Có 40+ tài liệu thuộc chủ đề "clinical pharmacology"
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Drugs and the skin. This account is confined to therapy directed primarily at the skin.. Pharmacokinetics of the skin. Topical preparations:Vehicles for presenting drugs to the skin. The stratum corneum (superficial keratin layer) is both the principal barrier to penetration of drugs into the skin and a reservoir for drugs. a corticosteroid may be detectable even 4 weeks after a...
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One of the greatest services doctors can do their patients is to acquire skill in the management of pain.. 1 It is mediated by specific nerve fibres to the brain where its conscious appreciation may be modified by various factors.. An understanding of the phenomenon of pain ought to accommodate the following points:. 5 Twycross R G 1984 Journal of...
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Obstetric analgesia and anaesthesia Anaesthesia in patients already taking drugs Anaesthesia in the diseased, the elderly and children. But the pioneer administered it to his wife for, 'as all three agreed, he could find another wife, but could never get another mother' (Journal of the American Medical Association . The next important developments in anaesthesia were in the 20th century...
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Drugs provide a degree of stability and control in the lives of those suffering from schizophrenia, a chronic. Similarly, the impact of medication in alleviating the burden on individuals, their families and society of depression, which has a lifetime prevalence of up to I in 6 of the population, is substantial. Disorders that would formerly have been grouped under 'neuroses'...
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Atypical drugs that do antagonise dopamine D 2 - receptors appear to have affinity for those in the. In contrast to classical antipsychotics, risperidone shares with clozapine an ability antagonise a 2 -adrenoceptors, a property which may have utility in the treatment of schizo- phrenia and is seen as an area of interest for developing new drugs.. Again in common...
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Humans spend about a third of the time asleep but why we sleep is not yet fully understood. When a recording is made of the electroencephalogram (EEG) and other physiolo- gical variables such as muscle activity and eye movements during sleep (a technique called poly- somnography), a pattern of sleep emerges, consisting of five different stages. This pattern varies from...
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Bromide (1857) was the first drug to be used for the treatment of epilepsy, but it is now obsolete.. Since then many other drugs have been discovered, but phenytoin still remains a drug of choice in the treatment of major epilepsy. Over the past ten years there has been a dramatic increase in the number of new anticonvulsant drugs (vigabatrin,...
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Acetylcholine is a widespread chemotransmitter in the body, mediating a broad range of physiological effects.There are two distinct classes of receptor for acetylcholine defined on the basis of their preferential activation by the alkaloids, nicotine (from tobacco) and muscarine (from a fungus, Amanita muscaria).. atropine, are often imprecisely called anticholinergics.The more precise term antimuscarinic is preferred here.. Cholinergic drugs. Disorders...
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The discovery in 1895 of the hypertensive effect of adrenaline (epinephrine) was initiated by Dr Oliver, a physician in practice, who conducted a series of experiments on his young son into whom he injected an extract of bovine suprarenal. The effect was confirmed in animals and led eventually to the iso- lation and synthesis of adrenaline in the early 1900s.....
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Hypertension affects above 20% of the total population of the USA with its major impact on those over age 50. Blood pressure. reduced venous return to the heart (preload) leads to reduced cardiac output, especially in the upright position. peripheral resistance), so reducing the work of the heart in perfusing the tissues. according to Starling's Law of the heart, workload...
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Receptor blockade will outlast the persistence of the drug in the plasma.. Instead of the damage (blood vessel changes with metaplasia and keratinisation of the conjunctive) being on the front of the eye exposed by the open lids, it was initially in the areas behind and protected by the lids. 'state of the art defence' applied. Glucagon, which has cardiac...
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Nevertheless many patients with arrhythmias respond well to therapy with drugs and a working knowledge of their effects and indications pays dividends, for irregularity of the heart-beat is at least inconvenient and at worst fatal.The mechanisms by which the failing heart may be sustained are now better understood. In addition, all antiarrhythmics are also capable of generating arrhythmias and should...
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nicotinic acid and derivatives. Cholesterol is absorbed from the intestine and transported to the liver by chylomicron. The quantity of cholesterol transported from the liver to peripheral tissues greatly exceeds its catabolism there and mechanisms exist to return cholesterol to the liver. Through this 'reverse transport', cholesterol is carried by high-density lipoprotein (HDL) from peripheral cells to the liver where...
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The kidneys comprise only 0.5% of body weight, yet they receive 25% of the cardiac output. Disease of the kidney must be taken into account when prescribing drugs that are eliminated by it.. Prescribing for renal disease: adjusting the dose according to the characteristics of the drug and to the degree of renal impairment. Some 65% of the filtered sodium...
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Occlusive vascular disease is a major cause of morbidity and mortality.There is now better understanding of the mechanisms by which the haemostatic system ensures blood remains fluid within vessels, yet forms a solid plug when a vessel is breached, and of the ways in which haemostasis may be altered by drugs to prevent or reverse (lyse) pathological thrombosis.. (anticoagulants, thrombolytics,...
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Iron: therapy, acute overdose Vitamin B 12 (cobalamins) Folic acid. The rational use of iron could not begin until both the presence of iron in the. 'colouring matter' of the blood and the 'defective nature of the colouring matter' in anaemia were recognised. Iron absorption takes place predominantly in the duodenum where the acid environment enhances solubility, but also throughout...
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About 75% of cancers are due to environmental factors, some of which are within the control of the individual, e.g.. of cancers are familial.The different systemic modalities used to treat cancer patients are discussed. Tendency to spread to other parts of the body (metastasise). Tendency to retain some characteristics of the tissue of origin.. Details of the exploitation of all...
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Approximately one-third of the population in Western societies experiences regular dyspepsia, although more than half self- medicate with over-the-counter antacid preparations and do not seek medical advice.. The remainder, in whom no abnormality is found, are diagnosed as having nonulcer dyspepsia.The pathophysiology and treatment differ for each of these three conditions.. Neutralisation of secreted acid Reduction of acid secretion Enhancing...
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Infective diarrhoeal diseases are a significant cause of morbidity and mortality worldwide, especially in infants and children.The management of these conditions is reviewed.. They are medicines that promote defaecation largely by reducing the viscosity of the contents of the lower colon and are classified as follows:. Most of the fibre in our diet is in the form of nonstarch poly-...
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The liver is the most important organ in which drugs are structurally altered. Some of the resulting metabolites may be biologically inactive, some active and some toxic (see Chapter 7).The liver is exposed to drugs in higher concentrations than are most organs because most are administered orally and are absorbed from the gastrointestinal tract.Thus the whole dose must pass through...