Course Description: This seminar will explore the history of general anesthesia, current anesthetic practices and primarily focus on the molecular mechanisms of anesthetic actions in the mammalian brain. Prerequisite: either BIO 230, 256, 325 or 330. Enrollment limited to 12. 4 credits. Sept 13th: Introduction, Overview and General Concepts of General Anesthesia Sept 20th: History of Anesthesia and Anesthetic Practice, Surgery suite tour. Sept 27th: Clinical Practice. Guest lecturer: Dr. Vijay Gandevia, Dept. Anesthesiology, Baystate Medical Center. Oct 4th: Pharmacology of General Anesthesia. (Oct 11th): AUTUMN RECESS- No Class. Oct 18th: Meyer-Overton, MAC and the Protein-Lipid Debate. (Oct 25th): ACH away at American Society for Anesthesiology Meeting, Atlanta, GA – No Class. Nov 1st: Highlights of ASA meeting and Intro to modulation of ion channels by volatiles. Nov 8th: Anesthetic modulation of voltage-gated channels. Presentation #1+2 (Nov 15th): ACH away at Society for Neuroscience Meeting, Washington, DC. -No Class Nov 22nd: Modulation of excitatory ligand-gated ion channels. Presentation #3+4 Nov 29th: Anesthetic action at postsynaptic GABA A receptors. Presentation #5+6 Dec 6th: Term Paper presentations Dec 13th: Field trip to Boston to visit Dr. Elliott Miller at Mass. Gen. Hosp.
Assigned Readings 9/20: (1) The Development of Concepts of Mechanisms of Anesthesia, Chapter 1, Neural Mechanisms of Anesthesia, D. Caton and Antognini, (2003). (2) Ether Day , J.M. Fenster, (2002).
9/27 + 10/4 (1) “ Pharmacokinetics and Pharmacodynamics” Chapter 1, Pharmacology and Physiology in Anesthetic Practice, R. K. Stoelting (2) “Inhaled Anesthetics” Chapter 2, Pharmacology and Physiology in Anesthetic Practice, R. K. Stoelting.
10/18 (1) “Basic Pharmacology of volatile anesthetics” Chapter 1, J.P. Dilger in ‘Molecular Bases of Anesthesia’ Moody and Skolnick, (2001). (2) “ Which molecular targets are most relevant to general anesthesia?” N.P. Franks and W. Lieb, Toxicology Letters, 100-101, 1-8 (1998).
11/1 (1) Chapters 11, 12 and 13 of “Essentials of neural science and behavior” Kandel, Schwartz and Jessell (2) Molecular and cellular mechanisms of general anesthesia, N.P. Franks and W. Lieb, Nature, 367, 607-614 (1994).
11/8 (1) ‘Volatile anesthetics significantly suppress central and peripheral mammalian sodium channels’, D.S. Duch, B. Rehberg, T.N. Vysotskaya, Toxicology Letters, 100-101, 255-263 (1998) (2) ‘ Volatile anesthetic effects on Calcium Channels’ H.C. Hemmings, Chapter 6 in ‘Molecular Bases of Anesthesia’ Moody and Skolnick, (2001).
11/22 (2) ‘Volatile anesthetic effects at excitatory amino acid receptors’ J.E. Dildy-Mayfield and R.A. Harris, Chapter 9 in ‘Molecular Bases of Anesthesia’ Moody and Skolnick, (2001). (3) ‘Effects of volatile anesthetics at nicotinic acetylcholine receptors’ P. Flood, Chapter 13 in ‘Molecular Bases of Anesthesia’ Moody and Skolnick, (2001).
11/29
Assignments
HISTORY OF ANESTHESIA ESSAY After our discussion of the key players in the discovery of anesthesia, and after reading ‘Ether Day’ by Julie Fenster, write a short essay (3 page maximum) entitled “Who discovered general anesthesia?”. You must decide which historical character you determine was the most influential in introducing general anesthetics into surgical practice. Back up your selection with arguments highlighting their input and the impact it had on the medical and scientific communities. Due on Oct 18 th in class. ARTICLE PRESENTATION After reading background reviews (see assigned reading) and after consultation with AH, pairs will select one article ( primary literature only) to present.This presentation should be ~15-20 minutes in length and consist of an in depth explication of the primary literature article. Give a brief background and explain the methodology as needed to interpret the experiments. Then discuss how the knowledge gained elucidates some aspect of anesthetic action in the mammalian brain. This is aPowerpoint presentation with handouts as needed to clarify the material. Please email AH the Powerpoint slides by 5 p.m the Monday before your presentation. TERM PAPER Choose a class of neuronal molecules (e.g. a receptor type, an ion channel, an enzyme involved in a second messenger cascade) that you know to be affected by the action of general anesthetics. Your term paper should explore how general anesthetics modulate the activity of your chosen class of molecules and how this modulation may explain some aspect of anesthesia (e.g. hypnosis, loss of consciousness, amnesia, emesis) in the mammalian brain. The paper should draw largely from the primary literature, comparing and contrasting the viewsof researchers in the field. Coverage : Your discussion of an anesthetic mechanism should include: 1. An abstract of no more than 150 words as the opening page. 2. Definitions of the key molecules (e.g. receptors, channels) involved 3. A brief historical perspective and discussion of the development of our changes in understanding of the role of these molecules in anesthesia. 4.In your own words, a synthesis of the primary literature pertaining to your chosen anesthetic mechanism, comparing and contrasting all the relevant articles. 5. A brief overview of the net effects on the nervous system (e.g. behavioural changes) resulting from the anesthetic modulation of the molecules that you have chosen to study. Documentation: The use of proper and complete referencing and documentation is important. The references cited should be given in the format given below. Be sure to include all authors. Author, A. B. (complete listing of all authors), Year, Title of the article. Abbreviated Journal Title, Vol.: Complete Pagination. For example: Duch, D.S., Rehberg, B., Vysotskaya, T.N. 1998, Volatile anesthetics significantly suppress central and peripheral mammalian sodium channels, Toxicol. Lett., 100-101, 255-263. Franks, N.P. and Lieb W.R., 1998, Which molecular targets are most relevant to general anesthesia? Toxicol. Lett., 100-101, 1-8. Within the body of the paper, please refer to the references by author and year within parentheses. For example, this syllabus was prepared at Smith College (Hall, 2005). It has been demonstrated that isoflurane affects GABA A receptors stereoselectively (Hall et al., 1994). Hall et al., (1994) established that the modulation of GABA A receptors by isoflurane was stereoselective…. If you have any questions, please feel free to consult AH. Optional Draft due: 11/22/05 in class Completed paper is due on: 12/09/05 Friday at 5.00pm Format: The paper should be typed on white paper, double-spaced, 12 pitch Times-Roman, paginated and up to 10 pages in length (exclusive of abstract, figures and bibliography). ANNOTATED BIBLIOGRAPHY An annotated bibliography is a combination of the complete bibliographic citation along with several sentences (5-6) of concise summary of that article. This usually includes the most important results and the relevance of the study to the field. The articles you choose will be ones that you are using or have considered for use in your term paper. You should have a minimum of 15 references of primary literature in your annotated bibliography. Any reviews cited do not require annotation. TERM PAPER PRESENTATION This short presentation (maximum of 5 minutes) will consist of a summary describing your chosen molecular mechanism of anesthetic action including reference to the net effects on the mammalian nervous system.No more than five Powerpoint slides may be used. Please email AH the Powerpoint slides on Monday December 5 the daybefore the presentation. FIELD TRIP There will be a field trip to Massachusetts General Hospital and Mount Auburn Cemetery, Cambridge, MA. We will be traveling in a Smith College van, leaving promptly at 12:00 from Smith to arrive at MGH by 2 pm., then departing around 4pm to return to Smith at approximately 6 pm. During the course of our time there, we will be joined by Dr. Elliott Miller, an expert in anesthesia and in the history of anesthetic practice. DEADLINES All work is due on the designated day. If work is handed in late, 5% will be deductedfrom the grade per day beyond the deadline. |
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