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Abstract
Designed to help you learn and retain key information in pharmacology, this foundational text takes you from course exams and the USMLE Step 1 right through to clinical practice. Brenner and Stevens’ Pharmacology, 5th Edition, focuses on the essential principles you need to know, in a concise yet comprehensive manner that’s easy to understand. Highly illustrated and formatted for quick reference, it’s your go-to text for the must-know aspects of pharmacology you’ll need for clinical problem solving and decision making.
- Teaches the fundamental aspects of pharmacology using full-color illustrations, detailed explanations, and a consistent format to present classification of drugs for each system/disease.
- Features useful tables, drug classifications boxes, case studies, and self-assessments in each chapter to help you review and prepare for course exams and Step 1.
- Includes the latest pharmacologic mechanisms and applications with new and updated drug information throughout
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | cover | ||
| Inside Front Cover | ifc1 | ||
| Brenner and Stevens Pharmacology | i | ||
| Copyright Page | iv | ||
| Preface | v | ||
| Table Of Contents | vii | ||
| I Principles of Pharmacology | 1 | ||
| Section 1_text | 1 | ||
| 1 Introduction to Pharmacology | 3 | ||
| Pharmacology and Related Sciences | 3 | ||
| History and Definition of Pharmacology | 3 | ||
| Pharmacology and Its Subdivisions | 3 | ||
| Toxicology | 4 | ||
| Pharmacotherapeutics | 4 | ||
| Pharmacy and Related Sciences | 4 | ||
| Drug Sources and Preparations | 5 | ||
| II Autonomic and Neuromuscular Pharmacology | 57 | ||
| Section 2_text | 57 | ||
| 6 Peripheral Neuropharmacology and Acetylcholine Agonists | 59 | ||
| Overview | 59 | ||
| Anatomy and Physiology of the Peripheral Nervous System | 59 | ||
| Autonomic Nervous System | 59 | ||
| Enteric Nervous System | 60 | ||
| Somatic Nervous System | 60 | ||
| Neurotransmission and Sites of Drug Action | 60 | ||
| Neurotransmitters | 60 | ||
| Cholinergic Neurotransmission | 62 | ||
| Drugs Affecting Cholinergic Neurotransmission | 63 | ||
| Acetylcholine Receptors | 63 | ||
| Muscarinic Receptors | 63 | ||
| Nicotinic Receptors | 64 | ||
| Acetylcholine Agonists | 64 | ||
| Direct-Acting Acetylcholine Receptor Agonists | 64 | ||
| Choline Esters | 64 | ||
| Ocular Effects. | 64 | ||
| Respiratory Tract Effects. | 64 | ||
| Cardiac Effects. | 64 | ||
| Vascular Effects. | 65 | ||
| Gastrointestinal and Urinary Tract Effects. | 65 | ||
| Acetylcholine | 65 | ||
| Bethanechol and Carbachol | 66 | ||
| Plant Alkaloids | 66 | ||
| Other Drugs | 66 | ||
| Indirect-Acting Acetylcholine Agonists | 66 | ||
| Cholinesterase Inhibitors | 66 | ||
| Reversible Cholinesterase Inhibitors | 66 | ||
| Edrophonium. | 66 | ||
| Neostigmine, Physostigmine, and Pyridostigmine. | 68 | ||
| Quasireversible Cholinesterase Inhibitors | 68 | ||
| Management of Organophosphate Poisoning. | 68 | ||
| Centrally Acting, Reversible Cholinesterase Inhibitors | 70 | ||
| Type 5 Phosphodiesterase Inhibitors | 70 | ||
| Pharmacokinetics | 70 | ||
| Adverse Effects and Interactions | 70 | ||
| Indications | 71 | ||
| Summary of Important Points | 72 | ||
| Review Questions | 72 | ||
| 7 Acetylcholine Receptor Antagonists | 73 | ||
| Overview | 73 | ||
| Muscarinic Receptor Antagonists | 73 | ||
| Belladonna Alkaloids | 73 | ||
| Atropine and Scopolamine | 73 | ||
| Chemistry and Pharmacokinetics. | 73 | ||
| Pharmacologic Effects. | 73 | ||
| Ocular Effects. | 74 | ||
| Cardiac Effects. | 74 | ||
| Respiratory Tract Effects. | 74 | ||
| Gastrointestinal and Urinary Tract Effects. | 74 | ||
| Central Nervous System Effects. | 75 | ||
| Other Effects. | 75 | ||
| Ocular Indications. | 75 | ||
| Cardiac Indications. | 75 | ||
| Respiratory Tract Indications. | 75 | ||
| Gastrointestinal and Urinary Tract Indications. | 75 | ||
| Central Nervous System Indications. | 75 | ||
| Other Indications. | 75 | ||
| Hyoscyamine | 75 | ||
| Semisynthetic and Synthetic Muscarinic Receptor Antagonists | 75 | ||
| Ipratropium and Tiotropium | 75 | ||
| Dicyclomine, Oxybutynin, Solifenacin, and Related Drugs | 75 | ||
| Glycopyrrolate | 76 | ||
| Tropicamide | 76 | ||
| Pirenzepine | 76 | ||
| Nicotinic Receptor Antagonists | 76 | ||
| Ganglionic Blocking Agents | 76 | ||
| Neuromuscular Blocking Agents | 76 | ||
| Nondepolarizing Neuromuscular Blocking Agents | 76 | ||
| General Properties. | 76 | ||
| Chemistry and Pharmacokinetics. | 76 | ||
| Mechanisms and Effects. | 76 | ||
| Interactions. | 77 | ||
| Indications. | 77 | ||
| Drug Selection. | 78 | ||
| Depolarizing Neuromuscular Blocking Agents | 78 | ||
| Summary of Important Points | 79 | ||
| Review Questions | 79 | ||
| 8 Sympathetic Neurotransmission and Adrenoceptor Agonists | 81 | ||
| Overview | 81 | ||
| Sympathetic Neurotransmission | 81 | ||
| Drugs Affecting Adrenergic Neurotransmission | 81 | ||
| Drugs Modulating the Baroreceptor Reflex | 81 | ||
| Adrenoceptor Agonists | 82 | ||
| Adrenoceptors | 83 | ||
| α-Adrenoceptors | 83 | ||
| β-Adrenoceptors | 84 | ||
| Dopamine Receptors | 84 | ||
| Imidazoline Receptors | 84 | ||
| Signal Transduction | 84 | ||
| Classification of Adrenoceptor Agonists | 84 | ||
| Direct-Acting Adrenoceptor Agonists | 84 | ||
| Catecholamines | 85 | ||
| Chemistry and Pharmacokinetics | 85 | ||
| Mechanisms and Effects | 86 | ||
| Cardiovascular Effects | 86 | ||
| Respiratory Tract Effects | 87 | ||
| Adverse Effects. | 87 | ||
| Specific Drugs | 88 | ||
| Noncatecholamines | 88 | ||
| Phenylephrine | 89 | ||
| Pharmacokinetics. | 89 | ||
| Mechanisms and Effects. | 89 | ||
| Indications. | 89 | ||
| Midodrine | 89 | ||
| Albuterol, Salmeterol, Terbutaline, and Related Drugs | 89 | ||
| III Cardiovascular, Renal, and Hematologic Pharmacology | 101 | ||
| Section 3_text | 101 | ||
| 10 Antihypertensive Drugs | 103 | ||
| Overview | 103 | ||
| Hypertension | 103 | ||
| Classification of Blood Pressure | 104 | ||
| Regulation of Blood Pressure | 104 | ||
| Sites and Effects of Antihypertensive Drug Action | 104 | ||
| Diuretics | 105 | ||
| Thiazide and Related Diuretics | 105 | ||
| Loop Diuretics | 107 | ||
| Potassium-Sparing Diuretics | 107 | ||
| Sympatholytic Drugs | 108 | ||
| Adrenoceptor Antagonists | 109 | ||
| α-Adrenoceptor Antagonists | 109 | ||
| β-Adrenoceptor Antagonists | 109 | ||
| Centrally Acting Drugs | 109 | ||
| Angiotensin Inhibitors | 110 | ||
| Angiotensin-Converting Enzyme Inhibitors | 110 | ||
| Mechanism of Action | 110 | ||
| Pharmacokinetics | 111 | ||
| Adverse Effects | 111 | ||
| Interactions | 111 | ||
| Indications | 111 | ||
| Specific Drugs | 112 | ||
| Angiotensin Receptor Blockers | 112 | ||
| Direct Renin Inhibitor | 113 | ||
| Vasodilators | 113 | ||
| Calcium Channel Blockers | 113 | ||
| Other Vasodilators | 113 | ||
| Hydralazine and Minoxidil | 113 | ||
| Nitroprusside | 113 | ||
| Fenoldopam | 113 | ||
| The Management of Hypertension | 114 | ||
| Lifestyle Modifications | 114 | ||
| Selection of Drug Therapy | 114 | ||
| Patients With Specific Traits or Diseases | 114 | ||
| Hypertensive Emergencies and Urgencies | 114 | ||
| Summary of Important Points | 115 | ||
| Review Questions | 115 | ||
| 11 Antianginal Drugs | 117 | ||
| Overview | 117 | ||
| Coronary Heart Disease | 117 | ||
| Mechanisms and Effects of Antianginal Drugs | 117 | ||
| Vasodilators | 119 | ||
| Organic Nitrites and Nitrates | 119 | ||
| Amyl Nitrite | 119 | ||
| Nitroglycerin, Isosorbide Dinitrate, and Isosorbide Mononitrate | 120 | ||
| Pharmacokinetics. | 120 | ||
| Mechanisms and Pharmacologic Effects. | 120 | ||
| Tolerance. | 120 | ||
| Adverse Effects and Interactions. | 120 | ||
| Calcium Channel Blockers | 120 | ||
| Pharmacokinetics | 121 | ||
| Mechanisms and Pharmacologic Effects | 121 | ||
| Adverse Effects | 122 | ||
| Specific Drugs | 122 | ||
| Βeta-Adrenoceptor Antagonists | 122 | ||
| Other Antianginal Agents | 122 | ||
| Ivabradine | 122 | ||
| Agents That Alter Metabolism | 123 | ||
| Management of Angina Pectoris | 123 | ||
| Summary of Important Points | 124 | ||
| Review Questions | 124 | ||
| 12 Drugs for Heart Failure | 125 | ||
| Overview | 125 | ||
| Pathophysiology of Heart Failure | 125 | ||
| Mechanisms and Effects of Drugs for Heart Failure | 127 | ||
| Positively Inotropic Drugs | 127 | ||
| Digoxin | 127 | ||
| Drug Properties | 128 | ||
| Chemistry and Pharmacokinetics. | 128 | ||
| Mechanisms and Pharmacologic Effects. | 128 | ||
| Positive Inotropic Effect. | 128 | ||
| Electrophysiologic and Electrocardiographic Effects. | 128 | ||
| Adverse Effects. | 129 | ||
| Interactions. | 129 | ||
| Indications. | 129 | ||
| Digoxin Immune Fab | 130 | ||
| Dobutamine | 130 | ||
| Milrinone | 131 | ||
| Vasodilators | 131 | ||
| Angiotensin-Converting Enzyme Inhibitors | 131 | ||
| Angiotensin Receptor Blockers | 131 | ||
| Natriuretic Peptide | 132 | ||
| Neprilysin Inhibitor | 132 | ||
| Hydralazine and Nitrates | 132 | ||
| Βeta-Adrenoceptor Antagonists | 132 | ||
| Aldosterone Antagonists | 133 | ||
| Diuretics | 133 | ||
| Management of Heart Failure | 133 | ||
| Summary of Important Points | 134 | ||
| Review Questions | 134 | ||
| 13 Diuretics | 135 | ||
| Overview | 135 | ||
| Nephron Function and Sites of Drug Action | 135 | ||
| Glomerular Filtration | 135 | ||
| Proximal Tubule | 135 | ||
| Loop of Henle | 135 | ||
| Distal Tubule | 136 | ||
| Collecting Duct | 136 | ||
| Diuretic Agents | 138 | ||
| Thiazide and Related Diuretics | 138 | ||
| Drug Properties | 138 | ||
| Chemistry and Pharmacokinetics. | 138 | ||
| Mechanisms and Pharmacologic Effects. | 138 | ||
| Adverse Effects and Interactions. | 139 | ||
| Indications. | 139 | ||
| Hydrochlorothiazide | 140 | ||
| Thiazide-Like Diuretics | 140 | ||
| Loop Diuretics | 140 | ||
| Drug Properties | 140 | ||
| Chemistry and Pharmacokinetics. | 140 | ||
| Mechanisms and Pharmacologic Effects. | 141 | ||
| Adverse Effects and Interactions. | 141 | ||
| Indications. | 141 | ||
| Bumetanide, Furosemide, and Torsemide | 141 | ||
| Ethacrynic Acid | 141 | ||
| Potassium-Sparing Diuretics | 141 | ||
| Amiloride and Triamterene | 141 | ||
| Spironolactone | 142 | ||
| Osmotic Diuretics | 142 | ||
| Carbonic Anhydrase Inhibitors | 142 | ||
| Drug Properties | 142 | ||
| Pharmacokinetics. | 142 | ||
| Mechanisms, Pharmacologic Effects, and Indications. | 142 | ||
| Adverse Effects and Interactions. | 143 | ||
| Antidiuretic Hormone Antagonists | 143 | ||
| Management of Edema | 143 | ||
| Summary of Important Points | 144 | ||
| Review Questions | 144 | ||
| 14 Drugs for Cardiac Dysrhythmia | 145 | ||
| Overveiw | 145 | ||
| Cardiac Action Potentials and Electrocardiographic Findings | 145 | ||
| Pathophysiology of Dysrhythmias | 146 | ||
| Abnormal Impulse Formation | 146 | ||
| Increased Automaticity | 148 | ||
| Afterdepolarizations | 148 | ||
| Reentry | 148 | ||
| Drug-Induced Dysrhythmias | 148 | ||
| Mechanisms and Classification of Antidysrhythmic Drugs | 149 | ||
| Sodium Channel Blockers | 149 | ||
| Class IA Drugs | 149 | ||
| Drug Properties | 149 | ||
| Quinidine | 150 | ||
| Procainamide | 150 | ||
| Disopyramide | 150 | ||
| Class IB Drugs | 151 | ||
| Drug Properties | 151 | ||
| Chemistry and Pharmacokinetics. | 151 | ||
| Mechanisms and Effects. | 151 | ||
| Adverse Effects. | 151 | ||
| Indications. | 151 | ||
| Class IC Drugs | 151 | ||
| Flecainide | 151 | ||
| Propafenone | 152 | ||
| Class II Drugs | 153 | ||
| Esmolol | 153 | ||
| Metoprolol and Propranolol | 153 | ||
| Class III Drugs | 153 | ||
| Amiodarone | 153 | ||
| Chemistry and Pharmacokinetics. | 153 | ||
| Mechanisms and Pharmacologic Effects. | 154 | ||
| Adverse Effects and Interactions. | 154 | ||
| Indications. | 154 | ||
| Dronedarone | 154 | ||
| Ibutilide and Dofetilide | 154 | ||
| Sotalol | 155 | ||
| Class IV Drugs | 155 | ||
| Miscellaneous Drugs | 155 | ||
| Adenosine | 155 | ||
| Digoxin | 155 | ||
| Magnesium Sulfate | 155 | ||
| Ivabradine and Ranolazine | 156 | ||
| Management of Dysrhythmias | 156 | ||
| Atrial Fibrillation and Flutter | 156 | ||
| Supraventricular Tachycardia | 157 | ||
| Ventricular Tachycardia and Fibrillation | 157 | ||
| Torsades de Pointes | 157 | ||
| Summary of Important Points | 157 | ||
| Review Questions | 158 | ||
| 15 Drugs for Hyperlipidemia | 159 | ||
| Overview | 159 | ||
| Lipoproteins and Lipid Transport | 159 | ||
| Chylomicrons | 159 | ||
| Very-Low-Density and Low-Density Lipoproteins | 160 | ||
| High-Density Lipoproteins | 160 | ||
| Lipoprotein (a) | 162 | ||
| Causes and Types of Hyperlipoproteinemia | 162 | ||
| Guidelines for Management of Hypercholesterolemia | 162 | ||
| Lifestyle Changes | 163 | ||
| Drugs for Hypercholesterolemia | 164 | ||
| Statins (HMG-CoA Reductase Inhibitors) | 164 | ||
| Chemistry and Pharmacokinetics | 164 | ||
| Mechanisms and Pharmacologic Effects | 165 | ||
| Indications | 165 | ||
| Adverse Effects | 166 | ||
| Interactions | 166 | ||
| Bile Acid–Binding Resins | 166 | ||
| Chemistry and Pharmacokinetics | 166 | ||
| Mechanisms and Pharmacologic Effects | 166 | ||
| Adverse Effects and Interactions | 166 | ||
| Indications | 167 | ||
| Preparations | 167 | ||
| Ezetimibe | 167 | ||
| Niacin (Nicotinic Acid) | 167 | ||
| Chemistry and Pharmacokinetics | 167 | ||
| IV Central Nervous System Pharmacology | 191 | ||
| Section 4_text | 191 | ||
| 18 Introduction to Central Nervous System Pharmacology | 193 | ||
| Overview | 193 | ||
| Neurotransmission in the Central Nervous System | 193 | ||
| Principles of Neurotransmission | 193 | ||
| Neurotransmitter Synthesis and Metabolism | 193 | ||
| Excitatory and Inhibitory Neurotransmission | 193 | ||
| Fast Versus Slow Signals | 194 | ||
| Neurotransmitters and Receptors | 195 | ||
| Acetylcholine | 195 | ||
| Amino Acids | 195 | ||
| GABA. | 195 | ||
| Glycine. | 195 | ||
| Glutamate and Aspartate. | 196 | ||
| Biogenic Amines | 197 | ||
| Dopamine. | 197 | ||
| Norepinephrine. | 199 | ||
| Serotonin. | 199 | ||
| Histamine. | 199 | ||
| Neuropeptides | 199 | ||
| Other Neurotransmitters | 199 | ||
| Mechanisms of Drug Action | 200 | ||
| Neurotransmitter Synthesis, Storage, and Release | 200 | ||
| Neurotransmitter Reuptake and Degradation | 200 | ||
| Receptor Activation or Blockade | 200 | ||
| Receptor Alterations Caused by Central Nervous System Drug Treatment | 200 | ||
| Neuronal Systems in the Central Nervous System | 200 | ||
| Cognitive Processing | 200 | ||
| Memory | 200 | ||
| Emotional Processing | 201 | ||
| Sensory Processing | 202 | ||
| Motor Processing | 202 | ||
| Autonomic Processing | 202 | ||
| Summary of Important Points | 202 | ||
| Review Questions | 202 | ||
| 19 Sedative-Hypnotic and Anxiolytic Drugs | 205 | ||
| Overview | 205 | ||
| Anxiety Disorders | 205 | ||
| Neurologic Basis of Anxiety | 205 | ||
| Classification and Treatment of Anxiety Disorders | 206 | ||
| Acute Anxiety | 206 | ||
| Panic Disorder | 206 | ||
| Phobic Disorders | 206 | ||
| Obsessive-Compulsive Disorder | 206 | ||
| Generalized Anxiety Disorder | 206 | ||
| Posttraumatic Stress Disorder | 206 | ||
| Sleep Disorders | 206 | ||
| Neurologic Basis of Sleep | 206 | ||
| Classification and Treatment of Sleep Disorders | 206 | ||
| Insomnia | 206 | ||
| Other Sleep Disorders | 207 | ||
| Sedative-Hypnotic Drugs | 207 | ||
| Benzodiazepines | 207 | ||
| Drug Properties | 207 | ||
| Pharmacokinetics. | 207 | ||
| Mechanism of Action. | 209 | ||
| Pharmacologic Effects. | 210 | ||
| Adverse Effects. | 211 | ||
| Interactions and Treatment of Adverse Effects. | 213 | ||
| Indications. | 213 | ||
| Specific Agents | 213 | ||
| Other Benzodiazepines | 214 | ||
| Barbiturates | 214 | ||
| Drug Properties | 214 | ||
| Pharmacokinetics. | 214 | ||
| Mechanism of Action. | 214 | ||
| Pharmacologic Effects. | 214 | ||
| Interactions. | 214 | ||
| Indications. | 214 | ||
| Specific Agents | 214 | ||
| Antihistamines | 215 | ||
| Other Sedative-Hypnotic Drugs | 215 | ||
| Zolpidem, Zaleplon, and Eszopiclone | 215 | ||
| Melatonin and Related Drugs | 215 | ||
| Chloral Hydrate | 215 | ||
| Nonsedating Anxiolytic Drugs | 215 | ||
| Buspirone | 215 | ||
| Propranolol | 216 | ||
| Summary of Important Points | 216 | ||
| Review Questions | 216 | ||
| 20 Antiepileptic Drugs | 217 | ||
| Overview | 217 | ||
| Classification of Seizures | 217 | ||
| Neurobiology of Seizures | 218 | ||
| Mechanisms of Antiepileptic Drugs | 218 | ||
| Effects on Ion Channels | 218 | ||
| Effects on GABAergic Systems | 218 | ||
| Effects on Glutaminergic Systems | 218 | ||
| Treatment of Seizure Disorders | 218 | ||
| Drugs for Partial and Generalized Tonic-Clonic Seizures | 221 | ||
| Carbamazepine and Oxcarbazepine | 221 | ||
| Pharmacokinetics. | 221 | ||
| Mechanisms and Effects. | 221 | ||
| Interactions. | 222 | ||
| Indications. | 222 | ||
| Eslicarbazepine | 222 | ||
| Phenytoin and Fosphenytoin | 224 | ||
| Pharmacokinetics. | 224 | ||
| Mechanisms and Effects. | 224 | ||
| Interactions. | 224 | ||
| V Pharmacology of Respiratory and Other Systems | 299 | ||
| Section 5_text | 299 | ||
| 26 Autacoid Drugs | 301 | ||
| Overview | 301 | ||
| Histamine and Related Drugs | 301 | ||
| Histamine Biosynthesis and Release | 301 | ||
| Histamine Receptors and Effects | 302 | ||
| Antihistamine Drugs | 302 | ||
| Histamine H1 Receptor Antagonists | 302 | ||
| Classification | 302 | ||
| Mechanisms and Pharmacokinetics | 302 | ||
| Pharmacologic Effects and Indications | 303 | ||
| First-Generation Antihistamines | 303 | ||
| Second-Generation Antihistamines | 304 | ||
| Intranasal Antihistamines | 304 | ||
| Ophthalmic Antihistamines | 304 | ||
| Adverse Effects and Interactions | 304 | ||
| First-Generation Antihistamines. | 304 | ||
| Second-Generation Antihistamines. | 304 | ||
| Intranasal Antihistamines. | 304 | ||
| Ophthalmic Antihistamines. | 305 | ||
| Serotonin and Related Drugs | 305 | ||
| Serotonin Biosynthesis and Release | 305 | ||
| Serotonin Receptors and Effects | 305 | ||
| Serotonin Agonists | 305 | ||
| Serotonin Antagonists | 306 | ||
| Serotonin Reuptake Inhibitors | 306 | ||
| Eicosanoids and Related Drugs | 306 | ||
| Eicosanoid Biosynthesis and Release | 306 | ||
| Eicosanoid Receptors and Effects | 306 | ||
| Eicosanoid Drugs | 308 | ||
| Eicosanoid Synthesis Inhibitors | 308 | ||
| Prostaglandin Drugs | 308 | ||
| Prostaglandin E1 and Prostaglandin E1 Derivatives | 308 | ||
| Prostaglandin E2 and Prostaglandin F2α Derivatives | 309 | ||
| Prostaglandin I2 and Prostaglandin I2 Derivatives | 309 | ||
| Endothelin-1 Antagonists | 309 | ||
| Summary of Important Points | 309 | ||
| Review Questions | 310 | ||
| 27 Respiratory Pharmacology | 311 | ||
| Overview | 311 | ||
| Respiratory Tract Disorders | 311 | ||
| Asthma | 311 | ||
| Chronic Obstructive Pulmonary Disease (COPD) | 312 | ||
| Rhinitis | 312 | ||
| Antiinflammatory Drugs | 312 | ||
| Corticosteroids | 312 | ||
| Mast Cell Stabilizers | 314 | ||
| Cromolyn Sodium | 314 | ||
| Chemistry and Mechanisms. | 314 | ||
| Pharmacokinetics. | 314 | ||
| Indications. | 314 | ||
| Adverse Effects. | 314 | ||
| Lodoxamide and Nedocromil | 314 | ||
| Leukotriene Inhibitors | 315 | ||
| Leukotriene Receptor Antagonists | 315 | ||
| Mechanisms. | 315 | ||
| Pharmacokinetics. | 315 | ||
| Effects and Indications. | 315 | ||
| Adverse Effects and Interactions. | 315 | ||
| Zileuton | 316 | ||
| Effects and Indications. | 316 | ||
| VI Endocrine Pharmacology | 357 | ||
| Section 6_text | 357 | ||
| 31 Hypothalamic and Pituitary Drugs | 359 | ||
| Overview | 359 | ||
| Neuropeptides and Dopamine Released From the Hypothalamus | 359 | ||
| Hormones Released From the Anterior Lobe of the Pituitary | 359 | ||
| Hormones Released From the Posterior Lobe of the Pituitary | 360 | ||
| Clinical Uses of Hypothalamic and Pituitary Hormones | 360 | ||
| Anterior Pituitary Hormones | 361 | ||
| Corticotropin and Related Drugs | 361 | ||
| Corticotropin Preparations | 361 | ||
| Corticotropin-Releasing Hormone | 361 | ||
| Growth Hormone and Related Drugs | 361 | ||
| Growth Hormone Preparations | 361 | ||
| Growth Hormone–Inhibiting Hormone Preparations | 361 | ||
| Growth Hormone Receptor Antagonist | 362 | ||
| Gonadotropins and Related Drugs | 362 | ||
| Gonadotropin Preparations | 362 | ||
| Gonadotropin-Releasing Hormone Agonists | 363 | ||
| Gonadotropin-Releasing Hormone Antagonists | 363 | ||
| Prolactin and Related Drugs | 363 | ||
| Posterior Pituitary Hormones | 363 | ||
| Oxytocin and Related Drugs | 363 | ||
| Vasopressin and Related Drugs | 364 | ||
| Summary of Important Points | 364 | ||
| Review Questions | 365 | ||
| 32 Thyroid Drugs | 367 | ||
| Overview | 367 | ||
| Thyroid Hormone Secretion | 367 | ||
| Thyroid Disorders | 367 | ||
| Hypothyroidism | 368 | ||
| Hyperthyroidism | 368 | ||
| Thyroid Hormone Preparations | 369 | ||
| Levothyroxine | 369 | ||
| Pharmacokinetics | 369 | ||
| Indications | 370 | ||
| Adverse Effects | 370 | ||
| Interactions | 370 | ||
| Liothyronine | 370 | ||
| Antithyroid Agents | 371 | ||
| Thioamide Drugs | 371 | ||
| Mechanisms | 371 | ||
| Pharmacokinetics | 371 | ||
| Indications | 371 | ||
| Adverse Effects | 371 | ||
| Specific Drugs | 371 | ||
| Beta-Adrenoceptor Antagonists | 371 | ||
| Other Antithyroid Agents | 371 | ||
| Iodide Salts | 371 | ||
| Radioactive Iodine (RAI) | 372 | ||
| Thyrotropin | 372 | ||
| Drugs for Thyroid Treatment After Nuclear Reactor Accident or Nuclear Bomb Explosion | 372 | ||
| Summary of Important Points | 372 | ||
| Review Questions | 373 | ||
| 33 Adrenal Steroids and Related Drugs | 375 | ||
| Overview | 375 | ||
| Synthesis and Secretion of Adrenal Steroids | 375 | ||
| Physiologic Effects of Adrenal Steroids | 375 | ||
| Corticosteroid Drugs | 377 | ||
| Mineralocorticoids | 377 | ||
| Glucocorticoids | 377 | ||
| Classification | 378 | ||
| Low-Potency, Short-Acting Glucocorticoids | 378 | ||
| Medium-Potency, Intermediate-Acting Glucocorticoids | 378 | ||
| High-Potency, Long-Acting Glucocorticoids | 378 | ||
| Antiinflammatory Effects | 378 | ||
| Indications | 379 | ||
| Inflammation, Allergy, and Autoimmune Disorders | 379 | ||
| Cancer | 379 | ||
| Respiratory Distress Syndrome | 379 | ||
| Adrenal Insufficiency | 379 | ||
| Congenital Adrenal Hyperplasia | 379 | ||
| Cushing Syndrome | 379 | ||
| Dermatologic Conditions | 380 | ||
| Other Disorders | 380 | ||
| Systemic Administration and Pharmacokinetics | 380 | ||
| Adverse Effects | 381 | ||
| Adrenal Androgens | 381 | ||
| Corticosteroid Synthesis Inhibitors | 381 | ||
| Metyrapone | 381 | ||
| Ketoconazole and Fluconazole | 381 | ||
| Corticosteroid Receptor Antagonists | 381 | ||
| Spironolactone | 381 | ||
| Mifepristone | 381 | ||
| DHEA Use in Older Men | 381 | ||
| Summary of Important Points | 382 | ||
| Review Questions | 382 | ||
| 34 Drugs Affecting Fertility and Reproduction | 383 | ||
| Overview | 383 | ||
| Biosynthesis of Gonadal Steroids | 383 | ||
| Hormonal Actions of Estrogens and Progesterone | 385 | ||
| Hormonal Actions of Testosterone | 385 | ||
| Estrogens and Progestin Drugs | 385 | ||
| Estrogens | 385 | ||
| Mechanism of Action | 385 | ||
| Preparations and Disposition | 386 | ||
| Indications | 387 | ||
| Adverse Effects | 387 | ||
| Progestins | 388 | ||
| Synthetic Progestins | 388 | ||
| Hormone Replacement Therapy | 388 | ||
| Therapeutic Effects | 388 | ||
| Treatment Considerations | 389 | ||
| Contraceptives | 389 | ||
| Estrogen-Progestin Contraceptives | 390 | ||
| Classification | 390 | ||
| Mechanisms and Pharmacologic Effects | 390 | ||
| Administration | 390 | ||
| Adverse Effects | 391 | ||
| Interactions | 391 | ||
| Progestin-Only Contraceptives | 392 | ||
| Long-Acting Reversible Contraceptives (LARCs) | 392 | ||
| Emergency Contraceptives | 392 | ||
| Selective Estrogen Receptor Modulators (Serms) | 393 | ||
| Clomiphene | 393 | ||
| Pharmacokinetics | 393 | ||
| Mechanisms and Indications | 393 | ||
| VII Chemotherapy | 423 | ||
| Section 7_text | 423 | ||
| 37 Principles of Antimicrobial Chemotherapy | 425 | ||
| Overview | 425 | ||
| Antibiotics and Chemotherapy | 425 | ||
| Classification of Antimicrobial Drugs | 425 | ||
| Antimicrobial Activity | 425 | ||
| Bactericidal or Bacteriostatic Effect | 425 | ||
| Antimicrobial Spectrum | 427 | ||
| Concentration- and Time-Dependent Effects | 427 | ||
| Microbial Sensitivity and Resistance | 427 | ||
| Laboratory Tests for Microbial Sensitivity | 427 | ||
| Microbial Resistance to Drugs | 429 | ||
| Origin of Resistance | 429 | ||
| Mutation and Selection | 429 | ||
| Transferable Resistance | 429 | ||
| Mechanisms of Resistance | 429 | ||
| Selection of Antimicrobial Drugs | 430 | ||
| Host Factors | 430 | ||
| Antimicrobial Activity | 431 | ||
| Pharmacokinetic Properties | 431 | ||
| Adverse Effect Profile | 432 | ||
| Combination Drug Therapy | 432 | ||
| Prophylactic Therapy | 434 | ||
| Prevention of Infection Caused by Invasive Procedures | 434 | ||
| Prevention of Disease Transmission | 435 | ||
| Summary of Important Points | 435 | ||
| Review Questions | 435 | ||
| 38 Inhibitors of Bacterial Cell Wall Synthesis | 437 | ||
| Overview | 437 | ||
| Cell Envelope | 437 | ||
| Cytoplasmic and Outer Membranes | 437 | ||
| Cell Wall | 438 | ||
| Sites of Drug Action | 438 | ||
| β-Lactam Drugs | 438 | ||
| Other Drugs | 438 | ||
| β-Lactam Antibiotics | 439 | ||
| Penicillins | 439 | ||
| Chemistry and Pharmacokinetics | 440 | ||
| Spectrum and Indications | 440 | ||
| Bacterial Resistance | 443 | ||
| β-Lactamase Inhibitors | 444 | ||
| Adverse Effects | 444 | ||
| Cephalosporins | 444 | ||
| Chemistry | 444 | ||
| Pharmacokinetics | 444 | ||
| Clinical Use | 444 | ||
| Bacterial Resistance | 445 | ||
| Adverse Effects | 445 | ||
| Monobactam | 445 | ||
| Carbapenems | 445 | ||
| Other Bacterial Cell Wall Synthesis Inhibitors | 446 | ||
| Vancomycin and Telavancin | 446 | ||
| Bacitracin | 446 | ||
| Fosfomycin | 446 | ||
| Summary of Important Points | 446 | ||
| Review Questions | 447 | ||
| 39 Inhibitors of Bacterial Protein Synthesis | 449 | ||
| Overview | 449 | ||
| Bacterial Protein Synthesis | 449 | ||
| Sites of Drug Action | 449 | ||
| Drugs That Affect the 30S Ribosomal Subunit | 449 | ||
| Aminoglycosides | 449 | ||
| Chemistry and Pharmacokinetics | 451 | ||
| Spectrum and Indications | 451 | ||
| Bacterial Resistance | 451 | ||
| Adverse Effects | 452 | ||
| Tetracyclines | 453 | ||
| Chemistry and Pharmacokinetics | 453 | ||
| Spectrum and Indications | 453 | ||
| Bacterial Resistance | 453 | ||
| Adverse Effects | 453 | ||
| Drugs That Affect the 50S Ribosomal Subunit | 454 | ||
| Macrolide Antibiotics | 454 | ||
| Chemistry and Pharmacokinetics | 454 | ||
| Spectrum and Indications | 454 | ||
| Bacterial Resistance | 455 | ||
| Adverse Effects | 455 | ||
| Drug Interactions | 455 | ||
| Clindamycin | 455 | ||
| Chloramphenicol | 455 | ||
| Quinupristin-Dalfopristin | 456 | ||
| Other Protein Synthesis Inhibitors | 456 | ||
| Linezolid | 456 | ||
| Mupirocin | 456 | ||
| Summary of Important Points | 456 | ||
| Review Questions | 457 | ||
| 40 Quinolones, Antifolate Drugs, and Other Agents | 459 | ||
| Overview | 459 | ||
| Antifolate Drugs | 459 | ||
| Mechanisms of Action | 459 | ||
| Sulfonamides | 459 | ||
| Chemistry and Pharmacokinetics | 459 | ||
| Spectrum, Indications, and Bacterial Resistance | 459 | ||
| Adverse Effects | 461 | ||
| Trimethoprim | 461 | ||
| Trimethoprim-Sulfamethoxazole | 461 | ||
| Pharmacokinetics | 461 | ||
| Spectrum and Indications | 461 | ||
| Adverse Effects | 462 | ||
| Fluoroquinolones | 462 | ||
| Pharmacokinetics | 462 | ||
| Spectrum and Indications | 462 | ||
| Bacterial Resistance | 463 | ||
| Adverse Effects and Interactions | 464 | ||
| Other Antibacterial Drugs | 464 | ||
| Nitrofurantoin | 464 | ||
| Daptomycin | 464 | ||
| Polymyxin B | 464 | ||
| Rifaximin | 464 | ||
| Fidaxomicin | 465 | ||
| Summary of Important Points | 465 | ||
| Review Questions | 465 | ||
| 41 Antimycobacterial Drugs | 467 | ||
| Overview | 467 | ||
| Mycobacterial Infections | 467 | ||
| Drug Regimens | 467 | ||
| Drugs for Mycobacterial Infections | 468 | ||
| Drugs for Tuberculosis | 468 | ||
| Isoniazid | 468 | ||
| Pharmacokinetics. | 468 | ||
| Mechanism of Action and Resistance. | 468 | ||
| Spectrum and Indications. | 470 | ||
| Adverse Effects. | 470 | ||
| Ethambutol | 470 | ||
| Pyrazinamide | 471 | ||
| Rifampin | 471 | ||
| Chemistry and Pharmacokinetics. | 471 | ||
| Mechanisms, Spectrum, and Indications. | 472 | ||
| Bacterial Resistance. | 472 | ||
| Adverse Effects and Interactions. | 472 | ||
| Rifapentine and Rifabutin | 472 | ||
| Other Drugs | 472 | ||
| New Drugs for Tuberculosis | 472 | ||
| Drugs for M. avium-intracellulare Infections | 473 | ||
| Drugs for Leprosy | 473 | ||
| Sulfones | 473 | ||
| Rifampin | 473 | ||
| Clofazimine | 473 | ||
| Thalidomide | 473 | ||
| Summary of Important Points | 473 | ||
| Review Questions | 474 | ||
| 42 Antifungal Drugs | 475 | ||
| Overview | 475 | ||
| Fungal Infections | 475 | ||
| Clinical Uses and Mechanisms of Antifungal Drugs | 475 | ||
| Antifungal Drugs | 476 | ||
| Polyene Antibiotics | 476 | ||
| Amphotericin B | 476 | ||
| Pharmacokinetics. | 476 | ||
| Spectrum and Indications. | 477 | ||
| Fungal Resistance. | 479 | ||
| Adverse Effects. | 479 | ||
| Nystatin and Natamycin | 479 | ||
| Azole Derivatives | 479 | ||
| Pharmacokinetics and Drug Interactions | 480 | ||
| Spectrum and Indications | 480 | ||
| Adverse Effects | 480 | ||
| Specific Drugs | 480 | ||
| Allylamine Drugs | 481 | ||
| Echinocandin Drugs | 481 | ||
| Other Antifungal Drugs | 481 | ||
| Flucytosine | 481 | ||
| Griseofulvin | 481 | ||
| Ciclopirox | 482 | ||
| Tolnaftate | 482 | ||
| Summary of Important Points | 482 | ||
| Review Questions | 482 | ||
| 43 Antiviral Drugs | 483 | ||
| Overview | 483 | ||
| Drugs for Herpesvirus Infections | 483 | ||
| Nucleoside Analogs | 484 | ||
| Chemistry and Mechanisms | 484 | ||
| Pharmacokinetics and Indications | 484 | ||
| Viral Resistance | 484 | ||
| Acyclovir, Famciclovir, and Valacyclovir | 484 | ||
| Penciclovir | 486 | ||
| Ganciclovir, Valganciclovir, and Cidofovir | 486 | ||
| Trifluridine | 487 | ||
| Foscarnet | 487 | ||
| Drugs for Human Immunodeficiency Virus Infection | 487 | ||
| Sites of Drug Action | 487 | ||
| Nucleoside Reverse Transcriptase Inhibitors | 488 | ||
| Mechanism of Action | 488 | ||
| Chemistry and Pharmacokinetics | 488 | ||
| Clinical Use | 489 | ||
| Viral Resistance. | 489 | ||
| Adverse Effects and Interactions. | 489 | ||
| Specific Drugs | 489 | ||
| Nonnucleoside Reverse Transcriptase Inhibitors | 490 | ||
| Answers and Explanations | 525 | ||
| Chapter 1 | 525 | ||
| Chapter 2 | 525 | ||
| Chapter 3 | 525 | ||
| Chapter 4 | 526 | ||
| Chapter 5 | 526 | ||
| Chapter 6 | 526 | ||
| Chapter 7 | 527 | ||
| Chapter 8 | 527 | ||
| Chapter 9 | 528 | ||
| Chapter 10 | 528 | ||
| Chapter 11 | 529 | ||
| Chapter 12 | 529 | ||
| Chapter 13 | 529 | ||
| Chapter 14 | 530 | ||
| Chapter 15 | 530 | ||
| Chapter 16 | 531 | ||
| Chapter 17 | 531 | ||
| Chapter 18 | 531 | ||
| Chapter 19 | 532 | ||
| Chapter 20 | 533 | ||
| Chapter 21 | 533 | ||
| Chapter 22 | 533 | ||
| Chapter 23 | 534 | ||
| Chapter 24 | 534 | ||
| Chapter 25 | 535 | ||
| Chapter 26 | 535 | ||
| Chapter 27 | 536 | ||
| Chapter 28 | 536 | ||
| Chapter 29 | 536 | ||
| Chapter 30 | 537 | ||
| Chapter 31 | 537 | ||
| Chapter 32 | 538 | ||
| Chapter 33 | 538 | ||
| Chapter 34 | 538 | ||
| Chapter 35 | 539 | ||
| Chapter 36 | 539 | ||
| Chapter 37 | 540 | ||
| Chapter 38 | 540 | ||
| Chapter 39 | 541 | ||
| Chapter 40 | 541 | ||
| Chapter 41 | 541 | ||
| Chapter 42 | 542 | ||
| Chapter 43 | 542 | ||
| Chapter 44 | 542 | ||
| Chapter 45 | 543 | ||
| Index | 545 | ||
| A | 545 | ||
| B | 548 | ||
| C | 549 | ||
| D | 551 | ||
| E | 553 | ||
| F | 554 | ||
| G | 554 | ||
| H | 555 | ||
| I | 556 | ||
| J | 557 | ||
| K | 557 | ||
| L | 557 | ||
| M | 558 | ||
| N | 560 | ||
| O | 561 | ||
| P | 561 | ||
| Q | 563 | ||
| R | 563 | ||
| S | 564 | ||
| T | 566 | ||
| U | 567 | ||
| V | 567 | ||
| W | 567 | ||
| X | 568 | ||
| Y | 568 | ||
| Z | 568 | ||
| Inside Back Cover | ibc1 |