Pharmacology in rehabilitation

POTENTIAL INTERACTIONS BETWEEN PHYSICAL AGENTS AND THERAPEUTIC DRUGS
IFC
Contemporary Perspectives in Rehabilitation
Title Page
Copyright
Dedication
Foreword to the Fourth Edition
Preface
Acknowledgments
Reviewers
Brief Contents
Contents
Section 1 
General Principles of Pharmacology
	Chapter 1
Basic Principles of Pharmacology
		RELEVANCE OF PHARMACOLOGY IN REHABILITATION
		DRUG NOMENCLATURE
		SUBSTITUTION OF GENERIC DRUGS FOR BRAND-NAME PRODUCTS
		WHAT CONSTITUTES A DRUG: DEVELOPMENT AND APPROVAL OF THERAPEUTIC AGENTS
			Drug Approval Process
			Orphan Drugs
			Off-Label Prescribing
			Prescription Versus Over-the-Counter Medication
			Controlled Substances
		BASIC CONCEPTS IN DRUG THERAPY
			Dose-Response Curves and Maximal Effi cacy
			Potency
		ELEMENTS OF DRUG SAFETY
			Quantal Dose-Response Curves and the Median Effective Dose
			Median Toxic Dose
			Therapeutic Index
		SUMMARY
		REFERENCES
	Chapter 2
Pharmacokinetics I: Drug Administration, Absorption, and Distribution
		ROUTES OF ADMINISTRATION
			Enteral
			Parenteral
			Transdermal
		BIOAVAILABILITY AND DRUG ABSORPTION ACROSS THE CELL MEMBRANE
			Membrane Structure and Function
			Movement Across Membrane Barriers
		DISTRIBUTION OF DRUGS WITHIN THE BODY
			Factors Affecting Distribution
			Volume of Distribution
		DRUG STORAGE
			Storage Sites
			Adverse Consequences of Drug Storage
		NEWER TECHNIQUES FOR DRUG DELIVERY
			Controlled-Release Preparations
			Implanted Drug Delivery Systems
			Targeting Drug Delivery to Specifi c Cells and Tissues
		SUMMARY
		REFERENCES
	Chapter 3 
Pharmacokinetics II: Drug Elimination
		BIOTRANSFORMATION
			Cellular Mechanisms of Drug Biotransformation
			Organs Responsible for Drug Biotransformation
			Enzyme Induction
		DRUG EXCRETION
		DRUG ELIMINATION RATES
			Clearance
			Half-Life
		DOSING SCHEDULES AND PLASMA CONCENTRATION
		VARIATIONS IN DRUG RESPONSE AND METABOLISM
			Genetics
			Disease
			Drug Interactions
			Age
			Diet
			Sex
			Other Factors
		SUMMARY
		REFERENCES
	Chatper 4 Drug Receptors
		RECEPTORS LOCATED ON THE CELL’S SURFACE
			Surface Receptors Linked Directly to Ion Channels
			Surface Receptors Linked Directly to Enzymes
			Surface Receptors Linked to Regulatory (G) Proteins and the Role of the Second Messenger
		INTRACELLULAR RECEPTORS
		DRUG–RECEPTOR INTERACTIONS
		FUNCTIONAL ASPECTS OF DRUG–RECEPTOR INTERACTIONS
			Drug Selectivity and Receptor Subtypes
			Dose-Response
			Classifi cation of Drugs: Agonist Versus Antagonist
			Competitive Versus Noncompetitive Antagonists
			Partial Agonists
			Mixed Agonist–Antagonists and Inverse Agonists
		RECEPTOR REGULATION
			Receptor Desensitization and Down-Regulation
			Receptor Supersensitivity
		NONRECEPTOR DRUG MECHANISMS
		SUMMARY
		REFERENCES
Section 2 
Pharmacology of the Central Nervous System
	Chapter 5 General Principles of Central Ner vous System Phar macology
		CNS ORGANIZATION
			Cerebrum
			Basal Ganglia
			Diencephalon
			Mesencephalon and Brainstem
			Cerebellum
			Limbic System
			Spinal Cord
		THE BLOOD-BRAIN BARRIER
		CNS NEUROTRANSMITTERS
			Acetylcholine
			Monoamines
			Amino Acids
			Peptides
			Other Transmitters
		THE GENERAL MECHANISMS OF CNS DRUGS
		SUMMARY
		REFERENCES
	Chapter 6  Sedative-Hypnotic and Antianxiety Drugs
		SEDATIVE-HYPNOTIC DRUGS
			Benzodiazepines
			Nonbenzodiazepines
			Pharmacokinetics
			Problems and Adverse Effects of Sedative-Hypnotics
		ANTIANXIETY DRUGS
			Benzodiazepines
			Buspirone
			Use of Antidepressants in Anxiety
			Other Antianxiety Drugs
			Problems and Adverse Effects of Anxiolytics
		Special Concerns for Rehabilitation Patients
		CASE STUDY
			SEDATIVE-HYPNOTIC DRUGS
		SUMMARY
		REFERENCES
	Chapter 7 
Drugs to T reat Affective Disorders: Depression and Bipolar Syndrome
		DEPRESSION
			Pathophysiology of Depression
			Antidepressant Drugs
			Pharmacokinetics of Antidepressants
			Problems and Adverse Effects
			Antidepressants and Chronic Pain
		BIPOLAR DISORDER
			Lithium
			Other Drugs for Bipolar Disorder
		Special Concerns for Rehabilitation Patients
		CASE STUDY
			ANTIDEPRESSANT DRUGS
		SUMMARY
		REFERENCES
	Chapter 8 Antipsychotic Dr ugs
		SCHIZOPHRENIA
			Pathogenesis of Schizophrenia
			Neurotransmitter Changes in Schizophrenia
		ANTIPSYCHOTICS MECHANISM OF ACTION
		ANTIPSYCHOTIC DRUGS
			Traditional Antipsychotics
			Atypical Antipsychotics
		PHARMACOKINETICS
		OTHER USES OF ANTIPSYCHOTICS
		PROBLEMS AND ADVERSE EFFECTS
			Extrapyramidal Symptoms
			Nonmotor Effects
			Other Side Effects
		Special Concerns for Rehabilitation Patients
		CASE STUDY
			ANTIPSYCHOTIC DRUGS
		SUMMARY
		REFERENCES
	Chapter 9 
Antiepileptic Drugs
		CLASSIFICATION OF EPILEPTIC SEIZURES
		RATIONALE FOR DRUG TREATMENT
		ANTISEIZURE DRUGS
			First-Generation Antiseizure Drugs
			Second-Generation Agents
		SELECTION OF A SPECIFIC ANTIEPILEPTIC AGENT
		PHARMACOKINETICS
		SPECIAL PRECAUTIONS DURING PREGNANCY
		TREATMENT OF STATUS EPILEPTICUS
		WITHDRAWAL OF ANTISEIZURE MEDICATIONS
		Special Concerns for Rehabilitation Patients
		CASE STUDY
			ANTIEPILEPTIC DRUGS
		SUMMARY
		REFERENCES
	Chapter 10 
Pharmacological Management of Parkinson Disease
		PATHOPHYSIOLOGY OF PARKINSON DISEASE
		ETIOLOGY OF PARKINSON DISEASE: GENETIC AND ENVIRONMENTAL FACTORS
			Genetic Factors
			Environmental Factors
		THERAPEUTIC AGENTS IN PARKINSONISM
			Levodopa
			Pharmacokinetics of Levodopa
			Use of Peripheral Decarboxylase Inhibitors
			Problems and Adverse Effects of Levodopa Therapy
			Drug Holidays From Levodopa
		OTHER DRUGS TO TREAT PARKINSON DISEASE
			Dopamine Agonists
			Anticholinergic Drugs
			Amantadine
			Monoamine Oxidase B Inhibitors
			Catechol-O-Methyltransferase Inhibitors
		CLINICAL COURSE OF PARKINSON DISEASE: WHEN TO USE SPECIFIC DRUGS
		NEUROSURGICAL INTERVENTIONS IN PARKINSON DISEASE
		Special Concerns for Rehabilitation Patients
		CASE STUDY
			ANTI-PARKINSON DRUGS
		SUMMARY
		REFERENCES
	Chapter 11 
General Anesthetics
		REQUIREMENTS FOR GENERAL ANESTHESIA
		INDUCTION STAGES OF GENERAL ANESTHESIA
		GENERAL ANESTHETIC AGENTS: CLASSIFICATION AND USE ACCORDING TO ROUTE OF ADMINISTRATION
			Inhalation Anesthetics
			Intravenous Anesthetics
		PHARMACOKINETICS
		MECHANISM OF ACTION
		ADJUVANTS IN GENERAL ANESTHESIA
			Preoperative Medications
			Neuromuscular Blockers
			Nondepolarizing Blockers
			Depolarizing Blocker
		Special Concerns for Rehabilitation Patients
		CASE STUDY
			GENERAL ANESTHETICS
		SUMMARY
		REFERENCES
	Chapter 12 
Local Anesthetics
		TYPES OF LOCAL ANESTHETICS
		PHARMACOKINETICS
		CLINICAL USE OF LOCAL ANESTHETICS
			Topical Administration
			Transdermal Administration
			Infiltration Anesthesia
			Peripheral Nerve Block
			Central Neural Blockade
			Sympathetic Blockade
			Intravenous Regional Anesthesia (Bier Block)
		MECHANISM OF ACTION
		DIFFERENTIAL NERVE BLOCK
		SYSTEMIC EFFECTS OF LOCAL ANESTHETICS
		Special Concerns for Rehabilitation Patients
		CASE STUDY
			LOCAL ANESTHETICS
		SUMMARY
		REFERENCES
Section 3 
Drugs Affecting Skeletal Muscle
	Chapter 13 
Skeletal Muscle Relaxants
		INCREASED MUSCLE TONE: SPASTICITY VERSUS MUSCLE SPASMS
		ANTISPASM DRUGS
			Diazepam
			Centrally Acting Antispasm Drugs
		ANTISPASTICITY DRUGS
			Baclofen
			Intrathecal Baclofen
			Dantrolene Sodium
			Diazepam
			Gabapentin
			Tizanidine
		USE OF BOTULINUM TOXIN AS A MUSCLE RELAXANT
			Mechanism of Action
			Clinical Use of Botulinum Toxin
			Limitations and Adverse Effects
		PHARMACOKINETICS
		Special Concerns for Rehabilitation Patients
		CASE STUDY
			MUSCLE RELAXANTS
		SUMMARY
		REFERENCES
Section 4 Drugs Used to Treat Pain and Inf ammation
	Chapter 14 
Opioid Analgesics
		SOURCES OF OPIOID ANALGESICS
		ENDOGENOUS OPIOID PEPTIDES AND OPIOID RECEPTORS
			Endogenous Opioids
			Opioid Receptors
		CLASSIFICATION OF SPECIFIC AGENTS
			Strong Agonists
			Mild-to-Moderate Agonists
			Mixed Agonist–Antagonists
			Antagonists
		PHARMACOKINETICS
		MECHANISM OF ACTION
			Sites of Opioid Effects
			Effects of Opioids on Synaptic Activity
		CLINICAL APPLICATIONS
			Treatment of Pain
			Use of Opioids in Patient-Controlled Analgesia
			Other Opioid Uses
		PROBLEMS AND ADVERSE EFFECTS
		CONCEPTS OF ADDICTION, TOLERANCE, AND PHYSICAL DEPENDENCE
			Tolerance
			Physical Dependence
			Tolerance and Dependence During Therapeutic Opioid Use
			Use of Opioids in Patient-Controlled Analgesia
			Opioid-Induced Hyperalgesia
			Pharmacological Treatment of Opioid Addiction
		Special Concerns for Rehabilitation Patients
		CASE STUDY
			OPIOID ANALGESICS
		SUMMARY
		REFERENCES
	Chapter 15 
Nonsteroidal Anti-Inf ammatory Drugs
		ASPIRIN AND OTHER NSAIDS: GENERAL ASPECTS
		PROSTAGLANDINS, THROMBOXANES, AND LEUKOTRIENES
			Eicosanoid Biosynthesis
			Role of Eicosanoids in Health and Disease
		MECHANISM OF NSAID ACTION: INHIBITION OF PROSTAGLANDIN AND THROMBOXANE SYNTHESIS
		ASPIRIN: THE PROTOTYPICAL NSAID
		CLINICAL APPLICATIONS OF ASPIRINLIKE DRUGS
			Treatment of Pain and Infl ammation
			Treatment of Fever
			Treatment of Vascular Disorders
			Prevention of Cancer
		PROBLEMS AND ADVERSE EFFECTS OF ASPIRINLIKE DRUGS
			Gastrointestinal Problems
			Cardiovascular Problems
			Other Side Effects
		COMPARISON OF ASPIRIN WITH OTHER NSAIDS
		COX-2 SELECTIVE DRUGS
			COX-2 Drugs and the Risk of Heart Attackand Stroke
		ACETAMINOPHEN
		PHARMACOKINETICS OF NSAIDS AND ACETAMINOPHEN
		Special Concerns for Rehabilitation Patients
		CASE STUDY
			NONSTEROIDAL ANTI-INFLAMMATORY DRUGS
		SUMMARY
		REFERENCES
	Chapter 16  Pharmacological Management of Rheumatoid Ar thritis and Osteoar thritis
		RHEUMATOID ARTHRITIS
			Immune Basis for Rheumatoid Arthritis
			Overview of Drug Therapy in Rheumatoid Arthritis
			NSAIDs
			Glucocorticoids
			Disease-Modifying Antirheumatic Drugs
			Traditional (Nonbiological) DMARDs
			Biological DMARDs
			Other DMARDs
			DMARD Combinations Used in Rheumatoid Arthritis
			Dietary Implications for Rheumatoid Arthritis
		OSTEOARTHRITIS
			Acetaminophen and NSAIDs
			Viscosupplementation
			Glucosamine and Chondroitin Sulfate
		Special Concerns for Rehabilitation Patients
		CASE STUDY
			RHEUMATOID ARTHRITIS
		SUMMARY
		REFERENCES
	Chapter 17 
Patient-Controlled Analgesia
		PHARMACOKINETIC BASIS FOR PCA
		PCA DOSING STRATEGIES AND PARAMETERS
		TYPES OF ANALGESICS USED FOR PCA
		PCA PUMPS
		ADMINISTRATION ROUTES DURING PCA
			IV PCA
			Epidural PCA
			Regional PCA
			Transdermal PCA
			Other Potential Administration Routes for PCA
		COMPARISON OF PCA TO OTHER METHODS OF ANALGESIC ADMINISTRATION
		COMPARISON OF PCA TO CONTINUOUS NERVE BLOCKS
		PROBLEMS AND ADVERSE EFFECTS OF PCA
			Pharmacological Adverse Effects
			Problems With PCA Delivery
		Special Concerns for Rehabilitation Patients
		SUMMARY
		REFERENCES
Section 5 
Autonomic and Cardiovascular Pharmacology
	Chapter 18 
Introduction to Autonomic Pharmacology
		ANATOMY OF THE AUTONOMIC NERVOUS SYSTEM: SYMPATHETIC AND PARASYMPATHETIC DIVISIONS
			Preganglionic and Postganglionic Neurons
			Sympathetic Organization
			Parasympathetic Organization
			Functional Aspects of the Sympathetic and Parasympathetic Divisions
		FUNCTION OF THE ADRENAL MEDULLA
		AUTONOMIC INTEGRATION AND CONTROL
		AUTONOMIC NEUROTRANSMITTERS
			Acetylcholine and Norepinephrine
			Other Autonomic Neurotransmitters
		AUTONOMIC RECEPTORS
			Cholinergic Receptors
			Adrenergic Receptors
		PHARMACOLOGICAL SIGNIFICANCE OF AUTONOMIC RECEPTORS
		SUMMARY
		REFERENCES
	Chapter 19  Cholinergic Drugs
		CHOLINERGIC RECEPTORS
		CHOLINERGIC STIMULANTS
			Direct-Acting Cholinergic Stimulants
			Indirect-Acting Cholinergic Stimulants
			Clinical Applications of Cholinergic Stimulants
			Problems and Adverse Effects of Cholinergic Stimulants
		ANTICHOLINERGIC DRUGS
			Source and Mechanism of Action of Antimuscarinic Anticholinergic Drugs
			Clinical Applications of Antimuscarinic Drugs
			Problems and Adverse Effectsof Anticholinergic Drugs
		SUMMARY
		REFERENCES
	Chapter 20 Adrenergic Drugs
		ADRENERGIC RECEPTOR SUBCLASSIFICATIONS
		ADRENERGIC AGONISTS
			Alpha-1-Selective Agonists
			Alpha-2-Selective Agonists
			Beta-1-Selective Agonists
			Beta-2-Selective Agonists
			Drugs With Mixed Alphaand Beta-Agonist Activity
		ADRENERGIC ANTAGONISTS
			Alpha Antagonists
			Beta Antagonists
			Other Drugs That Inhibit Adrenergic Neurons
		SUMMARY
		REFERENCES
	Chapter 21 
Antihypertensive Drugs
		NORMAL CONTROL OF BLOOD PRESSURE
		PATHOGENESIS OF HYPERTENSION
			Essential Versus Secondary Hypertension
			Possible Mechanisms in Essential Hypertension
		DRUG THERAPY
			Diuretics
			Sympatholytic Drugs
			Vasodilators
			Renin-Angiotensin System Inhibitors
			Calcium Channel Blockers
		DRUG SELECTION FOR SPECIFIC PATIENTS WITH HYPERTENSION
		NONPHARMACOLOGICAL TREATMENT OF HYPERTENSION
		Special Concerns for Rehabilitation Patients
		CASE STUDY
			HYPERTENSION
		SUMMARY
		REFERENCES
	Chapter 22 Treatment of Angina Pectoris
		DRUGS USED TO TREAT ANGINA PECTORIS
			Organic Nitrates
			Beta-Adrenergic Blockers
			Calcium Channel Blockers
		OTHER DRUGS AFFECTING MYOCARDIAL OXYGEN BALANCE IN ANGINA PECTORIS
		USE OF ANTICOAGULANTS IN ANGINA PECTORIS
		TREATMENT OF SPECIFIC TYPES OF ANGINA PECTORIS
			Stable Angina
			Variant Angina (Prinzmetal Ischemia)
			Unstable Angina
		NONPHARMACOLOGICAL MANAGEMENT OF ANGINA PECTORIS
		Special Concerns for Rehabilitation Patients
		CASE STUDY
			ANTIANGINAL DRUGS
		SUMMARY
		REFERENCES
	Chapter 23 
Treatment of Cardiac Arrhythmias
		CARDIAC ELECTROPHYSIOLOGY
			Cardiac Action Potentials
			Normal Cardiac Rhythm
			Normal Conduction of the Cardiac Action Potential
		MECHANISMS OF CARDIAC ARRHYTHMIAS
		TYPES OF ARRHYTHMIAS
		CLASSIFICATION OF ANTIARRHYTHMIC DRUGS
			Class I: Sodium Channel Blockers
			Class II: Beta Blockers
			Class III: Drugs That Prolong Repolarization
			Class IV: Calcium Channel Blockers
		OTHER DRUGS USED TO TREAT ARRHYTHMIAS
		NONPHARMACOLOGICAL TREATMENT OF ARRHYTHMIAS
		Special Concerns for Rehabilitation Patients
		CASE STUDY
			ANTIARRHYTHMIC DRUGS
		SUMMARY
		REFERENCES
	Chapter 24 Treatment of Congestive Heart Failure
		PATHOPHYSIOLOGY OF CONGESTIVE HEART FAILURE
			The Vicious Cycle of Heart Failure
			Congestion in Left and Right Heart Failure
		PHARMACOTHERAPY
		DRUGS THAT INCREASE MYOCARDIAL CONTRACTION FORCE (POSITIVE INOTROPIC AGENTS)
			Digitalis
			Phosphodiesterase Inhibitors
			Dopamine and Dobutamine
		AGENTS THAT DECREASE CARDIAC WORKLOAD
			Drugs Affecting the Renin-Angiotensin System
			Beta Blockers
			Diuretics
			Vasodilators
		Special Concerns for Rehabilitation Patients
		CASE STUDY
			CONGESTIVE HEART FAILURE
		SUMMARY
		REFERENCES
	Chapter 25  Treatment of Coagulation Disorders and Hyperlipidemia
		NORMAL MECHANISM OF BLOOD COAGULATION
			Clot Formation
			Clot Breakdown
		DRUGS USED TO TREAT OVERACTIVE CLOTTING
			Anticoagulants
			Antiplatelet Drugs
			Fibrinolytics
		TREATMENT OF CLOTTING DEFICIENCIES
			Hemophilia
			Deficiencies of Vitamin K–Dependent Clotting Factors
			Antifibrinolytics
		AGENTS USED TO TREAT HYPERLIPIDEMIA
			HMG-CoA Reductase Inhibitors (Statins)
			Fibric Acids
			Other Lipid-Lowering Agents
			Adverse Effects of Antihyperlipidemic Agents
		Special Concerns for Rehabilitation Patients
		CASE STUDY
			CLOTTING DISORDERS
		SUMMARY
		REFERENCES
Section 6 
Respiratory and Gastrointestinal Pharmacology
	Chapter 26 Respiratory Drugs
		DRUGS USED TO TREAT RESPIRATORY TRACT IRRITATION AND CONTROL RESPIRATORY SECRETIONS
			Antitussives
			Decongestants
			Antihistamines
			Mucolytics and Expectorants
		DRUGS USED TO MAINTAIN AIRWAY PATENCY IN OBSTRUCTIVE PULMONARY DISEASE
			Beta-Adrenergic Agonists
			Xanthine Derivatives
			Anticholinergic Drugs
			Glucocorticoids
			Cromones
			Leukotriene Inhibitors
		TREATMENT OF BRONCHIAL ASTHMA
			Pathophysiology of Bronchial Asthma
			Long-Term Management of Asthma
		TREATMENT OF REVERSIBLE BRONCHOSPASM IN COPD
		TREATMENT OF RESPIRATORY PROBLEMS IN CYSTIC FIBROSIS
		Special Concerns for Rehabilitation Patients
		CASE STUDY
			RESPIRATORY DRUGS
		SUMMARY
		REFERENCES
	Chapter 27 Gastrointestinal Drugs
		DRUGS USED TO CONTROL GASTRIC ACIDITY AND SECRETION
			Antacids
			H2 Receptor Blockers
			Proton Pump Inhibitors
			Treatment of Helicobacter Pylori Infection in Gastric Ulcer Disease
			Other Agents Used to Control and Treat Gastric Ulcers
		ANTIDIARRHEAL AGENTS
			Opioid Derivatives
			Bismuth Salicylate
			Miscellaneous Agents Used to Treat Diarrhea
		LAXATIVES AND CATHARTICS
			Specific Agents and Mechanism of Action
			Adverse Effects
		MISCELLANEOUS GASTROINTESTINAL DRUGS
			Digestants
			Emetics
			Antiemetics
			Cholelitholytic Agents
		Special Concerns for Rehabilitation Patients
		CASE STUDY
			GASTROINTESTINAL DRUGS
		SUMMARY
		REFERENCES
Section 7 
Endocrine Pharmacology
	Chapter 28 Introduction to Endocrine Pharmacology
		PRIMARY ENDOCRINE GLANDS AND THEIR HORMONES
			Hypothalamus and Pituitary Gland
			Thyroid Gland
			Parathyroid Gland
			Pancreas
			Adrenal Gland
			Gonads
		ENDOCRINE PHYSIOLOGY AND PHARMACOLOGY
			Hormone Chemistry
			Synthesis and Release of Hormones
			Feedback Control Mechanisms in Endocrine Function
			Hormone Transport
			Hormone Effects on the Target Cell
		CLINICAL USE OF ENDOCRINE DRUGS
			Replacement Therapy
			Diagnosis of Endocrine Disorders
			Treatment of Excessive Endocrine Function
			Exploitation of Benefi cial Hormone Effects
			Use of Hormones to Alter Normal Endocrine Function
			Use of Hormones in Nonendocrine Disease
		SUMMARY
		REFERENCES
	Chapter 29 Adrenocorticosteroids
		STEROID SYNTHESIS
		GLUCOCORTICOIDS
			Role of Glucocorticoids in Normal Function
			Mechanism of Action of Glucocorticoids
			Physiological Effects of Glucocorticoids
		CLINICAL USES OF GLUCOCORTICOIDS
			Glucocorticoid Use in Endocrine Disorders
			Glucocorticoid Use in Nonendocrine Conditions
		ADVERSE EFFECTS OF GLUCOCORTICOIDS
			Adrenocortical Suppression
			Drug-Induced Cushing Syndrome
			Breakdown of Supporting Tissues
			Other Adverse Effects
		DRUGS THAT INHIBIT ADRENOCORTICAL HORMONE BIOSYNTHESIS
		MINERALOCORTICOIDS
			Regulation of Mineralocorticoid Secretion
			Mechanism of Action and Physiological Effects of Mineralocorticoids
			Therapeutic Use of Mineralocorticoid Drugs
			Adverse Effects of Mineralocorticoid Agonists
			Mineralocorticoid Antagonists
		Special Concerns for Rehabilitation Patients
		CASE STUDY
			ADRENOCORTICOSTEROIDS
		SUMMARY
		REFERENCES
	Chapter 30 Male and Female Hormones
		ANDROGENS
			Source and Regulation of Androgen Synthesis
			Physiological Effects of Androgens
		CLINICAL USE OF ANDROGENS
			Replacement Therapy
			Catabolic States
			Delayed Puberty
			Breast Cancer
			Anemia
			Hereditary Angioedema
			Specifi c Agents
			Adverse Effects of Clinical Androgen Use
			Antiandrogens
		ANDROGEN ABUSE
			Effects of Androgens on Athletic Performance
			Adverse Effects of Androgen Abuse
		ESTROGEN AND PROGESTERONE
			Effects of Estrogen and Progesterone on Sexual Maturation
			Regulation and Effects of Hormonal Synthesis During the Menstrual Cycle
			Female Hormones in Pregnancy and Parturition
		PHARMACOLOGICAL USE OF ESTROGEN AND PROGESTERONE
			Conditions Treated With Estrogen and Progesterone
			Use of Hormone Replacement Therapy Following Menopause
			Specifi c Agents
			Adverse Effects of Estrogen and Progesterone
		OTHER DRUGS THAT AFFECT ESTROGEN AND PROGESTERONE ACTIVITY
			Selective Estrogen Receptor Modulators
			Antiestrogens
			Antiprogestins
		HORMONAL CONTRACEPTIVES
			Types of Contraceptive Preparations
			Mechanism of Contraceptive Action
			Adverse Effects of Hormonal Contraceptives
		CASE STUDY
			MALE AND FEMALE HORMONES
		Special Concerns for Rehabilitation Patients
		SUMMARY
		REFERENCES
	Chapter 31 
Thyroid and P arathyroid Drugs: Agents Affecting Bone Mineralization
		HORMONES OF THE THYROID GLAND
			Synthesis of Thyroid Hormones
			Regulation of Thyroid Hormone Release
			Physiological Effects of Thyroid Hormones
			Mechanism of Action of Thyroid Hormones
		TREATMENT OF THYROID DISORDERS
			Hyperthyroidism
			Hypothyroidism
		PARATHYROID HORMONE
		REGULATION OF BONE MINERAL HOMEOSTASIS
			Parathyroid Hormone and Bone Formation
			Vitamin D
			Calcitonin
			Other Hormones
		PHARMACOLOGICAL CONTROL OF BONE MINERAL HOMEOSTASIS
			Calcium Supplements
			Vitamin D
			Bisphosphonates
			Calcitonin
			Estrogen Therapy
			Other Agents That Promote Bone Mineral Content
		Special Concerns for Rehabilitation Patients
		CASE STUDY
			AGENTS AFFECTING BONE MINERAL METABOLISM
		SUMMARY
		REFERENCES
	Chapter 32 Pancreatic Hormones and the Treatment of Diabetes Mellitus
		STRUCTURE AND FUNCTION OF THE ENDOCRINE PANCREAS
		INSULIN
			Effects of Insulin on Carbohydrate Metabolism
			Effects of Insulin on Proteinand Lipid Metabolism
			Cellular Mechanism of Insulin Action
		GLUCAGON
		CONTROL OF INSULIN AND GLUCAGON RELEASE
		DIABETES MELLITUS
			Type 1 Diabetes
			Type 2 Diabetes
			Effects and Complications of Diabetes Mellitus
		USE OF INSULIN IN DIABETES MELLITUS
			Therapeutic Effects and Rationale for Use
			Insulin Preparations
			Administration of Insulin
			Intensive Insulin Therapy
			Adverse Effects of Insulin Therapy
		PRIMARY AGENTS IN TYPE 2 DIABETES
			Drugs That Stimulate Insulin Secretion and Supply
			Insulin Sensitizers
			Other Antidiabetics
		PREVENTION OF TYPE 1 DIABETES MELLITUS: THE POTENTIAL ROLE OF IMMUNE-BASED THERAPIES
		NONPHARMACOLOGICAL INTERVENTION IN DIABETES MELLITUS
			Dietary Management and Weight Reduction
			Exercise
			Tissue Transplants and Gene Therapy
		CASE STUDY
			DIABETES MELLITUS
		SUMMARY
		REFERENCES
Section 8 
Chemotherapy of Infectious and Neoplastic Diseases
	Chapter 33 Treatment of Infections I: Antibacterial Dr ugs
		BACTERIA: BASIC CONCEPTS
			Bacterial Structure and Function
			Pathogenic Effects of Bacteria
			Bacterial Nomenclature and Classifi cation
		SPECTRUM AND ACTIVITY OF ANTIBACTERIAL DRUGS
			Spectrum of Antibacterial Activity
			Bactericidal Versus Bacteriostatic Activity
		BASIC MECHANISMS OF ANTIBACTERIAL DRUGS
			Inhibition of Bacterial Cell Wall Synthesisand Function
			Inhibition of Bacterial Protein Synthesis
			Inhibition of Bacterial DNA/RNA Synthesisand Function
		SPECIFIC ANTIBACTERIAL AGENTS
		ANTIBACTERIAL DRUGS THAT INHIBIT BACTERIAL CELL WALL SYNTHESIS AND FUNCTION
			Penicillins
			Cephalosporins
			Carbapenems
			Other Agents That Inhibit Bacterial Cell Wall Synthesis
			Use of Beta-Lactamase Inhibitors
		DRUGS THAT INHIBIT BACTERIAL PROTEIN SYNTHESIS
			Aminoglycosides
			Erythromycin and Other Macrolides
			Other Agents That Inhibit Bacterial Protein Synthesis
		DRUGS THAT INHIBIT BACTERIAL DNA/RNA SYNTHESIS AND FUNCTION
			Aminosalicylic Acid
			Clofazimine
			Dapsone
			Fluoroquinolones
			Metronidazole
			Mupirocin
			Rifamycins
			Sulfonamides
			Trimethoprim
		OTHER ANTIBACTERIAL DRUGS
			Capreomycin
			Daptomycin
			Isoniazid
			Methenamine
			Nitrofurantoin
			Pyrazinamide
		CLINICAL USE OF ANTIBACTERIAL DRUGS: RELATIONSHIP TO SPECIFIC BACTERIAL INFECTIONS
		RESISTANCE TO ANTIBACTERIAL DRUGS
		Special Concerns for Rehabilitation Patients
		CASE STUDY
			ANTIBACTERIAL DRUGS
		SUMMARY
		REFERENCES
	Chapter 34 
Treatment of Infections II: Antiviral Drugs
		VIRAL STRUCTURE AND FUNCTION
			Classification of Viruses
			Characteristics of Viruses
			Viral Replication
		SPECIFIC ANTIVIRAL DRUGS
			Acyclovir and Valacyclovir
			Amantadine and Rimantadine
			Cidofovir
			Docosanol
			Dolutegravir, Elvitegravir, and Raltegravir
			Enfuvirtide and Maraviroc
			Famciclovir and Penciclovir
			Foscarnet
			Ganciclovir and Valganciclovir
			Imiquimod
			Trifl uridine
			Oseltamivir and Zanamivir
			Protease Inhibitors
			Reverse Transcriptase Inhibitors
			Ribavirin
		VIRAL RESISTANCE
		INTERFERONS
			Synthesis and Cellular Effects of Interferons
			Pharmacological Applications of Interferons
			Adverse Effects of Interferons
		CONTROL OF VIRAL INFECTION WITH VACCINES
		HIV AND THE TREATMENT OF AIDS
			Inhibition of HIV Proliferation in InfectedIndividuals
			Anti-HIV Drug Combinations: Use of Highly Active Antiretroviral Therapy
			HIV Vaccines
			Management of Opportunistic Infections
		Special Concerns for Rehabilitation Patients
		CASE STUDY
			ANTIVIRAL DRUGS
		SUMMARY
		REFERENCES
	Chapter 35 
Treatment of Infections III: Antifungal and Antiparasitic Dr ugs
		ANTIFUNGAL AGENTS
			Systemic Antifungal Agents
			Topical Antifungal Agents
		ANTIPROTOZOAL AGENTS
			Antimalarial Agents
			Drugs Used to Treat Protozoal Infections in the Intestines and Other Tissues
			Other Antiprotozoal Drugs
		ANTHELMINTICS
			Albendazole
			Diethylcarbamazine
			Ivermectin
			Mebendazole
			Praziquantel
			Pyrantel Pamoate
			Thiabendazole
			Other Anthelmintics
		Special Concerns for Rehabilitation Patients
		CASE STUDY
			ANTIFUNGAL DRUGS
		SUMMARY
		REFERENCES
	Chapter 36 
Cancer Chemotherapy
		GENERAL PRINCIPLES
			Cytotoxic Strategy
			Cell-Cycle–Specific Versus Cell-Cycle–Nonspecific Drugs
			Concepts of Growth Fraction and Cell Kill
			Prevalence and Management of Adverse Effects
		SPECIFIC ANTICANCER DRUGS
			Alkylating Agents
			Antimetabolites
			Anticancer Antibiotics
			Antimicrotubule Agents
			Topoisomerase Inhibitors
			Anticancer Hormones
			Targeted and Biological Therapies
			Platinum Coordination Complexes
			Aspirin and Other NSAIDs
			Miscellaneous Agents
		COMBINATION CHEMOTHERAPY
		USE OF ANTICANCER DRUGS WITH OTHER TREATMENTS
		SUCCESS OF ANTICANCER DRUGS
		RESISTANCE TO ANTICANCER DRUGS
		FUTURE PERSPECTIVES
		Special Concerns for Rehabilitation Patients
		CASE STUDY
			CANCER CHEMOTHERAPY
		SUMMARY
		REFERENCES
	Chapter 37 
Immunomodulating Agents
		OVERVIEW OF THE IMMUNE RESPONSE
		PHARMACOLOGICAL SUPPRESSION OF THE IMMUNE RESPONSE
		SPECIFIC IMMUNOSUPPRESSIVE AGENTS
			Azathioprine
			Cyclophosphamide
			Cyclosporine
			Glucocorticoids
			Methotrexate
			Mycophenolate Mofetil
			Sulfasalazine
			Sirolimus and other mTOR Inhibitors
			Tacrolimus
			Other Methods of Immunosuppression
		IMMUNOSTIMULANTS
			Bacille Calmette-Guérin
			Immune Globulin
		OTHER IMMUNOMODULATORS
		Special Concerns for Rehabilitation Patients
		CASE STUDY
			IMMUNOMODULATING AGENTS
		SUMMARY
		REFERENCES
	Chapter 38 
Complementary and Alternative Medications
		PROBLEMS ASSOCIATED WITH CAMS
			Misconceptions About CAM Safety
			Failure to Report CAM Use
			Lack of Standards for Quality and Purity of CAMs
			Delayed Use of Conventional Medications
		POTENTIAL ADVERSE EFFECTS OF CAMS
		SPECIFIC CAMS
			Bee Venom
			Echinacea
			Garlic
			Ginger
			Ginkgo Biloba
			Ginseng
			Glucosamine and Chondroitin
			Kava
			Melatonin
			Saw Palmetto
			St. John’s Wort
			Valerian
		VITAMINS AND MINERALS
			Vitamins
			Minerals
		Special Concerns for Rehabilitation Patients
		CASE STUDY
			COMPLEMENTARY AND ALTERNATIVE MEDICATIONS
		SUMMARY
		REFERENCES
APPENDIX A Drugs Administered by Iontophoresis and Phonophoresis
APPENDIX B Drugs of Abuse
APPENDIX C Answers to Case Study Questions
Glossar y
Index
COMMON DRUG SUFFIXES