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Pharmacology for Pharmacy and the Health Sciences
Pharmacology for
Pharmacy and the
Health Sciences
A patient-centred approach
Second edition
Michael Boarder
Formerly Professor of Pharmacology, Leicester School of Pharmacy,
De Montfort University, UK
Jane Dixon
Senior Lecturer, Leicester School of Pharmacy, De Montfort University, UK
David Newby
Associate Professor, Discipline of Clinical Pharmacology,
School of Medicine and Public Health, University of Newcastle, Australia
Phyllis Navti
Divisional Lead Prescribing Advisor, Leicestershire County and
Rutland Primary Care Trust NHS, and Senior Lecturer in Pharmacy Practice,
Leicester School of Pharmacy, De Montfort University, UK
Tyra Zetterström
Reader in Neuropharmacology, Leicester School of Pharmacy,
De Montfort University, UK
3
3
Great Clarendon Street, Oxford, OX2 6DP,
United Kingdom
Oxford University Press is a department of the University of Oxford.
It furthers the University’s objective of excellence in research, scholarship,
and education by publishing worldwide. Oxford is a registered trade mark of
Oxford University Press in the UK and in certain other countries
© Oxford University Press 2017
e moral rights of the authors have been asserted
First Edition 2010
Impression: 1
All rights reserved. No part of this publication may be reproduced, stored in
a retrieval system, or transmitted, in any form or by any means, without the
prior permission in writing of Oxford University Press, or as expressly permitted
by law, by licence or under terms agreed with the appropriate reprographics
rights organization. Enquiries concerning reproduction outside the scope of the
above should be sent to the Rights Department, Oxford University Press, at the
address above
You must not circulate this work in any other form
and you must impose this same condition on any acquirer
Published in the United States of America by Oxford University Press
198 Madison Avenue, New York, NY 10016, United States of America
British Library Cataloguing in Publication Data
Data available
Library of Congress Control Number: 2016951219
ISBN 978–0–19–107072–3
Printed in Great Britain by
Bell & Bain Ltd., Glasgow
Links to third party websites are provided by Oxford in good faith and
for information only. Oxford disclaims any responsibility for the materials
contained in any third party website referenced in this work.
Oxford University Press makes no representation, express or implied, that the
drug dosages in this book are correct. Readers must therefore always check
the product information and clinical procedures with the most up-to-date
published product information and data sheets provided by the manufacturers
and the most recent codes of conduct and safety regulations. e authors and
publishers do not accept responsibility or legal liability for any errors in the
text or for the misuse or misapplication of material in this work.
Acknowledgements
We would like to thank all those involved in the rst edition of this book, and extend our
special thanks to a number of individuals who have been particularly helpful with this
second edition. ose people are: Benjamin Gronier (for help with Chapters 14 and 15);
Laura Smith (for help with Chapter 22); Amanda Kemp (for material in the workbooks in
Chapters 20 and 21); Anisha Patel (for material in the workbooks in Part 1); Geo Hall (for
his expertise in areas of medicinal chemistry); and Peter Dixon (for his unerring attention to
detail).
Contents at a glance
Abbreviations xiv
Clinical clerking abbreviations xviii
Part 1
Introduction 1
1 Drugs, patients, and this book 3
2 How do drugs work? An introduction 6
3 Pharmacokinetics 29
Part 2
The cardiovascular system 41
4 Haemostasis and thromboembolic disorders 43
5 Hypertension 76
6 Atherosclerosis and ischaemic heart disease 109
7 Arrhythmias and chronic heart failure 142
Part 3
Inflammation and immune disease 171
8 Inflammation and the skin: dermatitis, psoriasis, and acne 183
9 Rheumatoid arthritis 211
10 Allergies: rhinitis and urticaria 245
11 Respiratory disease: asthma and chronic obstructive
pulmonary disease (COPD) 263
Part 4
Gastrointestinal and endocrine disorders 295
12 Upper gastrointestinal tract disorders 305
13 Disorders of the lower gastrointestinal tract 329
14 Diabetes mellitus and obesity 347
15 Thyroid disorders and pharmacological methods of contraception 378
viii Contents at a glance
Part 5
Central nervous system 401
16 Epilepsy 407
17 Neurodegenerative diseases 433
18 Schizophrenia 456
19 Depression and anxiety 480
20 Pain and its drug treatment 511
21 Drug addiction and recreational drugs 537
Part 6
The treatment of infections and cancer management 565
22 The treatment of infections 571
23 Cancer chemotherapy 618
Appendix: Summary of receptors 663
Index 673
Contents in full
Abbreviations xiv
Clinical clerking abbreviations xviii
Part 1
Introduction 1
1 Drugs, patients, and this book 3
1.1 How does this fit in with your career development in the
changing world of healthcare delivery? 3
1.2 So, what is pharmacology? 4
1.3 How to use this book 4
1.4 Comment for instructors 5
1.5 Online Resource Centre 5
2 How do drugs work? An introduction 6
2.1 Agonists and antagonists: drugs acting at receptors 8
2.2 How receptor activation changes cells 17
2.3 Ion channels as drug targets 27
2.4 Enzymes as drug targets 27
2.5 Transporter proteins as drug targets 27
3 Pharmacokinetics 29
3.1 The core principles of pharmacokinetics: ADME 30
3.2 Drug elimination: clearance 30
3.3 Volume of distribution 35
3.4 Half-life of a drug 36
3.5 Absorption and bioavailability 38
Part 2
The cardiovascular system 41
4 Haemostasis and thromboembolic disorders 43
4.1 How thrombi are formed and destroyed: the targets for drug action 44
4.2 Drugs used in the treatment of thromboembolic disorders 52
WORKBOOK 1 Thromboembolic disorders 67