 62. VIII. CARCINOID - p. 133 63. 8 Infectious Diseases and Infection Control in Anesthesia - p. 136 64. I. INTRODUCTION - p. 136 65. II. INFECTION CONTROL IN THE OR - p. 136 66. III. PERIOPERATIVE ANTIBIOTICS - p. 140 67. IV. PATHOGENIC ORGANISMS OF ANESTHETIC CONCERN - p. 143 68. V. OCCUPATIONAL EXPOSURE TO INFECTIOUS DISEASE - p. 146 69. VI. IMMUNOCOMPROMISED PATIENTS - p. 146 70. PART II: ADMINISTRATION OF ANESTHESIA - p. 148 71. 9 Safety in Anesthesia - p. 148 72. I. OVERVIEW OF SAFETY IN ANESTHESIA - p. 148 73. II. STANDARDS FOR SAFE ANESTHESIA CARE - p. 149 74. III. TYPES OF ERRORS - p. 149 75. IV. GENERAL SAFETY STRATEGIES - p. 153 76. V. QUALITY ASSURANCE AND SAFETY IMPROVEMENT PROGRAMS - p. 155 77. 10 The Anesthesia Machine - p. 158 78. I. OVERVIEW - p. 158 79. II. THE GAS DELIVERY SYSTEM (FIGURE 10.1) - p. 158 80. III. BREATHING SYSTEMS - p. 161 81. IV. ANESTHESIA VENTILATORS - p. 162 82. V. SAFETY FEATURES - p. 164 83. VI. SCAVENGING - p. 164 84. VII. GAS ANALYSIS - p. 165 85. VIII. EMERGENCY EQUIPMENT - p. 166 86. IX. ANESTHESIA MACHINE CHECKOUT RECOMMENDATIONS - p. 166 87. 11 Administration of General Anesthesia - p. 168 88. I. INDICATIONS - p. 168 89. II. PRE-­OP EVALUATION AND PLANNING - p. 168 90. III. INDUCTION OF ANESTHESIA - p. 170 91. IV. AIRWAY MANAGEMENT - p. 171 92. V. MAINTENANCE OF ANESTHESIA - p. 171 93. VI. EMERGENCE AND EXTUBATION - p. 173 94. VII. TRANSPORT AND DISPOSITION - p. 173 95. VIII. INTRAOPERATIVE ADVERSE EFFECTS RELATED TO GENERAL ANESTHESIA AND MANAGEMENT - p. 173 96. IX. POSTOPERATIVE ADVERSE EFFECTS RELATED TO GENERAL ANESTHESIA - p. 175 97. 12 Intravenous and Inhalation Anesthetics - p. 177 98. I. PHARMACOLOGY OF INTRAVENOUS ANESTHETICS - p. 177 99. II. PHARMACOLOGY OF INHALATION ANESTHETICS - p. 188 100. 13 Airway Evaluation and Management - p. 193 101. I. APPLIED ANATOMY - p. 193 102. II. EVALUATION - p. 194 103. III. MASK AIRWAY - p. 199 104. IV. LARYNGEAL MASK AIRWAY - p. 201 105. V. ENDOTRACHEAL INTUBATION - p. 204 106. VI. THE DIFFICULT AIRWAY AND EMERGENCY AIRWAY TECHNIQUES - p. 210 107. VII. SPECIAL CONSIDERATIONS - p. 213 108. 14 Neuromuscular Blockade - p. 217 109. I. NEUROMUSCULAR JUNCTION - p. 217 110. II. GENERAL PHARMACOLOGY - p. 217 111. III. NEUROMUSCULAR BLOCKADE - p. 219 112. IV. MONITORING OF NEUROMUSCULAR FUNCTION - p. 224 113. V. REVERSAL OF NMB - p. 226 114. VI. EFFECTS OF NMB - p. 228 115. VII. DISORDERS THAT INFLUENCE THE RESPONSE TO NMBDS - p. 228 116. 15 Monitoring - p. 232 117. I. STANDARD MONITORING - p. 232 118. II. CARDIOVASCULAR SYSTEM - p. 232 119. III. CVP AND CARDIAC OUTPUT - p. 235 120. IV. RESPIRATORY SYSTEM - p. 248 121. V. TEMPERATURE MONITORING - p. 251 122. 16 Monitoring Anesthetic Brain States - p. 254 123. I. GENERAL CONSIDERATIONS - p. 254 124. II. ELECTROENCEPHALOGRAM-BASED INDICES OF LEVEL OF CONSCIOUSNESS - p. 254 125. III. END-TIDAL ANESTHETIC CONCENTRATION - p. 257 126. IV. THE SPECTRAL ANALYSIS OF THE EEG - p. 258 127. V. EFFECTS OF DIFFERENT ANESTHETICS ON THE BRAIN - p. 258 128. VI. AGE-RELATED CHANGES IN ANESTHETIC-INDUCED EEG SIGNATURES - p. 265 129. VII. CLINICAL MONITORING OF ANESTHETIC STATES - p. 266 130. VIII. CONCLUSION - p. 267 131. 17 Intra-anesthetic Problems - p. 269 132. I. HYPOTENSION - p. 269 133. II. HYPERTENSION - p. 271 134. III. DYSRHYTHMIAS - p. 272 135. IV. HYPOXEMIA - p. 276 136. V. HYPERCARBIA - p. 277 137. VI. ABNORMAL URINE OUTPUT - p. 278 138. VII. HYPOTHERMIA - p. 278 139. VIII. HYPERTHERMIA - p. 280 140. IX. DIAPHORESIS (SWEATING) - p. 281 141. X. LARYNGOSPASM - p. 281 142. XI. BRONCHOSPASM - p. 281 143. XII. ASPIRATION - p. 282 144. XIII. PNEUMOTHORAX - p. 283 145. XIV. MYOCARDIAL ISCHEMIA - p. 284 146. XV. PULMONARY EMBOLISM - p. 285 147. XVI. CARDIAC TAMPONADE - p. 286 148. XVII. MALIGNANT HYPERTHERMIA - p. 287 149. XVIII. ANAPHYLACTIC AND ANAPHYLACTOID REACTIONS - p. 289 150. XIX. FIRE AND ELECTRICAL HAZARDS IN THE OPERATING ROOM - p. 290 151. XX. EQUIPMENT MALFUNCTIONS - p. 291 152. 18 Perioperative Hemodynamic Control - p. 293 153. I. BLOOD PRESSURE - p. 293 154. II. AUTOREGULATION - p. 293 155. III. ADRENERGIC RECEPTOR PHYSIOLOGY (TABLE 18.1) - p. 293 156. IV. ADRENERGIC AGONISTS (TABLE 18.2) - p. 296 157. V. NONADRENERGIC AGENTS - p. 300 158. VI. β-Adrenergic Antagonists (Table 18.3) - p. 301 159. VII. VASODILATORS (TABLE 18.4) - p. 303 160. VIII. CONTROLLED HYPOTENSION - p. 308 161. IX. DRUG DOSAGE CALCULATIONS - p. 309 162. 19 Local Anesthetics - p. 311 163. I. General Principles - p. 311 164. II. Clinical Uses of Local Anesthetics - p. 313 165. III. Toxicity - p. 316 166. IV. Novel Developments - p. 319 167. 20 Spinal, Epidural, and Caudal Anesthesia - p. 321 168. I. GENERAL CONSIDERATIONS - p. 321 169. II. SEGMENTAL LEVEL REQUIRED FOR SURGERY - p. 321 170. III. CONTRAINDICATIONS TO NEURAXIAL ANESTHESIA - p. 321 171. IV. SPINAL ANESTHESIA - p. 322 172. V. EPIDURAL ANESTHESIA - p. 333 173. VI. COMBINED SPINAL-EPIDURAL ANESTHESIA - p. 341 174. VII. CAUDAL ANESTHESIA - p. 341 175. VIII. ANTICOAGULATION AND NEURAXIAL BLOCKADE - p. 343 176. 21 Regional Anesthesia - p. 345 177. I. GENERAL CONSIDERATIONS - p. 345 178. II. GENERAL CONTRAINDICATIONS - p. 346 179. III. COMPLICATIONS COMMON TO ALL NERVE BLOCKS - p. 346 180. IV. EQUIPMENT - p. 347 181. V. NERVE LOCALIZATION TECHNIQUES - p. 347 182. VI. REGIONAL ANESTHESIA OF THE NECK - p. 350 183. VII. REGIONAL ANESTHESIA OF THE UPPER EXTREMITY - p. 351 184. VIII. REGIONAL ANESTHESIA OF THE LOWER EXTREMITY - p. 359 185. IX. REGIONAL ANESTHESIA OF THE TRUNK - p. 367 186. 22 Anesthesia for Orthopedic Surgery - p. 375 187. I. GENERAL CONSIDERATION - p. 375 188. II. ANESTHESIA FOR TOTAL HIP AND KNEE ARTHROPLASTY - p. 375 189. III. ANESTHESIA FOR SHOULDER SURGERY - p. 377 190. IV. ANESTHESIA FOR FOOT AND ANKLE SURGERY - p. 378 191. V. ANESTHESIA FOR ELBOW, ARM, AND HAND SURGERY - p. 379 192. VI. ANESTHESIA FOR ORTHOPEDIC ONCOLOGY - p. 380 193. VII. ANESTHESIA FOR ORTHOPEDIC TRAUMA - p. 381 194. VIII. ANESTHESIA FOR SPINE SURGERY - p. 384 195. 23 Anesthesia for Neurosurgery - p. 386 196. I. PHYSIOLOGY - p. 386 197. II. PHARMACOLOGY - p. 389 198. III. ELECTROPHYSIOLOGIC MONITORING - p. 391 199. IV. PREOPERATIVE CONSIDERATIONS FOR NEUROSURGICAL PROCEDURES - p. 393 200. V. INTRAOPERATIVE MANAGEMENT - p. 394 201. VI. SPECIFIC NEUROSURGICAL PROCEDURES - p. 397 202. VII. SURGERY ON THE SPINE AND SPINAL CORD - p. 404 203. 24 Anesthesia for Spine Surgery - p. 407 204. I. BLOOD LOSS - p. 409 205. II. SPINAL CORD PERFUSION - p. 410 206. III. DISPOSITION - p. 411 207. IV. POSTOPERATIVE PAIN MANAGEMENT - p. 411 208. 25 Anesthesia for Transplant Surgery - p. 414 209. I. HISTORY AND ETHICAL CONSIDERATIONS - p. 414 210. II. ANESTHESIA FOR KIDNEY TRANSPLANTATION - p. 415 211. III. ANESTHESIA FOR PANCREAS TRANSPLANTATION - p. 417 212. IV. ANESTHESIA FOR LIVER TRANSPLANTATION - p. 419 213. V. ANESTHESIA FOR ORGAN PROCUREMENT - p. 425 214. 26 Anesthesia for Abdominal Surgery - p. 428 215. I. PREANESTHETIC CONSIDERATIONS - p. 428 216. II. ANESTHETIC TECHNIQUES - p. 429 217. III. MANAGEMENT OF ANESTHESIA - p. 430 218. IV. ANESTHETIC CONSIDERATIONS FOR SPECIFIC ABDOMINAL PROCEDURES - p. 433 219. 27 Anesthesia for Thoracic Surgery - p. 445 220. I. PREOPERATIVE EVALUATION - p. 445 221. II. PREOPERATIVE PREPARATION - p. 446 222. III. MONITORING - p. 446 223. IV. ENDOSCOPIC PROCEDURES - p. 447 224. V. MEDIASTINAL OPERATIONS - p. 449 225. VI. PULMONARY RESECTION - p. 452 226. VII. TRACHEAL RESECTION AND RECONSTRUCTION - p. 458 227. VIII. INTRAPULMONARY HEMORRHAGE - p. 461 228. IX. BRONCHOPLEURAL FISTULA - p. 461 229. X. ESOPHAGEAL SURGERY - p. 462 230. 28 Anesthesia for Vascular Surgery - p. 465 231. I. PREOPERATIVE ASSESSMENT AND MANAGEMENT - p. 465 232. II. PERIPHERAL ARTERIAL SURGERY - p. 467 233. III. CAROTID REVASCULARIZATION - p. 469 234. IV. ABDOMINAL AORTIC REPAIR - p. 472 235. V. THORACOABDOMINAL AORTIC ANEURYSM REPAIR - p. 478 236. VI. AMPUTATIONS - p. 483 237. 29 Anesthesia for Cardiac Surgery - p. 485 238. I. CARDIOPULMONARY BYPASS - p. 485 239. II. PREOPERATIVE ASSESSMENT FOR CARDIAC SURGERY - p. 486 240. III. ANESTHETIC MANAGEMENT - p. 490 241. IV. INDUCTION - p. 492 242. V. Postoperative Care - p. 501 243. VI. Pediatric Cardiac Anesthesia - p. 501 244. VII. Other Cardiac Procedures - p. 509 245. VIII. ANESTHESIA FOR “OFF-SITE” CARDIAC PROCEDURES - p. 515 246. 30 Anesthesia for Head and Neck Surgery - p. 518 247. I. Anesthesia for Ophthalmic Surgery - p. 518 248. II. ANESTHESIA FOR OTORHINOLARYNGOLOGIC PROCEDURES - p. 523 249. III. ANESTHESIA FOR PROCEDURES OF THE NECK - p. 527 250. IV. ANESTHESIA FOR DENTISTRY AND ORAL AND MAXILLOFACIAL SURGERY - p. 529 251. 31 Anesthesia for Urologic Surgery - p. 532 252. I. ANESTHESIA FOR SPECIFIC UROLOGIC PROCEDURES - p. 532 253. II. LITHOTRIPSY - p. 537 254. III. PATIENTS WITH SPINAL CORD PATHOLOGY - p. 538 255. 32 Anesthesia for Obstetrics and Gynecology - p. 540 256. I. MATERNAL PHYSIOLOGY IN PREGNANCY (TABLE 32.1) - p. 540 257. II. LABOR AND DELIVERY - p. 543 258. III. MEDICATIONS COMMONLY USED FOR LABOR AND DELIVERY - p. 546 259. IV. PLACENTAL TRANSFER OF DRUGS - p. 547 260. V. ANALGESIA FOR LABOR AND VAGINAL DELIVERY - p. 548 261. VI. ANESTHESIA FOR CESAREAN DELIVERY - p. 551 262. VII. PREECLAMPSIA - p. 553 263. VIII. PERIPARTUM HEMORRHAGE - p. 554 264. IX. AMNIOTIC FLUID EMBOLISM - p. 556 265. X. ANESTHESIA FOR NONOBSTETRIC SURGERY DURING PREGNANCY - p. 557 266. XI. CPR DURING PREGNANCY - p. 559 267. XII. ANESTHESIA FOR GYNECOLOGIC SURGERY - p. 560 268. XIII. ANESTHESIA FOR OOCYTE RETRIEVAL - p. 560 269. 33 Anesthesia for Pediatric Surgery and Care of the Neonate - p. 562 270. I. Development - p. 562 271. II. GENERAL ASSESSMENT - p. 564 272. III. COMMON NEONATAL PROBLEMS PERTINENT TO ANESTHESIA - p. 568 273. IV. ANATOMY AND PHYSIOLOGY - p. 585 274. V. THE PREANESTHETIC VISIT - p. 589 275. VI. PERIPROCEDURAL CONSIDERATIONS AND FASTING GUIDELINES - p. 590 276. VII. PREPARATION OF THE OR - p. 591 277. VIII. INDUCTION TECHNIQUES - p. 594 278. IX. ENDOTRACHEAL INTUBATION - p. 597 279. X. ANALGESIA - p. 598 280. XI. PHARMACOTHERAPY - p. 598 281. XII. FLUID MANAGEMENT - p. 603 282. XIII. EMERGENCE AND POST-ANESTHESIA CARE - p. 604 283. XIV. SPECIFIC PEDIATRIC ANESTHESIA PROBLEMS - p. 605 284. 34 Non-Operating Room Anesthesia - p. 612 285. I. General Considerations - p. 612 286. II. ANESTHESIA TECHNIQUES - p. 613 287. III. CONTRAST MEDIA - p. 614 288. IV. ANESTHESIA FOR DIAGNOSTIC RADIOLOGY - p. 616 289. V. ANESTHESIA FOR CT-GUIDED THERMAL ABLATIONS - p. 617 290. VI. ANESTHESIA FOR NEUROINTERVENTIONS - p. 619 291. VII. ANESTHESIA FOR GASTROINTESTINAL/GENITOURINARY AND VASCULAR RADIOLOGY PROCEDURES - p. 624 292. VIII. ANESTHESIA FOR PROTON BEAM THERAPY AND RADIATION THERAPY - p. 627 293. IX. ANESTHESIA FOR ELECTROCONVULSIVE THERAPY - p. 628 294. X. ANESTHESIA FOR GASTROINTESTINAL PROCEDURES - p. 630 295. 35 Anesthesia for Trauma and Burns - p. 633 296. I. INITIAL EVALUATION OF THE TRAUMA PATIENT - p. 633 297. II. SPECIFIC INJURIES - p. 638 298. III. THE PEDIATRIC TRAUMA PATIENT - p. 647 299. IV. THE PREGNANT TRAUMA PATIENT - p. 648 300. V. MAJOR BURN INJURIES - p. 649 301. 36 Transfusion Therapy - p. 658 302. I. THE DECISION TO TRANSFUSE - p. 658 303. II. COAGULATION STUDIES - p. 661 304. III. BLOOD TYPING AND CROSS-MATCHING - p. 662 305. IV. BLOOD COMPONENT THERAPY - p. 664 306. V. PLASMA SUBSTITUTES - p. 666 307. VI. PHARMACOLOGIC THERAPY - p. 666 308. VII. CONSERVATION AND SALVAGE TECHNIQUES - p. 667 309. VIII. COMPLICATIONS OF BLOOD TRANSFUSION THERAPY - p. 668 310. IX. PERIOPERATIVE COAGULOPATHY - p. 673 311. X. SPECIAL CONSIDERATIONS - p. 678 312. XI. Acknowledgment - p. 680 313. PART III: PERIOPERATIVE ISSUES - p. 680 314. 37 The Post-anesthesia Care Unit - p. 681 315. I. GENERAL CONSIDERATIONS - p. 681 316. II. ADMISSION TO THE PACU - p. 681 317. III. MONITORING - p. 682 318. IV. GENERAL COMPLICATIONS - p. 682 319. V. EFFECTS OF ANESTHETICS AND SEDATIVES - p. 683 320. VI. RESPIRATORY AND AIRWAY COMPLICATIONS - p. 683 321. VII. HEMODYNAMIC AND CARDIOVASCULAR COMPLICATIONS - p. 689 322. VIII. RENAL COMPLICATIONS - p. 692 323. IX. NEUROLOGIC COMPLICATIONS - p. 693 324. X. POSTOPERATIVE NAUSEA AND VOMITING - p. 695 325. XI. PRINCIPLES OF PAIN MANAGEMENT - p. 696 326. XII. BODY TEMPERATURE CHANGES - p. 697 327. XIII. RECOVERY FROM REGIONAL AND NEURAXIAL ANESTHESIA - p. 697 328. XIV. CRITERIA FOR DISCHARGE - p. 697 329. XV. ENHANCED RECOVERY AFTER SURGERY - p. 698 330. XVI. CONSIDERATIONS FOR PEDIATRIC RECOVERY - p. 698 331. XVII. CRITICAL CARE IN THE POST-ANESTHESIA RECOVERY UNIT - p. 699 332. 38 Pain Management - p. 701 333. I. DEFINITION AND TERMINOLOGY - p. 701 334. II. TREATMENT OF ACUTE PAIN IN THE PERIOPERATIVE SETTING - p. 702 335. III. COMPLEMENTARY AND ALTERNATIVE MEDICINE IN PAIN MANAGEMENT - p. 717 336. 39 Adult, Pediatric, and Newborn Resuscitation - p. 723 337. I. OVERVIEW - p. 723 338. II. CARDIAC ARREST - p. 724 339. III. ADULT RESUSCITATION - p. 725 340. IV. PEDIATRIC RESUSCITATION - p. 737 341. V. NEONATAL RESUSCITATION - p. 739 342. 40 Vascular Access - p. 747 343. I. OVERVIEW - p. 747 344. II. APPLIED VASCULAR ANATOMY - p. 747 345. III. VASCULAR ACCESS DEVICES - p. 747 346. IV. PRINCIPLES OF IMAGE-GUIDED VASCULAR ACCESS - p. 747 347. V. COMMON ISSUES AND TROUBLESHOOTING - p. 751 348. Appendix I: Drugs With Narrow Therapeutic Ranges and Potential for Harm - p. 752 349. Appendix II: Commonly Used Drugs - p. 756 350. Appendix III: Common Intravenous Antibiotics - p. 775 351. Index - p. 777