Crash Course: Pharmacology Updated Edition - E-Book

Description

Covering all aspects of the syllabus, Crash Course offers students a fast way to recap on what they need to know to get through the exams with ease. Styled in an easy-to-follow, readily accessible format, each book is prepared by senior medical students or junior doctors - under faculty supervision - to give them the correct level of information perfectly tailored to current curricula requirements. The series now includes improved pedagogic features and a fully revised self-assessment section, updated to meet current examination needs.Provides the exam syllabus in one place!Written by senior medical students or junior doctors - authors who really understand today's exam situation!Senior Faculty Advisors ensure complete accuracy of the text!Full artwork programme, improved 'Hints and Tips' boxes, and 'Clinical Application' boxes help you remember the key points!Self-Assessment section - fully updated to reflect new curriculum requirements - helps you maximise your grade!Solid, accurate, user-friendly coverage provides enough detail even for those aiming at distinction!Fully updated self-assessment section - ideal for current examination practice!Includes useful 'Learning Objectives' at the start of each chapter.Integrated approach between basic and clinical sciences provides a firm basis for problem solving in clinical practice.Includes new chapter on pain control and anaesthesia.Fully updated to include feedback from hundreds of students! Welcome to Crash Course - the revision aid to get you the results you need!Crash Course is a complete revision guide designed specifically to save you time by providing everything you could be asked in the exam in one place!Each book in the series has been specially written either by senior medical students or junior doctors - carefully supervised by faculty advisors - to ensure that it exactly matches your needs by having been prepared by someone who has just been in the exam situation!Fully updated and revised to improve accessibility, this essential revision aid includes new features such as 'Learning Objectives' at the start of each chapter, improved 'Hints and Tips' boxes, 'Clinical Application' boxes and a completely revised self-assessment section tailored to the current exam formats!Crash Course - an easier way to get through the exam! Front Cover Crash Course: Pharmacology Copyright Series editor foreword Prefaces Acknowledgements Contents Chapter 1: Introduction to pharmacology Molecular basis of pharmacology What is pharmacology? Drug names and classification How do drugs work? Transport systems Ion channels Carrier molecules Enzymes Receptors Receptors directly linked to ion channels G-protein linked receptors Molecular structure of the receptor G-proteins Targets for G-proteins Adenylyl cyclase/cAMP system Phospholipase C/inositol phosphate system Guanylyl cyclase system Tyrosine kinase linked receptors DNA linked receptors Drug-receptor interactions Agonists Antagonists Competitive antagonists Non-competitive antagonists Receptor reserve Potency Pharmacokinetics Administration Topical Enteral Parenteral Drug absorption Cell membranes Size pH Drug distribution Drug metabolism Sites of metabolism Phase 1 metabolic reactions Oxidation Reduction Hydrolysis Phase 2 metabolic reactions Factors affecting metabolism Overdose Drug excretion Renal excretion Gastrointestinal excretion Mathematical aspects of pharmacokinetics Kinetic order One-compartment model Model-independent approach Adherence Drug interactions and adverse effects Drug interactions Pharmacodynamic interactions Pharmacokinetic interactions Adverse effects Drug history and drug development Drug history Drug development Chapter 2: Cardiovascular system The heart Basic concepts Cardiac rate and rhythm Cardiac action potential Non-nodal cells Nodal cells Autonomic control of the heart Cardiac contractility Cardiac dysfunction and treatment Congestive cardiac failure Extrinsic cardiac compensation Intrinsic cardiac compensation Drugs used in heart failure Cardiac glycosides Mechanism of action Route of administration Indications Contraindications Adverse effects Therapeutic notes Phosphodiesterase inhibitors Mechanism of action Route of administration Indications Adverse effects β-Adrenoceptor agonists Diuretics Angiotensin-converting-enzyme inhibitors Nitrates Vasodilating drugs Arrhythmias Abnormal impulse generation Automatic Triggered Abnormal impulse conduction Heart block Re-entry Antiarrhythmic drugs Class I Class Ia Mechanism of action Route of administration Indications Contraindications Adverse effects Class Ib Mechanism of action Route of administration Indications Contraindications Adverse effects Class Ic Mechanism of action Route of administration Indications Contraindications Adverse effects Class II Class III Mechanism of action Route of administration Indications Contraindications Adverse effects Class IV Other antiarrhythmics Adenosine Mechanism of action Route of administration Indications Contraindications Adverse effects Angina pectoris Antianginal drugs Organic nitrates Mechanism of action Route of administration Indications Contraindications Adverse effects Therapeutic notes β-Adrenoceptor antagonists (β-blockers) Mechanism of action Route of administration Indications Contraindications Adverse effects Calcium-channel blockers Mechanism of action Route of administration Indications Contraindications Adverse effects Potassium-channel activators Mechanism of action Route of administration Indications Contraindications Adverse effects The circulation Control of vascular tone α-Adrenoceptor activation β2-Adrenoceptor activation M3-receptor activation Renin-angiotensin system Hypertension Treatment of hypertension Vasodilators Angiotensin-converting enzyme inhibitors Mechanism of action Route of administration Indications Contraindications Adverse effects Therapeutic notes Angiotensin-II receptor antagonists Mechanism of action Route of administration Indications Contraindications Adverse effects Calcium antagonists α1-Adrenoceptor antagonists Mechanism of action Route of administration Indications Contraindications Adverse effects Hydralazine Mechanism of action Route of administration Indications Contraindications Adverse effects Minoxidil Mechanism of action Route of administration Indications Contraindications Adverse effects Therapeutic notes Sodium nitroprusside Mechanism of action Route of administration Indications Contraindications Adverse effects Therapeutic notes Diuretic drugs Mechanism of action Centrally acting antihypertensive drugs Mechanism of action Route of administration Indications Contraindications Adverse effects Phaeochromocytoma Phenoxybenzamine Mechanism of action Route of administration Indications Contraindications Adverse effects Therapeutic notes Vasoconstrictors and the management of shock Shock Management of shock Sympathomimetic amines Mechanism of action Route of administration Indications Contraindications Adverse effects Therapeutic notes Dopamine and dobutamine Mechanism of action Route of administration Indications Contraindications Adverse effects Therapeutic notes Vasopressin and desmopressin Mechanism of action Route of administration Indications Contraindications Adverse effects Corticosteroids Lipoprotein circulation and atherosclerosis Hyperlipidaemias Primary Secondary Treatment (lipid-lowering drugs) HMG CoA reductase inhibitors ('statins') Mechanism of action Route of administration Indications Contraindications Adverse effects Fibrates Mechanism of action Route of administration Indications Contraindications Adverse effects Nicotinic acid Mechanism of action Route of administration Indications Contraindications Adverse effects Bile acid binding resins Mechanism of action Route of administration Indications Contraindications Adverse effects Therapeutic regimen Other lipid-lowering drugs Haemostasis and thrombosis Haemostasis Blood vessel constriction Platelet plug formation Clot formation Fibrinolysis Thrombosis Treatment of thrombosis Anticoagulants Vitamin K antagonists Mechanism of action Route of administration Indications Contraindications Adverse effects Therapeutic notes Heparin and the low-molecular-weight heparins Mechanism of action Route of administration Indications Contraindications Adverse effects Therapeutic regimen Therapeutic notes Hirudins Mechanism of action Route of administration Indications Contraindications Adverse effects Antiplatelet agents Aspirin Mechanism of action Route of administration Indications Contraindications Adverse effects Therapeutic regimen Dipyridamole Mechanism of action Route of administration Indications Adverse effects Clopidogrel Mechanism of action Route of administration Indications Adverse effects Therapeutic notes Glycoprotein llb/llla inhibitors Mechanism of action Route of administration Indications Contraindications Adverse effects Therapeutic notes Fibrinolytic agents Streptokinase Mechanism of action Route of administration Indications Contraindications Adverse effects Therapeutic regimen Tissue-type plasminogen activators (tPAs) Mechanism of action Route of administration Indications Contraindications Adverse effects Bleeding disorders Treatment of bleeding disorders Vitamin K Mechanism of action Route of administration Indications Adverse effects Protamine Mechanism of action Route of administration Indications Adverse effects Clotting factors Mechanism of action Route of administration Indications Adverse effects Desmopressin Mechanism of action Route of administration Indications Adverse effects Tranexamic acid Mechanism of action Route of administration Indications Contraindications Adverse effects Aprotinin Mechanism of action Route of administration Indications Adverse effects Etamsylate Mechanism of action Route of administration Indications Contraindications Adverse effects The blood and fluid replacement Anaemia Iron Mechanism of action Route of administration Indications Contraindications Adverse effects Therapeutic notes Vitamin B12 Mechanism of action Route of administration Indications Contraindications Adverse effects Therapeutic notes Folate Mechanism of action Route of administration Indications Contraindications Adverse effects Therapeutic notes Erythropoietin Mechanism of action Route of administration Indications Contraindications Adverse effects Therapeutic notes Myeloproliferative disorders Fluid replacement Chapter 3: Respiratory system Basic concepts Obstructive airways diseases Asthma Immediate-phase response Late-phase response Chronic obstructive pulmonary disease Management of obstructive airways disease Bronchodilators β2-Adrenoceptor agonists Mechanism of action Route of administration Indications Contraindications Adverse effects Therapeutic notes Anticholinergics Mechanism of action Route of administration Indications Contraindications Adverse effects Therapeutic notes Xanthines Mechanism of action Route of administration Indications Contraindications Adverse effects Therapeutic notes Leukotriene receptor antagonists Mechanism of action Route of administration Indications Contraindications Adverse effects Therapeutic notes Prophylactic and anti-inflammatory drugs Mast-cell stabilizers Mechanism of action Route of administration Indications Adverse effects Therapeutic notes Glucocorticoids Mechanism of action Route of administration Indications Contraindications Adverse effects Therapeutic notes Use of inhalers, nebulizers and oxygen Inhalers Nebulizers Oxygen Allergic rhinitis Decongestants Ephedrine Mechanism of action Route of administration Indications Contraindications Adverse effects Therapeutic notes Respiratory stimulants and pulmonary surfactants Respiratory stimulants Doxapram Mechanism of action Route of administration Indications Adverse effects Pulmonary surfactants Antitussives and mucolytics Antitussives Drugs that reduce receptor activation Menthol vapour and topical local anaesthetics Mechanism of action Route of administration Indications Drugs that reduce the sensitivity of the 'cough centre' Opioids Mechanism of action Route of administration Indications Adverse effects Mucolytics Carbocisteine and mecysteine hydrochloride Mechanism of action Route of administration Indications Therapeutic notes Chapter 4: Peripheral nervous system Nerve conduction Sodium channel Size of the nerve fibre Somatic nervous system Neuromuscular junction Physiology of transduction Nicotinic acetylcholine receptor Pharmacological targets Drugs affecting the neuromuscular junction Presynaptic agents Drugs inhibiting ACh synthesis Drugs inhibiting vesicular packaging of ACh Drugs inhibiting ACh release Postsynaptic agents Non-depolarizing blockers Depolarizing (non-competitive) blockers Anticholinesterases Autonomic nervous system Autonomic ganglia Ganglion-stimulating drugs Nicotinic agonists Ganglion-blocking drugs Non-depolarizing ganglion blockers Sympathetic nervous system Adrenal medulla Adrenoceptors Effects mediated by α-adrenoreceptors α1-Receptors α2-Receptors Effects mediated by β-adrenoceptors β1-Receptors β2-Receptors Drugs acting on the sympathetic system Presynaptic agents Noradrenaline synthesis Drugs decreasing noradrenaline synthesis Drugs increasing noradrenaline synthesis Drugs inhibiting noradrenaline storage Drugs inhibiting the breakdown of leaked noradrenaline stores Drugs inhibiting noradrenaline release Drugs promoting noradrenaline release Postsynaptic agents Adrenoceptor agonists Adrenoceptor antagonists Inactivation Uptake 1 Uptake 2 Metabolism of catecholamines by the enzyme monoamine oxidase Metabolism of catecholamines by COMT Parasympathetic nervous system Parasympathetic receptors 'Neuroparietal' M1 receptors 'Neurocardiac' M2 receptors 'Smooth muscle-glandular' M3 receptors 'Eye' M4 receptors Drugs acting on the parasympathetic system Presynaptic agents Anticholinesterases Postsynaptic agents Muscarinic-receptor agonists Muscarinic-receptor antagonists Nitrergic nervous system Chapter 5: Central nervous system Basic concepts Parkinson's disease and parkinsonism Aetiology Pathogenesis Treatment of parkinsonism Drugs that increase dopaminergic activity Dopamine precursors Mechanism of action Route of administration Indications Contraindications Adverse effects Therapeutic notes Dopamine agonists Mechanism of action Route of administration Indications Adverse effects Therapeutic notes Drugs stimulating release of dopamine Mechanism of action Route of administration Indications Adverse effects Therapeutic notes MAOB inhibitors Mechanism of action Route of administration Indications Adverse effects COMT inhibitors Mechanism of action Route of administration Indications Contraindications Adverse effects Therapeutic notes Drugs that inhibit striatal cholinergic activity Anticholinergic agents Mechanism of action Route of administration Adverse effects Therapeutic notes Transplantation Dementia Cholinesterase inhibitors Mechanism of action Route of administration Indications Contraindications Adverse effects Anxiety and sleep disorders Anxiety and anxiolytics Sleep disorders and hypnotics γ-Aminobutyric acid receptor Anxiolytic and hypnotic drugs Benzodiazepines Mechanism of action Indications Route of administration Contraindications Adverse effects Therapeutic notes Non-benzodiazepine hypnotics Anxiolytic drugs acting at serotonergic receptors 5-HT1A agonists Mechanism of action Route of administration Indications Contraindications Adverse effects Therapeutic notes 5-hydroxytryptamine 3 antagonists β-Adrenoreceptor blockers Mechanism of action Route of administration Indications Contraindications Adverse effects Barbiturates Miscellaneous agents Chloral hydrate and derivatives Clomethiazole (chlormethiazole) Antidepressants Sedative antihistamines Affective disorders Monoamine theory of depression Unipolar affective disorders Treatment of unipolar depressive disorders TCAs and related drugs Mechanism of action Contraindications Adverse effects Therapeutic notes Selective serotonin reuptake inhibitors (SSRIs) Mechanism of action Contraindications Adverse effects Therapeutic notes Serotonin-noradrenaline reuptake inhibitors Mechanism of action Contraindications Adverse effects Therapeutic notes MAO inhibitors Mechanism of action Adverse effects Therapeutic notes Atypical antidepressants Mechanism of action Contraindications Adverse effects Therapeutic notes Bipolar affective disorder Treatment of bipolar affective disorders Lithium Mechanism of action Indications Contraindications Adverse effects Therapeutic notes Carbamazepine Mechanism of action Adverse effects Therapeutic notes Psychotic disorders Schizophrenia Epidemiology Symptoms and signs Theories of schizophrenia Treatment of schizophrenia Mechanism of action Route of administration Typical neuroleptics Phenothiazines Butyrophenones and thioxanthenes Atypical neuroleptics Dibenzodiazepines Indications Adverse effects Therapeutic notes Dopamine/5-HT blockers Adverse effects of neuroleptics Adverse effects on the dopaminergic pathways Adverse effects from non-selective receptor blockade Adverse effects due to individual drugs or immune reactions Neuroleptic malignant syndrome Drug misuse Definitions Drug misuse Drug dependence Drug tolerance Withdrawal Drugs of misuse Central stimulants Amphetamines Other names Mechanism of action Route of administration Effects Clinical uses Tolerance, dependence and withdrawal Adverse effects Cocaine Other names Mechanism of action Route of administration Effects Clinical uses Tolerance, dependence and withdrawal Adverse effects Methylenedioxymethamphetamine (MDMA) Other names Mechanism of action Route of administration Effects Clinical uses Tolerance, dependence and withdrawal Adverse effects Nicotine Mechanism of action Route of administration Effects Clinical uses Tolerance, dependence and withdrawal Adverse effects Nicotine products Mechanism of action Route of administration Indications Contraindications Adverse effects Therapeutic notes Bupropion (Zyban) Mechanism of action Route of administration Indications Contraindications Adverse effects Therapeutic notes Central depressants Ethanol Mechanism of action Route of administration Effects Clinical uses Tolerance, dependence and withdrawal Adverse effects Benzodiazepines Mechanism of action Route of administration Effects Clinical uses Tolerance, dependence and withdrawal Adverse effects Opioid analgesics Diamorphine (heroin) and other opioids Other names Mechanism of action Route of administration Effects Clinical uses Tolerance, dependence and withdrawal Treatment of withdrawal Adverse effects Cannabinoids Cannabis Other names Mechanism of action Route of administration Effects Clinical uses Tolerance, dependence and withdrawal Adverse effects Psychotomimetic drugs or hallucinogens Street names Mechanism of action Route of administration Effects Clinical uses Tolerance, dependence and withdrawal Adverse effects Epilepsy Common types of epileptic syndrome Causes of epilepsy Treatment of epilepsy Mechanisms of action of antiepileptics Inhibition of ionic channels involved in neuronal excitability Inhibition of excitatory transmission Enhancement of GABA-mediated inhibition Antiepileptic drugs (anticonvulsants) Phenytoin Mechanism of action Route of administration Indications Contraindications Adverse effects Therapeutic notes Sodium valproate Mechanism of action Route of administration Indications Contraindications Adverse effects Therapeutic notes Carbamazepine Mechanism of action Route of administration Indications Contraindications Adverse effects Therapeutic notes Ethosuximide Mechanism of action Route of administration Indications Contraindications Adverse effects Vigabatrin Mechanism of action Route of administration Indications Contraindications Adverse effects Therapeutic notes Lamotrigine Mechanism of action Route of administration Indications Contraindications Adverse effects Gabapentin Mechanism of action Route of administration Indications Contraindications Adverse effects Barbiturates Mechanism of action Route of administration Indications Contraindications Adverse effects Therapeutic notes Benzodiazepines Mechanism of action Route of administration Indications Contraindications Adverse effects Therapeutic notes Other anticonvulsants Status epilepticus The eye Glaucoma Treatment of open-angle glaucoma Drugs used to inhibit aqueous production β-Adrenoceptor antagonists Mechanism of action Route of administration Indications Contraindications Adverse effects Prostaglandin analogues Mechanism of action Indications Contraindication Adverse effects Sympathomimetics (adrenoceptor agonists) Mechanism of action Route of administration Indications Contraindications Adverse effects Therapeutic notes Carbonic anhydrase inhibitors (CAIs) Mechanism of action Route of administration Indications Contraindications Adverse effects Drugs used to increase the drainage of aqueous humour Miotics-muscarinic agonists Mechanism of action Route of administration Indications Contraindications Adverse effects Treatment of closed-angle glaucoma Examining the eye Muscarinic antagonists α-Adrenoceptor agonists Muscarinic agonists and α-antagonists Chapter 6: Endocrine and reproductive systems The thyroid gland Basic concepts Production of thyroid hormones Control of thyroid hormone secretion Thyroid dysfunction Hypothyroidism Management of hypothyroidism Levothyroxine Mechanism of action Route of administration Indications Contraindications Adverse effects Therapeutic regimen Liothyronine sodium (L-triiodothyronine sodium) Mechanism of action Route of administration Indications Contraindications Adverse effects Therapeutic regimen Hyperthyroidism Management of hyperthyroidism Thioureylenes Mechanism of action Route of administration Indications Contraindications Adverse effects Therapeutic regimen Anion inhibitors Mechanism of action Route of administration Indications Contraindications Adverse effects Therapeutic regimen β-Adrenoceptor antagonists Mechanism of action Route of administration Indications Contraindications Adverse effects Radioiodine The endocrine pancreas and diabetes mellitus Control of plasma glucose Insulin Diabetes mellitus Type 1 diabetes Type 2 diabetes Secondary diabetes mellitus Management of diabetes mellitus Insulin Mechanism of action Route of administration Indications Adverse effects Therapeutic regimen Therapeutic notes Oral hypoglycaemics Sulphonylureas Mechanism of action Route of administration Indications Contraindications Adverse effects Therapeutic regimen Biguanides Mechanism of action Route of administration Indications Contraindications Adverse effects Therapeutic regimen Other antidiabetics α-Glucosidase inhibitors Mechanism of action Route of administration Indications Contraindications Adverse effects Therapeutic notes Thiazolidinediones Mechanism of action Route of administration Indications Contraindications Adverse effects Therapeutic notes Diet and fluid replacement Dietary control Rehydration therapy Hypoglycaemia Glucose (dextrose monohydrate) Mechanism of action Route of administration Indications Contraindications Adverse effects Therapeutic notes Glucagon Mechanism of action Route of administration Indications Contraindications Adverse effects Therapeutic notes Adrenal corticosteroids Basic concepts Synthesis and release Glucocorticoids Mineralocorticoids Mechanism of action of corticosteroids Therapeutic use of corticosteroids Exogenous corticosteroids Mechanism of action Indications Contraindications Route of administration Adverse effects Therapeutic notes on specific steroid agents Glucocorticoids Mineralocorticoids The reproductive system Hormonal control of the reproductive system Physiology of the female reproductive tract Menstrual cycle Physiology of the male reproductive tract Drugs that affect the reproductive system Oral contraceptives Combined oral contraceptive pill Mechanism of action Route of administration Indications Contraindications Adverse effects Therapeutic regimen Progesterone-only pill (minipill) Mechanism of action Route of administration Indications Contraindications Adverse effects Therapeutic regimen Other contraceptive regimens Depot-progesterone Mechanism of action Route of administration Indications Contraindications Adverse effects Therapeutic notes Emergency contraception ('morning-after' pill) Mechanism of action Route of administration Indications Contraindications Adverse effects Therapeutic regimen Oestrogens and antioestrogens Oestrogen agonists Mechanism of action Route of administration Indications Contraindications Adverse effects Therapeutic regimen Oestrogen antagonists Mechanism of action Route of administration Indications Contraindications Adverse effects Progestogens and anti-progestogens Progestogen agonists Mechanism of action Route of administration Indications Contraindications Adverse effects Progestogen antagonists Mechanism of action Route of administration Indications Contraindications Adverse effects Androgens and antiandrogens Androgen agonists Mechanism of action Route of administration Indications Contraindications Adverse effects Androgen antagonists Mechanism of action Route of administration Indications Contraindications Adverse effects Therapeutic notes Anabolic steroids Mechanism of action Route of administration Indications Contraindications Adverse effects GnRH agonists and antagonists Agonists Mechanism of action Route of administration Indications Adverse effects Therapeutic regimen Antagonists Mechanism of action Route of administration Indications Contraindications Adverse effects Therapeutic notes Oxytocic drugs Mechanism of action Route of administration Indications Contraindications Adverse effects Bone and calcium Bone and calcium physiology Disorders of bone and calcium Drugs used in bone and calcium disorders Outline placeholder Bisphosphonates Mechanism of action Route of administration Indications Contraindications Adverse effects Calcium salts Mechanism of action Route of administration Indications Contraindications Adverse effects Therapeutic notes Vitamin D Mechanism of action Route of administration Indications Contraindications Adverse effects Therapeutic notes Calcitonin Mechanism of action Route of administration Indications Contraindications Adverse effects Selective oestrogen receptor modulator Mechanism of action Route of administration Indications Contraindications Adverse effects Therapeutic notes Future drugs Chapter 7: Kidney and urinary system Basic concepts The kidney Functions of the kidney The nephron Blood supply Glomerular filtration Tubular function Sodium and water reabsorption Proximal tubule Loop of Henle Juxtaglomerular apparatus Distal convoluted tubule and collecting tubule Diuretics Types of diuretics Loop diuretics Site of action Mechanism of action Route of administration Indications Contraindications Adverse effects Thiazide and related diuretics Site of action Mechanism of action Route of administration Indications Contraindications Adverse effects Potassium-sparing diuretics Site of action Mechanism of action Route of administration Indications Contraindications Adverse effects Therapeutic notes Osmotic diuretics Site of action Mechanism of action Route of administration Indications Contraindications Adverse effects Therapeutic notes The urinary system Urinary retention α-Blockers Parasympathomimetics Anti-androgens Urinary incontinence Antimuscarinics Mechanism of action Route of administration Indications Contraindications Adverse effects Therapeutic notes Erectile dysfunction Phosphodiesterase inhibitors Mechanism of action Route of administration Indications Contraindications Adverse effects Therapeutic notes Prostaglandin E1 Mechanism of action Route of administration Indications Contraindications Adverse effects Chapter 8: Gastrointestinal system The stomach Basic concepts Peptic ulceration Protective factors Acid secretion Gastro-oesophageal reflux Prevention and treatment of acid-related disease Reduction of acid secretion Proton pump inhibitors (PPI) Mechanism of action Route of administration Indications Contraindications Adverse effects Histamine H2-receptor antagonists Mechanism of action Route of administration Indications Contraindications Adverse effects Therapeutic notes Mucosal strengtheners Misoprostol Mechanism of action Route of administration Indications Contraindications Adverse effects Therapeutic notes Chelates Antacids Mechanism of action Route of administration Indications Contraindications Adverse effects Therapeutic notes Alginates Helicobacter pylori eradication regimens Nausea and vomiting Basic concepts Emetic drugs Antiemetic drugs H1-receptor antagonists Mechanism of action Route of administration Indications Adverse effects Therapeutic notes Phenothiazines Mechanism of action Route of administration Indications Contraindications Adverse effects Dopamine antagonists Mechanism of action Route of administration Indications Contraindications Adverse effects 5-HT3 receptor antagonists Mechanism of action Route of administration Indications Adverse effects Other antiemetics The intestines Basic concepts Intestinal motility Neuronal control Hormonal control Drugs that affect intestinal motility Motility stimulants Antispasmodics Antimuscarinics Mechanism of action Route of administration Indications Contraindications Adverse effects Drugs acting directly on smooth muscle Mechanism of action Route of administration Indications Contraindications Adverse effects Laxatives Bulk-forming laxatives Mechanism of action Route of administration Indications Contraindications Adverse effects Therapeutic notes Osmotic laxatives Mechanism of action Route of administration Indications Contraindications Adverse effects Stimulant laxatives Mechanism of action Route of administration Indications Contraindications Adverse effects Therapeutic notes Faecal softeners Mechanism of action Route of administration Indications Contraindications Adverse effects Therapeutic notes Antidiarrhoeal drugs Maintenance of fluid and electrolyte balance through ORT Use of antimicrobial drugs Use of opiate-like antimotility drugs Mechanism of action Route of administration Indications Contraindications Adverse effects Therapeutic notes Use of stool modifiers/adsorbents Mechanism of action Route of administration Indications Contraindications Adverse effects Therapeutic notes Inflammatory bowel disease Glucocorticoids Mechanism of action Route of administration Indications Contraindications Adverse effects Therapeutic notes Aminosalicylates Mechanism of action Route of administration Indications Contraindications Adverse effects Immunosuppressives, cytotoxics and antibiotics Obesity Drugs acting on the gastrointestinal tract Mechanism of action Route of administration Adverse effects Other anti-obesity drugs Anal disorders The pancreas and gall bladder Pancreatic supplements Gall bladder Ursodeoxycholic acid Colestyramine Chapter 9: Pain and anaesthesia Basic concepts Pain perception Activation of nociceptors in the peripheral tissues Transmission of pain information Onward passage of pain information Opioid receptors Endogenous opioids Opioid analgesic drugs Mechanism of action Route of administration Indications Contraindications Adverse effects Tolerance and dependence Therapeutic notes Mechanism of action Route of administration Indications Adverse effects Opioid antagonists Headache and neuralgic pain Headache Serotonin (5-HT1) agonists Mechanism of action Route of administration Indications Contraindications Adverse effects Antihistamine/serotonin antagonists Mechanism of action Route of administration Indications Contraindications Adverse effects Neuralgic pain Local anaesthesia Basic concepts Chemistry Pharmacokinetics Mechanism of block Importance of pH and ionization Routes of block Routes of administration Surface anaesthesia Infiltration anaesthesia Nerve block anaesthesia Spinal and epidural anaesthesia Unwanted effects Properties and uses General anaesthesia Basic concepts Premedication Relief from anxiety Reduction of parasympathetic bradycardia and secretions Analgesia Postoperative antiemesis Induction Maintenance Anaesthetic agents Intravenous anaesthetics Thiopental Mechanism of action Route of administration Indications Contraindications Adverse effects Therapeutic notes Propofol Mechanism of action Route of administration Indications Contraindications Adverse effects Therapeutic notes Etomidate Mechanism of action Route of administration Indications Contraindications Adverse effects Therapeutic notes Ketamine Mechanism of action Route of administration Indications Contraindications Adverse effects Therapeutic notes Inhalation anaesthetics Mechanism of action Pharmacokinetic aspects Nitrous oxide Mechanism of action Route of administration Indications Contraindications Adverse effects Therapeutic notes Halothane Mechanism of action Route of administration Indications Contraindications Adverse effects Therapeutic notes Enflurane Mechanism of action Route of administration Indications Contraindications Adverse effects Therapeutic notes Isoflurane Mechanism of action Route of administration Indications Contraindications Adverse effects Therapeutic notes Sevoflurane Mechanism of action Route of administration Indications Contraindications Adverse effects Therapeutic notes Use of neuromuscular blockers in anaesthesia Chapter 10: Inflammation, allergic diseases and immunosuppression Inflammation Arachidonic acid metabolites: the eicosanoids Anti-inflammatory drugs NSAIDs Mechanism of action Clinical effects Indications Contraindications Adverse effects Therapeutic notes on individual NSAIDs Steroidal anti-inflammatory drugs (glucocorticoids) Inflammatory diseases Rheumatoid arthritis DMARDs (disease modifying anti-rheumatic drugs) Gold salts Mechanism of action Route of administration Adverse effects Therapeutic notes Penicillamine Mechanism of action Route of administration Adverse effects Therapeutic notes Antimalarials Mechanism of action Route of administration Adverse effects Therapeutic notes Sulfasalazine Mechanism of action Route of administration Adverse effects Therapeutic notes Immunosuppressants Cytokine inhibitors Monoclonal antibodies Mechanism of action Indications Contraindications Route of administration Adverse effects Interactions Therapeutic notes Soluble TNF-α blocker Mechanism of action Indications Contraindications Route of administration Adverse effects Interactions Therapeutic notes Gout Treatment of an acute attack Non-steroidal anti-inflammatory drugs Colchicine Mechanism of action Route of administration Adverse effects Therapeutic notes Prophylaxis against recurrent attacks Agents that reduce uric acid synthesis Mechanism of action Route of administration Adverse effects Therapeutic notes Agents that increase uric acid excretion Mechanism of action Route of administration Adverse effects Therapeutic notes Skin disorders Eczema (dermatitis) Acne Psoriasis Treatment of skin disorders Corticosteroids Mechanism of action Route of administration Indications Contraindications Adverse effects Therapeutic notes Dithranol Mechanism of action Route of administration Contraindications Adverse effects Vitamin D analogues Mechanism of action Route of administration Indications Contraindications Adverse effects Tar preparations Mechanism of action Route of administration Indications Contraindications Adverse effects Salicylates Mechanism of action Route of administration Indications Contraindications Adverse effects Emollients Mechanism of action Route of administration Indications Contraindications Adverse effects Therapeutic notes Other drugs used in skin disease Preparations of drugs for use on skin Allergic disorders and drug therapy Drug therapy of allergic disorders Histamine and antihistamines H1-receptor antagonists: antihistamines Mechanism of action Indications Route of administration Adverse effects Immunosuppressants Calcineurin inhibitors Mechanism of action Indications Route of administration Adverse effects Therapeutic notes Anti-proliferatives Azathioprine Mechanism of action Indications Route of administration Adverse effects Therapeutic notes Mycophenolate mofetil Mechanism of action Indications Contraindications Route of administration Adverse effects Glucocorticoids Chapter 11: Infectious diseases Antibacterial drugs Concepts of antibacterial chemotherapy Classification of antibiotics Antibiotic resistance Innate resistance Acquired resistance Prescribing antibiotics Antibacterial drugs that inhibit cell wall synthesis Penicillins Mechanism of action Spectrum of activity Route of administration Contraindications Adverse effects Therapeutic notes Cephalosporins Mechanism of action Spectrum of activity Route of administration Contraindications Adverse effects Therapeutic notes Glycopeptides Mechanism of action Spectrum of activity Route of administration Adverse effects Therapeutic notes Monobactam and carbapenems Antibacterial drugs that inhibit bacterial nucleic acids Antifolates Mechanism of action Spectrum of activity Route of administration Contraindications Adverse effects Therapeutic notes Quinolones Mechanism of action Spectrum of activity Route of administration Contraindications Adverse effects Antibacterial drugs that inhibit protein synthesis Aminoglycosides Mechanism of action Spectrum of activity Route of administration Contraindications Adverse effects Therapeutic notes Tetracyclines Mechanism of action Spectrum of activity Route of administration Contraindications Adverse effects Therapeutic notes Chloramphenicol Mechanism of action Spectrum of activity Route of administration Contraindications Adverse effects Therapeutic notes Macrolides Mechanism of action Spectrum of activity Route of administration Adverse effects Therapeutic notes Fusidic acid Mechanism of action Spectrum of activity Route of administration Adverse effects Therapeutic notes Lincosamides Mechanism of action Spectrum of activity Route of administration Adverse effects Therapeutic notes Miscellaneous antibacterials Metronidazole and tinidazole Mechanism of action Spectrum of activity Route of administration Contraindications Adverse effects Therapeutic notes Nitrofurantoin Mechanism of action Spectrum of activity Route of administration Adverse effects Therapeutic notes Bacitracin Mechanism of action Spectrum of activity Route of administration Adverse effects Therapeutic notes Polymyxins Mechanism of action Spectrum of activity Route of administration Adverse effects Therapeutic notes Antimycobacterial drugs Antituberculosis therapy Anti-leprosy therapy Antiviral drugs Concepts of viral infection Antiviral agents Inhibition of attachment to or penetration of host cells Amantadine Mechanism of action Route of administration Indications Adverse effects Therapeutic notes Neuraminidase inhibitors Mechanism of action Route of administration Indications Contraindications Adverse effects Immunoglobulins Mechanism of action Route of administration Indications Contraindications Adverse effects Therapeutic notes Inhibition of nucleic acid replication Aciclovir and related drugs Mechanism of action Route of administration Indications Adverse effects Therapeutic notes Ganciclovir Mechanism of action Route of administration Indications Adverse effects Therapeutic notes Ribavirin (tribavirin) Mechanism of action Route of administration Indications Adverse effects Therapeutic notes Nucleoside analogue reverse transcriptase inhibitors Mechanism of action Route of administration Indications Adverse effects Therapeutic notes Non-nucleoside reverse transcriptase inhibitors Mechanism of action Route of administration Contraindications Adverse effects Therapeutic notes Inhibition of post-translational events Protease inhibitors Mechanism of action Route of administration Indications Adverse effects Therapeutic notes Immunomodulators Interferons Mechanism of action Route of administration Indications Adverse effects Therapeutic notes Drugs used in HIV infection Future anti-HIV drug therapy Antifungal drugs Concepts of fungal infection Antifungal drugs Polyene macrolides Mechanism of action Route of administration Indications Adverse effects Therapeutic notes Imidazoles Mechanism of action Route of administration Indications Adverse effects Therapeutic notes Triazoles Mechanism of action Route of administration Indications Adverse effects Therapeutic notes Other antifungals Mechanism of action Route of administration Indications Adverse effects Therapeutic notes Allylamines Flucytosine Mechanism of action Route of administration Indications Adverse effects Therapeutic notes Griseofulvin Mechanism of action Route of administration Indications Adverse effects Therapeutic notes Antiprotozoal drugs Concepts of protozoal infection Malaria Approaches to antimalarial chemotherapy Prophylactic use Curative (therapeutic use) Antimalarial drugs 4-aminoquinolines Mechanism of action Route of administration Indications Adverse effects Therapeutic notes Quinoline-methanols Mechanism of action Route of administration Indications Adverse effects Therapeutic notes Antifolates Mechanism of action Route of administration Indications Adverse effects Therapeutic notes 8-aminoquinolines Mechanism of action Route of administration Indications Contraindications Adverse effects Therapeutic notes Artemisinin Mechanism of action Route of administration Indications Contraindications Adverse effects Treatment of other protozoal infections Amoebiasis Giardiasis Trichomonas vaginitis Trypanosomiasis and leishmaniasis Trypanosomiasis Leishmaniasis Pneumocystis pneumonia Anthelmintic drugs Concepts of helminthic infection The anthelmintic drugs Niclosamide Mechanism of action Route of administration Indications Adverse effects Therapeutic notes Praziquantel Mechanism of action Route of administration Indications Adverse effects Therapeutic notes Piperazine Mechanism of action Route of administration Indications Adverse effects Therapeutic notes Benzimidazoles Mechanism of action Route of administration Indications Contraindications Adverse effects Therapeutic notes Diethylcarbamazine Mechanism of action Route of administration Indications Adverse effects Therapeutic notes Ivermectin Mechanism of action Route of administration Indications Adverse effects Levamisole Mechanism of action Route of administration Indications Adverse effects Chapter 12: Cancer Concepts of cancer chemotherapy Cancer Chemotherapy Cytotoxic chemotherapy Mechanisms of action Selectivity Resistance to cytotoxic drugs Mechanisms of genetic resistance to cytotoxic drugs Cytotoxic agents Alkylating agents Mechanism of action Route of administration Indications Adverse effects Therapeutic notes Antimetabolites Mechanism of action Route of administration Indications Adverse effects Therapeutic notes Cytotoxic antibiotics Mechanism of action Route of administration Indications Adverse effects Mitotic inhibitors Mechanism of action Route of administration Indications Adverse effects Therapeutic notes Platinum compounds Mechanism of action Indications Contraindications Route of administration Adverse effects Multikinase inhibitors Miscellaneous agents Procarbazine Mechanism of action Route of administration Indication Adverse effects Therapeutic notes Hydroxyurea Mechanism of action Route of administration Indications Adverse effects Crisantaspase Mechanism of action Route of administration Indication Adverse effects Therapeutic notes Endocrine therapy Hormones and antihormones Immunotherapy Monoclonal antibodies Mechanism of action Indications Contraindications Route of administration Adverse effects The future Self-Assessment Best of fives (BOFs) Extended-matching questions (EMQs) BOF answers EMQ answers Glossary Index