Trounce's Clinical Pharmacology for Nurses and Allied Health Professionals

Höfundar: Clive P. Page; Ruma Anand; Stephen DeWilde (Útgáfa: 19)
Trounce's Clinical Pharmacology for Nurses and Allied Health Professionals

Kaup valmöguleikar

Since it was first published in 1958, Trounce’s Clinical Pharmacology has been the go-to resource for health professionals who prescribe as well as administer medications. Now in its nineteenth edition, the text has been fully updated to reflect the breadth and complexity of modern practice. The book provides everything the reader needs to know when becoming a prescriber. The text is organised by body system, making it easy to follow, and covers considerations for different patient categories as well as the management of pain, cancer and infection, substance abuse and complementary and alternative medicines.

With a strong clinical orientation and written by practising clinicians, essential information is delivered in an engaging and friendly style that will ensure this book’s continued popularity with nurses and allied health professionals for many years to come. Easy navigation makes learning enjoyable Hot topics including cardiology, rheumatology and the use of targeted therapies in cancer keep the reader up to date Learning Objectives, Summary Boxes, Revision Tips and Hints make this suitable for exam preparation Updated to include discussion of the expanding role of professionals in prescribing drugs and latest changes in legislation and guidelines Extensive glossary for those new to prescribing.

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Útgefandi
Elsevier Limited (UK)
ISBN
9780702067228
Print ISBN
9780702067051
Format
ePub
Útgáfa
19
Höfundar
Clive P. Page; Ruma Anand; Stephen DeWilde
Tungumál
English
Útgefið
2021-10-10
Prent takmörkun á líftíma
10

Kaflar

  • Trounce's Clinical Pharmacology for Nurses and Allied Health Professionals
  • Cover
  • Front Matter
  • Trounce’s Clinical Pharmacology for Nurses and Allied Health Professionals
  • Table of Contents
  • Copyright
  • Contributors
  • List of Illustrations
  • List of Tables
  • 1 : The Use of Pharmaceuticals
  • Chapter Outline
  • Learning Objectives
  • Drug Development
  • Basic Pharmacokinetics
  • The Dose
  • The Therapeutic Index
  • Choosing and Adjusting the Dose
  • Route of Administration
  • Terminology
  • Internal and External Environments
  • Bioavailability
  • Specific Routes of Drug Administration
  • Oral Drugs
  • Tablets and Capsules
  • Liquids
  • Advantages of Oral Administration
  • Disadvantages of Oral Administration
  • Topical
  • Dermal
  • Transdermal
  • Advantages
  • Disadvantages
  • Rectal and Vaginal
  • Inhalation
  • Advantages
  • Disadvantages
  • Intravenous (IV) Injection
  • Advantages
  • Disadvantages
  • Intramuscular (IM) Injection
  • Advantages
  • Disadvantages
  • Intradermal Injection
  • Subcutaneous (SC) Injection
  • Advantages
  • Disadvantages
  • Intrathecal Injection
  • Absorption, Distribution and Elimination
  • Absorption
  • Distribution of the Drug in the Body
  • Drugs and the Placenta
  • Drugs and the Blood–Brain Barrier
  • Plasma Protein Binding of Drugs
  • First Pass Metabolism
  • Elimination of Drugs
  • Drug Efflux
  • Plasma Half-Life of a Drug (t½)
  • Summary
  • Factors that May Modify the Efficacy and Choice of Dose of a Drug in Patients
  • Patient Age and Size
  • Genetic Factors
  • Examples
  • Ethnicity
  • Nutritional Factors
  • Intercurrent Illness
  • The Kidney
  • Drug Interactions
  • Psychological Factors
  • Basic Pharmacodynamics
  • Receptors as Targets for Drug Actions
  • Selectivity
  • Affinity
  • Efficacy
  • Potency
  • Agonists and Antagonists
  • Agonists
  • Antagonists
  • Partial Agonists
  • Functional Consequences of Agonist–Receptor Interaction
  • Ion Channels and Enzymes as Targets for Drug Actions
  • Other Targets for Drug Action
  • The Dose–Response Curve
  • Summary
  • References and Further Reading
  • Useful Website
  • 2 : The Role of Nurses in Drug Administration
  • Chapter Outline
  • Learning Objectives
  • Non-Medical Prescribers
  • Independent Prescribers must Ensure that they have Professional Indemnity
  • The Prescribing Competency Framework
  • The Consultation
  • Prescribing Governance
  • Drug History
  • The Prescription
  • Generic Prescribing
  • Controlled Drugs
  • Drug Protocols
  • Nursing Aspects of Administration
  • Administration of Drugs on the Ward
  • Rules of Drug Administration
  • Dosage Calculations
  • Aids to Taking Oral Drugs
  • Rectal Medicines
  • Vaginal Medicines
  • Injections
  • Intradermal Injection
  • Subcutaneous Injection
  • Intramuscular Injection
  • Intravenous Injections and Additives
  • Administration of Drugs to Children
  • Administration of Drugs to Elderly Patients
  • Drugs Adherence
  • Patient Education
  • Missed Doses
  • Useful Points
  • Drug Errors
  • Non-Prescription Drugs
  • References and Further Reading
  • Useful Websites
  • 3 : Adverse Reactions to Drugs, Testing of Drugs and Pharmacovigilance
  • Chapter Outline
  • Learning Objectives
  • Types of Adverse Reactions
  • Type A Reactions
  • Decreased Elimination
  • Undue Sensitivity
  • Type B Reactions
  • Genetic Factors
  • Host Factors
  • Environmental Factors
  • Allergic Reactions
  • Clinical Disorders Caused by Allergic Reactions
  • Acute Anaphylaxis
  • Treatment
  • Serum Sickness
  • Rashes
  • Renal Disorders
  • Other Allergies
  • Sites of Drug Interactions
  • The Gastrointestinal Tract
  • The Blood
  • At the Site of Action
  • At Sites of Elimination
  • Monoamine Oxidase Inhibitors
  • Important Interactions
  • Beneficial Interactions
  • The Introduction and Testing of New Drugs
  • Post-marketing Surveillance and Pharmacovigilance
  • Voluntary Adverse Reaction Reporting
  • A Study of the National Statistics
  • Monitored Release and Prescription Event Monitoring
  • Cohort Studies
  • Case–Control Studies
  • Record Linkage
  • Therapeutic Trials
  • Defining the Question
  • Trial Design
  • The Placebo Response
  • Meta-Analysis
  • Risk–Benefit Analysis
  • Ethics Committees
  • Generic Prescribing
  • Formularies
  • The British National Formulary (BNF)
  • Pharmacoeconomics
  • References and Further Reading
  • Useful Websites
  • 4 : The Autonomic System
  • Chapter Outline
  • Learning Objectives
  • Introduction to the Autonomic Nervous System
  • Components of the Autonomic Nervous System
  • Sympathetic Nervous System
  • Parasympathetic Nervous System
  • Non-adrenergic Non-cholinergic Nerves
  • Sensory Fibres
  • Chemical Transmission of Nerve Impulses
  • The Parasympathetic System ( Fig. 4.2 )
  • The Sympathetic System ( Fig. 4.3 )
  • Adrenoreceptors
  • α 1 Receptors
  • α 2 Receptors
  • β 1 and β 2 Receptors
  • β 3 Receptors
  • Transmission at Autonomic Ganglia
  • Sympathomimetic Drugs
  • Adrenaline (Epinephrine)
  • Noradrenaline (Norepinephrine)
  • Isoprenaline
  • Selective β 2 Agonists
  • Salbutamol
  • Long Acting β 2 Receptor Agonists (LABAs) – Salmeterol and Formoterol
  • Other Sympathomimetic Drugs
  • Adrenergic Blocking Agents
  • α 1 -Adrenergic Blockers
  • Hypertension
  • Bladder Neck Obstruction
  • β-Adrenergic Blockers
  • General Actions of β-Blockers
  • Examples of Uses of β-Blockers
  • Adverse Effects
  • Parasympathomimetic Drugs
  • Acetylcholine
  • Carbachol and Methacholine
  • Uses of Carbachol
  • Administration and Effects of Carbachol after Injection
  • Bethanechol
  • Pilocarpine
  • The Anticholinesterases
  • Important Effects of Anticholinesterases
  • Clinically Used Anticholinesterases
  • Uses of Neostigmine
  • Adverse Effects of the Anticholinesterases
  • Treatment
  • Non-clinical Uses of Anticholinesterases
  • Drugs Inhibiting the Action of Acetylcholine
  • Effects of Blockade of the Parasympathetic Division of the Autonomic Nervous System
  • Atropine
  • Uses of Atropine
  • Administration, Absorption and Elimination of Atropine
  • Hyoscine
  • Synthetic Atropine-like Drugs
  • Drugs Affecting the Non-Adrenergic Non-Cholinergic System
  • Summary
  • References and Further Reading
  • Useful Websites
  • 5 : Cardiovascular System 1: Drugs Acting on the Heart
  • Chapter Outline
  • Learning Objectives
  • Drug Treatment in Two Major Disorders of Heart Function
  • Cardiac Failure
  • The Cardiac Output
  • Causes of Cardiac Failure
  • Consequences of Cardiac Failure
  • Drugs Used in the Treatment of Cardiac Failure
  • Diuretics
  • Mechanism of Action
  • Disadvantages
  • Mechanism of Action
  • Disadvantages
  • β-Blockers
  • Vasodilators
  • Positive Inotropic Drugs
  • Digoxin
  • The Neprilysin Inhibitors
  • Care and Treatment of Patients With Cardiac Failure
  • Non-drug Management of Cardiac Failure
  • Drug Management of Cardiac Failure
  • Cardiac Arrhythmias
  • The Normal Cardiac Cycle
  • Some Useful Definitions
  • Disorders of Cardiac Rhythm
  • Arrhythmias Due to Overexcitability
  • Extrasystoles (Ectopic Beats)
  • Paroxysmal Tachycardias
  • Ventricular Tachycardias
  • Supraventricular Tachycardias
  • Atrial Flutter
  • Atrial Fibrillation
  • Arrhythmia Due to Conduction Defects
  • Drugs Used to Treat Arrhythmias
  • Vaughan Williams Classification of Antiarrhythmic Drugs
  • Functional Classification of Antiarrhythmic Drugs
  • Lidocaine
  • Contraindications and Adverse Effects
  • Verapamil (and Diltiazem)
  • Drug Interactions
  • β-Blockers
  • Mechanism of Action
  • Drug Interactions
  • Adenosine
  • Mechanism of Action and Use
  • Adverse Effects
  • Digoxin
  • Disopyramide
  • Mechanism of Action
  • Adverse Effects
  • Amiodarone
  • Mechanism of Action
  • Adverse Effects
  • Drug Interactions
  • Flecainide
  • Mechanism of Action
  • Adverse Effects
  • Propafenone
  • Direct Current Cardioversion
  • Ablation
  • Electrolytes and Arrhythmias
  • Treatment of Individual Arrhythmias
  • Atrial Fibrillation
  • Atrial Flutter
  • Ventricular Tachycardia
  • Supraventricular Tachycardia
  • Drug Treatment
  • The Wolff–Parkinson–White Syndrome
  • Arrhythmias Due to Conduction Defects
  • References and Further Reading
  • 6 : Cardiovascular System 2: Drugs Used for Blood Pressure
  • Chapter Outline
  • Learning Objectives
  • The Normal Control of Blood Pressure
  • Measurement of Blood Pressure
  • Hypertension
  • Causes of Hypertension
  • How Drugs Can Lower Blood Pressure
  • Medicines to Lower Total Peripheral Resistance
  • Angiotensin-converting Enzyme Inhibitors
  • Mechanism of Action
  • Therapeutic Use and Preparations Available
  • Preparations and Uses
  • Effects of ACE Inhibitors
  • Contraindications for ACE Inhibitors
  • Adverse Effects and Interactions
  • Angiotensin II Receptor Blockers (ARB)
  • Adverse Effects
  • Vasodilators
  • Calcium Channel Antagonists (Blockers)
  • Mechanism of Action
  • Uses
  • Short-Acting Calcium Antagonists Used for Hypertension or Angina
  • Long-Acting Calcium Antagonists Used for Hypertension or Angina
  • Calcium Antagonists Used for Hypertension Only
  • Calcium Antagonists Used for Hypertension, Angina and Cardiac Arrhythmias
  • Adverse Effects of Calcium Antagonists
  • Drug Interactions
  • Hydralazine
  • Mechanism of Action and Pharmacokinetics
  • Use of Hydralazine
  • Adverse Effects of Hydralazine
  • Minoxidil
  • Mechanism of Action and Pharmacokinetics
  • Use of Minoxidil
  • Adverse Effects of Minoxidil
  • Sympathetic Blocking Drugs
  • Mechanism of Action and Uses
  • Nitrovasodilators Exemplified by Sodium Nitroprusside
  • Use of Sodium Nitroprusside
  • Adverse Effects of Sodium Nitroprusside
  • Drugs to Lower Cardiac Output
  • β-Blockers for Treating Comorbidities
  • Drugs to Decrease Blood Volume
  • Diuretics
  • Therapeutic Use of Diuretics
  • Contraindications and Adverse Effects
  • Drug Interactions
  • Drugs That Act Centrally
  • Methyldopa
  • Therapeutic Use
  • Adverse Effects
  • Moxonidine
  • Adverse Effects
  • The Treatment of Hypertension
  • British and Irish Hypertension Society Guidelines for Hypertension Management
  • Resistant Hypertension
  • Hypertensive Emergencies
  • Rapid Reduction in Blood Pressure
  • Hypertension in Pregnancy
  • Measuring blood pressure
  • Summary
  • Drugs to treat Peripheral Vascular Disease
  • Treatment
  • Drugs for Patients in Shock
  • Drugs Commonly in Use for the Treatment of Shock
  • Dopamine
  • Dobutamine
  • References and Further Reading
  • Useful Websites
  • 7 : Cardiovascular system 3: Atheroma and Thrombosis – Anticoagulants and Thrombolytic Agents
  • Chapter Outline
  • Learning Objectives
  • Coagulation and Thrombosis
  • Coagulation
  • Thrombosis
  • Venous Thrombosis
  • Heparin and Heparin-like Compounds
  • Mechanism of Action of Heparin
  • Preparations of Heparin
  • Unfractionated Heparin
  • administration
  • Low Molecular Weight Heparins
  • Heparin-like Compounds
  • Oral Anticoagulants
  • Warfarin and the Coumarins
  • Mechanism of Action of Warfarin and Other Coumarins
  • Administration
  • Precautions to be Taken when Prescribing Warfarin
  • Adverse Effects of Warfarin
  • Use in Pregnancy
  • Drug Interactions with Warfarin
  • Direct Oral Anticoagulants
  • Direct Thrombin Inhibitors
  • Direct Factor Xa Inhibitors
  • Antidotes to DOACs
  • Prevention of Venous Thrombosis (Thromboprophylaxis)
  • Anticoagulation for Venous Thrombosis/Pulmonary Embolism
  • Summary
  • Atheroma and Arterial Thrombosis
  • Causes of Atheroma
  • The Hyperlipidaemias and Cholesterol
  • Reducing Plasma Cholesterol Levels
  • Diet and Weight Reduction
  • Drugs
  • Statins
  • Ezetimibe
  • PCSK9 Inhibitors
  • Other Drugs
  • Summary
  • Ischaemic Heart Disease
  • Drugs Used in Chronic Coronary Syndrome
  • β-Blockers
  • Clinical Use
  • Calcium Channel Blockers
  • Adverse Effects
  • The Nitrates
  • Glyceryl Trinitrate
  • tablets
  • pump spray
  • impregnated skin patches
  • intravenous infusion
  • effects
  • other uses
  • Isosorbide Dinitrate and Isosorbide Mononitrate
  • Adverse Effects of Nitrates
  • Tolerance
  • Nicorandil
  • Adverse Effects
  • Ivabradine
  • Adverse Effects
  • Ranolazine
  • Adverse Effects
  • Acute Coronary Syndrome
  • Thrombolytic Drugs
  • Fibrinolysis
  • Streptokinase/Anistreplase
  • Therapeutic Use
  • Adverse Effects
  • Contraindications
  • Tissue Plasminogen Activators
  • Urokinase
  • Antiplatelet Drugs
  • Aspirin
  • Dipyridamole
  • Adenosine Diphosphate Receptor Antagonists – Clopidogrel, Ticagrelor, Prasugrel
  • Clopidogrel
  • Ticagrelor
  • Prasugrel
  • Glycoprotein IIb/IIIa Receptor Antagonists
  • Treatment of Acute Coronary Syndrome
  • Strokes
  • Peripheral Vascular Disease
  • References and Further Reading
  • Useful Websites
  • 8 : Resuscitation
  • Chapter Outline
  • Learning Objectives
  • Background
  • Oral Rehydration Solutions
  • Intravenous Fluids
  • The Fluid Compartments of the Body
  • Osmotic Pressure and Oncotic Pressure
  • Isotonic, Hypotonic and Hypertonic Fluids
  • Crystalloids and Colloids
  • Crystalloids
  • Colloids
  • Intravenous Fluid Treatment
  • Intravenous Fluids in Shock
  • Maintenance Intravenous Fluids
  • Drugs Used During Cardiopulmonary Resuscitation
  • Basic Life Support
  • Advanced Life Support
  • Drugs Used During Resuscitation
  • Route of Administration of Drugs During Cardiopulmonary Resuscitation
  • Drugs Used in Anaphylactic Shock
  • Summary
  • References and Further Reading
  • 9 : The Respiratory System
  • Chapter Outline
  • Learning Objectives
  • Asthma
  • Treatment of Asthma
  • Bronchodilators
  • Inhaled β 2 Agonists
  • Oral and IV β 2 Agonists
  • Corticosteroids
  • ICS/LABA Fixed Dose Combination Inhalers
  • Leukotriene Receptor Antagonist
  • Methylxanthines
  • Aminophylline and Theophylline
  • Anticholinergic Drugs
  • Other Drug Classes Used to Treat Asthma
  • Sodium Cromoglycate and Nedocromil Sodium
  • Biologics
  • Management of Chronic Asthma
  • Management of Acute Asthma
  • Chronic Obstructive Pulmonary Disease
  • Inhalation Delivery Systems
  • Pressurized Metered Dose Inhalers and Breath-activated Inhalers
  • Spacers
  • Nebulisers
  • Delivery Systems for Children
  • Cough Remedies
  • The Coughing Reflex
  • Expectorants and Decongestants
  • Cough Suppressants (Antitussive Drugs)
  • Demulcents
  • Opioids
  • Antihistamines
  • Inhalations and Mucolytic Agents
  • Benzoin Tincture
  • Pulmonary Surfactants
  • Respiratory Failure
  • Type I
  • Type II
  • Respiratory Stimulant Drugs
  • Summary
  • References And Further Reading
  • Useful Websites
  • 10 : Drugs Affecting the Gastrointestinal System
  • Chapter Outline
  • Learning Objectives
  • The Mouth
  • Salivation
  • Prevention of Oral Infection
  • Mouthwashes
  • Artificial Salivas
  • Hydrogen Peroxide
  • Oral Infections and Ulceration
  • Candida
  • Oral Herpes Simplex/Herpes Labialis (Cold Sores)
  • Stomatitis with/without Ulceration
  • Aphthous Ulceration
  • Infections of the Pharynx and Tonsils
  • The Oesophagus and Stomach
  • Dyspepsia and Peptic Ulcers
  • The Production of Acid and Pepsin
  • Treatment of Peptic Ulcers and Dyspepsia
  • Approach to the Treatment of Peptic Ulcers
  • Aims of Treatment
  • Drugs for Reducing Acidity
  • Antacids
  • Antacid Mixtures
  • Antacids in Renal Failure and Other Disorders
  • Drug Interactions
  • Blocking Gastric Acid Secretion
  • Histamine Receptor (H 2 ) Blockers
  • Adverse Effects
  • Drug Reactions
  • Proton Pump Inhibitors
  • Adverse Effects
  • Ulcer Protection
  • Eradication of H. Pylori
  • Summary
  • Non-ulcer Dyspepsia
  • Carminatives (Flatus-relieving)
  • The Intestines
  • Enemas and Suppositories
  • Enemas
  • Suppositories
  • The Treatment of Chronic Inflammatory Bowel Disease
  • Corticosteroids
  • Mesalazine
  • Sulfasalazine
  • Adverse Effects
  • Immunosuppressants
  • Azathioprine
  • Methotrexate
  • Biologic Therapy
  • Infliximab
  • Mechanism of Action
  • Administration
  • Effects
  • Adverse Effects
  • Adalimumab
  • Administration
  • Diet
  • The Treatment of Constipation
  • Causes of Delayed Stool Passage
  • Neglecting the Body’s Signal to Defecate
  • Laxatives
  • Bulk Laxatives
  • Bran
  • Methylcellulose
  • Ispaghula Husk
  • Stool Softeners
  • Liquid Paraffin
  • Docusate Sodium
  • Osmotic Laxatives
  • Saline Laxatives
  • Lactulose
  • Stimulant Laxatives
  • Senna
  • Bisacodyl
  • Co-danthramer
  • Sodium Picosulfate
  • Laxative Abuse
  • Adverse Effects of Laxatives
  • Summary
  • Intestinal ‘Sedatives’
  • Anticholinergic Medicines
  • Opioids
  • Co-phenotrope (Lomotil)
  • Loperamide
  • Pancreatic Supplements
  • Gallstones
  • Ursodeoxycholic Acid
  • Drugs and the Liver
  • Chronic Viral Hepatitis
  • Interferons
  • Adverse Effects
  • Vaccines
  • Emetics
  • Mechanism of Vomiting
  • Reflex Emetics
  • Central Emetics (those Acting on the Brain)
  • Antiemetics
  • Cautionary Note
  • Muscarinic Acetylcholine Receptor Antagonists
  • Antihistamines (H 1 Receptor Antagonists)
  • Dopamine Antagonists
  • 5-HT Antagonists
  • Miscellaneous Antiemetics
  • Cannabinoids
  • Betahistine
  • Dexamethasone
  • Summary
  • References and Further Reading
  • 11 : Vitamins, Iron and Treatment of Anaemia
  • Chapter Outline
  • Learning Objectives
  • Vitamins
  • Vitamin A (Retinol)
  • Occurrence
  • Absorption, Function and Deficiency
  • Therapeutic Use
  • Toxicity
  • Retinoids
  • Therapeutic Use of Retinoids
  • Adverse Effects and Precautions
  • Topical Application
  • Oral Use
  • Contraindications
  • Vitamin B Group
  • Thiamine (Vitamin B 1 )
  • Occurrence
  • Function and Deficiency
  • Therapeutic Use
  • Adverse Effects
  • Vitamin B 2 (Riboflavin)
  • Occurrence
  • Function and Deficiency
  • Therapeutic Use
  • Nicotinic Acid
  • Occurrence
  • Function
  • Deficiency
  • Therapeutic Use
  • Adverse Effects
  • Vitamin B 6 (Pyridoxine)
  • Occurrence
  • Function
  • Deficiency
  • Therapeutic Use
  • Adverse Effects
  • Vitamin C (Ascorbic Acid)
  • Occurrence and Function
  • Scurvy
  • Therapeutic Use
  • Minimum Human Requirements
  • Vitamin B and C Combination
  • Vitamin D
  • Occurrence and Function
  • Deficiency
  • Therapeutic Use
  • Adverse Effects
  • Minimum Human Requirements
  • Vitamin E (Tocopherol)
  • Occurrence and Function
  • Vitamin K (Phytomenadione)
  • Occurrence and Function
  • Deficiency
  • Trace Elements
  • Antioxidants
  • Iron Deficiency Anaemia
  • Absorption and Metabolism of Iron
  • Iron Preparations
  • Drugs Used to Treat Other Anaemias
  • Cobalamins (Vitamin B 12 )
  • Source
  • Absorption of Vitamin B 12
  • Deficiency of Vitamin B 12
  • Treatment
  • Therapeutic Use
  • Folic Acid
  • Sources
  • Deficiency
  • Preparations
  • Therapeutic Use
  • Epoetins
  • Preparations and Therapeutic Use
  • Adverse Effects
  • Blood Growth Factors
  • Summary
  • References and Further Reading
  • Useful Websites
  • 12 : Drugs Affecting the Kidney
  • Chapter Outline
  • Learning Objectives
  • Introduction to Diuretics
  • Oedema
  • Factors Causing Fluid Retention
  • Renal Function
  • Glomerular Filtration
  • Tubular Reabsorption
  • Diuretic Drugs
  • Water
  • Osmotic Diuretics
  • Mechanism of Action
  • Mannitol
  • Administration and Therapeutic Uses
  • Adverse Effects
  • Thiazide Diuretics
  • Mechanism of Action
  • Therapeutic Uses
  • Mild Cardiac Failure
  • Hypertension
  • Cirrhosis of the Liver with Ascites
  • Nephrotic Syndrome
  • Prevention of Renal Stone Formation in Patients with Idiopathic Hypercalciuria
  • Adverse Effects
  • Loop Diuretics
  • Mechanism of Action
  • Administration, Distribution and Metabolism
  • Clinical Use of Loop Diuretics
  • Furosemide
  • Bumetanide
  • Adverse Effects of Loop Diuretics
  • Drug Interactions that can Occur when Treating with Thiazides and Loop Diuretics
  • Diuretics and Potassium Depletion
  • Risk Factors
  • Potassium-sparing Diuretics
  • Triamterene and Amiloride
  • Mechanism of Action
  • Administration and Absorption
  • Clinical Use
  • Adverse Effects
  • Spironolactone
  • Administration, Absorption and Clinical Use
  • Adverse Effects
  • Drug Interactions
  • Diuretics in Patients with Cirrhosis of the Liver
  • Diuretics in Elderly Patients
  • Acetazolamide
  • Other Uses of Acetazolamide
  • Making Urine Alkaline
  • Summary
  • References and Further Reading
  • Useful Websites
  • 13 : Drugs Used for the Treatment of Rheumatological Conditions: Treatment of Arthritis and Gout
  • Chapter Outline
  • Learning Objectives
  • The Acute Inflammatory Reaction
  • Innate Response
  • Acquired Response (Antibody Response)
  • Non-Steroidal Antiinflammatory Drugs
  • Mechanism of Action of NSAIDs
  • NSAIDs and the Kidney
  • The Salicylates
  • Aspirin (Acetylsalicylic Acid)
  • Modes of Action
  • Therapeutic Uses
  • Side Effects
  • Treatment of Aspirin Poisoning
  • Drug Interactions
  • Paracetamol
  • Therapeutic Use
  • Adverse Effects
  • Analgesic Mixtures with Aspirin or Paracetamol
  • Non-selective NSAIDs
  • Drug Interactions of the Non-selective COX Inhibitors
  • Selective COX-2 Inhibitors
  • Adverse Effects of all NSAIDs
  • Clinical Use of all NSAIDs
  • Summary
  • Rheumatoid Arthritis (and Other Rheumatic Disorders)
  • Treatment of Rheumatoid Arthritis
  • Antiinflammatory Corticosteroids
  • Disease-modifying Drugs (DMARDs)
  • Conventional (Non-biologic) DMARDs
  • Monitoring of DMARDs
  • Methotrexate
  • Adverse Effects
  • Sulfasalazine
  • Leflunomide
  • Adverse Effects
  • Hydroxychloroquine (and Chloroquine)
  • Adverse Effects
  • Azathioprine
  • Adverse Effects
  • Baricitinib and Tofacitinib
  • Adverse Effects
  • Apremilast
  • Adverse Effects
  • Biologic DMARDs
  • Monitoring of bDMARDs
  • bDMARDs in Rheumatoid Arthritis and Other Rheumatological Disorders
  • Administration and Therapeutic Effects
  • Adverse Effects
  • Concurrent Care
  • Summary
  • Gout
  • Drug Treatment of Gout
  • Therapeutic Use
  • Adverse Effects
  • Prevention of Gout
  • Drugs Preventing the Production of Uric Acid: Allopurinol and Febuxostat
  • Therapeutic Use
  • Adverse Effects
  • Uricosuric Drugs
  • Summary
  • References and Further Reading
  • Useful Website
  • 14 : Endocrine system 1: The Hypothalamus and Pituitary
  • Chapter Outline
  • Learning Objectives
  • Hormones
  • Classification of Endocrine Glands
  • The Hypothalamic–Pituitary Axis
  • The Pituitary Stalk
  • Control of Pituitary Hormone Release
  • Control of Anterior Lobe Hormone Release
  • CRH
  • GnRH
  • TRH
  • GHIH (Somatostatin)
  • Uses of Octreotide
  • GHRH (Somatorelin)
  • Dopamine
  • Hormones of the Anterior Lobe
  • Adrenocorticotrophic Hormone
  • Release of ACTH
  • Stimulation of the Synthesis and Release of Cortisol from the Adrenal Cortex
  • Trophic (Growth) Action on Adrenal Cortex Cells and Regulation of Adrenal Enzymes that Synthesize Cortisol
  • Uses of ACTH
  • LH and FSH (Gonadotrophins)
  • Thyroid-stimulating Hormone (Thyrotrophin)
  • Release of TSH
  • Actions of TSH
  • Growth Hormone (Somatotrophin)
  • Prolactin
  • Milk Production
  • Inhibition of Ovarian Function
  • Hormones of the Posterior Lobe
  • Oxytocin
  • Vasopressin (Antidiuretic Hormone)
  • Vasopressin Release
  • Therapeutic Use of Vasopressin: Diabetes Insipidus
  • Therapeutic Use of Vasopressin: Bleeding from Oesophageal Varices
  • The Hypothalamus and Obesity
  • Summary
  • References and Further Reading
  • Useful Website
  • 15 : Endocrine system 2: Hormones and Metabolism – Thyroid and Parathyroid Disorders
  • Chapter Outline
  • Learning Objectives
  • The Thyroid Gland and Thyroid Hormones
  • Introduction
  • Production and Release of Thyroid Hormones
  • Uptake of Iodide into the Thyroid
  • Biosynthesis of T3 and T4
  • Plasma Binding of Thyroxine and Thyroid Function Tests
  • Action of Thyroid Hormones
  • Abnormalities of Thyroid Function
  • Hypothyroidism
  • Congenital Hypothyroidism
  • Treatment of Hypothyroidism
  • Levothyroxine
  • Liothyronine
  • Hyperthyroidism (Thyrotoxicosis)
  • Symptoms of Hyperthyroidism
  • Types of Hyperthyroidism
  • Graves’ Disease
  • Toxic Nodular Goitre
  • Treatment of Thyrotoxicosis
  • Surgery
  • Use of Drugs to Treat Thyrotoxicosis
  • The Thionamides
  • Mechanism of Action
  • Therapeutic Use
  • Adverse Effects
  • Radio-iodine
  • Administration
  • Action and Use of 131 I
  • Precautions with 131 I
  • Other Uses of 131 I
  • Aqueous Iodine Solution/Saturated Potassium Iodide Solution
  • Adverse Effects
  • Other Drugs
  • Summary
  • Bone Metabolism, the Parathyroid Glands and Calcium
  • The Parathyroid Glands and Parathyroid Hormone
  • Actions of Parathyroid Hormone
  • Parathyroid Hormone and Calcium Deficiency
  • Treatment of Tetany
  • Calcium
  • Calcium Absorption
  • Parathyroid Hormone
  • Vitamin D
  • Hypercalcaemia
  • Treatment of Hypercalcaemia
  • Calcitonin
  • Osteoporosis and Its Treatment
  • The Bisphosphonates
  • Mechanism of Action
  • Clinical Use
  • Adverse Effects
  • Atypical Femoral Fractures
  • Osteonecrosis of the Jaw
  • Osteonecrosis of the External Auditory Canal
  • Other Drugs Used in Osteoporosis
  • Hormone Replacement Therapy
  • Other Strategies for Preventing Osteoporosis
  • Summary
  • References and Further Reading
  • 16 : Endocrine system 3: Hormones and Metabolism – Diabetes
  • Chapter Outline
  • Learning Objectives
  • The Pancreas
  • The Normal Control of Glucose Metabolism
  • Insulin
  • Actions of Insulin
  • Release of Insulin
  • Mechanism of Action of Insulin
  • Diabetes Mellitus
  • Types of Diabetes Mellitus
  • Type 1 Diabetes Mellitus
  • Type 2 Diabetes Mellitus
  • Later Complications of Both Type 1 and Type 2 Diabetes Mellitus
  • Treatment of Type 1 Diabetes
  • Dietary Management
  • Insulin
  • Sources of Insulin
  • Short-acting Insulins (Soluble Insulins)
  • Intermediate-acting Insulin
  • Isophane Insulin (NPH Insulin)
  • Long-acting Insulins
  • Insulin Detemir
  • Insulin Glargine
  • Insulin Degludec
  • Administration of Insulin
  • Strength of Insulin Preparations
  • Storage
  • Injection of Insulin
  • Other Injection Apparatus
  • Insulin Pens
  • Insulin Pumps
  • Glucose Concentrations
  • Hypoglycaemia
  • Driving a Car
  • Insulin in Special Circumstances
  • Pregnancy
  • Intercurrent Illness
  • Major Surgery
  • Diabetic Ketoacidosis and Coma
  • Management of Patients with Type 2 Diabetes Mellitus
  • Aims of Treatment
  • Oral Antidiabetic Agents
  • Metformin
  • Mechanism of Action
  • Other Effects
  • Clinical Use
  • Adverse Effects and Contraindications
  • Gliptins (DPP-4i)
  • Mechanism of Action
  • Other Effects
  • Clinical Use
  • Adverse Effects and Contraindications
  • The Thiazolidinediones (Glitazones)
  • Mechanism of Action
  • Other Effects
  • Clinical Use
  • Adverse Effects and Contraindications
  • Drug Interactions
  • The Sulphonylureas
  • Mechanism of Action
  • Clinical Use
  • Adverse Effects
  • The Meglitinides
  • Adverse Effects
  • SGL2 Inhibitors (the Flozins)
  • Mechanism of Action
  • Clinical Use
  • Adverse Effects
  • GLP-1 Agonists (Incretin Mimetics)
  • Mechanism of Action
  • Clinical Use
  • Adverse Effects
  • Acarbose
  • Mechanism of Action
  • Clinical Use
  • Insulin
  • Glucagon
  • Release of Glucagon
  • Actions of Glucagon
  • Clinical Use
  • The Nurse and the Patient with Diabetes At Home
  • Appetite Suppression and Obesity
  • Management
  • Drugs Used to Treat Obesity
  • Orlistat
  • Centrally Acting Appetite Suppressants
  • Drugs to Promote Satiety
  • Summary
  • References and Further Reading
  • Useful Websites
  • 17 : Endocrine system 4: Hormones and Metabolism – The Adrenal Glands
  • Chapter Outline
  • Learning Objectives
  • The Adrenal Glands
  • The Cortex
  • Glucocorticoid Hormones
  • Control of Cortisol Release
  • Classification
  • Effects of Cortisol and Other Corticosteroids
  • Physiological Effects of Cortisol
  • Effects on Blood Glucose
  • Survival Response to Stress
  • Adverse Effects of the Synthetic Glucocorticoids
  • Adrenal Cortical Suppression
  • Effects on Carbohydrate Metabolism
  • Effects on Electrolytes
  • Effects on Inflammation
  • Effects on the Stomach
  • Effects on Immunity
  • Effects on Bone
  • Psychological Effects
  • Responses to Stress
  • Masked Infection
  • Miscellaneous Effects
  • Clinical Use of Corticosteroids
  • Suppression of Disease Processes
  • Antiinflammatory Activity
  • Anti-allergic Activity
  • Suppression of Immunity
  • Anti-tumour Activity
  • Miscellaneous Uses
  • Replacement Therapy
  • The Adrenal Medulla
  • Summary
  • References and Further Reading
  • Useful Websites
  • 18 : Endocrine system 5: Hormones and Reproduction
  • Chapter Outline
  • Learning Objectives
  • The Female Sex Hormones
  • The Menstrual Cycle
  • Hormonal Control of the Menstrual Cycle
  • Proliferative Phase of the Cycle
  • Ovulation
  • The Luteal Phase
  • Conception
  • Pregnancy
  • The Male Sex Hormones
  • Clinical Use of GnRH Analogues
  • Synthetic GnRH and GnRH Analogues
  • Therapeutic Uses
  • Gonadorelin
  • GnRH Analogues (e.g. Zoladex)
  • Clinical Use of Gonadotrophins and Antagonists
  • FSH and LH
  • Clomifene and Cyclofenil
  • Danazol
  • Summary
  • The Oestrogens
  • Therapeutic Use of Oestrogens
  • Oral Contraception
  • Combined Oral Contraceptive Pill
  • Mechanism of Action
  • Using the Combined Oral Contraceptive Pill
  • The UK Medical Eligibility Criteria
  • Beneficial Effects of the Combined Contraceptive Pill
  • Reported Adverse Effects and Unanswered Questions about the Combined Pill
  • Thrombosis
  • Migraine
  • Breast Cancer
  • Cancer of the Cervix
  • Cardiovascular Problems
  • Nausea
  • Weight Gain
  • Mood Changes
  • Cancer of the Ovary and Uterus
  • Drugs that Interfere with the Actions of Oral Contraceptives
  • Contraindications to the Use of the Combined Oral Contraceptive Pill
  • Progestogen-only Pill, Implants and Injections
  • Intrauterine System
  • Emergency Contraception
  • Summary
  • Hormone Replacement Therapy
  • Menopausal Symptoms
  • Osteoporosis
  • Hot Flushes
  • Aim of Hormone Replacement Therapy
  • Preparations
  • Oestrogen–Progestogen Combinations
  • Oestrogens
  • Factors to Consider When Prescribing Hormone Replacement Therapy
  • Symptoms to be Treated
  • Duration of Treatment
  • Risks
  • Adverse Effects of Hormone Replacement Therapy
  • Summary
  • Drugs That Affect Uterine Smooth Muscle
  • The Prostaglandins
  • Prostaglandins and Pathology
  • Inflammation
  • Thrombosis
  • Effects on Uterine Muscle
  • Effects on the Stomach
  • Therapeutic Uses of Prostaglandins
  • Ergometrine
  • Therapeutic Use of Ergometrine
  • Oxytocin
  • Therapeutic Use of Oxytocin
  • Adverse Effects of Oxytocin
  • Syntometrine
  • Termination of Pregnancy
  • Tocolytic Agents (Drugs Inhibiting Uterine Contractions)
  • Menorrhagia
  • Dysmenorrhoea
  • Primary Dysmenorrhoea
  • Secondary Dysmenorrhoea
  • Premenstrual Syndrome
  • Non-hormonal Therapy for PMS
  • Hormonal Therapy for PMS
  • Surgical Treatment for PMS
  • Summary
  • Male Sex Hormones
  • Testosterone
  • Therapeutic Use
  • Testicular Hormone Deficiency
  • Carcinoma of the Breast
  • Androgen Antagonists
  • Carcinoma of the Prostate
  • Anabolic Hormones
  • Male Erectile Dysfunction (Impotence)
  • Drugs that Interfere with Male Sexual Performance
  • Drugs that Help Induce an Erection
  • References and Further Reading
  • Useful Websites
  • 19 : Nervous System 1: General Anaesthesia and Local Anaesthetics
  • Chapter Outline
  • Learning Objectives
  • History
  • Preoperative Assessment of the Patient
  • Premedication
  • Relief from Anxiety
  • Anxiolytic Drugs
  • Opioids
  • Reducing the Production of Saliva
  • Reducing the Volume and Acidity of Gastric Contents
  • Intravenous Induction Agents
  • Propofol
  • Etomidate
  • Thiopental
  • Ketamine
  • Maintenance of Anaesthesia
  • Inhalational Anaesthetics
  • Volatile Anaesthetic Agents
  • Future Developments
  • Short-acting Opioid Analgesics
  • Muscle Relaxants
  • The Neuromuscular Junction
  • Competitive Muscle Relaxants
  • Depolarizing Muscle Relaxants
  • Reversal of Muscle Relaxants
  • Anticholinergic Drugs (Muscarinic Receptor Antagonists)
  • Malignant Hyperpyrexia
  • Local Anaesthetics
  • Vasoconstrictors and Local Anaesthetics
  • Toxicity of Local Anaesthetics
  • Signs of Toxicity
  • Treatment of Toxicity
  • Summary
  • References and Further Reading
  • Useful Websites
  • 20 : Nervous system 2: Opioid Analgesics
  • Chapter Outline
  • Learning Objectives
  • The Perception of Pain
  • Mechanism of Pain Perception
  • The Gating Theory of Pain
  • Ascending Impulses from the Periphery to the Brain
  • Descending Impulses from the Brain to the Periphery
  • Drugs That Relieve Pain
  • Sites of Action
  • Analgesics for the Treatment of Acute Pain
  • Attitudes to Acute Pain Relief
  • The Pain Relief Programme
  • Patient-controlled Analgesia
  • Opioid Analgesics
  • The Mechanism of Action of Opioid Analgesics and Antagonists of Opioid Action
  • Opioids and Related Drugs
  • Agonists
  • Partial Agonists
  • Antagonists
  • Opium: The Source of Morphine
  • Opioid Agonists
  • Morphine
  • Oral
  • Injection
  • Metabolism and Excretion
  • Central Nervous System Actions
  • CNS Depressant Effects
  • CNS Stimulant Effects
  • Peripheral Actions (Outside the CNS)
  • Constipation
  • Increase in Biliary Pressure
  • Urinary Retention
  • Histamine Release
  • Tolerance to Morphine
  • Common Uses of Morphine
  • Pain Control
  • Signs of Overdosage
  • Diamorphine (Heroin)
  • Adverse Effects of Morphine and Diamorphine
  • Hypersensitivity
  • Dependence
  • Pseudo-allergic Responses
  • Pregnancy
  • Drug Interactions
  • Methadone
  • Therapeutic Uses
  • Pain
  • Cough
  • Heroin Withdrawal
  • Pethidine (Meperidine)
  • Therapeutic Uses
  • Oxycodone
  • Fentanyl
  • Codeine and Dihydrocodeine
  • Therapeutic Uses
  • Opioid Partial Agonists
  • Buprenorphine
  • Therapeutic Use
  • Adverse Effects
  • Meptazinol
  • Tramadol
  • Opioid Antagonists
  • Naloxone
  • Naltrexone
  • Summary
  • Analgesics for Terminal Disease
  • Determination of the Cause of Pain
  • Concept of Total Pain
  • Adjusting the Dose of Analgesic to Keep the Patient Pain-Free
  • Mild Pain
  • Moderate-to-Severe Pain
  • Side-effects
  • Other Routes of Administration
  • Opioid Non-responsive Pain
  • Treatments for Opioid Non-responsive Pain
  • Other Methods
  • Analgesics in Non-painful Terminal Disease
  • Analgesics and Chronic Non-terminal Pain
  • Gabapentin and Pregabalin (Gabapentinoids)
  • Terminal Care Services and the Pain Control Team
  • Hospice Care
  • The Hospital Support Team
  • Pain Control Teams
  • References and Further Reading
  • Useful Websites
  • 21 : Drugs Used in Neurological Diseases: Migraine, Epilepsy and Parkinson’s Disease
  • Chapter Outline
  • Learning Objectives
  • Migraine
  • Introduction
  • Treatment of Acute Attacks
  • Analgesic Drugs
  • 5-HT Receptor Agonists (Triptans)
  • Treatment to Prevent Migraine
  • Medication Overuse Headache
  • Epilepsy
  • Introduction
  • Causes of Seizures
  • Neonatal Onset
  • Childhood and Adolescence
  • Adult
  • Drugs that May Cause Seizures
  • Classification of Epilepsy
  • Historical Classifications (Often Still Encountered)
  • 2017 ILAE Classification
  • Where Seizures Begin
  • Awareness
  • Other Features of Focal Seizures
  • Other Features of Generalized Onset Seizures
  • Myoclonic Seizures
  • General Approach to the Treatment of Epilepsy
  • The Aims of Treatment
  • Drugs Used in the Treatment of Epilepsy
  • Carbamazepine
  • Therapeutic Use
  • Adverse Effects
  • Drug Interactions
  • Oxcarbazepine
  • Sodium Valproate and Valproic Acid
  • Therapeutic Use
  • Adverse Effects
  • Phenytoin
  • Therapeutic Use
  • Adverse Effects
  • Drug Interactions
  • Fosphenytoin
  • Lamotrigine
  • Therapeutic Use
  • Adverse Effects
  • Levetiracetam and Brivaracetam
  • Tiagabine
  • Therapeutic Use
  • Adverse Effects
  • Topiramate
  • Therapeutic Use
  • Adverse Effects
  • Vigabatrin
  • Therapeutic Use
  • Adverse Effects
  • Zonisamide
  • Therapeutic Use
  • Adverse Effects
  • Gabapentin
  • Therapeutic Use
  • Adverse Effects
  • Pregabalin
  • Therapeutic Use
  • Adverse Effects
  • Ethosuximide
  • Therapeutic Use
  • Adverse Effects
  • Lacosamide
  • Therapeutic Use
  • Adverse Effects
  • Benzodiazepines
  • Phenobarbital
  • Primidone
  • Other Drugs
  • Outcome of Treatment
  • Antiepileptic Hypersensitivity Syndrome
  • Generic Versus Branded Prescribing
  • Driving
  • Status Epilepticus
  • Paraldehyde
  • Febrile Convulsions
  • Prevention
  • Antiepileptics and Pregnancy
  • Eclampsia
  • Prognosis in Epilepsy
  • Summary
  • Parkinson’s Disease
  • Introduction
  • Chief Symptoms
  • Other Clinical Features
  • Causes of Parkinson’s Disease and Parkinsonism
  • Neurotransmitters in Parkinson’s Disease and Parkinsonism
  • Drug-induced Parkinsonism
  • Drugs Used in the Treatment of Parkinson’s Disease
  • Drugs that Enhance Dopaminergic Activity
  • Drugs that Replace Dopamine: Levodopa
  • Therapeutic Use
  • Adverse Effects
  • Drug Interactions
  • Drugs that Act as Dopamine Receptor Agonists
  • Drugs that May Stimulate the Release of Dopamine from Dopaminergic Nerve Terminals in the Dorsal Striatum: Amantadine
  • Therapeutic Use
  • Adverse Effects
  • Contraindications
  • Drugs that Block the Breakdown of Dopamine
  • Drugs that Reduce Cholinergic Activity (Antimuscarinic Drugs)
  • Mechanism of Action
  • Therapeutic Use of Muscarinic Receptor Antagonists
  • Adverse Effects
  • The Treatment of Parkinson’s Disease
  • Family Needs in Parkinson’s Disease
  • Surgical Treatments in Parkinson’s Disease
  • Neural Transplantation
  • Pallidotomy (Pallidectomy)
  • Deep Brain Stimulation
  • References and Further Reading
  • Useful Websites
  • 22 : Drugs Used in Psychiatric Disorders: Antipsychotics, Antidepressants, Anxiolytics, Hypnotics and Anti-dementia drugs
  • Chapter Outline
  • Learning Objectives
  • Introduction
  • Types of Mental Illness
  • Brain Neurotransmitters and Psychiatric Disorders
  • Administration of Drugs to Psychiatric Patients
  • General Points
  • Antipsychotic Drugs
  • Classification of Antipsychotic Drugs
  • Mechanism of Action of Antipsychotic Drugs
  • First Generation Antipsychotic Drugs
  • Phenothiazines
  • Therapeutic Uses and Effects
  • Group 1
  • Group 2
  • Group 3
  • Adverse Effects
  • Thioxanthenes
  • Butyrophenones
  • Other Antipsychotics
  • Second Generation Antipsychotic Drugs
  • Depot Injections
  • Treatment of Schizophrenia
  • Introduction
  • Theories about Schizophrenia
  • Management of Patients with Schizophrenia
  • Lessons:
  • NICE Recommendations for Schizophrenia
  • Acute Confusional State
  • Aetiology
  • Diagnosis
  • Treatment
  • Anxiety
  • Types of Anxiety Disorders
  • NICE Guidance on Pharmacological Treatment of Anxiety Disorders
  • Anxiolytic Drugs
  • Antidepressants
  • Benzodiazepines (BZDs)
  • Mechanism of Action
  • Therapeutic Use of BZDs
  • Other Uses
  • Adverse Effects and Interactions
  • Buspirone
  • β-Blockers
  • Insomnia
  • The Nature of Sleep
  • Treatment Guidelines for Insomnia
  • Hypnotic Drugs
  • Zaleplon, Zopiclone and Zolpidem
  • BZDs
  • Melatonin Receptor Agonists
  • Sedating Antidepressants
  • Promethazine
  • Other Hypnotics
  • Sedatives Prior to Minor Procedures
  • Depression
  • Psychosocial Causes of Clinical Depression
  • Brain Neurotransmitters and Depression
  • Management of Depression
  • NICE Recommendations for Depression
  • Selective Serotonin Reuptake Inhibitors
  • Adverse Effects
  • Contraindications, Interactions and Precautions
  • Tricyclic Antidepressants
  • Imipramine and Amitriptyline
  • Therapeutic Use
  • Bedwetting
  • Adverse Effects of TCAs
  • Tricyclic Anxiolytics
  • Monoamine Oxidase Inhibitors
  • Therapeutic Use
  • Adverse Effects
  • Interactions
  • Other Antidepressants
  • Electroconvulsive Therapy
  • Lessons:
  • Mania/Bipolar Disorder
  • Lithium
  • Therapeutic Use
  • Preparations
  • Adverse Effects
  • Drug Interactions
  • Dementia
  • Symptoms of Dementia
  • Medication Treatments in Alzheimer’s Disease
  • Acetylcholinesterase Inhibitors
  • NMDA Receptor Antagonist
  • Attention Deficit Hyperactivity Disorder
  • NICE Guidelines for ADHD
  • ADHD Drugs
  • Other Drugs
  • Jet Lag
  • Summary
  • References and Further Reading
  • Useful Websites
  • 23 : Drug Dependence and Drug Abuse
  • Chapter Outline
  • Learning Objectives
  • Introduction
  • Tolerance to Drugs
  • Reasons for Harmful Use and Drug Dependence
  • Alcohol
  • Effects of Alcohol
  • Chronic Alcoholism
  • Alcohol Intake
  • Alcohol Withdrawal
  • Treatment
  • Alcohol and Driving
  • Opioids (see chapter 20)
  • Withdrawal and Other Risks of Dependence
  • NICE Guidance on Opioid Detoxification
  • Treatment of Opioid Dependence with Drugs
  • Methadone
  • Buprenorphine (see also Chapter 20 )
  • Naltrexone
  • Clonidine
  • Lofexidine
  • Cocaine
  • Amphetamines and Ecstasy
  • Barbiturates
  • Cannabis (Marijuana)
  • Lessons:
  • Volatile Solvents
  • Hallucinogens
  • Lysergic Acid Diethylamide
  • Psilocybin (‘Magic Mushrooms’)
  • Mescaline
  • New Psychoactive Substances
  • Nicotine
  • Treatment
  • Caffeine
  • Summary
  • References and Further Reading
  • Useful Websites
  • 24 : Drugs Used for Dermatological Conditions
  • Chapter Outline
  • Learning Objectives
  • Dermatological Diagnosis and Treatment
  • Emollients
  • Types of Skin Applications
  • Ointments
  • Creams
  • Pastes
  • Lotions
  • Dusting Powders
  • Ingredients in Preparations
  • The Base
  • Active Ingredients for Topical Treatment
  • Corticosteroids
  • Calcineurin Inhibitors
  • Calcitriol and Vitamin D Analogues
  • Retinoids
  • Keratolytics and Anti-comedonal Agents
  • Coal Tar
  • Dithranol
  • Antibacterial Agents
  • Antifungal Agents
  • Antiviral Agents
  • Cytotoxic Agents
  • Systemic Treatment of Skin Conditions
  • Treatment of Some Common Skin Conditions
  • Eczema
  • Psoriasis
  • Acne
  • Rosacea
  • Scabies
  • Pityriasis Versicolor
  • Seborrhoeic Dermatitis
  • Application of Skin Preparations
  • Use of Gloves by Nurses
  • Patient Education
  • Wet Wraps
  • Medicated Baths
  • Creams and Ointments
  • Application of Corticosteroids
  • Drug Eruptions
  • Contact Dermatitis
  • Light Sensitization
  • Treatment of Adverse Skin Reactions
  • Summary
  • References and Further Reading
  • 25 : Drugs Used For Ear, Nose and Throat Disorders
  • Chapter Outline
  • Learning Objectives
  • The Ear
  • Instillation of Drops
  • Wax in the Ear
  • Otitis Externa
  • Otitis Media
  • Glue Ear
  • Vertigo
  • The Nose
  • Applying Nose Drops
  • Nasal Congestion
  • Decongestant Nose Drops, Sprays and Tablets
  • Allergic and Chronic Rhinitis
  • Sinusitis
  • Local Antibiotics
  • The Throat
  • Treatment of Sore Throats
  • The Mouth
  • Dry Mouth
  • Mouth Ulcers
  • Halitosis
  • Summary
  • References and Further Reading
  • 26 : Antibacterials
  • Chapter Outline
  • Learning Objectives
  • Introduction
  • How Antibacterial Substances Work
  • Antibiotics and the Bacterial Cell Wall
  • Gram-Positive and Gram-Negative Bacteria
  • Anaerobes
  • Choosing an Antibiotic
  • Sulphonamides
  • Co-trimoxazole (Trimethoprim and Sulfamethoxazole)
  • Mechanism of Action
  • Therapeutic Use
  • Adverse Effects
  • Trimethoprim
  • Adverse effects
  • Contraindication
  • Nitrofurans
  • Quinolones
  • Ciprofloxacin
  • Therapeutic Use
  • Adverse Effects
  • Drug Interactions
  • Other Quinolones
  • β-Lactam Antibiotics
  • Penicillins
  • Benzylpenicillin
  • Elimination of Penicillins
  • Range of Benzylpenicillin
  • Procaine Benzylpenicillin
  • Penicillin Resistance: Penicillinase and the β-Lactam Ring
  • Other Penicillins
  • Phenoxymethylpenicillin
  • Flucloxacillin
  • Broad-spectrum Penicillins
  • Co-amoxiclav
  • Extended-spectrum Penicillins (Ureido Penicillins)
  • Adverse Effects of Penicillins
  • Cephalosporins
  • The Older Cephalosporins
  • The Newer Cephalosporins
  • Oral Cephalosporins
  • Carbapenems
  • Other β-Lactams
  • Aminoglycosides
  • Effectiveness of Aminoglycosides
  • Gentamicin
  • Therapeutic Use
  • Excretion
  • Drug Interactions and Adverse Effects
  • Neomycin
  • Streptomycin
  • Therapeutic Use
  • Resistance
  • Tetracyclines
  • Properties of the Main Tetracyclines
  • Administration
  • Distribution and Excretion
  • Therapeutic Use
  • Other Tetracyclines
  • Adverse Effects of the Tetracyclines
  • Contraindications
  • Chloramphenicol
  • Therapeutic Use
  • Adverse Effects
  • Macrolides
  • Erythromycin
  • Resistance
  • Therapeutic Use
  • Adverse Effects
  • Clarithromycin
  • Azithromycin
  • Glycopeptides
  • Vancomycin
  • Adverse Effects
  • Teicoplanin
  • Adverse Effects
  • Miscellaneous Antibiotics
  • Clindamycin
  • Adverse Effects
  • Polymyxin
  • Sodium Fusidate
  • Linezolid
  • Adverse Effects
  • Contraindications
  • Colistin and Polymyxin B
  • Dalfopristin with Quinupristin
  • Adverse Effects
  • Contraindications
  • Tuberculosis
  • Common Symptoms of Tuberculosis
  • Testing for Tuberculosis
  • Immunization
  • Main Drugs Used in Tuberculosis
  • Isoniazid
  • Therapeutic Use
  • Adverse Effects
  • Rifampicin
  • Adverse Effects
  • Rifabutin
  • Ethambutol
  • Pyrazinamide
  • Adverse Effects
  • Streptomycin
  • Adverse Effects
  • Combined Preparations
  • Drug Regimens for the Treatment of Tuberculosis
  • Bacterial Resistance to Antibiotics
  • Antimicrobial Resistance
  • Multidrug Resistance
  • Antimicrobial Stewardship
  • Role of the nursing team in antimicrobial stewardship
  • Antibiotic Drugs in the Treatment of Common Infections
  • The Common Cold
  • Sore Throat
  • Bronchitis
  • Pneumonia
  • Urinary Tract Infections
  • Meningitis
  • Meningococcal Meningitis
  • Prevention
  • Meningitis in Neonates
  • Streptococcus Pneumoniae Meningitis
  • Haemophilus Influenzae Meningitis
  • Infective Endocarditis
  • Staphylococcal Infections
  • Chlamydial Infection
  • Intestinal Infections
  • Septicaemias
  • Prevention of Surgical Site Infection
  • Practical Points in the Administration of Antibiotics
  • Routine Surveillane of Healthcare-Associated Infections
  • References and Further Reading
  • Useful Websites
  • 27 : Antivirals: Treatments for HIV, Hepatitis and Influenza
  • Chapter Outline
  • Learning Objectives
  • The Virus
  • Antiviral Agents
  • Aciclovir
  • Therapeutic Use
  • Adverse Effects
  • Contraindication
  • Cytomegalovirus
  • Human Immunodeficiency Virus (HIV) and Acquired Immunodeficiency Syndrome (AIDS)
  • HIV Treatment
  • Nucleoside Reverse Transcriptase Inhibitors
  • Non-nucleoside Reverse Transcriptase Inhibitors
  • Protease Inhibitors
  • Therapeutic Use
  • Adverse Effects
  • Contraindications
  • CCR5 Antagonists
  • Integrase Inhibitors
  • Fusion Inhibitors
  • Monitoring Treatment
  • Mother-to-Infant Transmission of HIV
  • Needle-stick Injuries
  • Pre-exposure Prophylaxis
  • Complications of HIV Infection
  • The Search for Vaccines
  • Summary
  • Hepatitis B and Hepatitis C Virus
  • Prevention and Management
  • The Interferons
  • Treatments for Viral Hepatitis
  • Influenza
  • Treatment of Influenza
  • Summary
  • Antifungal Agents
  • Introduction
  • Classification of Fungal Infections
  • Superficial Infections
  • Systemic Infections
  • Drugs Used to Treat Fungal Infections
  • Candidiasis
  • Treatment
  • Oral Candidiasis
  • Oesophageal, Intestinal or Systemic Candidiasis
  • Vaginal Candidiasis
  • Systemic Fungal Infections
  • Summary
  • References and Further Reading
  • Useful Websites
  • 28 : Vaccines
  • Chapter Outline
  • Learning Objectives
  • The Immune Reaction
  • Humoral Immunity
  • Cell-mediated Immunity
  • Active Immunization
  • Passive Immunization
  • Administration of Serum
  • Precautions when Injecting Serum
  • Antisera
  • Vaccines
  • Contraindications to Immunization
  • Immunization Against Viral Hepatitis
  • COVID-19
  • Avian Flu
  • Immunization Against the Human Papilloma Virus
  • Immunization Against Herpes Zoster (Shingles)
  • Drugs That Block the Immune Reaction
  • Summary
  • References and Further Reading
  • 29 : Drugs Used in the Treatment of Malignant Diseases
  • Chapter Outline
  • Learning Objectives
  • Introduction
  • The Mechanisms and Natural History of Cancer
  • The Cell Cycle
  • Approaches to Cancer Treatment
  • Drug Treatments for Cancer
  • Cytotoxic Drugs
  • Alkylating Agents
  • Cyclophosphamide
  • Adverse Effects
  • Chlorambucil
  • Therapeutic Use
  • Busulfan
  • Adverse Effects
  • Melphalan
  • Lomustine
  • Adverse Effects
  • Carmustine
  • Antimetabolites
  • Methotrexate
  • Therapeutic Use
  • Adverse Effects
  • Raltitrexed
  • Pemetrexed
  • Hydroxycarbamide
  • Nucleoside Analogues
  • Therapeutic Use
  • Topoisomerase I Inhibitors (Camptothecins)
  • Topoisomerase II Inhibitors (Podophyllotoxins and Others)
  • Anthracyclines (Cytotoxic Antibiotics)
  • Taxanes
  • Vinca Alkaloids
  • Platinum Compounds (Organoplatinum Compounds; ‘Platins’)
  • Other Cytotoxic Drugs
  • Targeted Therapies
  • Monoclonal Antibody Targeted Therapies
  • Small Molecule Targeted Therapies
  • Tyrosine Kinase Inhibitors
  • mTOR Inhibitors
  • Poly(ADP-ribose) Polymerase Inhibitors (PARP inhibitors)
  • Retinoids
  • Histone Deacetylase Inhibitors
  • Other Small Molecule Targeted Therapies
  • Immunotherapy
  • Corticosteroids and Other Immunosuppressants
  • Cytokines
  • Adjuvants
  • Sex Hormones and Hormone Antagonists
  • Hormone Antagonists
  • Sex Hormone Receptor Antagonists
  • Tamoxifen
  • Therapeutic Use
  • Adverse Effects and Contraindications
  • Toremifene
  • Adverse Effects
  • Contraindications
  • Aromatase Inhibitors
  • Adverse Effects
  • GnRH Analogues
  • Adverse Effects
  • Combination Therapy
  • Adjuvant Treatment
  • Palliative Chemotherapy
  • Practical Points
  • Storage of Drugs and Preparation of Solutions
  • Administration of Cytotoxic Drugs
  • Extravasation of Cytotoxic Drugs on Injection
  • Vomiting with Cytotoxic Drugs
  • Care of the Mouth
  • Alopecia
  • Bone Marrow Suppression and Infection
  • Long-Term Risks of the Use of Cytotoxic Drugs
  • Second Malignancy
  • Gonadal Damage
  • Teratogens
  • The Role of the Nurse in Cancer Chemotherapy
  • References and Further Reading
  • Useful Websites
  • 30 : Drugs Used in the Treatment of Tropical Diseases
  • Chapter Outline
  • Learning Objectives
  • Introduction
  • Preparations and Bite Avoidance
  • Mosquitoes
  • Sandflies
  • Diseases and Infestations
  • Travellers’ Diarrhoea
  • Amoebiasis (Amoebic Dysentery)
  • Giardiasis
  • Shigellosis (Bacillary Dysentery)
  • Cholera
  • Leprosy
  • Malaria
  • The Treatment of Malaria
  • Treatment of Established Disease
  • Drugs Used to Treat Malaria
  • Adverse effects
  • Adverse effects
  • Adverse effects
  • Leishmaniasis (Kala-Azar)
  • Adverse effects
  • Adverse effects
  • Schistosomiasis (Bilharzia)
  • Anthelmintics
  • Threadworms
  • Strongyloides Stercoralis
  • Tapeworms
  • Roundworms
  • Hookworms
  • Filariasis
  • Onchocerciasis (River Blindness)
  • References and Further Reading
  • Useful Websites
  • 31 : Drugs Used in the Treatment of Ophthalmological Diseases
  • Chapter Outline
  • Learning Objectives
  • Structure of the Eye
  • Conditions Affecting the Eye
  • Local Use of Drugs on the Eye: Types of Applications
  • Eye Lotions
  • Eye Drops
  • Eye Ointments
  • Subconjunctival Injections
  • Intracameral Injections
  • Types of Drugs Used
  • Antibacterial Agents
  • Bacterial Conjunctivitis
  • Acute Intraocular Infections
  • Other Antibiotics
  • Antifungal Drugs
  • Antiviral Agents
  • Antiprotozoan Drugs
  • Onchocerciasis
  • Acanthamoeba Keratitis
  • Steroids and Non-steroidal Antiinflammatory Drugs (NSAIDs)
  • Drugs Affecting Pupil Size
  • Mydriatics
  • Antimuscarinics
  • Atropine
  • Therapeutic use
  • Adverse effects
  • Homatropine
  • Cyclopentolate
  • Tropicamide
  • Sympathomimetics
  • Miotics
  • The Treatment of Glaucoma
  • Drugs Acting on the Autonomic Nervous System
  • β-Blockers
  • Sympathomimetics
  • Prostaglandin Analogues
  • Carbonic Anhydrase Inhibitors
  • Dehydrating Agents
  • Cytotoxics
  • The Treatment of Age-Related Macular Degeneration
  • Local Anaesthetics
  • Injection of Local Anaesthetics
  • Retrobulbar Injection
  • Peribulbar Anaesthesia
  • Ocular Lubricants
  • Tear Supplements
  • Stains Used in Ophthalmology
  • Fluorescein
  • Rose Bengal
  • Lissamine Green
  • Drugs with Adverse Effects on the Eye
  • Chloroquine
  • The Autonomic Nervous System
  • Corticosteroids
  • Phosphodiesterase Inhibitors
  • Ethambutol
  • Isotretinoin
  • Voriconazole
  • Antiepileptic Drugs
  • Amiodarone
  • Tamoxifen
  • Chemical Toxicity
  • Summary
  • References and Further Reading
  • Useful Websites
  • 32 : Special Considerations in Drug Use: Pregnancy, Paediatrics and the Older Patient
  • Chapter Outline
  • Learning Objectives
  • Introduction
  • Drugs in Pregnancy
  • Stages of Pregnancy
  • Drugs and Fetal Abnormality
  • Pregnancy and Dosage
  • Drugs in Newborn Infants
  • Analgesics and Hypnotics
  • Barbiturates and Benzodiazepines
  • β-Blockers
  • Chloramphenicol
  • Oxygen
  • Drugs Triggering Kernicterus
  • Breastfeeding and Drugs
  • Dosage of Medcines in Children
  • Use of Drugs in the Older Patient
  • Absorption, Distribution, Metabolism and Excretion
  • Drug Absorption
  • Drug Distribution
  • Drug Metabolism (Breakdown)
  • Drug Excretion
  • Organ Sensitivity
  • Adherence
  • Adverse Reactions
  • Some General Principles
  • Polypharmacy
  • Specific Therapeutic Problems
  • Sleep
  • Agitation
  • Depression
  • Hypertension
  • Chronic Heart Failure
  • Antibiotics
  • Analgesics
  • Palliative Care
  • Palliative Care Drugs
  • Drugs for Specific Symptoms
  • References and Further Reading
  • Useful Websites
  • 33 : Toxicity of Drugs and Treatment
  • Chapter Outline
  • Learning Objectives
  • Introduction
  • General Management
  • Severity of Poisoning
  • Level of Consciousness
  • Respiration
  • Circulation
  • Nature of Poison Used
  • Treatment
  • Non-specific Measures
  • Maintenance of Ventilation
  • Reducing Absorption of Poisons
  • Activated Charcoal
  • Maintenance of Blood Pressure
  • Increasing Elimination of Poisons
  • Nutrition, Hydration and Electrolyte Disturbances
  • Follow-up
  • Individual Poisons
  • Benzodiazepines
  • Treatment
  • Salicylates (Aspirin)
  • Symptoms
  • Treatment
  • Paracetamol
  • Treatment
  • Need for Rapid Treatment
  • Opioids
  • Symptoms
  • Treatment
  • Tricyclic Antidepressants
  • Symptoms
  • Treatment
  • Alcohol
  • Treatment
  • Barbiturates
  • Symptoms
  • Treatment
  • Carbon Monoxide
  • Symptoms
  • Treatment
  • Phenothiazines
  • Symptoms
  • Treatment
  • Iron Compounds
  • Symptoms
  • Treatment
  • Organophosphorous Insecticides
  • Chelating Agents
  • Dimercaprol (British Anti-Lewisite; BAL)
  • Therapeutic Use
  • Penicillamine
  • General Information
  • References and Further Reading
  • Useful Websites
  • 34 : Herbal Medicines and Homeopathy
  • Chapter Outline
  • Learning Objectives
  • Herbal Medicines
  • Introduction
  • History of Herbal Medicine
  • Categories of Traditional Herbs
  • Licensed Herbal Products
  • Dried Herbs Exempt from Licensing Requirements
  • Herbal Products Sold as Food Supplements
  • The Practice of Herbal Medicine
  • Safety and Efficacy
  • Herbal Extracts of Proven or Suspected Toxicity
  • Herbal Teas
  • Contamination of Natural Remedies
  • Metals in Herbal Mixtures
  • Other Herbal Preparations
  • Interactions Between Herbal Medicines and Drugs Used in Orthodox Treatment
  • Use of Some Common Herbal Remedies
  • Essential Oils
  • Homeopathy
  • History and Philosophy of Homeopathy
  • Features of Homeopathy
  • Diagnosis and Treatment
  • Mechanism of Action
  • The Placebo Response
  • Safety
  • References and Further Reading
  • Useful Websites
  • Appendix : Biologic Agents
  • Introduction
  • Types of Biological Therapy
  • Monoclonal Antibody-Based Biologics
  • Antibodies
  • How MAb Biologics are Made
  • MAb Biologic Names
  • Monoclonal Antibody Biologics
  • Fusion Protein Biologics
  • Uses of Biologics
  • Administration of Biologics
  • Biosimilars
  • Biosimilar Names
  • References and Further Reading
  • Useful Websites
  • Glossary
  • Index
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