Oxford Textbook of Clinical Pharmacology and Drug Therapy
by Grahame-Smith, David G.; Aronson, Jeffrey K.Edition: 2nd
Format: Hardcover
Pub. Date: 1992-11-05
Publisher(s): Oxford University Press
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Summary
Completely updated, the new edition of the Oxford Textbook of Clinical Pharmacology and Drug Therapy continues to provide medical students and clinicians with a unique insight into why drugs have their therapeutic effects, by presenting the basic principles of pharmacology as they affect the patient. An understanding of these principles is essential for rational, safe, effective, and economical prescribing. The text shows how knowledge of the scientific basis of drug action is applied in a clinical context to devise the most effective treatments for disease and to maximize the therapeutic effects of the drugs being used. This new edition includes an appraisal of the value of evidence-based medicine and a greater discussion of issues in genetics. There are specialist contributors for areas of infectious disease, gastrointestinal disorders, blood disorders, general anaesthesia, cancer chemotherapy, and immunosuppression. The revision also includes updates to both the pharmacopoeia and the drug therapy section, to reflect new developments in both available drugs and in their use.
Author Biography
D. G. Grahame-Smith, CBE, MBBS, PhD, FRCP: Emeritus Professor of Clinical Pharmacology, University of Oxford J. K. Aronson, MBChB, DPhil, FRCP: Clinical Reader in Clinical Pharmacology, University of Oxford Honorary Consultant Physician, Oxfordshire Health Authority
Table of Contents
| A note about drug nomenclature | p. viii |
| Consulting authors | p. ix |
| Clinical pharmacology: the scientific basis of drug therapy | |
| The four processes of drug therapy | |
| The pharmaceutical process | p. 4 |
| The pharmacokinetic process | p. 5 |
| The pharmacodynamic process | p. 5 |
| The therapeutic process | p. 5 |
| The pharmaceutical process: is the drug getting into the patient? | |
| Patient compliance/concordance | p. 7 |
| Systemic availability (bioavailability) | p. 8 |
| Special drug formulations | p. 9 |
| The pharmacokinetic process: is the drug getting to its site of action? | |
| Drug absorption and systemic availability | p. 13 |
| Drug distribution | p. 15 |
| Drug metabolism | p. 17 |
| Drug excretion | p. 19 |
| Simple pharmacokinetic calculations | p. 20 |
| The mathematics of pharmacokinetics | p. 29 |
| The pharmacodynamic process: is the drug producing the required pharmacological effect? | |
| The types of pharmacological actions of drugs | p. 35 |
| Stereoisomerism and drug action | p. 42 |
| Graded responses to drugs: the dose-responsive curve in drug therapy | p. 43 |
| The therapeutic process: is the pharmacological being translated into a therapeutic effect? | |
| Translation of the pharmacological effect of a drug into a therapeutic effect during short-term drug therapy | p. 47 |
| Translation of the pharmacological effect of a drug into a therapeutic effect during long-term drug therapy | p. 50 |
| The aims of drug therapy | p. 53 |
| Practical applications of the analysis of drug therapy | |
| The application of pharmacokinetics to the planning of drug dosage regimens | p. 57 |
| The application of the processes of drug therapy in analysing failure to respond to treatment | p. 61 |
| Monitoring drug therapy | |
| Monitoring the therapeutic effects of drugs | p. 68 |
| Monitoring the pharmacodynamic effects of drugs | p. 69 |
| Monitoring drug pharmacokinetics (plasma concentration measurement) | p. 71 |
| Pharmacogenetics and pharmacogenomics | |
| Pharmacokinetic genetic variations | p. 79 |
| Pharmacodynamic genetic variations | p. 83 |
| Adverse reactions to drugs | |
| History | p. 89 |
| Incidence of adverse drug reactions | p. 90 |
| Classification of adverse drug reactions | p. 90 |
| Dose-related adverse drug reactions | p. 92 |
| Non-dose-related adverse drug reactions | p. 94 |
| Long-term and withdrawal effects causing adverse drug reactions | p. 96 |
| Delayed effects causing adverse drug reactions | p. 98 |
| Surveillance methods used in detecting adverse drug reactions | p. 99 |
| Drug interactions | |
| Incidence of significant drug interactions | p. 105 |
| Drugs likely to be involved in interactions | p. 106 |
| Pharmaceutical interactions | p. 106 |
| Pharmacokinetic interactions | p. 107 |
| Pharmacodynamic interactions | p. 113 |
| Lists of clinically important drug interactions | p. 117 |
| Drug therapy in young and old people | |
| Drug therapy in young people | p. 119 |
| Drug therapy in old people | p. 123 |
| Drug therapy and reproduction | |
| Hormonal contraception | p. 127 |
| Hormone replacement therapy | p. 130 |
| The treatment of infertility | p. 130 |
| Drug therapy during pregnancy | p. 131 |
| Drug therapy in the termination of pregnancy and in the management of pre-term labour and labour | p. 138 |
| Drug therapy and breastfeeding | p. 139 |
| Patient compliance/concordance | |
| Factors that affect compliance | p. 141 |
| Methods of measuring compliance | p. 142 |
| Methods of improving compliance | p. 143 |
| Placebos | |
| Uses and abuses of placebos | p. 145 |
| Factors that influence the response to placebos | p. 146 |
| Mode of action of placebos | p. 146 |
| Adverse effects of placebos | p. 146 |
| Drug discovery and development: the pharmaceutical industry and the regulatory authorities | |
| Drug discovery | p. 147 |
| Drug development | p. 149 |
| Post-marketing surveillance | p. 150 |
| Advertising | p. 150 |
| Regulatory authorities | p. 150 |
| Local drug and therapeutics committees | p. 151 |
| Drug costs | p. 151 |
| Drug trials | |
| Definition of a clinical trial | p. 154 |
| The conduct of a clinical trial | p. 164 |
| Ethics | p. 164 |
| The drug history and the clinical examination and investigation of drug effects | |
| Taking the drug history | p. 167 |
| Clinical examination and investigation of drug effects | p. 169 |
| The importance of good records and communication | p. 170 |
| Practical prescribing | |
| Principles of prescribing | |
| The benefit:risk ratio in prescribing | p. 173 |
| Evidence-based medicine | p. 175 |
| How to choose a drug | p. 175 |
| How to write a prescription | |
| Practical prescription writing | p. 181 |
| Proprietary names versus approved names | p. 184 |
| Prescribing controlled drugs | p. 187 |
| Repeat prescribing | p. 187 |
| Abbreviations | p. 188 |
| Sources of information on drugs | |
| Pharmaceutical information | p. 189 |
| Pharmacokinetics | p. 190 |
| Pharmacological effects of drugs | p. 190 |
| Therapeutic | p. 190 |
| Pharmacogenetics | p. 190 |
| Adverse effects of drugs | p. 190 |
| Drug interactions | p. 190 |
| Clinical trials | p. 190 |
| Patient compliance | p. 190 |
| Prescribing information | p. 190 |
| Computerized databases | p. 191 |
| Drug information services | p. 191 |
| Bibliography | p. 191 |
| The drug therapy of disease | |
| Introduction to drug therapy | p. 197 |
| The drug therapy of infectious diseases | |
| Antibacterial drugs: the treatment of bacterial infections | p. 200 |
| Chemotherapy of viral infections | p. 210 |
| Chemotherapy of protozoal infections | p. 214 |
| Chemotherapy of helminthic infections | p. 218 |
| Chemotherapy of trematode infections | p. 218 |
| Chemotherapy of fungal infections | p. 218 |
| Prevention of infections using vaccines and immunoglobulins | p. 220 |
| The drug treatment of sexually transmitted diseases | p. 222 |
| The drug therapy of cardiovascular disorders | |
| Hypertension | p. 226 |
| Angina pectoris | p. 233 |
| Acute myocardiat infarction | p. 236 |
| Cardiac arrhythmias | p. 241 |
| Cardiac failure | p. 248 |
| Infective endocarditis | p. 253 |
| Venous thromboembolic disease | p. 255 |
| The drug therapy of respiratory diseases | |
| The use of oxygen in respiratory disorders | p. 260 |
| Cough | p. 260 |
| Pneumonias | p. 261 |
| Chronic obstructive lung disease | p. 263 |
| Bronchial asthma | p. 263 |
| Pulmonary tuberculosis | p. 270 |
| Inflammatory lung disorders | p. 272 |
| Cystic fibrosis | p. 273 |
| Drug-induced respiratory disorders | p. 273 |
| The drug therapy of gastrointestinal, hepatic, and biliary disorders | |
| Antacids | p. 276 |
| Antiemetics | p. 277 |
| Peptic ulceration | p. 279 |
| Laxatives | p. 282 |
| Antidiarrhoeal drugs | p. 283 |
| Irritable bowel syndrome | p. 284 |
| Gastrointestinal infections | p. 284 |
| Ulcerative colitis | p. 285 |
| Crohn's disease | p. 287 |
| Drugs and the liver | p. 288 |
| Drug therapy in the treatment of chronic liver disease | p. 291 |
| Drug treatment of gallstones | p. 292 |
| Drugs and the kidney and the drug therapy of renal, urinary tract, and prostatic disorders | |
| Diuretic therapy | p. 296 |
| Potassium depletion | p. 300 |
| Hyperkalaemia | p. 301 |
| The place of drugs in the management of acute renal insufficiency | p. 301 |
| The place of drugs in the management of chronic renal insufficiency | p. 302 |
| The drug treatment of glomerulonephritis | p. 305 |
| Drugs in the treatment of urinary tract infection | p. 306 |
| Drug treatment of urinary calculi | p. 307 |
| Drugs and the urinary bladder: the treatment of incontinence, detrusor instability, and enuresis | p. 307 |
| Drug therapy of tumours of the kidney | p. 308 |
| Drug therapy of prostatic disease | p. 308 |
| Drug-induced renal damage | p. 309 |
| Drugs and dialysis | p. 310 |
| The drug therapy of endocrine and metabolic disorders | |
| Disorders of the pituitary gland | p. 313 |
| Disorders of the adrenal gland | p. 316 |
| Disorders of the thyroid gland | p. 318 |
| Disorders of calcium metabolism | p. 321 |
| Diabetes mellitus | p. 324 |
| Disorders of lipid metabolism | p. 333 |
| The management of obesity | p. 337 |
| The drug therapy of blood disorders | |
| Anaemias | p. 339 |
| Myeloproliferative disorders | p. 342 |
| Lymphoproliferative disorders | p. 343 |
| Acute leukaemias | p. 344 |
| Monoclonal gammopathies | p. 345 |
| Drug-induced blood dyscrasias | p. 346 |
| Complications of blood transfusion | p. 348 |
| Blood substitutes | p. 349 |
| The drug therapy of disorders of bones and joints | |
| Arthritis | p. 351 |
| Gout and hyperuricaemia | p. 358 |
| Musculoskeletal disorders caused by drugs | p. 360 |
| Paget's disease of bone | p. 360 |
| The prevention and treatment of postmenopausal osteoporosis | p. 362 |
| The drug therapy of neurological disorders | |
| Meningitis and encephalitis | p. 363 |
| Parkinson's disease and Parkinsonism | p. 365 |
| Epilepsy | p. 367 |
| Migraine | p. 370 |
| Myasthenia gravis | p. 372 |
| Muscle spasticity | p. 374 |
| Vertigo | p. 375 |
| Trigeminal neuralgia | p. 376 |
| Drug-induced movement disorders | p. 376 |
| The drug therapy of psychiatric disorders | |
| Mechanisms of action of drugs used in psychiatric disorders | p. 377 |
| The use of psychotropic drugs | p. 380 |
| The relief of pain | |
| Anatomical and neuropharmacological mechanisms underlying pain sensation | p. 389 |
| Mechanisms of action of analgesics | p. 390 |
| Principles underlying the use of analgesics in the treatment of pain | p. 391 |
| The practical use of analgesics | p. 893 |
| The treatment of intractable pain in terminal malignant disease | p. 395 |
| Postoperative pain | p. 396 |
| General anaesthesia and local anaesthetics | |
| Premedication | p. 398 |
| Induction of anaesthesia | p. 398 |
| Muscle relaxants | p. 398 |
| Maintenance of anaesthesia | p. 400 |
| Postoperative medication | p. 404 |
| Local anaesthetics | p. 405 |
| Drug dependence and abuse | |
| Factors that predispose to drug dependence | p. 411 |
| Opiates | p. 412 |
| Cocaine and amphetamines (including Ecstasy) | p. 414 |
| Cannabis | p. 415 |
| LSD and other psychedelic drugs | p. 416 |
| Solvents and nitrites | p. 416 |
| Alcohol | p. 416 |
| Benzodiazepines | p. 417 |
| Barbiturates | p. 418 |
| Anabolic steroids | p. 418 |
| Tobacco (nicotine) | p. 418 |
| Accounts of drug dependence | p. 419 |
| The management of poisoning | |
| The immediate management of the acutely ill patient | p. 000 |
| The detailed management of poisoning | p. 000 |
| Sources of information | p. 000 |
| Agents used in the treatment of poisoning | p. 000 |
| The principles of cancer chemotherapy | |
| Tumour responsiveness to chemotherapy | p. 438 |
| The actions of chemotherapeutic drugs relevant to the clinical uses | p. 439 |
| Clinical evaluation of tumours before and after treatment | p. 442 |
| Combination chemotherapy | p. 442 |
| Regimens for cancer chemotherapy | p. 442 |
| Adverse effects of drugs used in cancer chemotherapy | p. 442 |
| The practical use of cytotoxic drugs | p. 444 |
| Immunosuppression and the drug therapy of allergies, connective tissue disorders, and primary immunodeficiencies | |
| Immune disease: pathogenesis and mechanisms of action of drugs | p. 447 |
| The use of glucocorticoids as anti-inflammatory, antiallergic, and immunosuppressive agents | p. 450 |
| The drug therapy of allergic and autoimmune disorders | p. 452 |
| The management of primary immunodeficiences | p. 454 |
| Immunosuppression in tissue and organ transplantation | p. 455 |
| Pharmacopoeia | |
| Introductory notes | p. 459 |
| Index to drugs listed in the pharmacopoeia | p. 461 |
| Pharmacopoeia | p. 469 |
| General index | p. 611 |
| Table of Contents provided by Syndetics. All Rights Reserved. |
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