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    Mark Dershwitz MD, PhD

    TitleProfessor
    InstitutionUniversity of Massachusetts Medical School
    DepartmentAnesthesiology
    AddressUniversity of Massachusetts Medical School
    55 Lake Avenue North
    Worcester MA 01655
    Phone508-856-2480
      Other Positions
      InstitutionUMMS - School of Medicine
      DepartmentBiochemistry and Molecular Pharmacology

      InstitutionUMMS - Graduate School of Biomedical Sciences
      DepartmentMillennium MD/PhD Program

        Overview 
        Narrative

        Academic Background


        Ph.D. (Pharmacology) Northwestern University, 1982
        M.D. Northwestern University, 1982



        Postdoctoral Training


        Massachusetts General Hospital, Residency in Anesthesiology, 1984-86
        Massachusetts General Hospital, Research Fellowship in Anesthesiology, 1986-88

        Photo: Mark Dershwitz, M.D., Ph.D.

        Although anesthetics have been given primarily via the inhalational route throughout the history of anesthesiology, I am interested in the pharmacokinetics (PK) and pharmacodynamics (PD) of intravenous anesthetics. I was involved in the initial clinical trial of the opioid remifentanil whose novel pathway of elimination, via tissue esterases, causes it to have an extremely short duration of action. That study demonstrated that the pharmacological effects of the drug can be expected to wear off within a few minutes regardless of the cumulative dose administered. Subsequently I studied remifentanil in persons with severe hepatic failure or with renal failure requiring dialysis. Based on the known pathway of remifentanil metabolism, such organ dysfunction should have no effect on its PK. These experiments, in which the persons with organ dysfunction were studied as volunteers, demonstrated that as expected remifentanil was as short-acting in these persons as in matched control subjects without organ disease. In addition, the PD experiments showed that persons with liver failure were more sensitive to the ventilatory depressant effects of remifentanil.

        Despite the use of morphine in medicine for thousands of years, until recently there was no simultaneous PK/PD study of morphine in humans. This study, again performed in volunteers, showed that even after intravenous administration, the time required for the peak morphine effect to occur was approximately 1.5 hr.

        Postoperative nausea and vomiting (PONV) remains a significant problem after anesthesia. I have been involved in several studies on two of the new antiemetics that are antagonists at the 5-HT3 receptor, ondansetron and dolasetron. Most recently, I performed the first detailed dose-response study of ondansetron in preventing PONV, the results of which had significant economic implications considering the expense of the drug and the frequency with which it is used.

        Please clickhereto see my web page in the Department of Anesthesiology that describes my clinical work and resident education in greater detail.



        Bibliographic 
        selected publications
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        1. Cooper JB, Blum RH, Carroll JS, Dershwitz M, Feinstein DM, Gaba DM, Morey JC, Singla AK. Differences in safety climate among hospital anesthesia departments and the effect of a realistic simulation-based training program. Anesth Analg. 2008 Feb; 106(2):574-84, table of contents.
          View in: PubMed
        2. Dershwitz M. There should be a threshold dose for the FDA black-box warning on droperidol. Anesth Analg. 2003 Nov; 97(5):1542-3; author reply 1543.
          View in: PubMed
        3. Dershwitz M. Droperidol: should the black box be light gray? J Clin Anesth. 2002 Dec; 14(8):598-603.
          View in: PubMed
        4. Dershwitz M, Michalowski P, Chang Y, Rosow CE, Conlay LA. Postoperative nausea and vomiting after total intravenous anesthesia with propofol and remifentanil or alfentanil: how important is the opioid? J Clin Anesth. 2002 Jun; 14(4):275-8.
          View in: PubMed
        5. Dershwitz M, Walsh JL, Morishige RJ, Connors PM, Rubsamen RM, Shafer SL, Rosow CE. Pharmacokinetics and pharmacodynamics of inhaled versus intravenous morphine in healthy volunteers. Anesthesiology. 2000 Sep; 93(3):619-28.
          View in: PubMed
        6. Philip BK, Pearman MH, Kovac AL, Chelly JE, Wetchler BV, McKenzie R, Monk TG, Dershwitz M, Mingus M, Sung YF, Hahne WF, Brown RA. Dolasetron for the prevention of postoperative nausea and vomiting following outpatient surgery with general anaesthesia: a randomized, placebo-controlled study. The Dolasetron PONV Prevention Study Group. Eur J Anaesthesiol. 2000 Jan; 17(1):23-32.
          View in: PubMed
        7. Dershwitz M, Conant JA, Chang Y, Rosow CE, Connors PM. A randomized, double-blind, dose-response study of ondansetron in the prevention of postoperative nausea and vomiting. J Clin Anesth. 1998 Jun; 10(4):314-20.
          View in: PubMed
        8. Kearse LA, Rosow C, Zaslavsky A, Connors P, Dershwitz M, Denman W. Bispectral analysis of the electroencephalogram predicts conscious processing of information during propofol sedation and hypnosis. Anesthesiology. 1998 Jan; 88(1):25-34.
          View in: PubMed
        9. Hoke JF, Shlugman D, Dershwitz M, Michalowski P, Malthouse-Dufore S, Connors PM, Martel D, Rosow CE, Muir KT, Rubin N, Glass PS. Pharmacokinetics and pharmacodynamics of remifentanil in persons with renal failure compared with healthy volunteers. Anesthesiology. 1997 Sep; 87(3):533-41.
          View in: PubMed
        10. Dershwitz M, Rosow CE. The pharmacokinetics and pharmacodynamics of remifentanil in volunteers with severe hepatic or renal dysfunction. J Clin Anesth. 1996 May; 8(3 Suppl):88S-90S.
          View in: PubMed
        11. Dershwitz M, Hoke JF, Rosow CE, Michalowski P, Connors PM, Muir KT, Dienstag JL. Pharmacokinetics and pharmacodynamics of remifentanil in volunteer subjects with severe liver disease. Anesthesiology. 1996 Apr; 84(4):812-20.
          View in: PubMed
        12. Dershwitz M, Randel GI, Rosow CE, Fragen RJ, Connors PM, Librojo ES, Shaw DL, Peng AW, Jamerson BD. Initial clinical experience with remifentanil, a new opioid metabolized by esterases. Anesth Analg. 1995 Sep; 81(3):619-23.
          View in: PubMed
        13. McKenzie R, Sharifi-Azad S, Dershwitz M, Miguel R, Joslyn AF, Tantisira B, Rosenblum F, Rosow CE, Downs JB, Bowie JR, et al. A randomized, double-blind pilot study examining the use of intravenous ondansetron in the prevention of postoperative nausea and vomiting in female inpatients. J Clin Anesth. 1993 Jan-Feb; 5(1):30-6.
          View in: PubMed
        14. Dershwitz M, Di Biase PM, Rosow CE, Wilson RS, Sanderson PE, Joslyn AF. Ondansetron does not affect alfentanil-induced ventilatory depression or sedation. Anesthesiology. 1992 Sep; 77(3):447-52.
          View in: PubMed
        15. Dershwitz M, Rosow CE, Di Biase PM, Joslyn AF, Sanderson PE. Ondansetron is effective in decreasing postoperative nausea and vomiting. Clin Pharmacol Ther. 1992 Jul; 52(1):96-101.
          View in: PubMed
        16. Dershwitz M, Rosow CE, DiBiase PM, Zaslavsky A. Comparison of the sedative effects of butorphanol and midazolam. Anesthesiology. 1991 Apr; 74(4):717-24.
          View in: PubMed
        17. Dershwitz M, Sherman EP. Acute myocardial infarction symptoms masked by epidural morphine? J Clin Anesth. 1991 Mar-Apr; 3(2):146-8.
          View in: PubMed
        18. Dershwitz M, Sr├ęter FA. Azumolene reverses episodes of malignant hyperthermia in susceptible swine. Anesth Analg. 1990 Mar; 70(3):253-5.
          View in: PubMed
        19. Dershwitz M, Sr├ęter FA, Ryan JF. Ketamine does not trigger malignant hyperthermia in susceptible swine. Anesth Analg. 1989 Oct; 69(4):501-3.
          View in: PubMed
        20. Dershwitz M, Ryan JF, Guralnick W. Safety of amide local anesthetics in patients susceptible to malignant hyperthermia. J Am Dent Assoc. 1989 Mar; 118(3):276, 278, 280.
          View in: PubMed
        21. Dershwitz M, Ts'ao CH, Novak RF. Metabolic and morphologic effects of the antimicrobial agent nitrofurantoin on human erythrocytes in vitro. Biochem Pharmacol. 1985 Jun 1; 34(11):1963-70.
          View in: PubMed
        22. Dershwitz M, Novak RF. Studies on the mechanism of nitrofurantoin-mediated red cell toxicity. J Pharmacol Exp Ther. 1982 Aug; 222(2):430-4.
          View in: PubMed
        23. Dershwitz M, Novak RF. Generation of superoxide via the interaction of nitrofurantoin with oxyhemoglobin. J Biol Chem. 1982 Jan 10; 257(1):75-9.
          View in: PubMed
        24. Dershwitz M, Novak RF. Lack of inhibition of glutathione reductase by anthracycline antibiotics. Biochem Pharmacol. 1981 Mar 15; 30(6):676-8.
          View in: PubMed
        25. Dershwitz M, Novak RF. Lack of inhibition of glutathione reductase by unnitrated derivatives of nitrofurantoin. Biochem Biophys Res Commun. 1980 Feb 27; 92(4):1313-9.
          View in: PubMed
        26. Novak RF, Dershwitz M, Novak FC. Characterization of the interaction of the aromatic hydrocarbons benzene and toluene with human hemoglobin. Mol Pharmacol. 1979 Nov; 16(3):1046-58.
          View in: PubMed
        27. Novak RF, Dershwitz M, Novak FC. The interaction of benzene with human hemoglobin as studied by 1H Fourier transform NMR spectroscopy. Biochem Biophys Res Commun. 1978 May 30; 82(2):634-40.
          View in: PubMed
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