Clinical Physiology Of Acid-base And Electrolyte Disorders 6th Edition Free Download ~REPACK~

Importance of the field: As with all potent therapeutic agents, the use of diuretic compounds has been linked with several adverse effects that may reduce quality of life and patient compliance and, in some cases, may be associated with considerable morbidity and mortality. Among the various types of adverse effects, disturbances of electrolyte and acid-base balance are perhaps the most common, and some of them are the aetiological factors of other side effects (i.e., hypokalaemia causing ventricular arrhythmias or glucose intolerance). The mechanism and site of action and, therefore, the pharmacological effects of each diuretic class largely determine the specific electrolyte or acid-base abnormalities that will accompany the use of each diuretic agent.

Areas covered in the review: This article reviews the major electrolyte disturbances (hypokalaemia, hyperkalaemia, hyponatraemia, disorders of magnesium and calcium balance), as well as the acid-base abnormalities complicating the use of the various diuretic agents.

Clinical Physiology Of Acid-base And Electrolyte Disorders 6th Edition Free Download

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What the reader will gain: The reader will gain insights into the pathogenesis of the diuretic-induced electrolyte and acid-base disorders together with considerations for their prevention and treatment.

Aminoglycosides produce disturbances in electrolyte homeostasis, resulting in hypokalemia, hypomagnesemia, and hypocalcemia. The mechanisms of the aminoglycoside-induced syndome of hypokalemic metabolic alkalosis associated with hypomagnesemia are not clear. It has been suggested that animoglycosides may stimulate the renal tubular chloride channel, resulting in excessive urinary chloride loss1). The sodium chloride wasting in the renal tubule can lead to the stimulation of the renin-angiotensin-aldosterone axis, and subsequently hypokalemic metabolic alkalosis. Hypomagnesemia may be due to the coexistent hypokalemia. Recently, some reported data also suggest that as aminoglycosides are cationic, they act on extracelluclar polyvalent cation-sensitive receptors which are present in the distal convoluted tubular cells, and thus can inhibit hormone-stimulated magnesium absorption in this segment2). This activation of renal calcium-sensitive receptors would also lead to an increased calcium excretion. Interestingly, gentamicin administered at standard clinical doses causes immediate and transient renal calcium and magnesium wasting in normal humans3).

These electrolytes can be imbalanced, leading to high or low levels. High or low levels of electrolytes disrupt normal bodily functions and can lead to life-threatening complications. This article reviews the basic physiology of electrolytes and their abnormalities, and the consequences of electrolyte imbalance.

Among the electrolyte disorders, hyponatremia is the most frequent. Hyponatremia is diagnosed when the serum sodium level is less than 135 mmol/L. Hyponatremia has neurological manifestations.[3] Patients may present with headaches, confusion, nausea, and delirium. Hypernatremia occurs when serum sodium levels are greater than 145 mmol/L. Symptoms of hypernatremia include tachypnea, sleeping difficulty, and restlessness. Rapid sodium corrections can have severe consequences like cerebral edema and osmotic demyelination syndrome (ODS). Other factors like chronic alcohol misuse disorder and malnutrition also play a role in the development of ODS.[4]

The acid-base status of the blood drives bicarbonate levels. The kidneys predominantly regulate bicarbonate concentration and maintain the acid-base balance. Kidneys reabsorb the filtered bicarbonate and generate new bicarbonate by net acid excretion, which occurs through the excretion of titrable acid and ammonia. Diarrhea usually results in bicarbonate loss, causing an imbalance in acid-base regulation.[12] Many kidney-related disorders can result in imbalanced bicarbonate metabolism leading to excess bicarbonate in the body.[13]

A buffer is a solution that resists a change in pH. There are many different buffer systems in the body, but the key one for understanding most acid-base disorders is the bicarbonate system present in the extracellular fluid. Like any buffer, this system comprises a weak acid (in this case carbonic acid, H2CO3) and its conjugate base (the bicarbonate ion, HCO3-), which exist in a dynamic equilibrium as shown in Equation 16:

Most laboratories measure total CO2 concentration as part of the standard electrolyte profile. The reason behind this is that it is technically difficult to measure bicarbonate ions in isolation, but relatively straightforward to measure total CO2. Total CO2 represents the total amount of bicarbonate ions, dissolved CO2 and other CO2-containing substances in a solution. Since bicarbonate normally constitutes the majority of this, total CO2 is normally used as a convenient surrogate measure of bicarbonate. The total CO2 on the electrolyte profile may provide the first clue to the presence of an acid-base disturbance in a patient and should not be overlooked when reviewing electrolyte results. One cannot, however, diagnose acid-base disturbances from an isolated total CO2 measurement. In order to characterise an acid-base disturbance, measures of pH, PaCO2, total CO2 or bicarbonate are required, as well as measurement of the anion gap.

Fluid, electrolyte, and acid-base disorders are frequently associated with problems encountered in family medicine. Rapid detection and treatment of these disorders are important, as they affect the quantity and quality of vital organ profusion. These disorders are seen in all age groups and various clinical settings; but the very young, the very old, and those with chronic diseases are particularly vulnerable to serious complications because of inadequate or immature mechanisms of compensation, correction, and prevention.l,2

Like its highly acclaimed predecessors, the Fifth Edition of this classic effectively integrates the essentials of renal and electrolyte physiology with the common clinical disorders of acid-base and electrolyte balance.

FEATURES:

*An easy-to-read writing style that demystifies this difficult subject

*Basic science coverage of water and electrolyte physiology, renal physiology, and regulation of water and electrolyte balance

*Clinical chapters that quickly guide you through key points of etiology, pathophysiology, symptoms, diagnosis, and treatment of common disorders

*Crystal clear figures and handy tables that summarize key information

*End-of-chapter problems that test mastery of the material

FEATURES:

*An easy-to-read writing style that demystifies this difficult subject

*Basic science coverage of water and electrolyte physiology, renal physiology, and regulation of water and electrolyte balance

*Clinical chapters that quickly guide you through key points of etiology, pathophysiology, symptoms, diagnosis, and treatment of common disorders

*Crystal clear figures and handy tables that summarize key information

*End-of-chapter problems that test mastery of the material

Superbly written text gives students, residents, and practitioners a unique advantage in understanding the mechanisms and clinical management of acid-base disorders. Presents the core information to understand renal and electrolyte physiology and also reviews the etiology, diagnosis, pathohysiology and treatment rationale for all major acid-base and electrolyte disturbances. New questions and answers are added to each chapter with significant updating to the entire text

The leading reference for the diagnosis and management of fluid, electrolyte, and acid-base imbalances in small animals, Fluid, Electrolyte, and Acid-Base Disorders in Small Animal Practice, 4th Edition provides cutting-edge, evidence-based guidelines to enhance your care of dogs and cats. Information is easy to find and easy to use, with comprehensive coverage including fluid and electrolyte physiology and pathophysiology and their clinical applications, as well as the newest advances in fluid therapy and a discussion of a new class of drugs called vaptans. Lead author Stephen DiBartola is a well-known speaker and the "go-to" expert in this field, and his team of contributors represents the most authoritative and respected clinicians and academicians in veterinary medicine.

"Acid-base could be considered the Marmite of veterinary medicine; you either love it or hate it! This book cannot guarantee to convert you to a fan of acid-base and fluid balance, but it will certainly enlighten you. This is the fourth edition of what many consider to be the definitive work on fluid, electrolytes and acid-base disorders in dogs and cats; it is an invaluable reference book for clinicians...For those in possession of the third edition of the book, this fourth edition, on first presentation, appears remarkably similar. On closer inspection, the addition of more recent references to all chapters offers an added bonus that will cheer individuals with a specific interest in this field of veterinary medicine...This book will offer all practices something!