By James M Ritter, Lionel D Lewis, Timothy GK Mant, Albert Ferro
Should you know how medications paintings (pharmacodynamics), how they're dealt with via the physique (pharmacokinetics), how they have interaction with one another, and the way medicines are assessed, you then becomes a greater prescriber. A Textbook of scientific Pharmacology and Therapeutics offers that realizing. absolutely revised all through and widely illustrated, the 5th variation of this well-established textbook has been streamlined to target what clinical scholars and junior medical professionals actually need to grasp so that it will comprehend the consequences of prescribing one drug over, or together with, one other. The textual content presents present info on all components of drug prescribing with up-to-date dialogue and assistance on such themes as hostile drug reactions, custom-made medication, gene and cell-based remedy, advances in melanoma remedy, and mechanisms of drug motion and remedy guidance in HIV and mycobacterial infections remedy. a brand new bankruptcy on substitute medications and nutraceuticals has been brought and additional studying lists were up-to-date to incorporate key scientific web pages. All scientific scholars and junior medical professionals who learn this e-book will research not just how you can use medicines competently and successfully, yet, importantly, the explanation at the back of potent prescribing judgements.
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Additional resources for A Textbook of Clinical Pharmacology and Therapeutics
FURTHER READING AND WEB MATERIAL Boobis AR, Edwards RJ, Adams DA, Davies DS. Dissecting the function of P450. British Journal of Clinical Pharmacology 1996; 42: 81–9. Coon MJ. Cytochrome P450: nature’s most versatile biological catalyst. Annual Review of Pharmacology and Toxicology 2005; 45: 1–25. Lin JH, Lu AY. Interindividual variability in inhibition and induction of cytochrome P450 enzymes. Annual Review of Pharmacology and Toxicology 2001; 41: 535–67. Nelson DR, Zeldin DC, Hoffman SM, Maltais LJ, Wain HM, Nebert DW.
5: Area under blood concentration–time curve after oral (᭹) and intravenous (᭺) administration of propranolol to humans in various doses. T is the apparent threshold for propranolol following oral administration. (Redrawn from Shand DG, Rangno RE. ) Key points • • • and is one of the major difficulties in their clinical use. Variability in first-pass metabolism results from: 1. Genetic variations – for example, the bioavailability of hydralazine is about double in slow compared to fast acetylators.
20 DRUG ABSORPTION AND ROUTES OF ADMINISTRATION 4. drug metabolism by intestinal flora – this may affect drug absorption. g. by concomitant use of antibiotics) can interrupt enterohepatic recycling and cause loss of efficacy of oral contraceptives (Chapter 13); 5. g. cytochrome P450 family 3A (CYP3A)) in the gastro-intestinal epithelium (Chapter 5); 6. g. P-glycoprotein (P-gp), ABCB1). Prolonged action and sustained-release preparations Some drugs with short elimination half-lives need to be administered frequently, at inconveniently short intervals, making adherence to the prescribed regimen difficult for the patient.