Table of contents for Fundamentals of pharmacology : an applied approach for nursing and health / Alan Galbraith ... [et al.].

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Brief contents
List of figures		xxxix
List of tables		xliii
Preface		xlvi
Acknowledgements	xlviii
Section I	Pharmacology within the social context	1
Chapter 1	An historical perspective	2
Chapter 2	Sociocultural aspects	8
Section II	Pharmacology within the professional context	17
Chapter 3	Drug administration and the law	19
Chapter 4	Ethical issues	28
Chapter 5	The roles and responsibilities of nurses	36
Chapter 6	The roles and responsibilities of other health-care professionals	42
Section III	Drug administration and professional responsibilities	51
Chapter 7	Drug formulations, storage and routes of administration	52
Chapter 8	The clinical decision-making process	72
Chapter 9	Drug administration strategies and documentation	77
Chapter 10	Medication errors	81
Chapter 11	Management of common adverse drug reactions	85
Section IV	General aspects of pharmacology	105
Chapter 12	Drug nomenclature	106
Chapter 13	Pharmacokinetics: absorption and distribution	109
Chapter 14	Pharmacokinetics: metabolism and excretion	115
Chapter 15	Drug interactions	122
Chapter 16	Pharmacodynamics	127
Chapter 17	Drug development, evaluation and safety	137
Chapter 18	Pharmacogenetics	145
Chapter 19	Pharmacokinetic factors that modify drug action	152
Chapter 20	Paediatric pharmacology and pharmacology in older people	157
Section V	Toxicology	169
Chapter 21	Poisoning and envenomation	170
Chapter 22	Management of clinical overdose	177
Chapter 23	Contemporary drugs of abuse	187
Chapter 24	Drug abuse in sport	196
Section VI	Autonomic pharmacology	205
Chapter 25	General aspects of autonomic pharmacology	206
Chapter 26	Adrenergic pharmacology	213
Chapter 27	Cholinergic pharmacology	238
Section VII	Chemical mediators	261
Chapter 28	Introduction to chemical mediators	262
Chapter 29	Histamine and antihistamines	265
Chapter 30	Prostaglandins and serotonin	271
Chapter 31	Nitric oxide and the endothelins	281
Section VIII	Modulation of behaviour, cognition and motor activity	289
Chapter 32	General concepts of central nervous system pharmacology	290
Chapter 33	Antipsychotic drugs	295
Chapter 34	Anxiolytics and hypnotics	305
Chapter 35	Antidepressants and mood stabilisers	313
Chapter 36	Drugs used in neurodegenerative disorders	328
Chapter 37	Antiseizure drugs and muscle relaxants	341
Chapter 38	Central nervous system stimulants	355
Section IX	Drugs used to relieve pain and produce anaesthesia	363
Chapter 39	Narcotic analgesics	364
Chapter 40	Non-steroidal anti-inflammatory, antipyretic and analgesic drugs	379
Chapter 41	General anaesthesia	393
Chapter 42	Local anaesthesia	403
Section X	Modulation of oxygenation and perfusion	413
Chapter 43	Drugs used to lower blood lipids	414
Chapter 44	Antihypertensive drugs	425
Chapter 45	Drugs used to promote tissue perfusion	444
Chapter 46	Anticoagulants, thrombolytics and antiplatelet drugs	457
Chapter 47	Diuretics and other renal drugs	472
Chapter 48	Drugs used to treat cardiac insufficiency	482
Chapter 49	Fluid and potassium imbalances	503
Chapter 50	Antianaemic drugs	518
Chapter 51	Drugs used to maintain gas exchange	525
Chapter 52	Over-the-counter respiratory medicines	542
Section xI	Modulation of gastrointestinal function	555
Chapter 53	Upper gastrointestinal tract drugs	556
Chapter 54	Lower gastrointestinal tract drugs	567
Chapter 55	Nausea and vomiting	582
Section XII	Modulation of body growth, development and metabolism	589
Chapter 56	Drugs and the pituitary gland	590
Chapter 57	The thyroid and the pancreas	601
Chapter 58	The adrenal cortex and the gonads	626
Chapter 59	Hyperuricaemia and gout	650
Chapter 60	Obesity	658
Section XIII	Nutritional and natural therapies	669
Chapter 61	Vitamins	670
Chapter 62	Minerals	682
Chapter 63	Amino acids	690
Chapter 64	Enteral and parenteral nutrition	694
Chapter 65	Herbal medicines	704
Section XIV	Modulation of cellular growth and proliferation	719
Chapter 66	Introduction to chemotherapy	721
Chapter 67	Sulphonamides and trimethoprim	727
Chapter 68	Antibacterial drugs	732
Chapter 69	Antituberculotic and antileprotic drugs	751
Chapter 70	Antiseptics and disinfectants	760
Chapter 71	Antiparasitic drugs	768
Chapter 72	Antimalarial drugs	777
Chapter 73	Antiviral drugs	785
Chapter 74	Antifungal drugs	797
Chapter 75	Vaccines and immunomodulating drugs	805
Chapter 76	Cytotoxic drugs	821
Chapter 77	Gene therapies	838
Section XV	Drugs used topically	847
Chapter 78	Drugs used in diseases of the skin	848
Chapter 79	Drugs and the eye	862
Appendix A 	Common prescription terminology	881
Appendix B	Common US generic drugs names	882
Appendix C	SI units	883
Appendix D	Drug calculations	886
Appendix e	Common symbols used in medication charts	890
Appendix F	Common word mix-ups	891
Appendix G	Drug-herb interactions	892
Glossary		894
Index		904
contents
List of figures			xxxix
List of tables			xliii
Preface			xlvi
Acknowledgements	xlviii
Section I	Pharmacology within the social context	1
Chapter 1	An historical perspective	2
	Objectives	2
	Key terms	2
	Drugs and society	3
	The ages of pharmacology	3
		The age of natural substances	4
		The age of synthetic agents	5
		The age of biotechnology	6
	Summary	7
Chapter 2	Sociocultural aspects	8		Objectives	8
	Key terms	8
	Drug advertising	9
	Over-the-counter preparations	10
		Common characteristics of over-the-counter preparations	11
	Generic versus brand-name preparations	12
	Drug therapy in the older person	13
		Polypharmacy	13
		Nurses and polypharmacy	14
	Drug therapy in ethnic groups	14
	Summary	16
Further reading			16
Web resources			16
Section II	Pharmacology within the professional context	17
Chapter 3	Drug administration and the law	19
	Objectives	19
	Key terms	19
	The Medicines Act 1968	20
	The Misuse of Drugs Act 1971	21
		Requisitions	22
		Safe custody of drugs	23
		Drug addiction	23
	Nurses, midwives and health visitors: Standards for the Administration 
	of Medicines	23
		Management of errors and incidents in the administration 
		of medicines	24
	Non-medical prescribing	24
		Independent nurse and pharmacist prescribing	24
		Supplementary prescribing	26
		Patient group directions	26
	Summary	26
	Questions	27
Chapter 4	Ethical issues	28
	Objectives	28
	Key terms	28
	Autonomy	29
		Informed and valid consent	29
		Rights of refusal	31
	Veracity	31
		The law and therapeutic privilege	32
		Exceptions to veracity	32
	Non-maleficence	32
		Euthanasia	32
		Withholding and withdrawing treatment	33
	Beneficence	33
		Duty of beneficence	33
		Problems with paternalism	34
		Conflicts with other principles	34
	Justice	34
		Allocation of scarce resources	34
	Confidentiality	35
		Difficulties in maintaining confidentiality	35
	Conclusion	35
	Summary	35
Chapter 5	The roles and responsibilities of nurses	36
	Objectives	36
	Key terms	36
	Patient adherence	37
	Patient education	38
		Learning principles	38
		Teaching principles	38
	Patient advocacy	39
	The nurse practitioner role	40
	Nursing research	40
	Summary	41
Chapter 6	The roles and responsibilities of other health-care professionals	42
	Objectives	42
	Key terms	42
	The prescriber	43
	The pharmacist	43
	The physiotherapist	45
	The podiatrist	45
	The dietician	46
	The paramedic	46
	The naturopath	46
	Summary	47
Case studies			48
Further reading			49
Web resources			50
Section III	Drug administration and professional responsibilities	51
Chapter 7	Drug formulations, storage and routes of administration	52
	Objectives	52
	Key terms	52
	Tablets	53
	Enteric-coated preparations	53
	Capsules	53
	Sustained-release preparations	53
	Oral liquid preparations	54
	Topical preparations	54
		Drops	55
		Creams and ointments	55
		Pastes	56
		Gels and lotions	58
	Sublingual and buccal administration	58
	Intranasal administration	58
	Transdermal administration	59
	Rectal administration	61
		Suppositories	61
		Enemas	62
	Vaginal administration	62
	Parenteral administration	64
		Intradermal administration	64
		Subcutaneous injections	64
		Intramuscular injections	64
		Intravenous injections	64
		Other modes of injection	67
	Nebuliser and inhaler administration	67
	Storage of drugs	69
	Summary	70
	Questions	70
Chapter 8	The clinical decision-making process	72
	Objectives	72
	Key terms	72
	Assessment	73
	Diagnosis	74
	Planning/goals	74
	Implementation	74
	Evaluation	75
	Summary	76
	Questions	76
Chapter 9	Drug administration strategies and documentation	77
	Objectives	77
	Key terms	77
	Five rights of drug administration	78
		Right drug	78
		Right dose	78
		Right patient	78
		Right route	78
		Right time	78
	NHS trust policies and procedures	78
	Checking procedures	78
	Documentation procedures	78
	Self-administration of medicines	80
	Conclusion	80
	Summary	80
	Questions	80
Chapter 10	Medication errors	81
	Objectives	81
	Key terms	81
	The five cardinal rights of drug administration	82
	Avoiding medication errors	82
	Management of errors	84
	Conclusion	84
	Summary	84
	Questions	84
Chapter 11	Management of common adverse drug reactions	85
	Objectives	85
	Key terms	85
	Definition and classification	86
	Common adverse effects of drugs	86
		Respiratory depression	86
		Anaphylactic shock	86
		Dizziness	86
		Constipation	86
		Hypertension	90
		Hypotension	90
		Oral candidiasis	90
		Rash	90
		Dry mouth	92
		Nausea	92
		Drowsiness and sedation	92
		Fever	95
		Photophobia	95
		Stomatitis	95
		Diarrhoea	95
		Anogenital candidiasis	95
		Vomiting	97
		Blistering	97
		Photosensitivity	97
		Postural hypotension	97
	Reporting adverse drug reactions	100
	Summary	101
	Questions	101
Case studies			102
Further reading			103
Web resources			103
Section IV	General aspects of pharmacology	105
Chapter 12	Drug nomenclature	106
	Objectives	106
	Key terms	106
	Naming of drugs	107
	Summary	108
	Questions	108
Chapter 13	Pharmacokinetics: absorption and distribution	109
	Objectives	109
	Key terms	109
	Drug absorption	110
	Drug distribution	111
		Protein binding	111
		The role of the liver in drug distribution	112
		The blood-brain barrier	113
		Other barriers	113
	Volume of distribution	113
	Summary	114
	Questions	114
Chapter 14	Pharmacokinetics: metabolism and excretion	115
	Objectives	115
	Key terms	115
	Drug metabolism	116
		Enzyme induction	117
		Enzyme inhibition	117
	Drug excretion	117
		Drug dosage and blood levels	118
		Bioavailability	119
		Kinetics of drug metabolism	120
		Missed doses	120
	Summary	120
	Questions	121
Chapter 15	Drug interactions	122
	Objectives	122
	Key terms	122
	Interactions and inactivation before administration	123
	Interactions in the gastrointestinal tract	123
	Interactions after absorption	124
	Liver enzymes and drug interactions	125
	Summary	125
	Questions	125
Chapter 16	Pharmacodynamics	127
	Objectives	127
	Key terms	127
	Drugs that work by chemical action	128
	Drugs that work by physical action	128
	Drugs that work by physicochemical action	129
	Dosage and action	129
	Drugs that act on enzymes	129
		Competitive inhibition	129
		Non-competitive inhibition	131
	Drugs that act on receptors	131
		Partial agonists	133
		Mixed agonist/antagonist drugs	133
		Affinity, specificity, efficacy and potency	133
		Inverse agonists	133
		First and second messengers	133
		Ion channel blockers	134
	Enzymes as drugs	135
	Summary	135
	Questions	135
Chapter 17	Drug development, evaluation and safety	137
	Objectives	137
	Key terms	137
	New drug development and approval	138
	Drug effectiveness	139
	Adverse drug reactions	139
	Drug hypersensitivity	140
		Type I hypersensitivity	140
		Type II hypersensitivity	140
		Type III hypersensitivity	140
		Type IV hypersensitivity	140
	Placental transfer to the fetal circulation	141
		Physicochemical drug properties	142
		Effect of drug dose	142
	Drug teratogenicity	142
	Drugs and lactation	142
	Summary	143
	Questions	144
Chapter 18	Pharmacogenetics	145
	Objectives	145
	Key terms	145
	Overview of pharmacogenetics	146
		Responders and non-responders	146
		Tailor-made drug therapy	146
		Diagnostic testing	146
	Polymorphism and drug metabolism	148
		Fast (effective) and slow (poor) acetylators	148
		Polymorphism involving cytochrome P450 enzymes	149
		Poor suxamethonium metabolism	149
		Erythrocyte reactions	149
	Pharmacogenetics and drug pharmacodynamics	150
		Variations in receptor structure	150
		Reactions to mydriatics	150
		Reactions to corticosteroids	150
	Ethical considerations associated with pharmacogenetics	150
	Summary	150
	Questions	151
Chapter 19	Pharmacokinetic factors that modify drug action	152
	Objectives	152
	Key terms	152
	Absorption and drug action	153
		Effects of disease	153
		Effects of exercise	153
		Effects of diet	153
		Effects of pregnancy	153
	Distribution and drug action	154
		Effects of disease	154
		Effects of pregnancy	154
	Metabolism and drug action	154
		Effects of disease	154
		Effects of occupation	154
		Effects of diet	155
	Excretion and drug action	155
		Effects of disease	155
	Summary	155
	Questions	155
Chapter 20	Paediatric pharmacology and pharmacology in 
older people	157
	Objectives	157
	Key terms	157
	Absorption and drug action	158
	Distribution and drug action	158
	Metabolism and drug action	158
	Excretion and drug action	158
	Paediatric dosage considerations	159
		Assessment	159
		Planning	159
		Implementation	159
		Evaluation	160
	Clinical management in older people	160
		Non-adherence with drug treatment and elderly people	160
		Principles of drug administration and elderly people	161
	Summary	164
	Questions	165
Case studies			166
Further reading			166
Web resources			167
Section V	Toxicology	169
Chapter 21	Poisoning and envenomation	170
	Objectives	170
	Key terms	170
	Management of poisoning	171
		Life support	171
		Patient assessment	171
		Decontamination and detoxification	172
		Elimination and neutralisation	172
	Envenomation	174
		The adder	174
		The weever fish (Echiichthys vipera)	174
		Poisonous plants	174
		Insect stings	175
	Summary	175
	Questions	175
	Drug summary table: poisoning and envenomation	176
Chapter 22	Management of clinical overdose	177
	Objectives	177
	Key terms	177
	Life support	178
	Patient assessment	179
	Drug detoxification	179
	Drug neutralisation and elimination	179
		Gastric lavage	179
		Haemodialysis and haemoperfusion	179
		Special antidotes	180
	Summary	184
	Questions	185
	Drug summary table: clinical overdose	186
Chapter 23	Contemporary drugs of abuse	187
	Objectives	187
	Key terms	187
	Alcohol	188
		Effects of alcohol	188
		Alcohol addiction	189
		Drug treatment of alcoholism	189
		Therapeutic uses of alcohol	190
	Nicotine	190
		Drug treatment in the cessation of smoking	191
	Caffeine	191
	Other drugs of abuse	192
		Hallucinogens	192
		Marijuana	194
		Cocaine	194
		Volatile substances	195
	Summary	195
	Questions	195
Chapter 24	Drug abuse in sport	196		Objectives	196
	Key terms	196
	Anabolic agents	198
	Peptide hormones	199
	Beta-blockers	199
	Stimulants	200
	Diuretic agents and urine testing	200
	Implications of drug use and abuse in sport	200
	Summary	200
	Questions	201
Case studies			202
Further reading			203
Web resources			203
Section VI	Autonomic pharmacology	205
Chapter 25	General aspects of autonomic pharmacology	206
	Objectives	206
	Key terms	206
	Organisation of the autonomic nervous system	207
		Chemical transmitters	207
		Subdivisions of the autonomic nervous system	207
	Sympathetic and parasympathetic divisions	207
		Similarities	207
		Differences	207
	Neuromodulation of autonomic nervous system function	211
	Summary	211
	Questions	212
Chapter 26	Adrenergic pharmacology	213
	Objectives	213
	Key terms	213
	Mechanism of adrenergic action	214
	Adrenergic receptor stimulation	214
		Alpha-1 receptors	214
		Beta-1 receptors	216
		Beta-2 receptors	218
		Alpha-2 receptors	220
	Second-messenger systems	220
	Direct- and indirect-acting sympathomimetics	221
	Adrenergic action in the central nervous system	224
	Adrenergic side effects	226
	Sympatholytics	226
		Alpha antagonist action	226
		Beta antagonist action	227
		Non-selective adrenergic blocking agents	229
	Peripheral actions of dopamine	231
	Summary	235
	Questions	235
	Drug summary table: adrenergic pharmacology	236
Chapter 27	Cholinergic pharmacology	238		Objectives	238
	Key terms	238
	Mechanisms of cholinergic action	239
	Cholinergic receptor stimulation	239
		Nicotinic receptors	240
		Muscarinic receptors	240
	Anticholinesterases	244
	Cholinergic second-messenger systems	245
	Cholinergic receptor blockage	245
		Nicotinic antagonists	246
		Ganglion blockers	246
		Neuromuscular blocking agents	247
		Muscarinic antagonists	249
	Cholinergic action in the central nervous system	250
	Cholinergic side effects	252
	Summary	256
	Questions	257
	Drug summary table: cholinergic pharmacology	258
Case studies			259
Further reading			260
Web resources			260
Section VII	Chemical mediators	261
Chapter 28	Introduction to chemical mediators	262
	Objectives	262
	Key terms	262
	Classification of chemical mediators	263
	Peptide and protein mediators	264
	Summary	264
	Questions	264
Chapter 29	Histamine and antihistamines	265
	Objectives	265
	Key terms	265
	Allergy and anaphylaxis	266
	Antihistamines	266
	Summary	269
	Questions	269
	Drug summary table: histamine and antihistamines	270
Chapter 30	Prostaglandins and serotonin	271
	Objectives	271
	Key terms	271
	Prostaglandins	272
		Termination of pregnancy and induction of labour	273
		Treatment of impotence	274
		Maintenance of patent ductus arteriosus	274
	Serotonin	274
	Migraine	274
		Migraine prophylaxis	275
		Treatment of acute attacks of migraine	276
	Summary	279
	Questions	279
	Drug summary table: prostaglandins and serotonin	280
Chapter 31	Nitric oxide and the endothelins	281		Objectives	281
	Key terms	281
	Nitric oxide	282
	The endothelins	283
	Summary	285
	Questions	285
Case study			286
Further reading			286
Web resources			287
Section VIII	Modulation of behaviour, cognition and motor activity	289
Chapter 32	General concepts of central nervous system pharmacology	290
	Objectives	290
	Key terms	290
	Divisions of the brain	291
		Cerebrum	291
		Diencephalon	291
		Cerebrum-diencephalon interactions	292
		Brain stem	292
		Brain stem-diencephalon-cerebrum interactions	292
		Cerebellum	292
		Motor pathways	292
	Chemical transmitters	292
		Neuromodulation	292
		Acetylcholine	292
		Dopamine	292
		Noradrenaline and serotonin	292
		GABA	293
		Glutamate	293
	Drug specificity	293
	Summary	294
	Questions	294
Chapter 33	Antipsychotic drugs	295
	Objectives	295
	Key terms	295
	Schizophrenia and dopamine receptors	296
	Antipsychotic drugs	296
		Typical antipsychotics	296
		Atypical antipsychotics	300
		Other uses of antipsychotics	301
	Summary	303
	Questions	303
	Drug summary table: antipsychotic drugs	304
Chapter 34	Anxiolytics and hypnotics	305
	Objectives	305
	Key terms	305
	Barbiturates	306
	Benzodiazepines	306
		Specific benzodiazepines	308
	Miscellaneous anxiolytics and hypnotics	309
	Antihistamines	310
	Summary	311
	Questions	311
	Drug summary table: anxiolytics and hypnotics	312
Chapter 35	Antidepressants and mood stabilisers	313
	Objectives	313
	Key terms	313
	Types of depression	314
	Physiology of depression	314
	Antidepressant drug groups	314
		Tricyclic antidepressants	314
		Selective serotonin reuptake inhibitors	315
		Tetracyclic antidepressants	318
		Non-selective and irreversible monoamine oxidase inhibitors	318
		Reversible inhibitors of monoamine oxidase	318
		Noradrenalin-serotonin reuptake inhibitors	319
		Selective noradrenaline reuptake inhibitors	319
	Antidepressant treatment considerations	320
	Other psychiatric conditions that respond to antidepressant drugs	320
	Mood stabilisers	320
		Anticonvulsants	321
	Summary	325
	Questions	325
	Drug summary table: antidepressants and mood stabilisers	327
Chapter 36	Drugs used in neurodegenerative disorders	328
	Objectives	328
	Key terms	328
	Parkinson's disease	329
		Pathophysiology	329
		Decreasing muscarinic activity	329
		Increasing dopaminergic activity	330
		Combination therapy	334
	Alzheimer's disease	334
		Pathophysiology	334
		Anticholinesterases	334
	Huntington's disease	334
		Pathophysiology	334
		Treatment	335
	Motor neuron disease	335
		Treatment	335
		Supportive therapy	335
	Multiple sclerosis	335
		Pathophysiology	335
	Summary	338
	Questions	339
	Drug summary table: neurodegenerative disorders	340
Chapter 37	Antiseizure drugs and muscle relaxants	341
	Objectives	341
	Key terms	341
	Epilepsy	342
	Antiseizure drugs	342
		Drugs affecting movement of sodium across the membrane	343
		Drugs that stabilise nerve membranes directly	344
		Drugs affecting GABA activity	345
		Miscellaneous antiseizure drugs and drugs with combined 
mechanisms of action	346
		Pharmacokinetic considerations	347
		Status epilepticus	348
	Muscle relaxants	348
		Centrally acting muscle relaxants	348
		Drugs affecting muscle excitability	349
		Intramuscularly acting muscle relaxants	350
	Summary	352
	Questions	353
	Drug summary table: antiseizure drugs and muscle relaxants	354
Chapter 38	Central nervous system stimulants	355		Objectives	355
	Key terms	355
	Attention deficit disorder and attention deficit hyperactivity 
disorder	356
	Other uses of amphetamines	357
	Abuse of amphetamines	357
	Summary	358
	Questions	358
	Drug summary table: central nervous system stimulants	359
Case study			360
Further reading			360
Web resources			361
Section IX	Drugs used to relieve pain and produce anaesthesia	363
Chapter 39	Narcotic analgesics	364
	Objectives	364
	Key terms	364
	Pain	365
		Pain assessment	366
	Properties of narcotic analgesics	367
		Opiates	372
		Opioids	373
		Other narcotic analgesics	374
	Narcotic antagonists	375
	Summary	377
	Questions	377
	Drug summary table: narcotic analgesics	378
Chapter 40	Non-steroidal anti-inflammatory, antipyretic and analgesic drugs	379
	Objectives	379
	Key terms	379
	Inflammation, prostaglandins and prostaglandin inhibitors	380
		Salicylates	381
		Propionic acid derivatives	383
		Indoleacetic acids	385
		Fenamates	385
		Oxicams	386
		Cyclo-oxygenase (COX-2) inhibitors	386
		Other analgesics	387
	Miscellaneous drugs used in inflammatory conditions	388
	Immunosuppressive drugs	389
	Miscellaneous analgesic agents	389
	Summary	391
	Questions	392
	Drug summary table: non-steroidal anti-inflammatory, antipyretic 
and analgesic drugs	393
Chapter 41	General anaesthesia	395
	Objectives	395
	Key terms	395
	Stages of anaesthesia	396
		Stage 1: analgesia	396
		Stage 2: excitement (delirium)	396
		Stage 3: surgical anaesthesia	396
		Stage 4: medullary paralysis (overdose)	396
	Mechanism of action of general anaesthetics	396
	Pharmacokinetics of inhalation anaesthetics	397
	Inhalation anaesthetics	397
	Injectable general anaesthetics	398
	Premedication	400
	Neuroleptanalgesia	400
	Summary	401
	Questions	401
	Drug summary table: general anaesthesia	402
Chapter 42	Local anaesthesia	403		Objectives	403
	Key terms	403
	Peripheral nerve physiology	404
	Commonly used local anaesthetics	405
	Summary	408
	Questions	408
	Drug summary table: local anaesthesia	409
Case studies			410
Further reading			410
Web resources			411
Section X	Modulation of oxygenation and perfusion	413
Chapter 43	Drugs used to lower blood lipids	414
	Objectives	414
	Key terms	414
	Drugs used in hypertriglyceridaemia	417
		Fibrates	417
		Other lipid-lowering drugs	417
	Drugs used in hypercholesterolaemia	418
		Anion exchange resins	418
		Other drugs used in hypercholesterolaemia	419
		HMG-CoA reductase inhibitors: statins	420
		Ezetimibe	421
	Summary	423
	Questions	423
	Drug summary table: drugs used to lower blood lipids	424
Chapter 44	Antihypertensive drugs	425
	Objectives	425
	Key terms	425
	Normal regulation of blood pressure	426
		Nervous control systems	426
		Humoral control systems	427
		Other factors influencing blood pressure	428
	Antihypertensive therapies	428
		Angiotensin-converting enzyme inhibitors	430
		Angiotensin receptor antagonists	430
		Alpha antagonists	431
		Beta-blockers	431
		Calcium channel antagonists	434
		Drugs with a combined action	434
		Diuretics	435
	Hypertensive emergencies and second-line antihypertensive therapies	435
		Peripheral vasodilators	435
		Other sympathomimetic nervous system depressants	436
	Approaches to antihypertensive therapy	436
	Summary	440
	Questions	440
	Drug summary table: antihypertensive drugs	441
Chapter 45	Drugs used to promote tissue perfusion	444
	Objectives	444
	Key terms	444
	Angina pectoris	445
		Peripheral vasodilators	445
		Beta-blockers	449
		Calcium channel blockers	449
		Potassium channel openers	450
	Cerebral ischaemia	450
	Erectile dysfunction	450
		Phosphodiesterase type 5 inhibitors	451
		Other drugs used in the treatment of erectile dysfunction	451
		General considerations of drugs used to treat erectile dysfunction	452
	Summary	454
	Questions	454
	Drug summary table: drugs used to promote tissue perfusion	455
Chapter 46	Anticoagulants, thrombolytics and antiplatelet drugs	457
	Objectives	457
	Key terms	457
	Anticoagulants	458
		Oral anticoagulants	460
	Fibrinolytic drugs	462
	Haemostatic agents	464
	Antiplatelet drugs	464
	Summary	469
	Questions	470
	Drug summary table: anticoagulants, thrombolytics and antiplatelet drugs	471
Chapter 47	Diuretics and other renal drugs	472
	Objectives	472
	Key terms	472
	Diuretics	473
		Loop diuretics	473
		Thiazide and thiazide-like diuretics	475
		Potassium-sparing diuretics	476
		Osmotic diuretics	476
		Carbonic anhydrase inhibitors	477
	Urinary alkalinisers	477
	Urinary acidifiers	478
	Antidiuretics	478
	Summary	480
	Questions	480
	Drug summary table: diuretics and other renal drugs	481
Chapter 48	Drugs used to treat cardiac insufficiency	482
	Objectives	482
	Key terms	482
	Heart failure	483
	Drug therapies in heart failure	483
		Angiotensin-converting enzyme inhibitors	485
		Diuretics	485
		Peripheral vasodilators	487
		Inotropic agents	487
		Beta-blockers	490
	Optimising heart-failure therapy	491
	Dysrhythmia	491
		Cardiac muscle physiology	491
		Pathophysiology of dysrhythmia	494
	Antidysrhythmic agents	495
		Class I antidysrhythmics	496
		Class II antidysrhythmics	497
		Class III antidysrhythmics	497
		Class IV antidysrhythmics	497
		Miscellaneous antidysrhythmics	498
	General considerations of antidysrhythmic agents	498
	Summary	500
	Questions	501
	Drug summary table: drugs used to treat cardiac insufficiency	502
Chapter 49	Fluid and potassium imbalances	503
	Objectives	503
	Key terms	503
	Fluids	504
		Body composition and fluid	504
		Fluid distribution	504
		Indications for fluid administration	508
		Aims of fluid therapy	508
		Crystalloid and colloid solutions	509
		Techniques used to administer fluids	509
	Potassium	510
		Hypokalaemia	510
		Hyperkalaemia	515
	Summary	517
	Questions	517
Chapter 50	Antianaemic drugs	518
	Objectives	518
	Key terms	518
	Therapy of nutritional anaemias	519
		Folic acid deficiency anaemia	519
		Vitamin B12 deficiency anaemia	519
		Iron deficiency anaemia	520
	Anaemias associated with decreased blood-cell production	520
	Summary	522
	Questions	523
	Drug summary table: aantianeaemic drugs	524
Chapter 51	Drugs used to maintain gas exchange	525
	Objectives	525
	Key terms	525
	Pathophysiological aspects of respiratory illness	526
	Respiratory pharmacology	527
		Bronchodilators	527
		Inhaled corticosteroids	531
		Use of systemic corticosteroids in asthma	533
		Prophylactic asthma preparations	533
	Approaches to asthma therapy	535
	Oxygen therapy	536
	Respiratory stimulants	536
	Surfactants	537
	Summary	539
	Questions	539
	Drug summary table: drugs used to maintain gas exchange	540
Chapter 52	Over-the-counter respiratory medicines	542
	Objectives	542
	Key terms	542
	Respiratory pharmacology	543
		Antitussive agents (cough suppressants)	543
		Expectorants	543
		Mucolytic agents	544
		Decongestants	544
		Antimuscarinic agents	546
		Antihistamines	546
		Analgesic and antipyretic agents	546
		Miscellaneous agents	547
	Summary	549
	Questions	549
Case studies			550
Further reading			552
Web resources			553
Section xI	Modulation of gastrointestinal function	555
Chapter 53	Upper gastrointestinal tract drugs	556
	Objectives	556
	Key terms	556
	Antacids	557
		Alginates	558
	Antiflatulents	558
	Peptic ulcers	558
		Histamine H2-receptor antagonists	560
		Proton pump inhibitors	560
		Prostaglandins	561
		Chelates and complexes	562
	Summary	564
	Questions	565
	Drug summary table: upper gastrointestinal tract drugs	566
Chapter 54	Lower gastrointestinal tract drugs	567
	Objectives	567
	Key terms	567
	Pancreatic enzymes	568
	Laxatives	568
		Osmotic laxatives	568
		Stimulant laxatives	570
		Faecal softeners	571
		Lubricants	571
		Dietary fibre and bulk-forming laxatives	572
	Antidiarrhoeals	573
		Non-specific antidiarrhoeal drugs	574
	Drugs used in irritable bowel syndrome	574
		Antispasmodics	575
	Drugs used in inflammatory bowel disease	575
	Drugs used in gall-stone dissolution	576
	Drugs used in the treatment of haemorrhoids	576
	Summary	580
	Questions	580
	Drug summary table: lower gastrointestinal tract drugs	581
Chapter 55	Nausea and vomiting	582
	Objectives	582
	Key terms	582
	Drugs used to treat nausea and vomiting	583
		Antimuscarinics	584
		Antihistamines	584
		Phenothiazines	584
		Metoclopramide and domperidone	584
		Setrons	584
	New approaches	585
		Neurokinin-1 antagonists	585
		Cannabinoids	585
	Nausea and vomiting in pregnancy	585
	Drugs used to induce vomiting	585
	Summary	586
	Questions	587
	Drug summary table: Nausea and vomiting	587
Case study			588
Further reading			588
Web resources			588
Section XII	Modulation of body growth, development and 
metabolism	589
Chapter 56	Drugs and the pituitary gland	590
	Objectives	590
	Key terms	590
	Drugs affecting the pituitary gland	591
		Trophic hormones affecting gonadal function	591
		Trophic hormones and the adrenal cortex	594
		Disorders of growth hormone secretion	594
		Disorders of prolactin secretion	595
		Clinical uses of posterior pituitary hormones	596
	Summary	598
	Questions	599
	Drug summary table: drugs and the pituitary gland	600
Chapter 57	The thyroid and the pancreas	601
	Objectives	601
	Key terms	601
	Drugs affecting the thyroid gland	602
		Hypothyroid states	602
		Hyperthyroid states	602
		Altered levels of blood calcium	604
		Osteoporosis	605
	Drugs affecting the pancreas	606
		Hyperglycaemic agents	606
		Diabetes mellitus	606
		Hypoglycaemic agents	607
	Summary	622
	Questions	623
	Drug summary table: the thyroid and the pancreas	624
Chapter 58	The adrenal cortex and the gonads	626
	Objectives	626
	Key terms	626
	Drugs affecting the adrenal cortex	627
		Adrenal cortex antagonists	629
	Drugs affecting the gonads	629
		Oestrogen-only preparations	629
		Oestrogenic drugs with mixed activity	631
		Progestin-only preparations	632
		Oestrogen-progestin combinations	633
		Postcoital contraception	634
		Postmenopausal hormone replacement therapy	634
		Androgens and anabolic agents	637
		Sex hormone antagonists	638
	Summary	644
	Questions	645
	Drug summary table: the adrenal cortex and the gonads	646
Chapter 59	Hyperuricaemia and gout	650
	Objectives	650
	Key terms	650
	Anti-inflammatory agents	651
		Non-steroidal anti-inflammatory drugs	651
		Intra-articular corticosteroids	652
		Other anti-inflammatories	652
	Uricosuric agents	652
	Inhibition of uric acid formation	653
	Uricolytic agents	653
	Other concurrent measures	654
	Summary	656
	Questions	656
	Drug summary table: hyperuricaemia and gout	657
Chapter 60	Obesity	658
	Objectives	658
	Key terms	658
	Energy balance	659
		Regulation of food intake	659
		Energy expenditure	659
	Monitoring nutritional status	660
	Management of obesity	660
		Non-pharmacological strategies	660
		Pharmacological strategies	660
	Summary	664
	Questions	664
	Drug summary table: obesity	664
Case studies			665
Further reading			666
Web resources			667
Section XIII	Nutritional and natural therapies	669
Chapter 61	Vitamins	670
	Objectives	670
	Key terms	670
	Vitamin A	671
	The vitamin B group	673
		Vitamin B1 (thiamine)	673
		Vitamin B2 (riboflavin)	673
		Vitamin B3 (nicotinamide) and nicotinic acid	674
		Vitamin B5 (pantothenic acid)	674
		Vitamin B6 (pyridoxine)	675
		Biotin	675
		Folic acid	675
		Vitamin B12 (hydroxocobalamin)	676
	Vitamin C (ascorbic acid)	677
	Vitamin D	678
	Vitamin E (the tocopherols)	679
	Vitamin K	679
	Summary	681
	Questions	681
Chapter 62	Minerals	682
	Objectives	682
	Key terms	682
	The macrominerals	683
		Calcium	683
		Phosphorus	683
		Magnesium	684
		Sodium, potassium and chloride	684
	The microminerals	685
		Iron	685
		Iodine	685
		Zinc	685
		Copper	686
		Fluorine	686
		Selenium	687
		Chromium	687
		Manganese	687
		Molybdenum	687
		Sulphur	687
		Other elements	688
	Summary	688
	Questions	689
Chapter 63	Amino acids	690
	Objectives	690
	Key terms	690
	Arginine and ornithine	691
	Cysteine	692
	Glutamic acid	692
	Glycine	692
	Histidine	692
	Lysine	692
	Tryptophan	692
	Clinical considerations of amino acids	693
	Summary	693
	Questions	693
Chapter 64	Enteral and parenteral nutrition	694
	Objectives	694
	Key terms	694
	Enteral nutrition	695
		Types of enteral feed	696
		Principles of management	696
		Complications of enteral nutrition	698
		Transition to oral feeding	698
	Parenteral nutrition	698
		Indications	698
		Delivery of parenteral nutrition	699
		Management and complications of parenteral nutrition	699
	Summary	703
	Questions	703
Chapter 65	Herbal medicines	704
	Objectives	704
	Key terms	704
	Aloe vera	705
	Cranberry	705
	Chamomile	705
	Echinacea	706
	Evening primrose oil	707
	Feverfew	707
	Garlic	707
	Ginger	708
	Ginkgo	708
	Ginseng	709
	Red clover	709
	St John's wort (hypericum)	710
	Saw palmetto	710
	Valerian	710
	Summary	716
	Questions	717
Case study			718
Further reading			718
Web resources			718
Section XIV	Modulation of cellular growth and proliferation	719
Chapter 66	Introduction to chemotherapy	721
	Objectives	721
	Key terms	721
	Mechanism of action of antimicrobial agents	722
		Inhibition of cell-wall synthesis	722
		Disruption of the microbial cell membrane	722
		Inhibition of protein synthesis	723
		Interference with metabolic processes	723
	Bactericidal action versus bacteriostatic action	723
	Spectrum of activity	723
	Unwanted effects	723
		Superinfection	723
		Hypersensitivity reactions	724
		Antibiotic-associated colitis	724
		Antimicrobial resistance	724
	Antimicrobial drugs in pregnancy	725
	Time-dependent and concentration-dependent activity	725
	Summary	726
	Questions	726
Chapter 67	Sulphonamides and trimethoprim	727
	Objectives	727
	Key terms	727
	Mechanism of action	728
	Adverse effects	728
	Uses and clinical considerations	728
	Summary	730
	Questions	730
	Drug summary table: sulphonamides and trimethoprim	731
Chapter 68	Antibacterial drugs	732
	Objectives	732
	Key terms	732
	Antibacterials that attack cell-wall synthesis	733
		Penicillins	733
		Cephalosporins	735
		Other beta-lactams	735
		Polypeptide and glycopeptide antibacterial agents	736
	Antibacterials that inhibit protein synthesis	736
		Aminoglycosides	736
		Tetracyclines	737
		Macrolides	738
		Streptogramins	738
		Oxazolidinones	739
		Other inhibitors of the larger ribosomal subunit	739
		Miscellaneous antibacterials	740
	Synthetic antibacterials affecting metabolism	740
	Antibacterials affecting plasma membrane permeability	741
		Polymyxins	741
	Synthetic antibacterials that inhibit DNA replication	741
		Quinolones	741
		Nitroimidazoles	742
	Summary	747
	Questions	748
	Drug summary table: antibacterial drugs	749
Chapter 69	Antituberculotic and antileprotic drugs	751
	Objectives	751
	Key terms	751
	Tuberculosis	752
		Antituberculotics	752
	Leprosy	755
		Antileprotic drugs	755
	Summary	758
	Questions	759
	Drug summary table: antituberculotic and antileprotic drugs	759
Chapter 70	Antiseptics and disinfectants	760
	Objectives	760
	Key terms	760
	Oxidising agents	761
	Alkylating agents	762
	Substances affecting cell permeability	762
	Phenols	764
	Alcohols	765
	Heavy metals	765
	Dyes	765
	Tea tree oil	765
	Honey	766
	Summary	766
	Questions	767
Chapter 71	Antiparasitic drugs	768
	Objectives	768
	Key terms	768
	Protozoan infections	769
		Amoebiasis	769
		Infections caused by flagellates	769
		Ciliates	769
		Sporozoans	769
	Antiprotozoal drugs	769
		Nitroimidazoles	769
		Other antiprotozoal drugs	770
	Worm infestations	770
		Nematode infestations	770
		Cestode infections	771
		Trematode infections	771
	Anthelmintics	771
	Summary	775
	Questions	775
	Drug summary table: antiparasitic drugs	776
Chapter 72	Antimalarial drugs	777
	Objectives	777
	Key terms	777
	Transmission of the disease	778
	Treatment and prophylaxis	778
	Antimalarial agents	779
	Summary	784
	Questions	784
	Drug summary table: antimalarial drugs	784
Chapter 73	Antiviral drugs	785
	Objectives	785
	Key terms	785
	Antiviral agents	786
		Influenza	786
		HIV infections	787
		Other antiviral agents	790
	Summary	795
	Questions	795
	Drug summary table: antiviral drugs	796
Chapter 74	Antifungal drugs	797
	Objectives	797
	Key terms	797
	Antifungal agents	798
		Azole derivatives	800
		Other antifungal drugs	801
	Summary	803
	Questions	803
	Drug summary table: antifungal drugs	804
Chapter 75	Vaccines and immunomodulating drugs	805
	Objectives	805
	Key terms	805
	Overview of immune cells and functions	806
	Immunomodulating agents that stimulate immunity	806
		Antisera	806
		Vaccines	807
		Cytokines	809
	Immunomodulating agents that suppress immunity	811
		Corticosteroids	811
		Anti-T-lymphocyte immunoglobulin	811
		Calcineurin inhibitors	812
		Antiproliferative agents	812
		Monoclonal antibodies	814
		Other immunosuppressants	815
	Summary	818
	Questions	819
	Drug summary table: vaccines and immunomodulating drugs	820
Chapter 76	Cytotoxic drugs	821
	Objectives	821
	Key terms	821
	The cell cycle	822
	General adverse effects of cytotoxic drugs	823
	Cytotoxic agents	824
		Cell-cycle-non-specific drugs	824
		Cell-cycle-specific drugs	825
		Tissue-specific agents	828
	Therapies used to mitigate drug-induced myelosuppression	831
	Chemical properties of cytotoxic drugs	831
	Combination cytotoxic drug therapy	831
	Summary	834
	Questions	835
	Drug summary table: cytotoxic drugs	836
Chapter 77	Gene therapies	838
	Objectives	838
	Key terms	838
	Types of gene therapy	839
	Gene therapy techniques	839
	Technical problems associated with gene therapy	840
	Gene therapy successes	840
	Future developments	840
	Safety considerations	840
	Summary	841
	Questions	841
Case studies			842
Further reading			844
Web resources			845
Section XV	Drugs used topically	847
Chapter 78	Drugs used in diseases of the skin	848
	Objectives	848
	Key terms	848
	Vehicles used in skin preparations	849
		Lotions	849
		Creams	849
		Gels	849
		Ointments	849
		Skin cleansers	849
		Desloughing agents	850
		Counter-irritants and rubefacients	850
		Sunscreens	850
	Common skin conditions and their treatment	851
		Psoriasis	851
		Eczema	853
		Acne	854
		Nappy rash	855
		Scabies and pediculosis	855
		Warts	856
		Hyperhidrosis	857
		Baldness	857
	Summary	859
	Questions	860
	Drug summary table: drugs used in diseases of the skin	861
Chapter 79	Drugs and the eye	862
	Objectives	862
	Key terms	862
	Structure and function of the eye	863
	Ophthalmic pharmacology	864
		Drug absorption	864
		Pharmaceutics	865
	Antimicrobial agents	865
		Antibacterial agents	865
		Trachoma	866
		Antiviral agents	866
	Corticosteroids	866
	Mydriatic agents	867
		Antimuscarinics	867
		Sympathomimetics	867
	Local anaesthetics	867
	Glaucoma	868
		Beta-blockers	868
		Miotics	869
		Sympathomimetic agents	869
		Diuretics	870
		Prostaglandins	871
		Prostamides	871
	Drugs used in eye surgery	871
		Anti-inflammatory drugs	872
	Allergic conjunctivitis	872
		Antihistamines	872
		Allergy prophylaxis	872
	Miscellaneous agents	872
		Blepharospasmolytic agents	872
		Photosensitisers	873
		Cleansers and lubricants	873
		Stains	873
		Preservatives	874
	Adverse effects of drugs on the eye	874
	Summary	876
	Questions	876
	Drug summary table: drugs and the eye	877
Case studies			879
Further reading			880
Web resources			880
Appendix A 	Common prescription terminology	881
Appendix B	Common US generic drugs names	882
Appendix C	SI units	883
Appendix D	Drug calculations	886
Appendix e	Common symbols used in medication charts	890
Appendix F	Common word mix-ups	891
Appendix G	Drug-herb interactions	892
Glossary			894
Index			904

Library of Congress Subject Headings for this publication:

Pharmacology.
Nursing.
Pharmacology -- Nurses' Instruction.
Pharmaceutical Preparations -- Nurses' Instruction.