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Book Details
Abstract
Pharmacology, 4th Edition helps you master the "must-know" concepts in this subject and how they apply to everyday clinical problem solving and decision making. This concise yet comprehensive text clearly explains and illustrates challenging concepts and helps you retain the material - from course exams and the USMLE Step 1 right through to clinical practice.
- Consult this title on your favorite e-reader with intuitive search tools and adjustable font sizes. Elsevier eBooks provide instant portable access to your entire library, no matter what device you're using or where you're located.
- Quickly reference essential information thanks to abundant tables throughout, and drug classification boxes at the beginning of each chapter.
- See how pharmacology applies to practice with real-world case studies.
- Prepare for exams with self-assessment questions at the end of each chapter.
- Understand complex concepts visually with the aid of superb full-color illustrations.
- Access the complete contents online at www.studentconsult.com, along with an additional glossary, chapter-by-chapter summaries and case studies, a full list of featured drugs, 150 USMLE-style questions, animations, and more.
- Learn the latest pharmacologic mechanisms and applications with new and updated drug information throughout.
- Be aware of new "off label" uses, including important FDA regulations.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front cover | cover | ||
| Student Consult page | FM1 | ||
| Pharmacology, 4/e | i | ||
| Copyright page | iv | ||
| Preface | v | ||
| Table of Contents | vii | ||
| I Principles of Pharmacology | 1 | ||
| 1 Introduction to Pharmacology | 2 | ||
| Pharmacology and Related Sciences | 2 | ||
| History and Role of Pharmacology | 2 | ||
| Pharmacology and Its Subdivisions | 2 | ||
| Toxicology | 3 | ||
| Pharmacotherapeutics | 3 | ||
| Pharmacy and Related Sciences | 3 | ||
| Drug Sources and Preparations | 4 | ||
| Natural Sources of Drugs | 4 | ||
| Synthetic Drugs | 4 | ||
| Drug Preparations | 4 | ||
| Crude Drug Preparations | 4 | ||
| Pure Drug Compounds | 4 | ||
| Pharmaceutical Preparations | 4 | ||
| Tablets and Capsules. | 5 | ||
| Solutions and Suspensions. | 5 | ||
| Skin Patches. | 5 | ||
| Aerosols. | 6 | ||
| Ointments, Creams, Lotions, and Suppositories. | 6 | ||
| Routes of Drug Administration | 6 | ||
| Enteral Administration | 6 | ||
| Parenteral Administration | 6 | ||
| Transdermal Administration | 7 | ||
| Inhalational Administration | 7 | ||
| Topical Administration | 7 | ||
| Drug Names | 7 | ||
| Summary of Important Points | 7 | ||
| Review Questions | 8 | ||
| Answers and Explanations | 8 | ||
| 2 Pharmacokinetics | 9 | ||
| Overview | 9 | ||
| Drug Absorption | 9 | ||
| Processes of Absorption | 9 | ||
| Effect of pH on Absorption of Weak Acids and Bases | 9 | ||
| Drug Distribution | 9 | ||
| Factors Affecting Distribution | 11 | ||
| Organ Blood Flow | 11 | ||
| Plasma Protein Binding | 11 | ||
| Molecular Size | 11 | ||
| Lipid Solubility. | 11 | ||
| Drug Biotransformation | 11 | ||
| Role of Drug Biotransformation | 11 | ||
| Formation of Active Metabolites | 11 | ||
| First-Pass Biotransformation | 11 | ||
| Phases of Drug Biotransformation | 11 | ||
| Phase I Biotransformation | 12 | ||
| Oxidative Reactions. | 12 | ||
| Hydrolytic Reactions. | 12 | ||
| Reductive Reactions. | 14 | ||
| Phase II Biotransformation | 14 | ||
| Glucuronide Formation. | 14 | ||
| Acetylation. | 14 | ||
| Sulfation. | 14 | ||
| Pharmacogenomics | 15 | ||
| Variations in Acetyltransferase Activity | 15 | ||
| Variations in CYP2D6 and CYP2C19 Activity | 15 | ||
| Other Variations in Drug Metabolism Enzymes | 15 | ||
| Drug Excretion | 15 | ||
| Renal Drug Excretion | 15 | ||
| Glomerular Filtration | 15 | ||
| Active Tubular Secretion | 15 | ||
| Passive Tubular Reabsorption | 15 | ||
| Biliary Excretion and Enterohepatic Cycling | 16 | ||
| Other Routes of Excretion | 17 | ||
| Quantitative Pharmacokinetics | 17 | ||
| Drug Plasma Concentration Curves | 17 | ||
| Bioavailability | 18 | ||
| Volume of Distribution | 18 | ||
| Calculation of the Volume of Distribution | 18 | ||
| Interpretation of the Volume of Distribution | 19 | ||
| Drug Clearance | 20 | ||
| Renal Clearance | 20 | ||
| Hepatic Clearance | 20 | ||
| Single-Dose Pharmacokinetics | 21 | ||
| First-Order Kinetics | 21 | ||
| Elimination Half-Life | 21 | ||
| Zero-Order Kinetics | 21 | ||
| Continuous-Dose and Multiple-Dose Kinetics | 21 | ||
| Drug Accumulation and the Steady-State Principle | 21 | ||
| Time Required to Reach the Steady-State Condition | 22 | ||
| Steady-State Drug Concentration | 22 | ||
| Dosage Calculations | 22 | ||
| Loading Dose | 22 | ||
| Maintenance Dose | 22 | ||
| Summary of Important Points | 23 | ||
| Review Questions | 25 | ||
| Answers and Explanations | 25 | ||
| 3 Pharmacodynamics | 26 | ||
| Overview | 26 | ||
| Nature of Drug Receptors | 26 | ||
| Types of Drug Receptors | 26 | ||
| Receptor Classification | 26 | ||
| Drug-Receptor Interactions | 26 | ||
| Receptor Binding and Affinity | 26 | ||
| Signal Transduction | 28 | ||
| G Protein–Coupled Receptors | 28 | ||
| Ligand-Gated Ion Channels | 28 | ||
| Membrane-Bound Enzymes | 29 | ||
| Nuclear Receptors | 30 | ||
| Efficacy | 30 | ||
| Receptor Regulation and Drug Tolerance | 30 | ||
| Dose-Response Relationships | 30 | ||
| Graded Dose-Response Relationships | 31 | ||
| Quantal Dose-Response Relationship | 31 | ||
| Summary of Important Points | 32 | ||
| Review Questions | 32 | ||
| Answers and Explanations | 32 | ||
| 4 Drug Development and Safety | 34 | ||
| Overview | 34 | ||
| Drug Development | 34 | ||
| Discovery and Characterization | 34 | ||
| Preclinical Studies | 34 | ||
| The Investigational New Drug Application | 34 | ||
| Clinical Trials | 34 | ||
| The New Drug Application and Its Approval | 35 | ||
| Postmarketing Surveillance | 36 | ||
| Federal Drug Laws and Regulations | 36 | ||
| Drug Safety and Efficacy Laws | 36 | ||
| Pure Food and Drug Act | 36 | ||
| Food, Drug, and Cosmetic Act | 36 | ||
| Provisions of the Food, Drug, and Cosmetic Act. | 36 | ||
| Amendments to the Food, Drug, and Cosmetic Act. | 36 | ||
| Drug Price Competition and Patent Term Restoration Act | 37 | ||
| Drug Abuse Prevention Laws | 37 | ||
| Harrison Narcotics Act | 37 | ||
| Comprehensive Drug Abuse Prevention and Control Act | 37 | ||
| Adverse Effects of Drugs | 38 | ||
| Excessive Pharmacologic Effects | 38 | ||
| Hypersensitivity Reactions | 38 | ||
| Adverse Effects on Organs | 38 | ||
| Hematopoietic Toxicity | 38 | ||
| Hepatotoxicity | 39 | ||
| Nephrotoxicity | 39 | ||
| Other Organ Toxicities | 39 | ||
| Idiosyncratic Reactions | 39 | ||
| Drug Interactions | 39 | ||
| Pharmaceutical Interactions | 39 | ||
| Pharmacodynamic Interactions | 39 | ||
| Pharmacokinetic Interactions | 40 | ||
| Altered Drug Absorption | 40 | ||
| Altered Drug Distribution | 40 | ||
| Altered Drug Biotransformation | 41 | ||
| Altered Drug Excretion | 41 | ||
| Clinical Significance of Drug Interactions | 41 | ||
| Factors Affecting Drug Safety and Efficacy | 42 | ||
| Age | 42 | ||
| Disease | 42 | ||
| Pregnancy and Lactation | 42 | ||
| Summary of Important Points | 43 | ||
| Review Questions | 44 | ||
| Answers and Explanations | 44 | ||
| II Autonomic and Neuromuscular Pharmacology | 45 | ||
| 5 Introduction to Autonomic and Neuromuscular Pharmacology | 46 | ||
| Overview | 46 | ||
| Anatomy and Physiology of the Peripheral Nervous System | 46 | ||
| Autonomic Nervous System | 46 | ||
| Somatic Nervous System | 46 | ||
| Enteric Nervous System | 46 | ||
| Neurotransmitters and Receptors | 47 | ||
| Neurotransmitters | 47 | ||
| Receptors for Acetylcholine, Norepinephrine, and Epinephrine | 47 | ||
| Neurotransmission and Sites of Drug Action | 48 | ||
| Cholinergic Neurotransmission | 49 | ||
| Drugs Affecting Cholinergic Neurotransmission | 50 | ||
| Sympathetic Neurotransmission | 50 | ||
| Drugs Affecting Adrenergic Neurotransmission | 50 | ||
| Drugs Modulating the Baroreceptor Reflex | 51 | ||
| Summary of Important Points | 51 | ||
| Review Questions | 52 | ||
| Answers and Explanations | 52 | ||
| 6 Acetylcholine Receptor Agonists | 53 | ||
| Overview of Cholinergic Pharmacology | 53 | ||
| Acetylcholine Receptors | 53 | ||
| Muscarinic Receptors | 53 | ||
| Nicotinic Receptors | 53 | ||
| Classification of Acetylcholine Receptor Agonists | 54 | ||
| Direct-Acting Acetylcholine Receptor Agonists | 54 | ||
| Choline Esters | 54 | ||
| General Properties | 54 | ||
| Ocular Effects. | 54 | ||
| Respiratory Tract Effects. | 54 | ||
| Cardiac Effects. | 54 | ||
| Vascular Effects. | 55 | ||
| Gastrointestinal and Urinary Tract Effects. | 55 | ||
| Acetylcholine | 55 | ||
| Chemistry and Pharmacokinetics. | 55 | ||
| Effects and Indications. | 55 | ||
| Bethanechol and Carbachol | 57 | ||
| III Cardiovascular, Renal, and Hematologic Pharmacology | 87 | ||
| 10 Antihypertensive Drugs | 88 | ||
| Overview | 88 | ||
| Hypertension | 88 | ||
| Classification of Blood Pressure | 88 | ||
| Regulation of Blood Pressure | 89 | ||
| Sites and Effects of Antihypertensive Drug Action | 89 | ||
| Diuretics | 89 | ||
| Thiazide and Related Diuretics | 90 | ||
| Loop Diuretics | 91 | ||
| Potassium-Sparing Diuretics | 91 | ||
| Sympatholytic Drugs | 91 | ||
| Adrenoceptor Antagonists | 92 | ||
| α-Adrenoceptor Antagonists | 92 | ||
| β-Adrenoceptor Antagonists | 92 | ||
| Centrally Acting Drugs | 93 | ||
| Angiotensin Inhibitors | 93 | ||
| Angiotensin-Converting Enzyme Inhibitors | 94 | ||
| Drug Properties | 94 | ||
| Chemistry and Pharmacokinetics. | 94 | ||
| Mechanisms and Pharmacologic Effects. | 95 | ||
| Adverse Effects. | 96 | ||
| Interactions. | 96 | ||
| Indications. | 96 | ||
| Specific Drugs | 97 | ||
| Angiotensin Receptor Blockers | 97 | ||
| Direct Renin Inhibitor | 97 | ||
| Vasodilators | 97 | ||
| Calcium Channel Blockers | 97 | ||
| Other Vasodilators | 98 | ||
| Hydralazine and Minoxidil | 98 | ||
| Nitroprusside | 98 | ||
| Fenoldopam | 98 | ||
| The Management of Hypertension | 98 | ||
| Lifestyle Modifications | 98 | ||
| Selection of Drug Therapy | 98 | ||
| Patients with Specific Traits or Diseases | 99 | ||
| Hypertensive Emergencies and Urgencies | 99 | ||
| Summary of Important Points | 100 | ||
| Review Questions | 100 | ||
| Answers and Explanations | 100 | ||
| 11 Antianginal Drugs | 102 | ||
| Overview | 102 | ||
| Coronary Heart Disease | 102 | ||
| Mechanisms and Effects of Antianginal Drugs | 102 | ||
| Vasodilators | 103 | ||
| Organic Nitrites and Nitrates | 103 | ||
| Amyl Nitrite | 103 | ||
| Nitroglycerin, Isosorbide Dinitrate, and Isosorbide Mononitrate | 104 | ||
| Pharmacokinetics. | 104 | ||
| Mechanisms and Pharmacologic Effects. | 104 | ||
| Tolerance. | 104 | ||
| Adverse Effects and Interactions. | 105 | ||
| Calcium Channel Blockers | 105 | ||
| Drug Properties | 106 | ||
| Pharmacokinetics. | 106 | ||
| Mechanisms and Pharmacologic Effects. | 106 | ||
| Adverse Effects. | 106 | ||
| Amlodipine and Related Drugs | 106 | ||
| Nimodipine | 107 | ||
| Diltiazem and Verapamil | 107 | ||
| β-Adrenoceptor Antagonists | 107 | ||
| Drugs that Modify Myocardial Metabolism | 107 | ||
| Ranolazine | 107 | ||
| Trimetazidine | 107 | ||
| Management of Angina Pectoris | 107 | ||
| Summary of Important Points | 108 | ||
| Review Questions | 109 | ||
| Answers and Explanations | 109 | ||
| 12 Drugs for Heart Failure | 110 | ||
| Overview | 110 | ||
| Pathophysiology of Heart Failure | 110 | ||
| Mechanisms and Effects of Drugs for Heart Failure | 111 | ||
| Positively Inotropic Drugs | 112 | ||
| Digoxin | 112 | ||
| Drug Properties | 112 | ||
| Chemistry and Pharmacokinetics. | 112 | ||
| Mechanisms and Pharmacologic Effects. | 113 | ||
| Positive Inotropic Effect. | 113 | ||
| Electrophysiologic and Electrocardiographic Effects. | 113 | ||
| Adverse Effects. | 114 | ||
| Interactions. | 114 | ||
| Indications. | 114 | ||
| Digoxin Immune Fab | 115 | ||
| Dobutamine | 115 | ||
| Milrinone | 116 | ||
| Vasodilators | 116 | ||
| Angiotensin-Converting Enzyme Inhibitors | 116 | ||
| Angiotensin Receptor Blockers | 117 | ||
| Hydralazine and Nitrates | 117 | ||
| Nesiritide | 117 | ||
| β-Adrenoceptor Antagonists | 117 | ||
| Aldosterone Antagonists | 118 | ||
| Diuretics | 118 | ||
| Management of Heart Failure | 118 | ||
| Summary of Important Points | 119 | ||
| Review Questions | 119 | ||
| Answers and Explanations | 119 | ||
| 13 Diuretics | 120 | ||
| Overview | 120 | ||
| Nephron Function and Sites of Drug Action | 120 | ||
| Glomerular Filtration | 120 | ||
| Proximal Tubule | 120 | ||
| Loop of Henle | 120 | ||
| Distal Tubule | 121 | ||
| Collecting Duct | 121 | ||
| Diuretic Agents | 121 | ||
| Thiazide and Related Diuretics | 121 | ||
| Drug Properties | 121 | ||
| Chemistry and Pharmacokinetics. | 121 | ||
| Mechanisms and Pharmacologic Effects. | 121 | ||
| Adverse Effects and Interactions. | 121 | ||
| Indications. | 124 | ||
| Hydrochlorothiazide | 125 | ||
| Thiazide-like Diuretics | 125 | ||
| Loop Diuretics | 125 | ||
| Drug Properties | 125 | ||
| Chemistry and Pharmacokinetics. | 125 | ||
| Mechanisms and Pharmacologic Effects. | 126 | ||
| Adverse Effects and Interactions. | 126 | ||
| Indications. | 126 | ||
| Bumetanide, Furosemide, and Torsemide | 126 | ||
| Ethacrynic Acid | 126 | ||
| Potassium-Sparing Diuretics | 126 | ||
| Amiloride and Triamterene | 126 | ||
| Spironolactone | 126 | ||
| Osmotic Diuretics | 127 | ||
| Carbonic Anhydrase Inhibitors | 127 | ||
| Drug Properties | 127 | ||
| Specific Drugs | 127 | ||
| Pharmacokinetics. | 127 | ||
| Mechanisms, Pharmacologic Effects, and Indications. | 127 | ||
| Adverse Effects and Interactions. | 128 | ||
| Antidiuretic Hormone Antagonists | 128 | ||
| Management of Edema | 128 | ||
| Summary of Important Points | 128 | ||
| Review Questions | 129 | ||
| Answers and Explanations | 129 | ||
| 14 Antiarrhythmic Drugs | 130 | ||
| Overview | 130 | ||
| Cardiac Action Potentials and Electrocardiographic Findings | 130 | ||
| Pathophysiology of Arrhythmias | 130 | ||
| Abnormal Impulse Formation | 130 | ||
| Increased Automaticity. | 131 | ||
| Afterdepolarizations. | 131 | ||
| Abnormal Impulse Conduction | 131 | ||
| Reentry in Ventricular Tissue. | 131 | ||
| Reentry in the Atrioventricular Node. | 133 | ||
| Drug-Induced Arrhythmias | 133 | ||
| Mechanisms and Classification of Antiarrhythmic Drugs | 133 | ||
| Sodium Channel Blockers | 134 | ||
| Class IA Drugs | 134 | ||
| Drug Properties | 134 | ||
| Quinidine | 135 | ||
| Procainamide | 137 | ||
| Disopyramide | 137 | ||
| Class IB Drugs | 137 | ||
| IV Central Nervous System Pharmacology | 173 | ||
| 18 Introduction to Central Nervous System Pharmacology | 174 | ||
| Overview | 174 | ||
| Neurotransmission in the Central Nervous System | 174 | ||
| Principles of Neurotransmission | 174 | ||
| Neurotransmitter Synthesis and Metabolism | 174 | ||
| Excitatory and Inhibitory Neurotransmission | 174 | ||
| Fast versus Slow Signals | 176 | ||
| Neurotransmitters and Receptors | 176 | ||
| Acetylcholine | 176 | ||
| Amino Acids | 176 | ||
| GABA. | 176 | ||
| Glycine and Taurine. | 176 | ||
| Glutamate and Aspartate. | 176 | ||
| Biogenic Amines | 177 | ||
| Dopamine. | 178 | ||
| Norepinephrine. | 179 | ||
| Serotonin. | 180 | ||
| Histamine. | 180 | ||
| Neuropeptides | 180 | ||
| Other Neurotransmitters | 180 | ||
| Mechanisms of Drug Action | 180 | ||
| Neurotransmitter Synthesis, Storage, and Release | 181 | ||
| Neurotransmitter Reuptake and Degradation | 181 | ||
| Receptor Activation or Blockade | 181 | ||
| Receptor Alterations Caused by Central Nervous System Drug Treatment | 181 | ||
| Neuronal Systems in the Central Nervous System | 181 | ||
| Cognitive Processing | 181 | ||
| Memory | 182 | ||
| Emotional Processing | 183 | ||
| Sensory Processing | 183 | ||
| Motor Processing | 183 | ||
| Autonomic Processing | 183 | ||
| Summary of Important Points | 183 | ||
| Review Questions | 184 | ||
| Answers and Explanations | 184 | ||
| 19 Sedative-Hypnotic and Anxiolytic Drugs | 186 | ||
| Overview | 186 | ||
| Anxiety Disorders | 186 | ||
| Neurologic Basis of Anxiety | 186 | ||
| Classification and Treatment of Anxiety Disorders | 186 | ||
| Acute Anxiety | 186 | ||
| Panic Disorder | 187 | ||
| Phobic Disorders | 187 | ||
| Obsessive-Compulsive Disorder | 187 | ||
| Generalized Anxiety Disorder | 187 | ||
| Posttraumatic Stress Disorder | 187 | ||
| Sleep Disorders | 187 | ||
| Neurologic Basis of Sleep | 187 | ||
| Classification and Treatment of Sleep Disorders | 187 | ||
| Insomnia | 187 | ||
| Other Sleep Disorders | 189 | ||
| Sedative-Hypnotic Drugs | 189 | ||
| Benzodiazepines | 189 | ||
| Drug Properties | 190 | ||
| Pharmacokinetics. | 190 | ||
| Mechanism of Action. | 191 | ||
| Pharmacologic Effects. | 192 | ||
| Adverse Effects. | 192 | ||
| Interactions and Treatment of Adverse Effects. | 193 | ||
| Indications. | 193 | ||
| Specific Agents | 193 | ||
| Other Benzodiazepines | 194 | ||
| Barbiturates | 194 | ||
| Drug Properties | 194 | ||
| Pharmacokinetics. | 194 | ||
| Mechanism of Action. | 194 | ||
| Pharmacologic Effects. | 194 | ||
| Interactions. | 194 | ||
| Indications. | 194 | ||
| Specific Agents | 194 | ||
| Antihistamines | 194 | ||
| Other Sedative-Hypnotic Drugs | 195 | ||
| Zolpidem, Zaleplon, and Eszopiclone | 195 | ||
| Melatonin and Ramelteon | 195 | ||
| Chloral Hydrate | 195 | ||
| Nonsedating Anxiolytic Drugs | 195 | ||
| Buspirone | 195 | ||
| Propranolol | 195 | ||
| Summary of Important Points | 195 | ||
| Review Questions | 196 | ||
| Answers and Explanations | 196 | ||
| 20 Antiepileptic Drugs | 198 | ||
| Overview | 198 | ||
| Classification of Seizures | 198 | ||
| Neurobiology of Seizures | 198 | ||
| Mechanisms of Antiepileptic Drugs | 199 | ||
| Effects on Ion Channels | 199 | ||
| Effects on GABAergic Systems | 199 | ||
| Effects on Glutaminergic Systems | 199 | ||
| Treatment of Seizure Disorders | 199 | ||
| Drugs for Partial and Generalized Tonic-Clonic Seizures | 203 | ||
| Carbamazepine and Oxcarbazepine | 203 | ||
| Pharmacokinetics. | 203 | ||
| Mechanisms and Effects. | 203 | ||
| Interactions. | 203 | ||
| Indications. | 203 | ||
| Phenytoin and Fosphenytoin | 204 | ||
| V Pharmacology of the Respiratory and Other Systems | 273 | ||
| 26 Autacoid Drugs | 274 | ||
| Overview | 274 | ||
| Histamine and Related Drugs | 274 | ||
| Histamine Biosynthesis and Release | 274 | ||
| Histamine Receptors and Effects | 276 | ||
| Antihistamine Drugs | 276 | ||
| Histamine H1 Receptor Antagonists | 276 | ||
| Classification | 276 | ||
| Mechanisms and Pharmacokinetics. | 276 | ||
| Pharmacologic Effects and Indications. | 276 | ||
| First-Generation Antihistamines | 276 | ||
| Second-Generation Antihistamines | 277 | ||
| Intranasal Antihistamines | 277 | ||
| VI Endocrine Pharmacology | 329 | ||
| 31 Hypothalamic and Pituitary Drugs | 330 | ||
| Overview | 330 | ||
| Adenohypophysis and Hypothalamus | 330 | ||
| Neurohypophysis | 330 | ||
| Uses of Hypothalamic and Pituitary Hormones | 330 | ||
| Anterior Pituitary Hormones | 330 | ||
| Corticotropin and Related Drugs | 330 | ||
| Corticotropin Preparations | 331 | ||
| Corticotropin-Releasing Hormone | 332 | ||
| Growth Hormone and Related Drugs | 332 | ||
| Growth Hormone Preparations | 332 | ||
| Growth Hormone–Inhibiting Hormone Preparations | 332 | ||
| Growth Hormone Receptor Antagonist | 333 | ||
| Gonadotropins and Related Drugs | 333 | ||
| Gonadotropin Preparations | 333 | ||
| Gonadotropin-Releasing Hormone Agonists | 333 | ||
| Gonadotropin-Releasing Hormone Antagonists | 333 | ||
| Thyrotropin | 333 | ||
| Prolactin and Related Drugs | 333 | ||
| Posterior Pituitary Hormones | 334 | ||
| Oxytocin and Related Drugs | 334 | ||
| Vasopressin and Related Drugs | 334 | ||
| Summary of Important Points | 334 | ||
| Review Questions | 335 | ||
| Answers and Explanations | 335 | ||
| 32 Thyroid Drugs | 336 | ||
| Overview | 336 | ||
| Thyroid Hormone Secretion | 336 | ||
| Thyroid Disorders | 336 | ||
| Hypothyroidism | 336 | ||
| Hyperthyroidism | 337 | ||
| Thyroid Hormone Preparations | 337 | ||
| Levothyroxine | 339 | ||
| Pharmacokinetics | 339 | ||
| Indications | 339 | ||
| Adverse Effects | 339 | ||
| Interactions | 339 | ||
| Liothyronine | 339 | ||
| Antithyroid Agents | 339 | ||
| Thioamide Drugs | 339 | ||
| Drug Properties | 339 | ||
| Mechanisms. | 339 | ||
| Pharmacokinetics. | 340 | ||
| Indications. | 340 | ||
| Adverse Effects. | 340 | ||
| Specific Drugs | 340 | ||
| β-Adrenoceptor Antagonists | 340 | ||
| Other Antithyroid Agents | 340 | ||
| Iodide Salts | 340 | ||
| Radioactive Iodine | 341 | ||
| Summary of Important Points | 341 | ||
| Review Questions | 341 | ||
| Answers and Explanations | 342 | ||
| 33 Adrenal Steroids and Related Drugs | 343 | ||
| Overview | 343 | ||
| Synthesis and Secretion of Adrenal Steroids | 343 | ||
| Physiologic Effects of Adrenal Steroids | 343 | ||
| Corticosteroid Drugs | 345 | ||
| Mineralocorticoids | 345 | ||
| Glucocorticoids | 345 | ||
| Classification | 345 | ||
| Low-Potency, Short-Acting Glucocorticoids | 346 | ||
| Medium-Potency, Intermediate-Acting Glucocorticoids | 346 | ||
| High-Potency, Long-Acting Glucocorticoids | 346 | ||
| Antiinflammatory Effects | 346 | ||
| Indications | 346 | ||
| Inflammation, Allergy, and Autoimmune Disorders | 347 | ||
| Cancer | 347 | ||
| Respiratory Distress Syndrome | 347 | ||
| Adrenal Insufficiency | 347 | ||
| Congenital Adrenal Hyperplasia | 347 | ||
| Cushing Syndrome | 347 | ||
| Dermatologic Conditions | 347 | ||
| Other Disorders | 348 | ||
| Systemic Administration and Pharmacokinetics | 348 | ||
| Adverse Effects | 348 | ||
| Adrenal Androgens | 349 | ||
| Corticosteroid Synthesis Inhibitors | 349 | ||
| Aminoglutethimide | 349 | ||
| Metyrapone | 349 | ||
| Ketoconazole and Fluconazole | 349 | ||
| Corticosteroid Receptor Antagonists | 349 | ||
| Spironolactone | 349 | ||
| Mifepristone | 349 | ||
| Summary of Important Points | 349 | ||
| Review Questions | 350 | ||
| Answers and Explanations | 350 | ||
| 34 Drugs Affecting Fertility and Reproduction | 351 | ||
| Overview | 351 | ||
| Biosynthesis of Gonadal Steroids | 351 | ||
| Physiologic Actions of Estrogens and Progesterone | 351 | ||
| Physiologic Actions of Testosterone | 354 | ||
| Estrogens and Progestins | 354 | ||
| Estrogens | 354 | ||
| Drug Properties | 354 | ||
| Chemistry. | 354 | ||
| Preparations. | 354 | ||
| Indications. | 354 | ||
| Adverse Effects. | 354 | ||
| Progesterone and Its Derivatives | 355 | ||
| Synthetic Progestins | 355 | ||
| Hormone Replacement Therapy | 355 | ||
| Therapeutic Effects | 355 | ||
| Treatment Considerations | 356 | ||
| Contraceptives | 356 | ||
| Estrogen-Progestin Contraceptives | 357 | ||
| Drug Properties | 357 | ||
| Classification. | 357 | ||
| Mechanisms and Pharmacologic Effects. | 357 | ||
| Administration. | 357 | ||
| Adverse Effects. | 358 | ||
| Interactions. | 358 | ||
| Progestin-Only Contraceptives | 358 | ||
| Other Contraceptives | 359 | ||
| Antiestrogens | 359 | ||
| Clomiphene | 359 | ||
| Drug Properties | 359 | ||
| Pharmacokinetics. | 359 | ||
| Mechanisms and Indications. | 359 | ||
| VII Chemotherapy | 385 | ||
| 37 Principles of Antimicrobial Chemotherapy | 386 | ||
| Overview | 386 | ||
| Antibiotics and Chemotherapy | 386 | ||
| Classification of Antimicrobial Drugs | 386 | ||
| Antimicrobial Activity | 386 | ||
| Bactericidal or Bacteriostatic Effect | 386 | ||
| Antimicrobial Spectrum | 387 | ||
| Concentration- and Time-Dependent Effects | 388 | ||
| Microbial Sensitivity and Resistance | 388 | ||
| Laboratory Tests for Microbial Sensitivity | 388 | ||
| Microbial Resistance to Drugs | 388 | ||
| Origin of Resistance | 388 | ||
| Mutation and Selection. | 388 | ||
| Transferable Resistance. | 391 | ||
| Mechanisms of Resistance | 391 | ||
| Selection of Antimicrobial Drugs | 391 | ||
| Host Factors | 391 | ||
| Antimicrobial Activity | 392 | ||
| Pharmacokinetic Properties | 392 | ||
| Adverse Effect Profile | 392 | ||
| Combination Drug Therapy | 392 | ||
| Prophylactic Therapy | 394 | ||
| Prevention of Infection Caused by Invasive Procedures | 394 | ||
| Prevention of Disease Transmission | 395 | ||
| Summary of Important Points | 395 | ||
| Review Questions | 396 | ||
| Answers and Explanations | 396 | ||
| 38 Inhibitors of Bacterial Cell Wall Synthesis | 397 | ||
| Overview | 397 | ||
| Cell Envelope | 397 | ||
| Cytoplasmic and Outer Membranes | 397 | ||
| Cell Wall | 397 | ||
| Sites of Drug Action | 398 | ||
| β-Lactam Drugs | 398 | ||
| Other Drugs | 398 | ||
| β-Lactam Antibiotics | 398 | ||
| Penicillins | 398 | ||
| Chemistry | 399 | ||
| Pharmacokinetics | 399 | ||
| Spectrum and Indications | 400 | ||
| Bacterial Resistance | 402 | ||
| Adverse Effects | 404 | ||
| β-Lactamase Inhibitors | 404 | ||
| Cephalosporins | 404 | ||
| Chemistry | 404 | ||
| Pharmacokinetics | 404 | ||
| Spectrum and Indications | 404 | ||
| Bacterial Resistance | 405 | ||
| Adverse Effects | 405 | ||
| Monobactam | 405 | ||
| Carbapenems | 405 | ||
| Other Bacterial Cell Wall Synthesis Inhibitors | 406 | ||
| Vancomycin and Telavancin | 406 | ||
| Bacitracin | 406 | ||
| Fosfomycin | 406 | ||
| Summary of Important Points | 406 | ||
| Review Questions | 407 | ||
| Answers and Explanations | 407 | ||
| 39 Inhibitors of Bacterial Protein Synthesis | 408 | ||
| Overview | 408 | ||
| Bacterial Protein Synthesis | 408 | ||
| Sites of Drug Action | 408 | ||
| Drugs That Affect the 30S Ribosomal Subunit | 408 | ||
| Aminoglycosides | 408 | ||
| Chemistry and Pharmacokinetics | 409 | ||
| Spectrum and Indications | 411 | ||
| Bacterial Resistance | 411 | ||
| Adverse Effects | 411 | ||
| Tetracyclines | 411 | ||
| Chemistry and Pharmacokinetics | 411 | ||
| Spectrum and Indications | 412 | ||
| Bacterial Resistance | 412 | ||
| Index | 481 | ||
| A | 481 | ||
| B | 486 | ||
| C | 488 | ||
| D | 492 | ||
| E | 495 | ||
| F | 496 | ||
| G | 498 | ||
| H | 499 | ||
| I | 501 | ||
| J | 502 | ||
| K | 502 | ||
| L | 502 | ||
| M | 504 | ||
| N | 506 | ||
| O | 508 | ||
| P | 509 | ||
| Q | 512 | ||
| R | 513 | ||
| S | 514 | ||
| T | 516 | ||
| U | 518 | ||
| V | 518 | ||
| W | 519 | ||
| X | 519 | ||
| Y | 519 | ||
| Z | 519 |