Efnisyfirlit

• Front Matter
• Preface
• AUTHORS
• EDITORIAL ADVISOR
• EDITOR-IN-CHIEF
• SERIES EDITORS
• Acknowledgements
• List of abbreviations
• DRUG DOSING AND ROUTES OF ADMINISTRATION
• ABBREVIATIONS
• An explanation of the text
• MICRO-facts
• MICRO-print
• MICRO-case
• MICRO-references
• MICRO-monitoring
• Part I Clinical pharmacology
• 1 Clinical pharmacokinetics
• 1.1 BASIC PRINCIPLES OF PHARMACOKINETICS
• DRUG CONCENTRATION/TIME CURVE
• MICRO-facts
• Fig. 1.1 Drug concentration/time curve.
• Fig. 1.2 Drug concentration/time curve for modified release preparations.
• BIOAVAILABILITY
• MICRO-print
• HALF-LIFE (t½)
• MICRO-facts
• MICRO-facts
• STEADY STATE (SS)
• Fig. 1.3 Steady-state example of an orally administered drug.
• MICRO-facts
• THE APPARENT ‘VOLUME OF DISTRIBUTION’ (Vd)
• Compartment models
• Fig. 1.4 The compartment model (basic three compartment model). Here size of the boxes represents compartment distribution volume, and width of arrows represents relative cardiac output.
• LINEAR AND NON-LINEAR PHARMACOKINETICS
• Linear (first order) kinetics
• Fig. 1.5 Steady-state plasma concentration and daily dose. (a) Linear ‘first order’ response: A change in dose is associated with a proportional increase in steady-state plasma concentration. (b) Non-linear ‘zero order’ response: between stage a and b there is a rapid and progressive increase in steady-state plasma concentration as the dose increases representing saturation of metabolism/elimination pathways.
• Fig. 1.6 First order drug elimination from the plasma. Note that the half-life is constant.
• Fig. 1.7 Zero order drug elimination from the plasma. Variable half-life indicated.
• Non-linear (zero order) kinetics
• Zero order kinetics
• 2 Clinical application of pharmacokinetics
• 2.1 PRINCIPLES OF DOSING
• 2.2 LOADING DOSES
• Fig. 2.1 Intermittent drug administration and drug concentration variance.
• MICRO-print
• PRINCIPLES OF LOADING DOSES
• MICRO-facts The ‘Bucket Rule’
• MICRO-case
• 2.3 MAINTENANCE DOSING
• MICRO-facts
• MICRO-facts
• 2.4 THERAPEUTIC DRUG MONITORING
• DRUG PROPERTIES
• MICRO-case
• Fig. 2.2 Ideal case: normal weight patient, normal renal function.
• Fig. 2.3 Body builder: heavy weight, poor renal function.
• Fig. 2.4 Elderly lady: small frame, light weight, normal renal function.
• TIMING OF DOSES AND PLASMA LEVELS
• 3 Pharmacodynamics
• 3.1 BASIC PRINCIPLES OF DRUG ACTION
• NON-SPECIFIC MECHANISMS
• SPECIFIC MECHANISMS
• Drug–protein binding
• Specificity of binding
• Drug–protein interactions
• Mechanisms of clinical effects
• Agonists
• Variable effects of agonists
• Antagonists
• Irreversible and competitive antagonism
• Slow processes
• Clinical response of drug–protein interactions
• Fig. 3.1 The concentration (dose)-response curve plotted showing actual physiological response, and semi-logarithmic display.
• Fig. 3.2 Concentration (dose)-response curves representing drugs with potencies decreasing from A–C.
• MICRO-print Spare receptors
• Receptor mechanisms
• Ligand gated ion channels
• Fig. 3.3 Receptor types with associated cellular mechanisms.
• G-protein coupled receptors
• Enzyme linked receptors
• Intranuclear receptors
• MICRO-print Steroid receptors
• Site-specific non-receptor mechanisms
• Enzyme interactions
• Transporters
• Ion channels (voltage gated)
• MICRO-print Types of ion channels
• Active transport systems
• 4 Drug handling by the body
• 4.1 DRUG ROUTE AND ABSORPTION
• ORAL ROUTE
• MICRO-facts Artificial alteration of absorption
• Fig. 4.1 Factors affecting bioavailability after oral administration.
• PARENTERAL ROUTES
• Intravenous
• Intramuscular and subcutaneous
• BUCCAL, SUBLINGUAL AND RECTAL
• TOPICAL
• 4.2 METABOLISM
• DRUG FACTORS
• Metabolism as a function
• ROUTE FACTORS
• PHYSIOLOGICAL FACTORS
• Hepatic metabolism
• Phase I metabolism
• Phase II metabolism
• Enzyme induction and inhibition
• Table 4.1 Enzyme inducers and inhibitors
• MICRO-facts Mnemonics for enzyme inducers and inhibitors
• MICRO-print Alcohol and effects on hepatic metabolism
• 4.3 Excretion
• RENAL EXCRETION
• MICRO-print pH associated renal excretion
• BILIARY EXCRETION
• MICRO-reference
• Part II Drugs and practical prescribing
• 5 Cardiovascular drugs
• 5.1 POSITIVE INOTROPES
• CARDIAC GLYCOSIDES (DIGOXIN)
• Pharmacodynamics
• MICRO-facts
• Pharmacokinetics
• Indications
• Contraindications
• MICRO-facts
• Cautions
• Adverse effects
• MICRO-monitoring
• MICRO-facts Digoxin toxicity
• Important interactions
• Examples
• MICRO-reference
• 5.2 DIURETICS
• THIAZIDE DIURETICS
• Pharmacodynamics
• Indications
• Contraindications
• Cautions
• Adverse effects
• Important interactions
• Examples
• LOOP DIURETICS
• Pharmacodynamics
• Pharmacokinetics
• Indications
• Cautions and contraindications
• Adverse effects
• Important interactions
• Examples
• MICRO-print
• Special requirements
• POTASSIUM-SPARING DIURETICS
• Pharmacodynamics
• Indications
• Cautions and contraindications
• Adverse effects
• Important interactions
• Examples
• Aldosterone antagonists
• Potassium sparing diuretics
• Special requirements
• OTHER DIURETICS
• 5.3 ANTIARRHYTHMIC DRUGS
• CLASSIFICATION OF DRUGS FOR ARRHYTHMIAS
• TREATMENT ALGORITHM FOR ARRHYTHMIAS
• Supraventricular (narrow complex) arrhythmias
• Regular rhythm
• Irregular rhythm
• Ventricular (broad complex) arrhythmias
• Regular rhythm
• Irregular rhythm
• MICRO-reference
• CLASSES OF ANTIARRHYTHMIC DRUGS
• Class I antiarrhythmics
• MICRO-reference
• Adenosine
• MICRO-facts Administration of adenosine
• Amiodarone and related drugs
• Pharmacodynamics
• Pharmacokinetics
• Indications
• Cautions and contraindications
• Adverse effects
• Important interactions
• Examples
• Special requirements
• 5.4 ADRENOCEPTOR ANTAGONISTS
• α-adrenoceptor blocking drugs
• Pharmacodynamics
• Indications
• Cautions and contraindications
• Adverse effects
• Examples and dosing
• MICRO-facts Phaeochromocytoma
• β-adrenoceptor blocking drugs
• Pharmacodynamics
• Pharmacokinetics
• Indications
• Cautions and contraindications
• Adverse effects
• Important interactions
• Examples
• Non-selective
• 5.5 ANTIHYPERTENSIVE AND RELATED MEDICATIONS
• INITIATING ANTIHYPERTENSIVE MEDICATION
• MICRO-reference
• CENTRALLY ACTING ANTIHYPERTENSIVES
• Pharmacodynamics
• Indications
• Contraindications
• Cautions
• Adverse effects
• Important interactions
• Special requirements
• VASODILATOR ANTIHYPERTENSIVES
• MICRO-facts Drug induced lupus
• MICRO-print Sodium nitroprusside and cyanide toxicity
• DRUGS AFFECTING THE RENIN–ANGIOTENSIN SYSTEM
• Pharmacodynamics
• Renin–Angiotensin–Aldosterone system
• ACE inhibitors
• ARBs
• Indications
• Cautions and contraindications
• MICRO-facts ACEis and renal function
• Adverse effects
• Important interactions
• Examples
• ACE inhibitors
• ARBs
• Special requirements
• 5.6 ANTIANGINAL AND RELATED DRUGS
• NITRATES
• Pharmacodynamics
• Pharmacokinetics
• Indications
• Contraindications
• Cautions
• Adverse effects
• Important interactions
• Examples
• MICRO-facts Nitrates and tolerance
• CALCIUM CHANNEL BLOCKERS (CCBS)
• Pharmacodynamics
• MICRO-print
• Indications
• Cautions and contraindications
• Adverse effects
• Dihydropyridines
• Non-dihydropyridines
• Important interactions
• Examples and dosing
• Dihydropyridines
• Non-dihydropyridines
• OTHER ANTIANGINALS
• Nicorandil (Ikorel®)
• Ivabradine (Procoralan®)
• Ranolazine (Ranexa®)
• 5.7 ANTIPLATELET DRUGS
• ASPIRIN
• Pharmacodynamics
• Indications
• Contraindications
• Cautions
• Adverse effects
• MICRO-facts Reye’s syndrome
• MICRO-print Aspirin overdose
• Important interactions
• Examples
• ADP ANTAGONISTS
• Pharmacodynamics
• Indications
• Contraindications
• Cautions
• Adverse effects
• Examples and dosing
• DIPYRIDAMOLE
• GLYCOPROTEIN IIB/IIIA INHIBITORS
• 5.8 LIPID-LOWERING DRUGS
• STATINS
• Pharmacodynamics
• Indications
• Contraindications
• Cautions
• Adverse effects
• Important interactions
• Examples and dosing
• Special requirements
• FIBRATES
• EZETIMIBE
• BILE ACID SEQUESTRANTS
• NICOTINIC ACID AND RELATED DRUGS
• OMEGA-3 FATTY ACIDS
• 5.9 FIBRINOLYTIC DRUGS
• Pharmacodynamics
• Indications
• Cautions/contraindications
• Examples and dosing
• 5.10 ANTIFIBRINOLYTIC DRUGS
• MICRO-reference
• 6 Respiratory drugs
• 6.1 INHALED THERAPY
• Inhaler devices
• Nebulized therapy
• 6.2 BRONCHODILATORS
• BETA2 AGONISTS
• Pharmacodynamics
• Pharmacokinetics
• Indications
• Cautions
• Adverse effects
• Important interactions
• Examples
• MUSCARINIC ANTAGONISTS
• Pharmacodynamics
• Indications
• Cautions
• Adverse effects
• Important interactions
• Examples
• MICRO-print Roflumilast
• THEOPHYLLINE
• Pharmacodynamics
• Pharmacokinetics
• Indications
• Contraindications
• Cautions
• Adverse effects
• Important interactions
• Examples
• Special requirements
• MICRO-monitoring
• MICRO-print Theophylline toxicity
• LEUKOTRIENE RECEPTOR ANTAGONISTS
• Pharmacodynamics
• Indications
• Adverse effects
• Examples
• MICRO-print Sodium cromoglicate and nedocromil sodium
• 6.3 INHALED CORTICOSTERIOIDS
• Pharmacodynamics
• Pharmacokinetics
• Indications
• Cautions
• Adverse effects
• Important interactions
• Examples
• Special requirements
• 6.4 OTHER RESPIRATORY MEDICATIONS
• ANTIHISTAMINES (H1 RECEPTOR ANTAGONISTS)
• Pharmacodynamics
• Pharmacokinetics
• Indications
• Cautions
• Adverse effects
• Important interactions
• Examples
• Sedating
• Non-sedating
• Special requirements
• MUCOLYTICS
• Pharmacodynamics
• Indications
• Cautions
• Adverse effects
• Examples
• MICRO-references
• 7 Gastrointestinal drugs
• 7.1 ACID SUPPRESSANT DRUGS
• MICRO-facts Red flags and acid-suppressant drugs
• MICRO-print Gastric acid secretion
• H2 RECEPTOR ANTAGONISTS
• Pharmacodynamics
• Indications
• Cautions
• Adverse effects
• Important interactions
• Examples
• PROTON PUMP INHIBITORS (PPIs)
• Pharmacodynamics
• Indications
• Cautions
• Adverse effects
• Important interactions
• Examples
• Special requirements
• MICRO-print Misoprostol
• 7.2 DRUGS USED IN INFLAMMATORY BOWEL DISEASE (IBD)
• STEP-WISE MANAGEMENT OF IBD
• AMINOSALICYLATES
• Pharmacodynamics
• Pharmacokinetics
• Indications
• Contraindications
• Cautions
• Adverse effects
• Important interactions
• Examples
• Special requirements
• CORTICOSTEROID PREPARATIONS
• 7.3 OTHER GASTROINTESTINAL MEDICATIONS
• LOPERAMIDE
• Pharmacodynamics
• Pharmacokinetics
• Indications
• Contraindications
• Adverse effects
• LAXATIVES
• MICRO-facts Treatment of constipation
• Pharmacodynamics
• Pharmacokinetics
• Indications
• Contraindications
• Cautions
• Adverse effects
• Examples
• Special requirements
• MICRO-print Methylnaltrexone and prucalopride
• MEBEVERINE AND ALVERINE
• Pharmacodynamics
• Indications
• Contraindications
• Adverse effects
• Examples
• MICRO-print Preparations for ano-rectal disorders
• ANTIMUSCARINIC ANTISPASMODICS
• Pharmacodynamics
• Indications
• Contraindications
• Cautions, adverse effects, interactions
• Examples
• MICRO-print Ursodeoxycholic acid
• 7.4 ANTI-EMETIC DRUGS
• PATHOPHYSIOLOGY OF NAUSEA AND VOMITING
• 5-HT3 ANTAGONISTS
• Pharmacodynamics
• Indications
• Cautions
• Adverse effects
• Important interactions
• Examples
• DOPAMINE ANTAGONISTS AS ANTI-EMETICS
• Pharmacodynamics
• Indications
• Cautions and contraindications, adverse effects, interactions and examples
• ANTIHISTAMINE ANTI-EMETICS
• Pharmacodynamics
• Indications
• Cautions and contraindications
• Cautions
• Adverse effects
• Important interactions
• Examples
• METOCLOPRAMIDE AND DOMPERIDONE
• Pharmacodynamics
• Indications
• Cautions and contraindications
• MICRO-facts
• Adverse effects
• Important interactions
• Examples
• MICRO-print Neurokinin receptor antagonists
• 7.5 ANTI-OBESITY DRUGS
• MICRO-reference
• ORLISTAT
• 8 Neurological medications
• 8.1 PARKINSON’S DISEASE AND OTHER MOVEMENT DISORDERS
• GENERAL PRINCIPLES
• MICRO-fact Parkinson plus syndromes
• MICRO-fact Prescribing in Parkinson’s disease
• LEVODOPA (AND DOPA-DECARBOXYLASE INHIBITORS)
• Pharmacodynamics
• Indications
• Contraindications
• Cautions
• Adverse effects
• Important interactions
• Examples
• Special requirements
• DOPAMINE RECEPTOR AGONISTS
• Pharmacodynamics
• Indications
• Contraindications
• Cautions
• Adverse effects
• Important interactions
• Examples
• Special requirements
• MICRO-print Apomorphine
• COMT INHIBITORS (CATECHOL-O-METHYL TRANSFERASE)
• Pharmacodynamics
• Indications
• Contraindications
• Cautions
• Adverse effects
• Important interactions
• Examples
• MAOB INHIBITORS (MONOAMINE OXIDASE)
• Pharmacodynamics
• Indications
• Cautions
• Adverse effects
• Important interactions
• Examples
• ANTIMUSCARINIC DRUGS
• Pharmacodynamics
• Indications
• Cautions
• Adverse effects
• Important interactions
• Examples
• AMANTADINE
• MICRO-print Other drugs used in movement disorders
• 8.2 ANTIDEPRESSANT MEDICATION
• GENERAL PRINCIPLES
• SSRIs (SELECTIVE SEROTONIN REUPTAKE INHIBITORS)
• Pharmacodynamics
• Indications
• Contraindications
• Cautions
• Adverse effects
• Important interactions
• Examples
• Special requirements
• TRICYCLIC ANTIDEPRESSANTS (TCAs)
• Pharmacodynamics
• Indications
• Contraindications
• Cautions
• Adverse effects
• Important interactions
• Examples
• MICRO-fact Tricyclic antidepressant overdose
• RELATED NON-TRICYCLIC ANTIDEPRESSANTS
• MONOAMINE-OXIDASE INHIBITORS (MAOIs)
• Pharmacodynamics
• Indications
• Contraindications
• Cautions
• Adverse effects
• Important interactions
• MICRO-fact MAOI interactions with amines
• Examples
• Special requirements
• OTHER ANTIDEPRESSANTS
• Serotonin–noradrenaline reuptake inhibitors (SNRIs)
• Noradrenaline reuptake inhibitors (NRIs)
• MICRO-print Uncommon antidepressants
• 8.3 ANTIEPILEPTIC MEDICATIONS
• GENERAL PRINCIPLES
• Mechanism of action of antiepileptic medications
• Choice
• MICRO-fact Antiepileptic choice
• MICRO-reference
• Pregnancy
• Withdrawal
• Interactions
• Driving
• MICRO-reference
• CARBAMAZEPINE AND RELATED ANTIEPILEPTIC DRUGS
• Pharmacodynamics
• Indications
• Contraindications
• Cautions
• Adverse effects
• Important interactions
• Examples
• Special requirements
• MICRO-print Anticonvulsant hypersensitivity syndrome (AHS)
• SODIUM VALPROATE
• Pharmacodynamics
• Pharmacokinetics
• Indications
• Contraindications
• Cautions
• Adverse effects
• Important interactions
• Examples and dosing
• Special requirements
• PHENYTOIN
• Pharmacodynamics
• Pharmacokinetics
• Indications
• Contraindications
• Cautions
• Adverse effects
• Important interactions
• Examples
• Special requirements
• MICRO-monitoring Phenytoin kinetics and plasma level monitoring toxicity
• Topiramate Topamax®
• GABAPENTIN AND PREGABALIN
• Pharmacodynamics
• Indications
• Cautions
• Adverse effects
• Important interactions
• Examples
• LAMOTRIGINE
• Pharmacodynamics
• Indications
• Cautions
• Adverse effects
• Important interactions
• Examples
• Special requirements
• BARBITURATES AND RELATED DRUGS
• BENZODIAZEPINES
• Pharmacodynamics, cautions, adverse effects
• Examples and dosing
• MICRO-print Other antiepileptics
• STATUS EPILEPTICUS
• First line treatment
• Second line treatment
• Refractory epilepsy
• Other agents
• 8.4 ANTIPSYCHOTIC (NEUROLEPTIC) MEDICATIONS
• GENERAL PRINCIPLES
• Pathophysiology of schizophrenia and antipsychotic medications
• Classification of antipsychotics
• First generation (typical) antipsychotics
• Second generation (atypical) antipsychotics
• Adverse effects
• MICRO-fact Neuroleptic malignant syndrome
• Choice
• FIRST GENERATION ‘TYPICAL’ ANTIPSYCHOTICS
• Pharmacodynamics
• Indications
• Contraindications
• Cautions
• Adverse effects
• Important interactions
• Examples
• Phenothiazine derivatives
• Butyrophenones
• Thioxanthenes
• Substituted benzamides
• SECOND GENERATION ‘ATYPICAL’ ANTIPSYCHOTICS
• Pharmacodynamics
• Indications
• Contraindications and cautions
• Important interactions
• Adverse effects
• Examples
• 8.5 HYPNOTIC AND ANXIOLYTIC MEDICATIONS
• GENERAL PRINCIPLES
• BENZODIAZEPINES
• Pharmacodynamics
• Pharmacokinetics
• Indications
• Contraindications
• Cautions
• Adverse effects
• Important interactions
• Examples
• Anxiolytics
• MICRO-facts Chlordiazepoxide reducing regimens
• Hypnotics
• MICRO-print Benzodiazepine overdose
• Other benzodiazepines
• NON-BENZODIAZEPINE HYPNOTICS (Z-DRUGS)
• MICRO-reference
• MICRO-reference Other anxiolytics
• MICRO-print Other hypnotics
• 8.6 MEDICATIONS FOR BIPOLAR DISORDER AND MANIA
• GENERAL PRINCIPLES
• Bipolar affective disorder
• Acute mania control
• Prophylaxis of mania and bipolar disorder
• MICRO-reference
• LITHIUM
• Pharmacodynamics
• Pharmacokinetics
• Indications
• Cautions
• Adverse effects
• Important interactions
• Examples
• Special requirements
• MICRO-monitoring Lithium monitoring and toxicity
• 8.7 CNS STIMULANTS
• GENERAL PRINCIPLES
• Examples and dosing
• 8.8 DRUG USE IN DEMENTIA
• GENERAL PRINCIPLES
• Acetylcholinesterase inhibitors
• MICRO-print Acetylcholinesterase selectivity
• NMDA receptor antagonist
• Antipsychotics
• 8.9 DRUG USE IN SUBSTANCE DEPENDENCE
• Alcohol dependence
• Smoking cessation
• Opioid dependence
• 9 Endocrinology
• 9.1 TREATMENT OF DIABETES
• GENERAL PRINCIPLES
• MICRO-references
• INSULIN
• ANTI-DIABETIC MEDICATIONS
• Biguanides (metformin)
• Pharmacodynamics
• Indications
• Contraindications
• Cautions
• Adverse effects
• Examples
• Special requirements
• Sulphonylureas
• Pharmacodynamics
• Indications
• Cautions and contraindications
• Adverse effects
• Examples
• OTHER ANTI-DIABETIC MEDICATIONS
• Acarbose
• Thiazolidinediones (glitazones)
• Pharmacodynamics
• Indications
• Contraindications
• Cautions
• Adverse effects
• Examples
• Special requirements
• Meglitinides (Glinides)
• Pharmacodynamics
• Indications
• Cautions and contraindications
• Adverse effects
• Examples
• Dipeptidylpeptidase (DPP-4) inhibitors (gliptins)
• Pharmacodynamics
• Indications
• Contraindications
• Cautions
• Adverse effects
• Examples, specific cautions and special requirements
• GLP-1 (glucagon like peptide-1) receptor agonists
• Pharmacodynamics
• Indications
• Contraindications
• Cautions
• Adverse effects
• Examples, specific cautions and special requirements
• Special requirements
• 9.2 TREATMENT OF THYROID DISORDERS
• THYROID HORMONES
• Pharmacodynamics
• Pharmacokinetics
• Indications
• Contraindications
• Cautions
• Adverse effects
• Examples
• Special requirements
• THIONAMIDES (ANTI-THYROID THERAPY)
• Pharmacodynamics
• Indications
• Cautions and contraindications
• Adverse effects
• Examples
• MICRO-fact Neutropenia and agranulocytosis with thionamide therapy
• MICRO-print Iodine and iodide
• 9.3 CORTICOSTEROID THERAPY
• GENERAL PRINCIPLES
• MICRO-fact Glucocorticoid equivalences
• GLUCOCORTICOIDS
• MICRO-print Local effects of corticosteroids
• Pharmacodynamics
• Indications
• Cautions and contraindications
• MICRO-print Other cautions with corticosteriod therapy:
• Adverse effects
• Examples
• Special requirements
• MICRO-facts Adrenal suppression and withdrawal of glucocorticoids
• MINERALOCORTICOIDS
• Indications
• 10 Analgesia
• 10.1 PRINCIPLES OF PRESCRIBING ANALGESIA
• CAUSES OF PAIN
• STRATEGIES FOR PAIN SUPPRESSION
• Nociception
• MICRO-print Reduction in nociceptive input and capsaicin
• Block primary afferent
• Interact with high level perception
• TIME LINE OF PAIN
• Chronic pain
• Fig. 10.1 WHO pain ladder.
• Rational prescribing of analgesia
• Acute pain
• Post-operative pain
• 10.2 SIMPLE ANALGESIA
• DRUG PROFILES
• Paracetamol
• Pharmacodynamics
• Indications
• Cautions and contraindications
• Adverse effects
• Important interactions
• Dosing
• Special requirements
• MICRO-fact Paracetamol overdose (OD)
• Nefopam
• Pharmacodynamics
• Indications
• Cautions and contraindications
• Adverse effects
• Important interactions
• Dosing
• Special requirements
• 10.3 NON-STEROIDAL ANTI-INFLAMMATORY DRUGS (NSAIDs)
• DRUG PROFILES
• Pharmacodynamics
• MICRO-print NSAIDs and COX selectivity versus specificity
• Indications
• Cautions and contraindications
• Adverse effects
• MICRO-fact NSAIDs and gastro-protection
• Important interactions
• Examples and dosing
• MICRO-fact NSAIDs and renal impairment
• Fig. 10.2 Mechanism of NSAID-associated renal impairment, and exacerbation of this by other medications. PG: Prostoglandin, AII: Angiotensin 2.
• CHOICE OF NSAID
• 10.4 OPIATES
• DRUG PROFILES
• Pharmacodynamics
• MICRO-print Opiate receptors
• Pharmacokinetics
• Indications
• Contraindications
• Cautions
• Adverse effects
• Important interactions
• Examples and dosing
• Weak opioids
• Strong opioids
• MICRO-print Transdermal patches
• Special requirements
• OPIATE DOSE CONVERSION GUIDE
• MICRO-reference
• MICRO-fact NSAIDs and renal impairment
• 11 Antimicrobials I: Antibacterials
• 11.1 PRINCIPLES OF ANTIBIOTIC THERAPY
• STARTING ANTIBIOTIC THERAPY
• MICRO-facts SIRS and sepsis
• SENSITIVITY AND RESISTANCE
• Sensitivity testing and antibacterial activity
• Antibiotic resistance
• PHARMACOKINETIC CONSIDERATIONS
• Absorption
• MICRO-print
• Distribution
• Metabolism
• Elimination
• 11.2 ANTIBIOTIC CLASSES
• MICRO-facts
• Table 11.1 Classification of bacteria
• BETA-LACTAMS
• Penicillins
• Examples
• Beta-lactamase inhibitors and extended spectrum penicillins
• Beta-lactamase inhibitors (and flucloxacillin)
• Extended spectrum penicillins
• Examples
• Cephalosporins
• First generation
• Second generation
• Third generation
• Advanced generations
• Carbapenems
• Examples
• Monobactams (mono-cyclic beta-lactam)
• MICRO-facts Beta-lactam allergy and other adverse effects
• GLYCOPEPTIDES
• Main adverse effects
• Examples
• MICRO-facts Vancomycin administration
• MACROLIDES
• Adverse effects
• Examples
• MICRO-print
• TETRACYCLINES
• Examples
• AMINOGLYCOSIDES
• MICRO-facts Aminoglycoside dosing
• Adverse effects
• Examples
• QUINOLONES
• Adverse effects
• Examples
• MICRO-facts
• OTHER ANTIBIOTICS
• Metronidazole
• Clindamycin
• Chloramphenicol
• Trimethoprim/co-trimoxazole
• Nitrofurantoin
• Daptomycin (Cubicin®)
• Fusidic acid
• Linezolid (Zyvox®)
• ANTI-TUBERCULOUS AGENTS
• 12 Antimicrobials II: Antivirals and antifungals
• 12.1 ANTIRETROVIRALS
• Table 12.1 Antiretroviral drug combinations
• MICRO-facts Immune reconstitution inflammatory syndrome (IRIS)
• NUCLEOSIDE REVERSE TRANSCRIPTASE INHIBITORS (NRTIs)
• Pharmacodynamics
• Adverse effects
• Examples
• MICRO-facts Lipodystrophy
• NON-NUCLEOSIDE REVERSE TRANSCRIPTASE INHIBITORS (NNRTIs)
• Pharmacodynamics
• Adverse effects
• Examples
• PROTEASE INHIBITORS
• Pharmacodynamics
• Adverse effects
• Examples
• OTHER AGENTS
• Integrase inhibitors
• Fusion inhibitors
• CCR5 receptor antagonists
• Antiretroviral drug combinations
• 12.2 OTHER ANTIVIRAL AGENTS
• ACICLOVIR AND RELATED DRUGS
• GANCICLOVIR AND DRUGS ACTIVE AGAINST CYTOMEGALOVIRUS (CMV)
• OSELTAMIVIR AND ZANAMIVIR
• DRUGS USED IN VIRAL HEPATITIS
• Hepatitis C
• Hepatitis B
• 12.3 ANTIFUNGAL DRUGS
• TRIAZOLES
• IMIDAZOLES
• POLYENES
• OTHER AGENTS
• 13 Musculoskeletal and metabolic drugs
• 13.1 CALCIUM AND BONE METABOLISM
• GENERAL PRINCIPLES
• MICRO-facts Hypercalcaemia
• BISPHOSPHONATES
• Pharmacodynamics
• Pharmacokinetics
• MICRO-print Bisphosphonates and food
• Indications
• Cautions and contraindications
• Adverse effects
• Important interactions
• Examples
• Special requirements
• MICRO-print Monitoring with bisphosphonates
• CALCITONIN AND PARATHYROID HORMONES
• Calcitonin
• Parathyroid hormone and related drugs
• STRONTIUM RANELATE
• 13.2 NEUROMUSCULAR DRUGS
• SKELETAL MUSCLE RELAXANTS
• Baclofen
• Dantrolene
• Tizanidine
• ANTICHOLINESTERASES (ACETYL CHOLINESTERASE INHIBITORS)
• Pharmacodynamics
• Contraindications
• Cautions
• Adverse effects
• Important interactions
• Examples
• QUININE
• Adverse effects
• Dosing
• 13.3 GOUT
• TREATMENT OF ACUTE GOUT
• General principles
• Colchicine
• Pharmacodynamics
• Indications
• Cautions
• Contraindications
• Adverse effects
• Important interactions
• MICRO-facts Colchicine dosing, adverse effects and interactions
• CONTROL OF CHRONIC GOUT
• General principles
• Allopurinol
• Pharmacodynamics
• Pharmacokinetics
• Indications
• Cautions
• Contraindications
• Adverse effects
• Important interactions
• MICRO-print
• 14 Prescribing anticoagulants
• 14.1 ANTICOAGULATION
• BLOOD COAGULATION CASCADE
• WARFARIN
• Pharmacodynamics
• Fig. 14.1 The coagulation cascade showing actions of anticoagulant agents.
• Fig. 14.2 Warfarin and vitamin K dependent clotting factor activation.
• MICRO-print International Normalised Ratio (INR)
• MICRO-facts
• Pharmacokinetics
• Indications
• Adverse effects
• Important interactions
• MICRO-facts Managing interactions with warfarin
• MICRO-reference
• Monitoring
• Initiation of treatment
• Rapid anticoagulation
• Fig. 14.3 General guidance for initiating warfarin therapy. (Permissions granted by Sheffield Teaching Hospitals Foundation Trust.)
• Slow anticoagulation
• Bridging protocols
• Overdose/overtreatment
• Avoiding prescribing errors
• Fig. 14.4 Management of over-anticoagulation and reversal indications for warfarin. Local protocols may apply. (British Journal of Haematology Guidance and Joint Formulary Committee, British National Formulary (online), London: BMJ Group and Pharmaceutical Press, http://www.medicinescomplete.com, Oral anticoagulants, accessed on December 20, 2013.)
• MICRO-reference
• THE HEPARINS
• General principles and pharmacodynamics
• Low molecular weight heparins
• Pharmacokinetics
• Indications
• Examples
• Unfractionated heparin (UFH)
• MICRO-print Protamine
• Pharmacokinetics
• Indications
• Initiation of treatment and dosing
• Monitoring
• Adverse effects (both UFH and LMWH)
• MICRO-print Heparin induced thrombocytopaenia
• Fondaparinux
• DIRECT FACTOR Xa INHIBITORS
• OTHER ANTICOAGULANTS
• Direct thrombin inhibitors
• Heparinoids
• 15 Prescribing of fluids
• 15.1 INTRAVENOUS FLUIDS, INFUSIONS AND ELECTROLYTES
• FLUID COMPARTMENTS AND DAILY REQUIREMENTS
• Fluid compartments
• Fig. 15.1 Approximate fluid content per compartment as proportion of total body fluid in 70 kg man.
• Daily fluid and electrolyte requirements
• FORMULATED INTRAVENOUS FLUIDS
• Crystalloids
• Hypotonic (and relatively hypotonic)
• Isotonic
• MICRO-facts Addition of potassium to fluids
• Hypertonic
• MICRO-facts Crystalloids in common use
• Colloids
• FLUID PRESCRIBING
• Maintenance fluids
• MICRO-facts
• Fluid replacement
• MICRO-facts Fluid status assessment (tennis score system)
• MICRO-reference
• Resuscitation
• MICRO-facts
• ELECTROLYTE DISTURBANCES
• Potassium
• Hyperkalaemia
• Causes
• Clinical features
• Management
• Hypokalaemia
• Causes
• Clinical features
• Management
• Sodium
• Hypernatraemia (Na+ >150 mmol/L)
• Causes
• Clinical features
• Management
• Hyponatraemia (Na+ <130 mmol/L)
• Causes
• Clinical features
• Management
• Calcium
• Hypercalcaemia (Ca2+ >2.65 mmol/L)
• Causes
• Clinical features
• Management
• Hypocalcaemia (Ca2+ <2.2 mmol/L)
• Causes
• Clinical features
• Management
• Magnesium
• Hypomagnesaemia (Mg2+ <0.7 mmol/L)
• Causes
• Clinical features
• Management
• Phosphate
• Hypophosphataemia (PO43− <0.8 mmol/L)
• Causes
• Clinical features
• Management
• 16 Prescribing in diabetes
• 16.1 INSULIN AND PRESCRIBING IN DIABETES
• PHARMACODYNAMICS
• Fig. 16.1 Insulin-mediated uptake of glucose into cells via GLUT 4 channels. (1) Insulin binding to specific receptor; (2) recruitment and activation by phosphorylation of IRS-1; (3) IRS-1 activated protein cascade, (4) GLUT 4 transportation to cell membrane and exocytosis onto surface; (5) intracellular transport of glucose.
• MICRO-print Insulin glucose transporters
• TYPES OF INSULIN
• Quick acting
• Short-acting soluble insulin
• Rapid acting insulin analogues
• Intermediate/long acting
• Isophane insulin
• Long acting insulin analogues (lente insulin)
• Mixed insulins
• INSULIN REGIMES
• Type 1 diabetes
• MICRO-facts
• Type 2 diabetes
• INSULIN AND DOSE CHANGES
• High blood sugars
• Low blood sugars
• MICRO-facts Hypoglycaemia in type 1 diabetics
• AVOIDING PRESCRIBING ERRORS
• MICRO-reference
• INSULIN INFUSIONS AND SLIDING SCALES
• Fixed rate insulin (diabetic emergencies)
• Diabetic ketoacidosis (DKA)
• Hyperosmolar hyperglycaemic state (HHS)
• Sliding scale regimens
• General principles
• Prescribing
• Table 16.1 Example intravenous insulin infusion regimens using insulin 50 units in 50 mL normal saline via infusion pump*
• Hypoglycaemia
• MICRO-facts
• Restarting patients usual insulin/oral hypoglycaemic regimen:
• PRE-OPERATIVE PATIENTS
• 17 Immunosuppressants
• 17.1 IMMUNOSUPPRESSANT AND IMMUNOMODULATORY DRUGS
• AZATHIOPRINE AND 6-MERCAPTOPURINE (6-MP)
• Pharmacodynamics
• Pharmacokinetics
• Indications
• Cautions
• Contraindications
• Adverse effects
• Important interactions
• Special requirements
• METHOTREXATE
• Pharmacodynamics
• Pharmacokinetics
• Indications
• Cautions
• Contraindications
• Adverse effects
• Important interactions
• Special requirements
• MICRO-print Folate supplementation in methotrexate therapy
• SULFASALAZINE
• LEFLUNOMIDE ARAVA®
• Pharmacodynamics
• Pharmacokinetics
• Indications
• Cautions
• Contraindications
• Adverse effects
• Important interactions
• Special requirements
• CICLOSPORIN
• Pharmacodynamics
• Pharmacokinetics
• Indications
• Cautions
• Contraindications
• Adverse effects
• Important interactions
• Special requirements
• ANTI-TNF-α AGENTS
• Pharmacodynamics
• Pharmacokinetics
• Indications
• Cautions
• Contraindications
• Adverse effects
• Examples
• Special requirements
• MICRO-print Cytokine modulators and monoclonal antibodies
• Table 17.1 Cytokine modulators
• MICRO-print Other immunosuppressant agents
• 18 Inotropes
• 18.1 INOTROPIC DRUGS (REFERENCE ONLY)
• BACKGROUND
• Table 18.1 Drug list (for reference only)
• Part III Self-assessment
• 19 Adverse drug reactions
• CASE PRESENTATION 1
• Question 1
• ADVERSE EFFECT OPTIONS
• CASE PRESENTATION 2
• Question 2
• ADVERSE EFFECT OPTIONS
• CASE PRESENTATION 3
• Question 3
• ADVERSE EFFECT OPTIONS
• CASE PRESENTATION 4
• Question 4
• ADVERSE EFFECT OPTIONS
• CASE PRESENTATION 5
• Question 5
• ADVERSE EFFECT OPTIONS
• CASE PRESENTATION 6
• Question 6
• ADVERSE EFFECT OPTIONS
• CASE PRESENTATION 7
• Question 7
• ADVERSE EFFECT OPTIONS
• CASE PRESENTATION 8
• Question 8
• ADVERSE EFFECT OPTIONS
• ANSWERS
• Answer 1: C
• Answer 2: D
• Answer 3: E
• Answer 4: C
• Answer 5: C
• Answer 6: D
• Answer 7: B
• Answer 8: D
• 20 Communicating information
• CASE PRESENTATION 1
• Question 1
• INFORMATION OPTIONS
• CASE PRESENTATION 2
• Question 2
• INFORMATION OPTIONS
• CASE PRESENTATION 3
• Question 3
• INFORMATION OPTIONS
• CASE PRESENTATION 4
• Question 4
• INFORMATION OPTIONS
• CASE PRESENTATION 5
• Question 5
• INFORMATION OPTIONS
• CASE PRESENTATION 6
• Question 6
• INFORMATION OPTIONS
• ANSWERS
• Answer 1: C
• Answer 2: E
• Answer 3: D
• Answer 4: C
• Answer 5: D
• Answer 6: E
• 21 Calculation skills
• CASE PRESENTATION 1
• Calculation 1
• CASE PRESENTATION 2
• Calculation 2
• CASE PRESENTATION 3
• Calculation 3
• CASE PRESENTATION 4
• Calculation 4
• CASE PRESENTATION 5
• Calculation 5
• CASE PRESENTATION 6
• Calculation 6
• CASE PRESENTATION 7
• Calculation 7
• CASE PRESENTATION 8
• Calculation 8
• ANSWERS
• Answer 1: 200 micrograms/mL
• Answer 2: 10 mL
• Answer 3: 27.8 mL
• Answer 4: 21 mL
• Answer 5: 38.3 mL
• Answer 6: 2 mg
• Answer 7: 132 mg
• Answer 8: First hour 37.5 mL, next 4 hours 12.5 mL, next 16 hours 25 mL
• 22 Drug monitoring
• Case presentation 1
• Question 1
• MONITORING OPTIONS
• Case presentation 2
• Question 2
• MONITORING OPTIONS
• Case presentation 3
• Question 3
• MONITORING OPTIONS
• Case presentation 4
• Question 4
• MONITORING OPTIONS
• Case presentation 5
• Question 5
• MONITORING OPTIONS
• Case presentation 6
• Question 6
• MONITORING OPTIONS
• Case presentation 7
• Question 7
• MONITORING OPTIONS
• Case presentation 8
• Question 8
• MONITORING OPTIONS
• Answers
• Answer 1: B
• Answer 2: B
• Answer 3: B
• Answer 4: C
• Answer 5: C
• Answer 6: D
• Answer 7: E
• Answer 8: A
• 23 Data interpretation
• Case presentation 1
• Question 1
• DECISION OPTIONS
• Case presentation 2
• Question 2
• DECISION OPTIONS
• Case presentation 3
• Question 3
• DECISION OPTIONS
• Case presentation 4
• Question 4
• DECISION OPTIONS
• Case presentation 5
• Question 5
• DECISION OPTIONS
• Case presentation 6
• Question 6
• DECISION OPTIONS
• Answers
• Answer 1: D
• Answer 2: A
• Answer 3: E
• Answer 4: D
• Answer 5: E
• Answer 6: C
• 24 Planning management
• Case presentation 1
• Question 1
• MANAGEMENT OPTIONS
• Case presentation 2
• Question 2
• MANAGEMENT OPTIONS
• Case presentation 3
• Question 3
• MANAGEMENT OPTIONS
• Case presentation 4
• Question 4
• MANAGEMENT OPTIONS
• Answers
• Answer 1: D
• Answer 2: C
• Answer 3: A
• Answer 4: B
• 25 Prescription review
• CASE PRESENTATION 1
• CURRENT PRESCRIPTIONS
• Question 1A
• Question 1B
• CASE PRESENTATION 2
• CURRENT PRESCRIPTIONS
• Question 2A
• Question 2B
• CASE PRESENTATION 3
• CURRENT PRESCRIPTIONS
• Question 3A
• Question 3B
• CASE PRESENTATION 4
• CURRENT PRESCRIPTIONS
• Question 4A
• Question 4B
• Question 4C
• CASE PRESENTATION 5
• CURRENT PRESCRIPTIONS
• Question 5A
• CASE PRESENTATION 6
• CURRENT PRESCRIPTIONS
• Question 6A
• Question 6B
• CASE PRESENTATION 7
• CURRENT MEDICATIONS
• Question 7A
• Question 7B
• CASE PRESENTATION 8
• CURRENT MEDICATIONS
• Question 8A
• Question 8B
• Answers
• Answer 1A: C
• Answer 1B: D, E, H
• Answer 2A: B, E
• Answer 2B: A, D
• Answer 3A: F, G
• Answer 3B: C
• Answer 4A: J
• Answer 4B: E, H
• Answer 4C: G
• Answer 5A: C, D, F, G, H
• Answer 6A: B, E
• Answer 6B: A, F
• Answer 7A: F, G
• Answer 7B: B, E
• Answer 8A: A, C
• Answer 8B: F, G
• 26 Prescribing
• QUESTIONS
• BACKGROUND
• QUESTION INFORMATION
• Scenario 1
• Scenario 2
• Scenario 3
• Scenario 4
• Scenario 5
• Scenario 6
• Scenario 7
• Scenario 8
• ANSWERS
• Scenario 1
• Scenario 2
• Scenario 3
• Scenario 4
• Scenario 5
• Scenario 6
• Scenario 7
• Scenario 8
• Back Matter
• Index