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Chủ đề : clinical pharmacology


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CLINICAL PHARMACOLOGY 2003 (PART 1)

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'Nature is not only odder than we think, but it is odder than we can think.'. It is really one of the most serious difficulties with which we have to contend. it is only its first stage.'. like all other sciences, it will get away by the scientific method.' 'Considered in itself, the experimental method is nothing but reasoning by...

CLINICAL PHARMACOLOGY 2003 (PART 2)

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Drug history can assist choice of drugs in the future.. Many of the drugs on the market may not have been available when a general practitioner was at medical school. It is both a surprise and a pleasure to be able to continue to quote with approval from such a source. misunderstanding of the role of medical schools. It is...

CLINICAL PHARMACOLOGY 2003 (PART 3)

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Complementary drugs are for use where, for any reason, drugs in the main list are unavailable, or there are exceptional medical circumstances, e.g.. Not every entry in the list is discussed in this book.. Drugs used to treat gout allopurinol. Disease-modifying agents used in rheumatic disorders azathioprine. Antiallergics and drugs used in anaphylaxis. Antidotes and other substances used in poisonings....

CLINICAL PHARMACOLOGY 2003 (PART 4)

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Clinical pharmacology. Clinical pharmacology comprises all aspects of the scientific study of drugs in man. Successful use of the power conferred (by bio- technology in particular) requires understanding of the enormous complexity of the consequences of interference. All these issues are the concern of clinical pharmacologists and are the subject of this book.. The drug and information 'explosion' of the...

CLINICAL PHARMACOLOGY 2003 (PART 5)

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Preclinical drug development. Discovery of new drugs in the laboratory is an exercise in prediction. Studies in animals and in humans. Failures of prediction occur and a drug may be abandoned at any stage,. New drug development is a colossally expensive and commercially driven activity.. The development of new medicines (drugs) is an exercise in prediction from laboratory studies in...

CLINICAL PHARMACOLOGY 2003 (PART 6)

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The key to the ethics of such studies is informed consent from patients, efficient scientific design and review by an independent research ethics committee.The key. interpretative factors in the analysis of trial results are calculations of confidence intervals and statistical significance.The potential clinical significance needs to be considered within the confines of controlled clinical trials.This is best expressed by stating...

CLINICAL PHARMACOLOGY 2003 (PART 7)

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The quality aspects may also need to be revised as manufacturing practices change. Only governments can provide the assurance about all those aspects in the life of a medicine, (in so far as it can be provided).. safety, in relation to its use: evaluation at the point of marketing is provisional in the sense that it is followed in the...

CLINICAL PHARMACOLOGY 2003 (PART 8)

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Any drug may have names in all three of the following classes:. Nonproprietary Names (rINN). In this book proprietary names are distinguished by an initial capital letter.. It is obviously unsuitable for prescribing.. Manufacture is con- fined to the owner of the trade mark or to others licensed by the owner. NONPROPRIETARY NAMES. Clarity: because it gives information of the...

CLINICAL PHARMACOLOGY 2003 (PART 9A)

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the effects of genetics, age, and disease on drug action — these topics are important for, although they will generally not be in the front of the conscious mind of the prescriber, an understanding of them will enhance rational decision taking.. Knowledge of the requirements for success and the explanations for failure and for adverse events will enable the doctor...

CLINICAL PHARMACOLOGY 2003 (PART 9B)

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infusion it is important to know when steady state has been reached, for maintaining the same dosing schedule will then ensure a constant amount of drug in the body and the patient will experience neither acute toxicity nor decline of effect. The t1/2 provides the answer: with the passage of each t1/2 period of time, the plasma concentration rises by...

CLINICAL PHARMACOLOGY 2003 (PART 9C)

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Substances that have a molecular weight in excess of 50 000 are excluded from the glomerular filtrate while those of molecular weight less than 10 000 (which includes almost all drugs) 21 pass easily through the pores of the glomerular membrane.. Cells of the proximal renal tubule actively transfer strongly charged molecules from the plasma to the tubular fluid. The...

CLINICAL PHARMACOLOGY 2003 (PART 10)

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it has no 'intentions' towards humans, though it is often unfavourable to them. It is mankind, in its desire to avoid suffering and death, that decides that some of the biological effects of drugs are desirable (therapeutic) and others are undesirable (adverse). Because of the variety of these factors, attempts to make a simple account of the unwanted effects of...

CLINICAL PHARMACOLOGY 2003 (PART 11)

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A curious by-product of the modern 'drug and prescribing explosion' is the rise in the incidence of nonfatal deliberate self-harm. In over 90% of instances in the UK, poisoning is the means chosen, usually by medi- cines taken in overdose and these amount to at least 70 000 hospital admissions per annum in England and Wales (population 51 million). of...

CLINICAL PHARMACOLOGY 2003 (PART 12A)

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The presence of poppy heads in the kitchen middens of the Swiss Lake Dwellers shows how early in his history man discovered the techniques of self- transcendence through drugs. The drives that induce a person more or less mentally healthy to resort to drugs to obtain chemical vacations from intolerable selfhood will be briefly considered here, as well as some...

CLINICAL PHARMACOLOGY 2003 (PART 12B)

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The acute effect of alcohol is to block NMDA receptors for which the normal agonist is glutamate, the main excitatory transmitter in the brain. Chronic exposure increases the number of NMDA receptors and also 'L type' calcium channels, while the action of the (inhibitory) GABA neurotransmitter is reduced.. The malnutrition complicates the long-term effects of alcohol itself.. cancer of the...

CLINICAL PHARMACOLOGY 2003 (PART 13)

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Infection is a major category of human disease and skilled management of antimicrobial drugs is of the first importance.The term. chemotherapy is used for the drug treatment of parasitic infections in which the parasites (viruses, bacteria, protozoa, fungi, worms) are destroyed or removed without injuring the hostThe use of the term to cover all drug or synthetic drug therapy needlessly...

CLINICAL PHARMACOLOGY 2003 (PART 14)

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In the UK recently all these names have been standardised to begin with 'cef'.. the names of the most recently introduced members of the group end in '-oxacin', e.g. Benzylpenicillin (1942) is produced by growing one of the penicillium moulds in deep tanks. Penicillins act by inhibiting the enzymes (Penicillin Binding Proteins, PBPs) in- volved in the crosslinking of the...

CLINICAL PHARMACOLOGY 2003 (PART 15)

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Infection of the blood. Accurate microbiological diagnosis is of the first importance and blood cultures should be taken before starting antimicrobial therapy. Staphylococcal septicaemia may be suspected where there is an abscess, e.g. The clinical problem is due to systemic effects of toxins produced by staphylococci: while this is not strictly an infection of the blood, flucloxacillin is used to...

CLINICAL PHARMACOLOGY 2003 (PART 16)

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Malaria is the major transmissible parasitic disease in the world.. considerable morbidity.The drugs that are effective against these organisms are summarised.. Apart from primary infection, viral illness is often the consequence of reactivation of latent virus in the body. It eff- ectively treats susceptible herpes viruses if started early in the course of infection, but it does not eradicate persistent...

CLINICAL PHARMACOLOGY 2003 (PART 17)

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Nonsteroidal anti-inflammatory drugs (NSAIDs) are widely used, and their gastrointestinal effects account for an estimated 1200 deaths per year in the UK. As understanding of the complex mechanisms underlying the inflammatory process increases, new ways of influencing it are developed, as witness therapies directed against specific cytokines, and COX-2 specific NSAIDs (COXIBs).. many different cells and cell products, and only...