Medical Pharmacology and Therapeutics

755 Pages·2022·20.663 MB·English

by  Derek G. Waller, Andrew W. Hitchings, Anthony P. Sampson

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2020_ME
MEDICAL
PHARMACOLOGY
THERAPEUTICS
&
DEDICATION
To our families
Sixth Edition
MEDICAL
PHARMACOLOGY
THERAPEUTICS
&
Derek G. Waller, BSc, DM, MB, BS, FRCP
Former Consultant Physician and Senior Clinical Lecturer
Department of Medicine
University Hospital Southampton
Southampton
United Kingdom
Anthony P. Sampson, MA, PhD, FHEA, FBPhS
Professorial Fellow in Clinical Pharmacology & Director of Undergraduate Programmes
Faculty of Medicine
University of Southampton
Southampton
United Kingdom
Andrew W. Hitchings, BSc, MBBS, PhD, FRCP, FFICM,
FHEA, FBPhS
Reader in Clinical Pharmacology
St George’s, University of London
Honorary Consultant in Neurointensive Care
St George’s University Hospitals NHS Foundation Trust
London
United Kingdom
For additional online content visit StudentConsult.com
London New York Oxford Philadelphia St Louis Sydney 2022
ELSEVIER
Copyright © 2022 by Elsevier Limited. All rights reserved.
First edition 2001
Second edition 2005
Third edition 2010
Fourth edition 2014
Fifth edition 2018
The rights of Derek G. Waller, Anthony P. Sampson and Andrew W. Hitchings to be identified as
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ISBN: 978-0-7020-8159-0
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Contents
Preface, vii SECTION 4 THE RENAL SYSTEM, 218
Drug Dosage and Nomenclature, viii
14. Diuretics, 218
15. Disorders of Micturition, 229
SECTION 1 GENERAL PRINCIPLES, 1
16. Erectile Dysfunction, 236
1. Principles of Pharmacology and Mechanisms of
Drug Action, 1
SECTION 5 THE NERVOUS SYSTEM, 242
2. Pharmacokinetics, 32
17. General Anaesthetics, 242
3. Drug Discovery, Safety and Efficacy, 62
18. Local Anaesthetics, 252
4. Neurotransmission and the Peripheral Autonomic
Nervous System, 71
19. Opioid Analgesics and the Management of Pain, 258
20. Anxiety, Obsessive-Compulsive Disorder and
SECTION 2 THE CARDIOVASCULAR Insomnia, 273
SYSTEM, 89
21. Schizophrenia and Bipolar Disorder, 281
5. Ischaemic Heart Disease, 89
22. Depression, Attention Deficit Hyperactivity
6. Systemic and Pulmonary Hypertension, 108 Disorder and Narcolepsy, 292
7. Heart Failure and Shock, 128 23. Seizures and Epilepsy, 308
8. Cardiac Arrhythmias, 142 24. Extrapyramidal Movement Disorders and
Spasticity, 323
9. Cerebrovascular Disease and Dementia, 160
25. Other Neurological Disorders: Multiple Sclerosis,
10. Peripheral Artery Disease, 169 Motor Neuron Disease and Guillain–Barré
Syndrome, 336
11. Haemostasis, 175
26. Migraine and Other Headaches, 342
SECTION 3 THE RESPIRATORY
SYSTEM, 192 SECTION 6 THE MUSCULOSKELETAL
SYSTEM, 350
12. Asthma and Chronic Obstructive
Pulmonary Disease, 192 27. The Neuromuscular Junction and Neuromuscular
Blockade, 350
13. Respiratory Disorders: Cough, Respiratory
Stimulants, Cystic Fibrosis, Idiopathic Pulmonary 28. Myasthenia Gravis, 357
Fibrosis and Neonatal Respiratory Distress
Syndrome, 211 29. Nonsteroidal Antiinflammatory Drugs, 361
v
00062-Waller-9780702081590 00062-Waller-9780702081590
These proofs may contain color figures. Those figures may print black and white in the final printed book if a color print product has not been planned. The color These proofs may contain color figures. Those figures may print black and white in the final printed book if a color print product has not been planned. The color
figures will appear in color in all electronic versions of this book. figures will appear in color in all electronic versions of this book.
To protect the rights of the author(s) and publisher we inform you that this PDF is an uncorrected proof for internal business use only by the author(s), editor(s), To protect the rights of the author(s) and publisher we inform you that this PDF is an uncorrected proof for internal business use only by the author(s), editor(s),
reviewer(s), Elsevier and typesetter Aptara. It is not allowed to publish this proof online or in print. This proof copy is the copyright property of the publisher and is reviewer(s), Elsevier and typesetter Aptara. It is not allowed to publish this proof online or in print. This proof copy is the copyright property of the publisher and is
confidential until formal publication. confidential until formal publication.
vi CONTENTS
30. Rheumatoid Arthritis, Other Inflammatory 44. Corticosteroids (Glucocorticoids and
Arthritides and Osteoarthritis, 371 Mineralocorticoids), 503
31. Hyperuricaemia, Gout and Pseudogout, 383 45. Female Reproduction, 512
46. Androgens, Antiandrogens and Anabolic
Steroids, 530
SECTION 7 THE GASTROINTESTINAL
SYSTEM, 389
47. Anaemia and Haematopoietic Colony-Stimulating
32. Nausea and Vomiting, 389 Factors, 535
33. Dyspepsia, Peptic Ulcer Disease and 48. Lipid Disorders, 545
Gastrooesophageal Reflux Disease, 397
34. Inflammatory Bowel Disease, 408 SECTION 10 THE SKIN AND EYES, 558
49. Skin Disorders, 558
35. Constipation, Diarrhoea and Irritable Bowel
Syndrome, 415
50. The Eye, 567
36. Liver Disease, 423
37. Obesity, 432 SECTION 11 ANTIMICROBIAL THERAPY, 578
51. Drugs for Infections, 578
SECTION 8 THE IMMUNE SYSTEM, 437
SECTION 12 CANCER, 630
38. The Immune Response and Immunosuppressant
Drugs, 437 52. Drugs for Cancer, 630
39. Antihistamines and Allergic Disease, 450
SECTION 13 GENERAL FEATURES: TOXICITY
AND PRESCRIBING, 661
SECTION 9 THE ENDOCRINE SYSTEM
53. Drug Toxicity and Overdose, 661
AND METABOLISM, 457
40. Diabetes Mellitus, 457 54. Substance Abuse and Dependence, 677
41. The Thyroid and Control of Metabolic Rate, 473 55. Prescribing, Adherence and Information About
Medicines, 693
42. Calcium Metabolism and Metabolic Bone
Disease, 480 56. Drug Therapy in Special Situations, 700
43. Pituitary and Hypothalamic Hormones, 491
Index, 712
00062-Waller-9780702081590 00062-Waller-9780702081590
These proofs may contain color figures. Those figures may print black and white in the final printed book if a color print product has not been planned. The color These proofs may contain color figures. Those figures may print black and white in the final printed book if a color print product has not been planned. The color
figures will appear in color in all electronic versions of this book. figures will appear in color in all electronic versions of this book.
Preface
The sixth edition of Medical Pharmacology and Thera- pharmacokinetic properties and unwanted effects
peutics has been revised and updated to build upon associated with individual drug classes. Example
the strengths and popular approach of previous edi- drugs are covered in depth to illustrate the common
tions. Its aim remains to provide a single volume for pharmacological characteristics of their class and to
healthcare professionals and students requiring a introduce the reader to those drugs currently in the
sound knowledge of the basic principles of clinical most widespread clinical use.
pharmacology combined with the practice of drug • A structured approach to the principles of disease
prescribing for the management of disease. management, outlining the core principles of drug
Medical Pharmacology and Therapeutics relates key choice and planning a therapeutic regimen for many
information on basic pharmacology to other relevant common diseases.
biomedical sciences in order to underpin the clini- • Drug compendia at the close of each chapter enable
cal contexts, and each disease-based chapter is then any drug encountered by the reader in day-to-day
structured to reflect the ways that relevant drugs are work or study to be placed within its drug class and
used in clinical practice. The chapters covering generic its key features related to the example drugs cov-
concepts in pharmacology and therapeutics include ered in the chapter.
sections on drug action at a cellular level, pharmaco- • An expanded section of self-assessment questions
kinetics, pharmacogenetics, drug development, drug for learning and revision of the concepts and con-
toxicity and the principles of prescribing. The sections tent in each chapter, including one-best-answer
on clinical management in each disease area have been (OBA), extended-matching-item (EMI), true-false
thoroughly revised and updated in line with best prac- and case scenario-based questions.
tice and the relevant national guidelines, including on It is our intention that the sixth edition of this book
COVID-19. will encourage readers to develop a deeper under-
Each chapter in this sixth edition retains the follow- standing of the principles of drug usage that will
ing key features: help them to become safe and effective prescribers,
• An up-to-date and succinct explanation of the major to enable them to evaluate the findings of basic and
pathogenic mechanisms of disease and consequent clinical research, to encourage them to teach and train
clinical symptoms and signs, helping the reader to others in their profession, and to develop the skills of
put into context the actions of drugs and the conse- lifelong learning that will enable them to tackle chang-
quences of their therapeutic use. ing healthcare needs and emerging threats.
• A comprehensive review of major drug classes
relevant to the disease in question. Basic pharma- DGW
cology is described with clear identification of the APS
molecular targets, clinical characteristics, important AWH
vii
Drug Dosage and Nomenclature
(epinephrine) and noradrenaline (norepinephrine). In
DRUG NOMENCLATURE
this book, where the use of these agents as adminis-
In the past, the nonproprietary (generic) names of tered drugs is being described, dual names are given.
some drugs have varied from country to country, In keeping with European convention, however, adren-
leading to potential confusion. Progressively, interna- aline and noradrenaline alone are used when referring
tional agreement has been reached to rationalise these to the physiological effects of the naturally occurring
variations in names and a single recommended Inter- substances.
national Nonproprietary Name (INN) given to all
drugs. Where the previously given British Approved
DRUG DOSAGES
Name (BAN) and the INN have differed, the INN is
now the accepted name and is used throughout this Medical knowledge is constantly changing. As new
book. information becomes available, changes in treatment,
A special case has been made for two medicinal sub- procedures, equipment and the use of drugs become
stances: adrenaline (INN: epinephrine) and noradren- necessary. The authors and the publishers have taken
aline (INN: norepinephrine). Because of the clinical care to ensure that the information given in the text is
importance of these substances and the widespread accurate and up to date. However, readers are strongly
European use and understanding of the terms adren- advised to confirm that the information, especially
aline and noradrenaline, manufacturers have been with regard to drug usage, complies with the latest
asked to continue to dual-label products adrenaline legislation and standards of practice.
viii