Brs pharmacology

394 Pages·2013·10.434 MB·English

by  Loose, David S

Pharmacology
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Pharmacology
Gary C. Rosenfeld, PhD
Professor
Department of Integrated Biology and Pharmacology and
Graduate School of Biomedical Sciences
Assistant Dean for Education Programs
University of Texas Medical School at Houston
Houston, Texas
David S. Loose, PhD
Associate Professor
Department of Integrated Biology and Pharmacology and
Graduate School of Biomedical Sciences
University of Texas Medical School at Houston
Houston, Texas
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Sixth Edition
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9 8 7 6 5 4 3 2 1
Library of Congress Cataloging-in-Publication Data
Rosenfeld, Gary C.
Pharmacology / Gary C. Rosenfeld, David S. Loose. — 6th ed.
p. ; cm. — (Board review series)
Includes index.
ISBN 978-1-4511-7535-6
I. Loose, David S. II. Title. III. Series: Board review series.
[DNLM: 1. Pharmacological Phenomena—Examination Questions. 2. Pharmaceutical Preparations—
Examination Questions. QV 18.2]
RM301.13
615'.1076—dc23
2013013307
DISCLAIMER
Care has been taken to confirm the accuracy of the information present and to describe generally accepted
practices. However, the authors, editors, and publisher are not responsible for errors or omissions or for any con-
sequences from application of the information in this book and make no warranty, expressed or implied, with
respect to the currency, completeness, or accuracy of the contents of the publication. Application of this informa-
tion in a particular situation remains the professional responsibility of the practitioner; the clinical treatments
described and recommended may not be considered absolute and universal recommendations.
The authors, editors, and publisher have exerted every effort to ensure that drug selection and
dosage set forth in this text are in accordance with the current recommendations and practice at the time of
publication. However, in view of ongoing research, changes in government regulations, and the constant flow
of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for
each drug for any change in indications and dosage and for added warnings and precautions. This is particularly
important when the recommended agent is a new or infrequently employed drug.
Some drugs and medical devices presented in this publication have Food and Drug Administration (FDA)
clearance for limited use in restricted research settings. It is the responsibility of the health care provider to ascer-
tain the FDA status of each drug or device planned for use in their clinical practice.
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Preface
This concise review of medical pharmacology is designed for medical students, dental
students, and others in the health care professions. It is intended primarily to help stu-
dents prepare for licensing examinations, such as the United States Medical Licensing
Examination Step 1 (USMLE) and other similar examinations. This book presents con-
densed and succinct descriptions of relevant and current Board-driven information
pertaining to pharmacology without the usual associated details. It is not meant to be
a substitute for the comprehensive presentation of information and difficult concepts
found in standard pharmacology texts.
ORGANIZATION
The sixth edition begins with a chapter devoted to the general principles of drug
action, followed by chapters concerned with drugs acting on the major body systems.
Other chapters discuss autocoids, ergots, anti-inflammatory and immunosuppressive
agents, drugs used to treat anemias and disorders of hemostasis, infectious diseases,
cancer, and toxicology.
Each chapter includes a presentation of specific drugs with a discussion of their
general properties, mechanism of action, pharmacologic effects, therapeutic uses,
and adverse effects. A drug list, tables, and figures summarize essential drug informa-
tion included in all chapters.
Clinically oriented, USMLE-style review questions and answers with explana-
tions follow each chapter to help students assess their understanding of the informa-
tion. Similarly, a comprehensive examination consisting of USMLE-style questions is
included at the end of the book. This examination serves as a self-assessment tool
to help students determine their fund of knowledge and diagnose any weaknesses in
pharmacology.
Key Features
n Updated with current drug information
n End-of-chapter review tests feature updated USMLE-style questions
n Four-color tables and figures summarize essential information for quick recall
n Updated drug lists for each chapter
n Additional USMLE-style comprehensive examination questions and
explanations
Gary C. Rosenfeld, PhD
David S. Loose, PhD
v
Acknowledgments
The authors acknowledge and thank our colleagues for their support and contribu-
tions to this book and our medical students for being our harshest critics.
Our special thanks to the following UT Medical students who reviewed the previ-
ous version of this book and offered many helpful suggestions towards this edition:
Michael Arriaga, Mark A Barros, Jason S Bluth, John R Burleson, Sean B Bury, Samuel
W Carson, Zachary R Compton, Andrew J Coyne, David B Doherty, Brittany L Duyka,
Lisa M Evans, Azure G Greeson, Stephen A Herrmann, Hans B Heymann, Ari J Hyman,
Jonathon S Jundt, Jacob A Mccoy, Elisabeth W Netherton, Alexander Reskallah, Reem
Sabouni, Brittany L Sambrano, Madeleine B Samuelson, David J Savage, Yusra Siddiqui,
Sara E Slabisak, Katherine A Smith, Agathe K Streiff, and Annise G Wilson.
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Contents
Preface v
Acknowledgments vi
1. GeNeRAL PRINCIPLeS OF DRuG ACTION 1
I. Dose–Response Relationships 1
II. Drug Absorption 6
III. Drug Distribution 10
IV. Drug Elimination and Termination of Action 11
V. Biotransformation (Metabolism) of Drugs 12
VI. Excretion of Drugs 15
VII. Pharmacokinetics 16
Review Test 20
2. DRuGS ACTING ON The AuTONOmIC
NeRVOuS SySTem 27
I. The Peripheral Efferent Nervous System 27
II. Parasympathomimetic Drugs 32
III. Muscarinic-Receptor Antagonists 37
IV. Ganglion-Blocking Drugs 39
V. Skeletal Muscle Relaxants 39
VI. Sympathomimetic Drugs 43
VII. Adrenergic Receptor Antagonists 48
Review Test 53
3. DRuGS ACTING ON The ReNAL SySTem 61
I. Diuretics 61
II. Nondiuretic Inhibitors of Tubular Transport 67
Review Test 69
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viii Contents
4. DRuGS ACTING ON The CARDIOVASCuLAR SySTem 73
I. Agents Used to Treat Congestive Heart Failure (CHF) 73
II. Antiarrhythmic Drugs 79
III. Antianginal Agents 85
IV. Antihypertensive Drugs 87
V. Drugs that Lower Plasma Lipids 92
Review Test 96
5. DRuGS ACTING ON The CeNTRAL NeRVOuS SySTem 101
I. Sedative–Hypnotic Drugs 101
II. Antipsychotic (Neuroleptic) Drugs 106
III. Antidepressant Drugs 109
IV. Lithium and Anticonvulsants Used to Treat Bipolar Disorder 114
V. Opioid Analgesics and Antagonists 116
VI. Antiparkinsonian Drugs and Drugs Used to Treat Alzheimer Disease 122
VII. Antiepileptic Drugs 125
VIII. General Anesthetics 129
IX. Local Anesthetics 134
X. Drugs of Abuse 136
Review Test 146
6. AuTOCOIDS, eRGOTS, ANTI-INFLAmmATORy
AGeNTS, AND ImmuNOSuPPReSSIVe AGeNTS 151
I. Histamine and Antihistamines 151
II. Serotonin and Serotonin Antagonists 154
III. Ergots 156
IV. Eicosanoids 158
V. Nonsteroidal Antiinflammatory Drugs (NSAIDs) 160
VI. Drugs Used for Gout 169
VII. Immunosuppressive Agents 170
Review Test 175
7. DRuGS uSeD IN ANemIA AND DISORDeRS
OF hemOSTASIS 179
I. Drugs Used in the Treatment of Anemias 179
II. Drugs Acting on Myeloid Cells 183
III. Drugs Used in Hemostatic Disorders 184
Review Test 192
8. DRuGS ACTING ON The GASTROINTeSTINAL TRACT 197
I. Antiemetics 197
II. Anorexigenics and Appetite Enhancers 198
III. Agents Used for Upper GI Tract Disorders 199