Full Description
This book is a comprehensive reference of the neuraxial route for the delivery of therapeutics. It reviews the historical evolution of this approach from its inception in the later 1800's to present day. This amply referenced text covers basic discussions of spinal anatomy, embryogenesis, neuraxial vascularity, cerebrospinal fluid flow dynamics and parenchymal molecule movement. The pharmacokinetic and pharmacodynamic properties of different intrathecal agents are explored in detail with particular reference to clinical correlates in pain and spasticity. Particular attention is paid to the issues relevant to preclinical models of intrathecal delivery and the assessment of spinal pathologies arising from acute and chronic intrathecal drug delivery. Chapters provide essential discussions of clinical aspects of patient care, including patient evaluation and screening, trialing and device management, troubleshooting problems and addressing complications, best practices, cost-effectiveness and future of the therapy.
Clinicians and researchers who practice intrathecal therapy and study neuraxial mechanisms will find Neuraxial Therapeutics, to be an invaluable guide to this treatment modality.
Contents
History and Evolution of Intrathecal Drug Delivery.- Intraspinal Anatomy: Considerations in Intrathecal Drug Delivery.- Spinal Target Receptors in Intrathecal Drug Delivery.- Mechanisms of Action of Intrathecally Administered Agents.- Physicochemical Properties and Compounding of Intrathecally Administered Agents.- Cerebrospinal Fluid Flow Dynamics.- Uptake and Distribution of Intrathecally Administered Agents.- Animal Models of Intrathecal Drug Delivery: Clinical Correlates.- Intrathecal Drug Delivery for Pain: Medical Considerations.- Intrathecal Drug Delivery for Pain: Psychological Considerations.- Intrathecal trialing Techniques for Pain Indications.- Catheter Localization and Programming Parameters for Pain.- Maintenance and Troubleshooting of Intrathecal Therapy for Pain.- Intrathecal Agents: Choices for Pain.- Intrathecal Therapy for Cancer Pain: Best Practices.- Intrathecal Therapy for Non-Cancer Pain: Best Practices.- Managing Complications of Intrathecal Therapy for Pain.- Assessing Patients with Movement Disorders for Intrathecal Therapy.- Trialing Techniques for Spasticity.- Catheter Localization and Programming Parameters for Spasticity.- Intrathecal Agents Use for Spasticity.- Maintenance and Troubleshooting of Intrathecal Therapy for Spasticity.- Managing Complications of Intrathecal Therapy for Spasticity.- System Choices.- Implantation Techniques.- Preoperative Considerations.- Managing Surgical Complications.- ;Special Patient Populations (Children, Anticoagulation, Other implanted devices) .- Cost Effectiveness of Intrathecal Drug Delivery.- Keys to Managing a Successful Targeted Drug Delivery Practice.- Targeted Drug Delivery: Beyond the Spinal Canal.
