Clinical Pharmacology Made Ridiculously Simple
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A concise overview of the most important principles in clinical pharmacology, with drug comparisons in clear chart format. Excellent Board review. Fourth edition.
dyspnea as a resuJt of airway obstruction and inflammation. COPD patients complain of persistent cough and dyspnea on exertion. On physical examination, use of accessory respiratory muscles and expiratory wheezing are commonly noted. Expiratory wheezing is due in part to bronchiolar collapse which traps air distal to the constricted site. • Beta-adrenergic agonists bind to ~l receptors on bronchial smooth muscle, causing an increase in the biochemical messenger, cyclic AMP (cAMP). In~ creased
anticancer drugs act by killing cells that are dividing. The drugs accomplish this by interfering with DNA, RNA, or protein synthesis or by inhibiting the formation of microtubules in mitosis. Such agents are called cell cycle-specific agents because they exert their actions during distinct phases of the cell cycle (Fig. 8.1). In general, agents that interfere with DNA synthesis are S-phase specific; those that interfere with microtubules disrupt mitosis and are called M~phase specific. DNA
Bone Marrow Suppressjon: Most agents Methotrexate 5-Fluorouracil Actinomycin 0 Corticosteroids Renal Toxicity; Cisplalin Sireplozocin ~~;<:--\,--\-~ Hemorrhagic Cystitis; Cyclophosphamide Ifosfamide No Marrow Suppression: Bleomycin Vincristine Delayed Marrow Suppression' Carmustine (BCNU) figure 8.3 Notable side effects of c/lemotllerapclltic agcllts. 123 Alkylating Agents Alkylating agents were the first anticancer agents developed. They are chemically related to mustard gas which was
anxiety and pruritis. Meclizine is used for motion sickness and vertigo. Sedative: [OW·MODERATE Anticholinergic: MODERATE Seasonal allergic rhinitis. Little or no sedation. H2 Receptor Antagonists - Described in detail In Table 6.1 Clmetldlne (Tagamet) H2 Receptor Duodenal/gastric ulcer, Ranitidine (Zantac) Antagonist hypersecretion of acid. Famotidine ,i;epcid) Nlzatidine ( xid) 140 Anti-inflammatory and Immunomodufating Agents Sedative: lOW-MODERATE AntichOline~ic: MODERATE GI upset: L W
Therefore the required dose is lower. However, these agents are no better than the others with regard to glucose control. re Reduces Intestinal uptake and hepatic production 01 glucose. Increases sensitivity of tissues to insulin. Generally does not cause hypoglycemia. May act synergistically with sulfonylureas. Rarely causes lactic acidosis, which Is potentially latal. More COrTmOnly causes gastrointestinal side elleets. ,!,lghtol (G~sel) Acarbose Precose) - stimulates Insu In secr~t!on ~y