Pharmacology

Front cover......Page 1
Student Consult page......Page 2
Pharmacology......Page 3
Copyright page......Page 6
Preface......Page 7
Table of Contents......Page 9
I Principles of Pharmacology......Page 11
Pharmacology and Its Subdivisions......Page 12
Pharmacy and Related Sciences......Page 13
Pharmaceutical Preparations......Page 14
Skin Patches.......Page 15
Parenteral Administration......Page 16
Summary of Important Points......Page 17
Answers and Explanations......Page 18
Drug Distribution......Page 19
Phases of Drug Biotransformation......Page 21
Hydrolytic Reactions.......Page 22
Sulfation.......Page 24
Passive Tubular Reabsorption......Page 25
Biliary Excretion and Enterohepatic Cycling......Page 26
Drug Plasma Concentration Curves......Page 27
Calculation of the Volume of Distribution......Page 28
Interpretation of the Volume of Distribution......Page 29
Hepatic Clearance......Page 30
Drug Accumulation and  the Steady-State Principle......Page 31
Maintenance Dose......Page 32
Summary of Important Points......Page 33
Answers and Explanations......Page 35
Receptor Binding and Affinity......Page 36
Ligand-Gated Ion Channels......Page 38
Membrane-Bound Enzymes......Page 39
Dose-Response Relationships......Page 40
Quantal Dose-Response Relationship......Page 41
Answers and Explanations......Page 42
Clinical Trials......Page 44
The New Drug Application and Its Approval......Page 45
Amendments to the Food, Drug, and Cosmetic Act.......Page 46
Comprehensive Drug Abuse Prevention  and Control Act......Page 47
Hematopoietic Toxicity......Page 48
Pharmacodynamic Interactions......Page 49
Altered Drug Distribution......Page 50
Clinical Significance of Drug Interactions......Page 51
Pregnancy and Lactation......Page 52
Summary of Important Points......Page 53
Answers and Explanations......Page 54
II Autonomic and Neuromuscular Pharmacology......Page 55
Enteric Nervous System......Page 56
Receptors for Acetylcholine, Norepinephrine,  and Epinephrine......Page 57
Neurotransmission and Sites  of Drug Action......Page 58
Cholinergic Neurotransmission......Page 59
Drugs Affecting Adrenergic Neurotransmission......Page 60
Summary of Important Points......Page 61
Answers and Explanations......Page 62
Nicotinic Receptors......Page 63
Cardiac Effects.......Page 64
Effects and Indications.......Page 65
Drugs That Inhibit Cholinesterase......Page 67
Mechanisms and Effects.......Page 69
Indications......Page 70
Review Questions......Page 71
Answers and Explanations......Page 72
Cardiac Effects.......Page 73
Central Nervous System Effects.......Page 74
Dicyclomine, Oxybutynin, Solifenacin,  and Related Drugs......Page 75
Chemistry and Pharmacokinetics.......Page 76
Depolarizing Neuromuscular Blocking Agents......Page 77
Answers and Explanations......Page 78
β-Adrenoceptors......Page 79
Signal Transduction......Page 80
Mechanisms and Effects.......Page 81
Specific Drugs......Page 82
Noncatecholamines......Page 84
Mechanisms, Effects, and Indications.......Page 85
Summary of Important Points......Page 86
Answers and Explanations......Page 87
Mechanisms, Effects, and Indications.......Page 88
Mechanisms, Effects, and Indications.......Page 89
Specific Drugs......Page 90
Mechanisms and Effects......Page 91
Specific Properties......Page 92
Summary of Important Points......Page 94
Answers and Explanations......Page 95
III Cardiovascular, Renal, and Hematologic Pharmacology......Page 97
Classification of Blood Pressure......Page 98
Diuretics......Page 99
Thiazide and Related Diuretics......Page 100
Sympatholytic Drugs......Page 101
β-Adrenoceptor Antagonists......Page 102
Angiotensin Inhibitors......Page 103
Chemistry and Pharmacokinetics.......Page 104
Mechanisms and Pharmacologic Effects.......Page 105
Indications.......Page 106
Calcium Channel Blockers......Page 107
Selection of Drug Therapy......Page 108
Hypertensive Emergencies and Urgencies......Page 109
Answers and Explanations......Page 110
Mechanisms and Effects of Antianginal Drugs......Page 112
Amyl Nitrite......Page 113
Tolerance.......Page 114
Calcium Channel Blockers......Page 115
Amlodipine and Related Drugs......Page 116
Management of Angina Pectoris......Page 117
Summary of Important Points......Page 118
Answers and Explanations......Page 119
Pathophysiology of Heart Failure......Page 120
Mechanisms and Effects of Drugs  for Heart Failure......Page 121
Chemistry and Pharmacokinetics.......Page 122
Electrophysiologic and Electrocardiographic Effects.......Page 123
Indications.......Page 124
Dobutamine......Page 125
Angiotensin-Converting Enzyme Inhibitors......Page 126
β-Adrenoceptor Antagonists......Page 127
Management of Heart Failure......Page 128
Answers and Explanations......Page 129
Loop of Henle......Page 130
Adverse Effects and Interactions.......Page 131
Indications.......Page 134
Chemistry and Pharmacokinetics.......Page 135
Spironolactone......Page 136
Mechanisms, Pharmacologic Effects, and Indications.......Page 137
Summary of Important Points......Page 138
Answers and Explanations......Page 139
Abnormal Impulse Formation......Page 140
Reentry in Ventricular Tissue.......Page 141
Mechanisms and Classification  of Antiarrhythmic Drugs......Page 143
Drug Properties......Page 144
Quinidine......Page 145
Drug Properties......Page 147
Chemistry and Pharmacokinetics.......Page 148
Ibutilide and Dofetilide......Page 149
Ivabradine......Page 150
Supraventricular Tachycardia......Page 151
Summary of Important Points......Page 152
Answers and Explanations......Page 153
Chylomicrons......Page 154
High-Density Lipoproteins......Page 155
Causes and Types of Hyperlipoproteinemia......Page 157
Therapeutic Lifestyle Changes......Page 158
Indications......Page 159
Adverse Effects......Page 160
Adverse Effects and Interactions......Page 161
Chemistry and Pharmacokinetics......Page 162
Indications......Page 163
Review Questions......Page 164
Answers and Explanations......Page 165
Anticoagulant Drugs......Page 166
Chemistry and Mechanisms......Page 167
Adverse Effects and Interactions......Page 168
Indications......Page 169
Indications......Page 170
Pharmacokinetics.......Page 171
Mechanisms and Pharmacologic Effects......Page 172
Adverse Effects and Interactions......Page 173
Abciximab......Page 174
Chemistry and Pharmacologic Effects......Page 175
Answers and Explanations......Page 176
Oral Iron Preparations......Page 178
Folic Acid......Page 179
Vitamin B12......Page 180
Filgrastim, Pegfilgrastim, and Sargramostim......Page 181
Answers and Explanations......Page 182
IV Central Nervous System Pharmacology......Page 183
Excitatory and Inhibitory Neurotransmission......Page 184
Glutamate and Aspartate.......Page 186
Biogenic Amines......Page 187
Dopamine.......Page 188
Norepinephrine.......Page 189
Mechanisms of Drug Action......Page 190
Cognitive Processing......Page 191
Memory......Page 192
Summary of Important Points......Page 193
Answers and Explanations......Page 194
Acute Anxiety......Page 196
Insomnia......Page 197
Benzodiazepines......Page 199
Pharmacokinetics.......Page 200
Mechanism of Action.......Page 201
Adverse Effects.......Page 202
Specific Agents......Page 203
Antihistamines......Page 204
Summary of Important Points......Page 205
Answers and Explanations......Page 206
Neurobiology of Seizures......Page 208
Treatment of Seizure Disorders......Page 209
Indications.......Page 213
Interactions.......Page 214
Topiramate......Page 215
Clonazepam and Other Drugs......Page 216
Principles of Drug Use......Page 217
Review Questions......Page 218
Answers and Explanations......Page 219
Mechanism of Action......Page 220
Adverse Effects and Interactions......Page 222
Ester-Type Local Anesthetics......Page 223
Pharmacokinetics......Page 224
Adverse Effects......Page 225
Parenteral Anesthetics......Page 227
Answers and Explanations......Page 229
Clinical Findings......Page 231
Dopamine Hypothesis......Page 232
Pharmacologic Effects......Page 233
Adverse Effects......Page 234
Adverse Effects.......Page 235
Risperidone.......Page 237
Biogenic Amine Hypothesis......Page 238
Antidepressant Drugs......Page 239
Selective Serotonin Reuptake Inhibitors......Page 240
Paroxetine and Sertraline.......Page 241
Bupropion......Page 242
Treatment Considerations......Page 243
Treatment Considerations......Page 244
Indications......Page 245
Review Questions......Page 246
Answers and Explanations......Page 247
Pain Pathways......Page 248
Opioid Peptides and Receptors......Page 250
Gastrointestinal, Biliary, and Genitourinary System.......Page 251
Tolerance and Physical Dependence......Page 252
Fentanyl and Its Derivatives......Page 253
Other Opioid Agonists......Page 254
Opioid Antagonists......Page 255
Chronic Pain......Page 256
Review Questions......Page 257
Answers and Explanations......Page 258
Etiology and Pathogenesis......Page 259
Drugs That Increase Dopamine Levels......Page 260
Mechanisms and Pharmacologic Effects.......Page 261
Mechanisms and Pharmacologic Effects.......Page 262
Pramipexole and Ropinirole......Page 263
Treatment......Page 265
Other Agents......Page 266
Antispastic Agents......Page 267
Summary of Important Points......Page 268
Answers and Explanations......Page 269
Psychological Dependence.......Page 270
Alcohols and Glycols......Page 271
Other Effects, Mechanisms, and Interactions.......Page 273
Opioids......Page 274
Cocaine......Page 275
Caffeine......Page 276
Hallucinogens......Page 277
Drug Intoxication and Withdrawal......Page 278
Treatment of Drug Dependence......Page 279
Review Questions......Page 280
Answers and Explanations......Page 281
V Pharmacology of the Respiratory and Other Systems......Page 283
Histamine Biosynthesis and Release......Page 284
First-Generation Antihistamines......Page 286
Serotonin Biosynthesis and Release......Page 287
Serotonin Antagonists.......Page 288
Eicosanoid Biosynthesis and Release......Page 289
Eicosanoid Synthesis Inhibitors......Page 290
Endothelin-1 Antagonists......Page 291
Review Questions......Page 292
Answers and Explanations......Page 293
Rhinitis......Page 294
Corticosteroids......Page 295
Effects and Indications.......Page 297
Mechanism and Effects.......Page 298
β2-Adrenoceptor Agonists......Page 299
Ipratropium and Tiotropium......Page 300
Indications......Page 301
Antitussives......Page 302
Summary of Important Points......Page 303
Answers and Explanations......Page 304
Drugs for Peptic Ulcer Disease......Page 305
Chemistry, Mechanisms, and Effects......Page 306
Proton Pump Inhibitors......Page 307
Misoprostol......Page 308
Aminosalicylates......Page 309
Adverse Effects.......Page 310
Lubiprostone and Tegaserod......Page 311
Antiemetics......Page 312
Dopamine D2 Receptor Antagonists......Page 314
Summary of Important Points......Page 315
Answers and Explanations......Page 316
Characteristics and Pathogenesis  of Migraine Headaches......Page 317
Anticonvulsants and Antidepressants......Page 318
Nonsteroidal Antiinflammatory Drugs......Page 319
Adverse Effects.......Page 320
Prophylactic Treatment of Migraines......Page 321
Summary of Important Points......Page 322
Answers and Explanations......Page 323
Osteoarthritis......Page 324
Prostaglandin Effects......Page 326
Nonselective Cyclooxygenase Inhibitors......Page 327
Pharmacokinetics.......Page 328
Pharmacokinetics.......Page 329
Indomethacin, Sulindac, and Ketorolac......Page 330
Pharmacologic Effects and Indications.......Page 331
Leflunomide......Page 332
Other Immunomodulating Agents.......Page 333
Uricosuric Drugs......Page 334
Summary of Important Points......Page 335
Answers and Explanations......Page 336
VI Endocrine Pharmacology......Page 339
Corticotropin and Related Drugs......Page 340
Corticotropin Preparations......Page 341
Growth Hormone–Inhibiting  Hormone Preparations......Page 342
Prolactin and Related Drugs......Page 343
Summary of Important Points......Page 344
Answers and Explanations......Page 345
Hypothyroidism......Page 346
Thyroid Hormone Preparations......Page 347
Mechanisms.......Page 349
Iodide Salts......Page 350
Review Questions......Page 351
Answers and Explanations......Page 352
Physiologic Effects of Adrenal Steroids......Page 353
Classification......Page 355
Indications......Page 356
Dermatologic Conditions......Page 357
Adverse Effects......Page 358
Summary of Important Points......Page 359
Answers and Explanations......Page 360
Physiologic Actions of Estrogens  and Progesterone......Page 361
Adverse Effects.......Page 364
Therapeutic Effects......Page 365
Contraceptives......Page 366
Administration.......Page 367
Progestin-Only Contraceptives......Page 368
Mechanisms and Indications.......Page 369
Testosterone and Methyltestosterone......Page 370
5α-Reductase Inhibitors......Page 371
Review Questions......Page 372
Answers and Explanations......Page 373
Mechanisms of Action......Page 374
Glucagon......Page 375
Classification......Page 376
Insulin Preparations......Page 377
Long-Acting Insulin......Page 378
Mechanisms and Pharmacologic Effects.......Page 379
Interactions.......Page 380
Mechanisms and Pharmacologic Effects......Page 381
Incretin Mimetics......Page 382
Objectives of Insulin Therapy......Page 383
Summary of Important Points......Page 384
Answers and Explanations......Page 385
Bone Disorders......Page 386
Calcium and Vitamin D......Page 387
Adverse Effects and Interactions.......Page 388
Pharmacologic Agents......Page 389
Specific Drugs......Page 390
Clinical Use and Effects......Page 391
Osteoporosis......Page 392
Review Questions......Page 393
Answers and Explanations......Page 394
VII Chemotherapy......Page 395
Bactericidal or Bacteriostatic Effect......Page 396
Antimicrobial Spectrum......Page 397
Mutation and Selection.......Page 398
Host Factors......Page 401
Combination Drug Therapy......Page 402
Prevention of Infection Caused  by Invasive Procedures......Page 404
Summary of Important Points......Page 405
Answers and Explanations......Page 406
Cell Wall......Page 407
Penicillins......Page 408
Pharmacokinetics......Page 409
Spectrum and Indications......Page 410
Bacterial Resistance......Page 412
Spectrum and Indications......Page 414
Carbapenems......Page 415
Summary of Important Points......Page 416
Answers and Explanations......Page 417
Aminoglycosides......Page 418
Chemistry and Pharmacokinetics......Page 419
Chemistry and Pharmacokinetics......Page 421
Bacterial Resistance......Page 422
Adverse Effects......Page 423
Chloramphenicol......Page 424
Summary of Important Points......Page 425
Answers and Explanations......Page 426
Spectrum, Indications, and Bacterial Resistance......Page 427
Pharmacokinetics......Page 428
Chemistry and Mechanisms......Page 429
Pharmacokinetics......Page 430
Nitrofurantoin......Page 431
Summary of Important Points......Page 432
Answers and Explanations......Page 433
Drugs for Tuberculosis......Page 434
Pharmacokinetics.......Page 435
Spectrum and Indications.......Page 436
Mechanisms, Spectrum, and Indications.......Page 437
Sulfones......Page 438
Summary of Important Points......Page 439
Answers and Explanations......Page 440
Clinical Uses and Mechanisms  of Antifungal Drugs......Page 441
Adverse Effects.......Page 443
Specific Drugs......Page 445
Flucytosine......Page 446
Review Questions......Page 447
Answers and Explanations......Page 448
Chemistry and Mechanisms.......Page 449
Acyclovir, Famciclovir, and Valacyclovir......Page 450
Other Drugs for Herpesvirus Infections......Page 452
Reverse Transcriptase Inhibitors......Page 453
Specific Drugs......Page 454
Adverse Effects and Interactions.......Page 455
Integrase Strand Transfer Inhibitor......Page 456
Neuraminidase Inhibitors......Page 457
Chemistry and Pharmacokinetics......Page 458
Review Questions......Page 459
Answers and Explanations......Page 460
Spectrum and Mechanisms.......Page 461
Indications.......Page 462
Sites and Mechanisms of Action......Page 464
Primaquine......Page 465
Drugs for Pneumocystis jiroveci  (carinii) Infections......Page 466
Drugs for Infections Caused  by Helminths......Page 467
Diethylcarbamazine......Page 468
Drugs for Infestations Caused  by Ectoparasites......Page 469
Answers and Explanations......Page 470
Overview......Page 472
Uses and Goals of Treatment......Page 473
Drug Toxicity......Page 474
Indications.......Page 475
Pemetrexed.......Page 477
Cytarabine, Fluorouracil, and Related Drugs.......Page 478
Chlorambucil, Mechlorethamine, and Melphalan.......Page 479
Adverse Effects.......Page 480
Adverse Effects.......Page 481
Adverse Effects.......Page 482
Adverse Effects.......Page 483
Protein Kinase Inhibitors......Page 484
Antineoplastic Monoclonal Antibodies......Page 485
Cytokines and Interferons......Page 486
Antiproliferative Agents......Page 487
Summary of Important Points......Page 488
Answers and Explanations......Page 489
Index......Page 491