Download Pharmacology and Therapeutics for Dentistry, 6e PDF

TitlePharmacology and Therapeutics for Dentistry, 6e
Author
LanguageEnglish
File Size25.3 MB
Total Pages957
Table of Contents
                            Front cover
Half title page
Title page
Copyright page
Contributors
Preface
	HOW TO APPROACH PHARMACOLOGY
	SUFFIXES AS CUES FOR REMEMBERING DRUG CLASSES
	ACKNOWLEDGMENTS
Table of contents
Introduction
	HISTORY
	SCOPE OF PHARMACOLOGY
Part 1: Principles of Pharmacology
	Chapter 1: Pharmacodynamics: Mechanisms of Drug Action
		DRUG-RECEPTOR INTERACTIONS
		DOSE-RESPONSE RELATIONSHIPS
		MULTISTATE MODEL OF DRUG ACTION
		RECEPTOR-INDEPENDENT DRUG ACTIONS
		CITED REFERENCES
		GENERAL REFERENCES
	Chapter 2: Pharmacokinetics:
		PASSAGE OF DRUGS ACROSS MEMBRANES
		ABSORPTION
		DISTRIBUTION
		METABOLISM
		EXCRETION
		TIME COURSE OF DRUG ACTION
		PHARMACOKINETIC-PHARMACODYNAMIC MODELING
		CITED REFERENCES
		GENERAL REFERENCES
	Chapter 3: Pharmacotherapeutics:
		FACTORS INFLUENCING DRUG EFFECTS
		ADVERSE DRUG REACTIONS
		DEVELOPMENT OF NEW DRUGS
		SOURCES OF DRUG INFORMATION
		CITED REFERENCES
		GENERAL REFERENCES
	Chapter 4: Pharmacogenetics and Pharmacogenomics
		PHARMACOKINETICS AND PHARMACODYNAMICS
		PHENOTYPE AND GENOTYPE
		MONOGENIC VERSUS POLYGENIC PHENOTYPES
		ETHNIC DIFFERENCES IN PHARMACOGENETICS
		PHARMACOGENETICS OF DRUG METABOLISM
		PHARMACOGENETIC POLYMORPHISMS IN DRUG TARGETS
		IMPLICATIONS FOR DENTISTRY
		CITED REFERENCES
		GENERAL REFERENCES
Part 2: Pharmacology of Specific Drug Groups
	Chapter 5: Introduction to Autonomic Nervous System Drugs
		AUTONOMIC NERVOUS SYSTEM
		NEUROTRANSMITTERS
		ADRENERGIC NEUROTRANSMISSION
		CHOLINERGIC TRANSMISSION
		SIGNAL TRANSDUCTION AND SECOND MESSENGERS
		DOPAMINERGIC TRANSMISSION
		PURINERGIC TRANSMISSION
		PEPTIDE TRANSMISSION AND CO-RELEASE OF NEUROTRANSMITTERS
		CENTRAL CONTROL OF AUTONOMIC FUNCTION
		SPECIFIC SITES AND MECHANISMS OF ACTION OF AUTONOMIC DRUGS
		CITED REFERENCES
		GENERAL REFERENCES
	Chapter 6: Adrenergic Agonists
		HISTORY
		CLASSIFICATION OF ADRENERGIC DRUGS AND RECEPTORS
		CHEMISTRY AND STRUCTURE-ACTIVITY RELATIONSHIPS
		PHARMACOLOGIC EFFECTS
		ABSORPTION, FATE, AND EXCRETION
		GENERAL THERAPEUTIC USES
		THERAPEUTIC USES IN DENTISTRY
		ADVERSE EFFECTS
		CITED REFERENCES
		GENERAL REFERENCES
	Chapter 7: Adrenergic Antagonists
		HISTORY
		SELECTIVE α1-ADRENERGIC RECEPTOR ANTAGONISTS
		NONSELECTIVE α-ADRENERGIC RECEPTOR ANTAGONISTS
		β-ADRENERGIC RECEPTOR ANTAGONISTS
		DRUGS WITH COMBINED α-ADRENERGIC AND β-ADRENERGIC RECEPTOR ANTAGONIST ACTIVITY
		DRUGS THAT REDUCE SYMPATHETIC OUTFLOW
		IMPLICATIONS FOR DENTISTRY
		CITED REFERENCES
		GENERAL REFERENCES
	Chapter 8: Cholinergic Drugs
		CHOLINOMIMETIC AGONISTS
		ANTICHOLINESTERASES
		GENERAL THERAPEUTIC USES
		THERAPEUTIC USES IN DENTISTRY
		CITED REFERENCES
		GENERAL REFERENCES
	Chapter 9: Antimuscarinic Drugs
		CHEMISTRY AND CLASSIFICATION
		MECHANISM OF ACTION
		PHARMACOLOGIC EFFECTS
		ABSORPTION, FATE, AND EXCRETION
		GENERAL THERAPEUTIC USES
		ADVERSE EFFECTS
		DRUG INTERACTIONS
		BOTULINUM TOXIN
		THERAPEUTIC USES IN DENTISTRY
		IMPLICATIONS FOR DENTISTRY
		CITED REFERENCES
		GENERAL REFERENCES
	Chapter 10: Drugs Affecting Nicotinic Receptors*
		DRUGS AFFECTING GANGLIONIC TRANSMISSION
		DRUGS AFFECTING NEUROMUSCULAR TRANSMISSION
		CITED REFERENCES
		GENERAL REFERENCES
	Chapter 11: Introduction to Central Nervous System Drugs*
		INVESTIGATION OF THE BRAIN
		ANATOMIC ORGANIZATION OF THE CENTRAL NERVOUS SYSTEM
		SYNAPTIC ORGANIZATION OF THE CENTRAL NERVOUS SYSTEM
		BIOCHEMICAL ORGANIZATION OF THE CENTRAL NERVOUS SYSTEM
		RELEASE OF NEUROTRANSMITTER
		RECEPTOR BINDING AND SIGNAL TRANSDUCTION
		TERMINATION OF NEUROTRANSMITTER EFFECT
		Termination of the Effects of Central Nervous System Drugs
		CITED REFERENCES
		GENERAL REFERENCES
	Chapter 12: Psychopharmacology:
		MAJOR PSYCHIATRIC DISORDERS
		ANTIPSYCHOTIC DRUGS
		ANTIDEPRESSANTS
		ANTIMANICS
		CITED REFERENCES
		GENERAL REFERENCES
	Chapter 13: Sedative-Hypnotics, Antianxiety Drugs, and Centrally Acting Muscle Relaxants*
		BENZODIAZEPINES
		BENZODIAZEPINE-LIKE SEDATIVE-HYPNOTICS
		MELATONIN RECEPTOR AGONISTS
		BARBITURATES
		CHLORAL HYDRATE AND OTHER SEDATIVE-HYPNOTICS
		ANTIHISTAMINES
		GENERAL THERAPEUTIC USES OF SEDATIVE-HYPNOTICS
		AZASPIRODECANEDIONES
		CENTRALLY ACTING MUSCLE RELAXANTS
		β-ADRENERGIC RECEPTOR-BLOCKING DRUGS
		α2-ADRENERGIC RECEPTOR AGONIST DRUGS
		IMPLICATIONS FOR DENTISTRY
		CITED REFERENCES
		GENERAL REFERENCES
	Chapter 14: Anticonvulsants*
		CLASSIFICATION OF EPILEPTIC DISORDERS
		PATHOPHYSIOLOGY
		ANTICONVULSANT THERAPY
		CHEMISTRY AND STRUCTURE-ACTIVITY RELATIONSHIPS
		HYDANTOINS
		BARBITURATES
		CARBAMAZEPINE
		VALPROIC ACID
		SUCCINIMIDES
		DRUGS AFFECTING γ-AMINOBUTYRIC ACID TRANSMISSION
		MISCELLANEOUS ANTICONVULSANTS
		NONPHARMACOLOGIC TREATMENTS
		GENERAL THERAPEUTIC USE
		IMPLICATIONS FOR DENTISTRY
		CITED REFERENCES
		GENERAL REFERENCES
	Chapter 15: Anti-Parkinson Drugs*
		NEUROBIOLOGY AND PATHOPHYSIOLOGY
		DOPAMINE REPLACEMENT AS A BASIS FOR THERAPY
		DRUG THERAPY FOR PARKINSON’S DISEASE
		SURGICAL THERAPY
		DRUGS USED FOR OTHER MOVEMENT DISORDERS
		IMPLICATIONS FOR DENTISTRY
		CITED REFERENCES
		GENERAL REFERENCES
	Chapter 16: Local Anesthetics
		CHEMISTRY AND CLASSIFICATION
		MECHANISM OF ACTION
		PHARMACOLOGIC EFFECTS
		ABSORPTION, FATE, AND EXCRETION
		ADVERSE EFFECTS
		DRUG INTERACTIONS
		GENERAL THERAPEUTIC USES
		USES IN DENTISTRY
		PREPARATIONS AND DOSAGE
		CITED REFERENCES
		GENERAL REFERENCES
	Chapter 17: Principles of General Anesthesia
		HISTORY
		COMMON TERMS
		GOALS OF ANESTHESIA
		MECHANISMS OF ANESTHESIA
		UPTAKE AND DISTRIBUTION OF INHALATION ANESTHETICS
		ELIMINATION AND METABOLISM OF ANESTHETIC GASES
		CHEMICAL PROPERTIES OF INHALATION ANESTHETICS
		PHARMACOLOGIC EFFECTS OF INHALATION ANESTHETICS
		ADMINISTRATION OF ANESTHETIC GASES
		CITED REFERENCES
		GENERAL REFERENCES
	Chapter 18: Agents Used in General Anesthesia and Sedation
		INHALATION AGENTS
		INTRAVENOUS AGENTS
		ANESTHETIC ADJUVANTS AND PREMEDICATION
		CITED REFERENCES
		GENERAL REFERENCES
	Chapter 19: Introduction to Antinociceptive Drugs
		PATHWAYS OF OROFACIAL PAIN
		PERIPHERAL MECHANISMS OF PAIN AND ANALGESIC DRUG ACTIONS
		CENTRAL MECHANISMS OF PAIN AND ANALGESIC DRUG ACTIONS
		MOLECULAR-GENETIC INFLUENCES ON PAIN AND ANALGESIC DRUG ACTIONS
		THERAPEUTIC STRATEGIES FOR USING ANTINOCICEPTIVE DRUGS
		CITED REFERENCES
	Chapter 20: Opioid Analgesics and Antagonists
		OPIOID ANALGESICS
		MIXED AGONIST-ANTAGONISTS AND OPIOID RECEPTOR ANTAGONISTS
		USE OF OPIOIDS IN THE CONTROL OF PAIN
		USES IN DENTISTRY
		IMPLICATIONS FOR DENTISTRY
		CITED REFERENCES
		GENERAL REFERENCES
	Chapter 21: Nonopioid Analgesics, Nonsteroidal Anti-inflammatory Drugs, and Antirheumatic and Antigout Drugs
		CAUSE OF INFLAMMATION
		NONSTEROIDAL ANTI-INFLAMMATORY DRUGS
		ACETAMINOPHEN
		COMBINATION ANALGESICS
		MISCELLANEOUS AGENTS FOR RHEUMATOID ARTHRITIS
		DRUGS USED TO TREAT GOUT
		CITED REFERENCES
		GENERAL REFERENCES
	Chapter 22: Histamine and Histamine Antagonists
		HISTAMINE
		HISTAMINE ANTAGONISTS
		CITED REFERENCES
		GENERAL REFERENCES
	Chapter 23: Drugs for Treating Orofacial Pain Syndromes
		PHARMACOLOGY AND CHRONIC PAIN
		SEROTONIN (5-HYDROXYTRYPTAMINE)
		DRUGS FOR ACUTE TREATMENT OF MIGRAINE
		DRUGS FOR MIGRAINE PROPHYLAXIS AND OTHER CHRONIC PAIN SYNDROMES
		DRUGS FOR MUSCULOSKELETAL PAIN
		DRUGS FOR NEUROPATHIC PAIN
		OTHER DRUGS USED FOR OROFACIAL PAIN
		IMPLICATIONS FOR DENTISTRY
		CITED REFERENCES
		GENERAL REFERENCES
	Chapter 24: Antiarrhythmic Drugs
		BASIC CARDIAC ELECTROPHYSIOLOGY
		ORIGINS OF ARRHYTHMIAS
		eletrocardiography AND COMMON ARRHYTHMIAS
		ANTIARRHYTHMIC DRUGS
		IMPLICATIONS FOR DENTISTRY
		CITED REFERENCES
		GENERAL REFERENCES
	Chapter 25: Drugs Used in Treating Heart Failure
		CARDIAC MUSCLE CONTRACTION AND HEART FAILURE
		DRUGS USED IN THE TREATMENT OF CHRONIC HEART FAILURE
		DIGOXIN
		CONDITIONS AFFECTING DIGOXIN THERAPY
		DRUGS USED FOR ACUTE THERAPY OF HEART FAILURE
		IMPLICATIONS FOR DENTISTRY
		CITED REFERENCES
		GENERAL REFERENCES
	Chapter 26: Antianginal Drugs
		NITRITES AND NITRATES
		β-ADRENERGIC RECEPTOR–BLOCKING DRUGS
		Ca++ CHANNEL BLOCKERS
		RANOLAZINE
		COMBINATION THERAPY
		PREVENTION OF MYOCARDIAL INFARCTION
		IMPLICATIONS FOR DENTISTRY
		CITED REFERENCES
		GENERAL REFERENCES
	Chapter 27: Diuretic Drugs
		CLASSES OF DIURETICS
		IMPLICATIONS FOR DENTISTRY
		CITED REFERENCES
		GENERAL REFERENCES
	Chapter 28: Antihypertensive Drugs
		CLINICAL ASPECTS OF HYPERTENSION
		DIURETICS
		DRUGS AFFECTING ANGIOTENSIN
		CA++ CHANNEL BLOCKERS
		DRUGS REDUCING SYMPATHETIC FUNCTION
		MISCELLANEOUS DRUGS
		TREATMENT OF HYPERTENSION
		IMPLICATIONS FOR DENTISTRY
		CITED REFERENCES
		GENERAL REFERENCES
	Chapter 29: Lipid-Lowering Drugs
		CHOLESTEROL AND ATHEROSCLEROSIS
		THERAPEUTIC AGENTS
		COMBINED-DRUG THERAPY
		CITED REFERENCES
		GENERAL REFERENCES
	Chapter 30: Antianemic and Hematopoietic Stimulating Drugs
		ANEMIA
		OTHER MINERALS AND HEMATOPOIESIS
		PORPHYRIA
		THALASSEMIA
		VITAMIN B12, FOLIC ACID, AND MEGALOBLASTIC ANEMIA
		HEMATOPOIETIC GROWTH FACTORS
		RED BLOOD CELL SUBSTITUTES AND PLASMA EXTENDERS
		IMPLICATIONS FOR DENTISTRY
		CITED REFERENCES
		GENERAL REFERENCES
	Chapter 31: Procoagulant, Anticoagulant, and Thrombolytic Drugs
		HEMOSTASIS
		PROCOAGULANT AGENTS
		AGENTS THAT PROMOTE OR INHIBIT FIBRINOLYSIS
		ANTICOAGULANTS
		PLATELET INHIBITORS
		IMPLICATIONS FOR DENTISTRY
		CITED REFERENCES
		GENERAL REFERENCES
	Chapter 32: Drugs Acting on the Respiratory System
		PATHOPHYSIOLOGY OF ASTHMA
		PATHOPHYSIOLOGY OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE
		DRUGS USED TO TREAT ASTHMA
		PHARMACOTHERAPY FOR ASTHMA
		ASPIRIN-INDUCED ASTHMA
		PHARMACOTHERAPY FOR CHRONIC OBSTRUCTIVE PULMONARY DISEASE
		IMPLICATIONS FOR DENTISTRY
		DRUGS FOR MILD RESPIRATORY ILLNESSES
		CITED REFERENCES
		GENERAL REFERENCES
	Chapter 33: Drugs Acting on the Gastrointestinal Tract
		GASTRIC HYPERACIDITY, GASTROESOPHAGEAL REFLUX DISEASE, AND PEPTIC ULCER DISEASE
		DRUGS USED TO REDUCE GASTRIC ACID and treat peptic ulcer disease
		ANTISIALAGOGUES
		EMETICS AND ADSORBENTS
		ANTIEMETICS
		LAXATIVES
		ANTIDIARRHEAL AGENTS
		GASTROINTESTINAL STIMULANTS
		IRRITABLE BOWEL SYNDROME
		ADVERSE REACTIONS OF THE GASTROINTESTINAL SYSTEM TO DRUGS
		CITED REFERENCES
		GENERAL REFERENCES
	Chapter 34: Pituitary, Thyroid, and Parathyroid Pharmacology
		HYPOTHALAMIC AND PITUITARY HORMONES
		POSTERIOR PITUITARY HORMONES
		ANTERIOR PITUITARY HORMONES
		THYROID HORMONES
		THYROID DISORDERS
		DRUGS USED IN THE TREATMENT OF HYPERTHYROIDISM
		IMPLICATIONS FOR DENTISTRY
		HORMONES OF Ca++ HOMEOSTASIS
		CITED REFERENCES
		GENERAL REFERENCES
	Chapter 35: Adrenal Corticosteroids
		GENERAL PHYSIOLOGIC AND PHARMACOLOGIC ACTIONS
		ABSORPTION, FATE, AND EXCRETION
		GENERAL THERAPEUTIC USES
		THERAPEUTIC USES IN DENTISTRY
		ADVERSE EFFECTS
		IMPLICATIONS FOR DENTISTRY
		PREPARATIONS
		CITED REFERENCES
		GENERAL REFERENCE
	Chapter 36: Insulin, Oral Hypoglycemics, and Glucagon
		insulin and the ENDOCRINE PANCREAS
		DIABETES MELLITUS
		ORAL ANTIHYPERGLYCEMIC AGENTS
		MISCELLANEOUS DRUGS USED IN THE TREATMENT OF DIABETIC PATIENTS
		GLUCAGON
		IMPLICATIONS FOR DENTISTRY
		CITED REFERENCES
		GENERAL REFERENCES
	Chapter 37: Steroid Hormones of Reproduction and Sexual Development*
		STRUCTURE AND FUNCTION
		MECHANISM OF ACTION
		THERAPEUTIC USES
		ADVERSE EFFECTS
		DRUG INTERACTIONS
		HORMONE ANTAGONISTS AND PARTIAL AGONISTS
		IMPLICATIONS FOR DENTISTRY
		PEPTIDE HORMONES
		CITED REFERENCES
		GENERAL REFERENCES
	Chapter 38: Principles of Antibiotic Therapy*
		INFECTIOUS DISEASE PAST AND PRESENT
		PATTERNS OF ANTIBIOTIC USE AND MISUSE
		ANTIBIOTIC MECHANISMS OF ACTION
		MICROBIAL RESISTANCE TO ANTIBIOTICS
		SPECIFIC RESISTANCE MECHANISMS
		RESISTANCE IN MAJOR MICROBIAL PATHOGENS
		SPECIFIC ANTIMICROBIAL AGENT RESISTANCE
		FACTORS INFLUENCING ANTIMICROBIAL THERAPY
		ANTIBIOTIC PHARMACOKINETICS AND PHARMACODYNAMICS
		PRINCIPLES OF ANTIBIOTIC DOSING
		COMBINATION ANTIBIOTIC THERAPY
		ANTIBIOTIC FAILURES
		HOST-MICROBE-ANTIBIOTIC INTERACTIONS
		ANTIBIOTIC ADVERSE REACTIONS
		NEW ANTIMICROBIAL APPROACHES
		CITED REFERENCES
		GENERAL REFERENCES
	Chapter 39: Antibacterial and Antibiotic Drugs*
		OROFACIAL INFECTIONS
		ANTIBACTERIAL ANTIMICROBIAL DRUGS
		CITED REFERENCES
	Chapter 40: Antifungal and Antiviral Agents
		ANTIFUNGAL AGENTS
		ANTIVIRAL AGENTS
		ANTIVIRAL THERAPY IN THE ORAL CAVITY
		CITED REFERENCES
		GENERAL REFERENCES
	Chapter 41: Immunotherapy
		OVERVIEW OF SPECIFIC IMMUNITY
		IMMUNOTHERAPEUTIC AGENTS
		CITED REFERENCES
		GENERAL REFERENCES
	Chapter 42: Antineoplastic Drugs
		HISTORY OF CANCER CHEMOTHERAPY
		PRINCIPLES OF CANCER CHEMOTHERAPY
		CHEMOTHERAPEUTIC DRUGS
		TARGETED ANTINEOPLASTIC THERAPY
		COMBINATION THERAPY
		IMPLICATIONS FOR DENTISTRY
		CITED REFERENCES
		GENERAL REFERENCES
	Chapter 43: Aliphatic Alcohols
		ETHANOL
		METHANOL
		ISOPENTANOL
		ISOPROPYL ALCOHOL
		ETHYLENE GLYCOL
		PROPYLENE GLYCOL
		CITED REFERENCES
		GENERAL REFERENCES
	Chapter 44: Anticaries Agents*
		SYSTEMIC FLUORIDE
		TOPICAL FLUORIDE
		FLUORIDE TOXICOLOGY
		CITED REFERENCES
		GENERAL REFERENCES
	Chapter 45: Antiplaque and Antigingivitis Agents*
		RATIONALE FOR BIOFILM DRUG THERAPY
		PHARMACOKINETICS OF THE ORAL CAVITY
		IDEAL PROPERTIES OF ANTIPLAQUE AGENTS
		ANTIPLAQUE AND ANTIGINGIVITIS AGENTS
		LIMITATIONS OF TOPICAL ANTIMICROBIAL THERAPY
		FUTURE DIRECTIONS
		CITED REFERENCES
		GENERAL REFERENCES
	Chapter 46: Antiseptics and Disinfectants
		HALOGENS AND HALOGEN-RELEASING COMPOUNDS
		ALDEHYDES
		PHENOLS AND RELATED COMPOUNDS
		ALCOHOLS
		SURFACE-ACTIVE AGENTS
		OXIDIZING COMPOUNDS
		HEAVY METALS
		USES IN DENTISTRY
		CITED REFERENCES
Part 3: Special Subjects in Pharmacology and Therapeutics
	Chapter 47: Analgesic Use for Effective Pain Control*
		PAIN CLASSIFICATION
		PAIN ASSESSMENT
		MISCONCEPTIONS REGARDING PAIN AND ANALGESICS
		CHOICE OF ANALGESIC REGIMEN
		CITED REFERENCES
	Chapter 48: Management of Fear and Anxiety
		GENERAL PRINCIPLES
		PHARMACOLOGIC APPROACHES
		MINIMAL AND MODERATE SEDATION
		DEEP SEDATION AND GENERAL ANESTHESIA
		REVERSAL AGENTS
		SUMMARY
		CITED REFERENCES
		GENERAL REFERENCES
	Chapter 49: Antibiotic Prophylaxis
		PRINCIPLES OF ANTIBIOTIC PROPHYLAXIS
		PREVENTION OF METASTATIC INFECTIONS
		EVIDENCE BASE FOR ANTIBIOTIC PROPHYLAXIS
		POTENTIAL BUT UNDOCUMENTED ANTIBIOTIC PROPHYLAXIS SITUATIONS
		DENTAL SURGICAL PROPHYLAXIS
		FUTURE OF ANTIBIOTIC PROPHYLAXIS
		CITED REFERENCES
	Chapter 50: Oral Complications of Cancer Therapy
		ORAL COMPLICATIONS OF CHEMOTHERAPY
		HEMATOPOIETIC CELL TRANSPLANTATION
		ORAL COMPLICATIONS OF RADIATION THERAPY FOR CANCER
		SUMMARY
		CITED REFERENCES
		GENERAL REFERENCES
	Chapter 51: Drugs of Abuse
		HISTORIC PERSPECTIVE
		DRUG ABUSE CHARACTERISTICS AND TERMINOLOGY
		ABUSE OF OPIOID ANALGESICS
		ABUSE OF SEDATIVE-HYPNOTICS
		ABUSE OF AMPHETAMINES, COCAINE, AND OTHER PSYCHOMOTOR STIMULANTS
		ABUSE OF HALLUCINOGENS
		ABUSE OF MARIJUANA
		ABUSE OF INHALANTS
		POLYDRUG ABUSE
		IMPLICATIONS FOR DENTISTRY
		CITED REFERENCES
		GENERAL REFERENCES
	Chapter 52: Toxicology
		GENERAL PRINCIPLES
		PREVENTION AND MANAGEMENT OF POISONING
		OCCUPATIONAL SAFETY IN DENTISTRY
		SPECIFIC TOXICANTS
		CITED REFERENCES
	Chapter 53: Geriatric Pharmacology
		PHYSIOLOGIC CHANGES ASSOCIATED WITH AGING
		NONPHYSIOLOGIC ASPECTS OF AGING
		PHARMACOLOGIC CHANGES ASSOCIATED WITH AGING
		IMPLICATIONS FOR DENTISTRY
		CITED REFERENCES
		GENERAL REFERENCES
	Chapter 54: Drugs for Medical Emergencies
		EMERGENCY PREPARATION
		EMERGENCY PREPAREDNESS
		EMERGENCY DRUGS
		CITED REFERENCES
		GENERAL REFERENCES
	Chapter 55: Prescription Writing and Drug Regulations
		PRESCRIPTION
		DRUG LAWS
		CITED REFERENCES
	Chapter 56: Use of Herbs and Herbal Dietary Supplements in Dentistry
		REGULATIONS AND QUALITY CONTROL
		TYPES OF HERBAL DIETARY SUPPLEMENTS AND RELATED BOTANICAL PRODUCTS
		INTEGRATED HEALTH CARE AND DENTISTRY
		SOURCES OF RELIABLE INFORMATION
		CITED REFERENCES
		GENERAL REFERENCES
APPENDIX 1: Drug Interactions in Clinical Dentistry
APPENDIX 2: Glossary of Abbreviations
Index
                        
Document Text Contents
Page 1

This ebook is uploaded by dentalebooks.com

Page 2

This ebook is uploaded by dentalebooks.com

Page 478

CHAPTER 29 Lipid-Lowering Drugs 463

TABLE 29-3

Properties of Lipid-Lowering Drugs

LIPOPROTEIN
CONCENTRATIONS

PLASMA
CHOLESTEROL

PLASMA
TRIGLYCERIDE TOXICITY DRUG INTERACTIONS

Clofibrate ↓ VLDL, ↓ IDL ↓ ↓ Nausea, diarrhea, myositis,
abnormal liver function tests,
skin rash, ventricular ectopy,
increased incidence of
noncardiac death

Enhanced effect of coumarin
anticoagulants

Gemfibrozil ↓ VLDL, ↓ IDL,
↑ HDL

↓ ↓ Abdominal pain, epigastric pain,
diarrhea, nausea, vomiting,
flatulence, rash, headache,
dizziness, anemia,
eosinophilia, leukopenia

Enhanced effect of coumarin
anticoagulants; myopathy
with HMG-CoA reductase
inhibitors

Nicotinic acid ↓ Chylomicrons,
↓ VLDL, ↓ IDL,
↓ LDL, ↑ HDL

↓ ↓ Flushing, pruritus, nausea,
diarrhea, glucose intolerance,
hyperuricemia,
hepatotoxicity

Myopathy, rhabdomyolysis,
renal failure with
HMG-CoA reductase
inhibitors

Cholestyramine,
colestipol

↑ VLDL (transient),
↓ LDL

↓ May increase
modestly in
some
patients

Constipation, nausea,
abdominal pain, flatulence,
biliary tract calcification,
steatorrhea, hyperchloremic
acidosis

Decreased absorption of
thiazides, tetracycline,
phenobarbital, thyroxine,
digitalis, coumarin
anticoagulants

HMG-CoA
reductase
inhibitors

↓ IDL, ↓ LDL,
↑ HDL

↓ ↓ Headache, flatulence,
abdominal pain, diarrhea,
rash, increased creatine
kinase and other enzyme
activities, myopathy

Enhanced effect of coumarin
anticoagulants;
myopathy,
rhabdomyolysis, renal
failure with nicotinic acid,
gemfibrozil, erythromycin,
cyclosporine

Ezetimibe ↓ LDL, ↓ HDL ↓ ↓ Headache, sinusitis, pharyngitis Cholestyramine binds
ezetimibe and lowers its
bioavailability; does not
alter bioavailability of
digitalis or coumarin
anticoagulants

↓, Decrease; ↑, increase.
HDLs, High-density lipoproteins; HMG-CoA, 3-hydroxy-3-methylglutaryl–coenzyme A; IDLs, intermediate-density lipoproteins; LDLs, low-density lipoproteins;
VLDLs, very-low-density lipoproteins.

anticoagulants, partly by displacing them from protein-
binding sites, but mostly because fibrates interfere with the
synthesis of several clotting factors (fibrinogen and factor VII).

Gemfibrozil is chemically distinct from other fibrates
because it has a propylene connector between the phenoxy
and isobutyrate ends of the molecule. The drug has been
shown to decrease the concentrations of blood triglycerides,
cholesterol, VLDL, IDL, and sometimes LDL. It also tends
to increase HDL concentrations more reliably than clofibrate.
In contrast to clofibrate, gemfibrozil has been shown to
decrease the incidence of myocardial infarction by 34% over
5 years.16 Principal side effects of gemfibrozil include abdomi-
nal pain, diarrhea, nausea, and vomiting. Less frequent adverse
effects are headache, dizziness, anemia, rash, eosinophilia, and
leukopenia. Similar to clofibrate, gemfibrozil enhances the
action of oral anticoagulants and may cause cholelithiasis.
When combined with an HMG-CoA reductase inhibitor,
muscle damage leading to rhabdomyolysis and myoglobinuria
has been reported.

Fenofibrate is the first of the second-generation fibric acid
derivatives to be tested in the United States. Although the

drug has been available in Europe since the early 1980s, it has
not been studied in a large prevention trial, as have clofibrate
and gemfibrozil. Nevertheless, the basic pharmacologic fea-
tures of fenofibrate are similar to the features of the previous
agents. A potential advantage of the second-generation drugs
is their greater ability to reduce LDL concentrations. Side
effects include the gastrointestinal disturbances common to
all fibrates and the potential for causing cholelithiasis.

Nicotinic Acid
Nicotinic acid, otherwise known as niacin, has been recog-
nized since the late 1930s as a member of the vitamin B
complex whose deficiency results in the disease pellagra. In
1955, it was reported that doses of nicotinic acid greater than
1 g (i.e., >50 times the recommended daily allowance of
niacin as a vitamin) reduce plasma cholesterol concentra-
tions,2 subsequently decreasing triglyceride concentrations.9
The function of niacin in the body, after conversion to nico-
tinamide adenine dinucleotide and nicotinamide adenine
dinucleotide phosphate, is to act as important enzyme cofac-
tors. The action of niacin as a lipid-lowering drug is not related

Page 479

464 PART II Pharmacology of Specific Drug Groups

CH CH2 CH CH2

CH2 CH CH2N
+(CH3)3Cl


n

n

HNCH2CH2NCH2CH2NCH2CH2NCH2CH2NH

CH2

HCOH

CH2

CH2

HCOH

CH2

CH2

HCOH

CH2

CH2

HCOH

CH2

CH2

HCOH

CH2

CH2CH2NCH2CH2N HNCH2CH2N HNCH2CH2

FIGURE 29-4 Structural formula of bile acid sequestrants cholestyramine and colestipol.

to its function as a vitamin. Nicotinamide, interchangeable
with nicotinic acid as vitamin B3, has no effect on plasma
lipids and should not be used.

Nicotinic acid is used most often to reduce VLDL and LDL
while increasing HDL levels. It has been used alone or in com-
bination with other lipid-lowering drugs. Its mechanism of
action seems to involve inhibition of VLDL synthesis through
inhibition of adipose tissue lipolysis and inhibition of subse-
quent delivery of fatty acids to the liver to produce triglycerides
for packaging into VLDL particles.19 Increased clearance of
VLDL may also play a role in the mechanism because of ele-
vated lipoprotein lipase activity. Nicotinic acid has the broad-
est spectrum of activity of the lipid-lowering agents and is
potentially useful in most forms of hyperlipidemia.

The major disadvantage of nicotinic acid, which affects
50% or more of the patient population, has been its tendency
to produce adverse effects sufficient to impair patient compli-
ance or force cessation of therapy. Common side effects
include cutaneous flushing, pruritus, and gastrointestinal dis-
tress. An additional side effect in some diabetic patients is
increased insulin resistance and hyperglycemia. If treatment
is instituted slowly, with a gradually increasing dosage, toler-
ance to the cutaneous flushing occurs, and therapy can be
continued. Aspirin or ibuprofen taken beforehand ameliorates
prostaglandin-dependent flushing. Withdrawal of nicotinic
acid is most frequently necessitated by gastric disturbances.
Other side effects include hyperuricemia, decreased glucose
tolerance, and abnormal liver function tests. Extended-release
preparations of nicotinic acid marketed in the past few years
have made this drug more tolerable to many patients, but do
not eliminate flushing in all patients.

Nicotinic acid is absorbed rapidly, usually reaching a peak
plasma concentration in less than 1 hour. The short half-life
is primarily due to rapid excretion of unmetabolized nicotinic
acid by the kidneys; this necessitates frequent administration
of the drug, usually three times a day with meals. Because of
the frequent lack of tolerance, doses are started at 100 mg
three times per day and are gradually increased at 100-mg
intervals until a dose of 1 to 1.5 g is reached. The usual thera-
peutic dose is 2 to 6 g/day. Extended-release preparations are
taken once each day, in the evening, and can be started at a
higher dose. These preparations have been shown to have less
incidence of side effects even in patients with diabetes.

Bile Acid Sequestrants
Bile acid sequestrants are nonabsorbable anion exchange
resins that bind bile acids in the intestinal lumen, prevent
their reabsorption, and promote their excretion in the feces.
Enterohepatic cycling of cholesterol is markedly reduced by
this mechanism, which blocks reabsorption of bile acids
from the jejunum and ileum, 95% of which are normally
reabsorbed, and increases bile acid excretion rate by 10-fold.
Bile acids are synthesized in the liver from cholesterol by
7α-hydroxylase, which is regulated through negative feedback
by bile acids. Hepatic cholesterol conversion to bile acids is
accelerated, and plasma cholesterol and LDL concentrations

are decreased. LDL concentrations are also reduced by these
drugs because of upregulation of LDL receptors and hepatic
uptake, whereas the VLDL concentration may be unchanged
or increased.26 These resins have no effect in patients with
homozygous familial hypercholesterolemia who have no func-
tioning LDL receptors.

Cholestyramine and colestipol are the two clinically avail-
able drugs in this category (Figure 29-4). They are very large
resins that are insoluble in water. The dry resin is mixed with
a liquid such as fruit juice and drunk as a slurry. Cl− is released
from the resin as bile acids bind to it, and the released Cl− is
absorbed, but the resin itself is not absorbed. Because it is not
absorbed, it has a high safety factor and absence of serious
side effects, but the annoying gastrointestinal side effects
(nausea, vomiting, abdominal distention, and constipation)
limit the use of these drugs. An unpleasant taste adds to the
problem of patient compliance with these agents. Because
cholestyramine and the hydrochloride salt of colestipol clini-
cally exchange Cl− for other anions, hyperchloremic acidosis
may develop when large doses are given to small patients.
Both resins decrease the absorption and the therapeutic effect
of other drugs, such as warfarin, thyroxine, digitalis, pro-
pranolol, and thiazides. This interaction can be partially over-
come by proper timing of the dosage.

Bile acid–binding resins are used alone or in combination
with nicotinic acid and cholesterol synthesis inhibitors. Cho-
lestyramine was used in the Lipid Research Clinics Program
Primary Prevention Trial.27 In this trial of almost 4000 healthy
men with hypercholesterolemia, there was a 20% decrease in
LDL cholesterol with the resin and a 24% reduction in deaths
from myocardial infarction.

The newest bile acid sequestrant to be approved for use
in the United States is colesevelam hydrochloride, which is
available in tablet form. Colesevelam has been found to lower
LDL cholesterol as effectively as cholestyramine,11 but has less
danger of interaction with other drugs such as warfarin
through adsorption.12 There are also somewhat fewer gastro-
intestinal side effects, and, because of the tablet form, compli-
ance is greater.

3-Hydroxy-3-Methylglutaryl–Coenzyme A
Reductase Inhibitors
The development of drugs that specifically inhibit the biosyn-
thesis of cholesterol has been the most important aspect of
hypolipidemic drug development. This class of drugs, called
the statins, currently includes lovastatin, pravastatin, simvas-
tatin, fluvastatin, cerivastatin, atorvastatin, and rosuvastatin.
These agents structurally resemble an intermediate in the
HMG-CoA reductase reaction (Figure 29-5) and are potent
competitive antagonists of HMG-CoA binding.20 (Lovastatin
and simvastatin are actually prodrugs in that they require
cleavage of their lactone ring to become active.) Numerous
clinical studies have now shown these drugs to be the best
tolerated and most effective drugs for lowering LDL choles-
terol and for reducing stroke, coronary heart disease, and
overall mortality. In addition to lowering LDL cholesterol,

Page 956

L1

Index 941

in dentistry, 182
development and use of, 165
inhibition of reuptake of 5-HT by, 376
for migraine prophylaxis, 383
for Parkinson’s disease, 236t
pharmacologic effects of, 175-176
therapeutic uses of, 181

Trifluoperazine, side effects of, 171t
Triflupromazine, side effects of, 171t
Trifluridine, for herpes virus infections, 651
Trigeminal nerve, in pain transmission, 300
Trigeminal neuralgia, 386

diagnostic criteria for, 387b
topical agents for, 389-390

Trigeminothalamic tract, in pain perception,
300f, 301, 303

Triglycerides, in lipoprotein metabolism,
459-460

Trihexyphenidyl, for Parkinson’s disease, 236t,
240

Triiodothyronine, structural formula of, 540f
Trimeprazine tartrate, structural formula and

dosages of, 363t-364t
Trimetazidine, for angina, mechanism of action

of, 423-424
Trimethadione

as anticonvulsant, 221
mechanisms of action and therapeutic uses

of, 216t
Trimethaphan

structural formula of, 138f
uses of, 139-140

Trimethobenzamide
as antiemetic, 531
for migraine, 381-382

Trimethoprim. See also Sulfonamides.
herbal product interactions with, 872t
mechanism of action of, 583
synergism of, with sulfonamides, 631
therapeutic uses of, 632, 633t

Trimethoprim-sulfamethoxazole, for traveler’s
diarrhea prevention, 535

Trimipramine, adverse effects of, 176t
Tripelennamine citrate, structural formula and

dosages of, 363t-364t
Tripolidine hydrochloride, structural formula

and dosages of, 363t-364t
Triptans

adverse reactions to, 381b
contraindications to, 381, 381b
for migraine, 380-381, 380t
names of, 391t

Trizivir, for human immunodeficiency virus
infection, 655

Troleandomycin, 618. See also Macrolide
antibiotics.

Trophoblasts, placental transfer of drugs and,
27-28

Tropicamide, for mydriasis and cycloplegia,
132

Tropomyosin, in cardiac muscle contraction,
410

Troponin, in cardiac muscle contraction,
410

TRP (transient receptor potential) channels, on
nociceptive neurons, 301

Tryptamine derivatives, abuse of, 807-808
Tryptophan, antidepressant action and, 173
Tryptophan hydroxylase, in serotonin

synthesis, 374f, 375
Tuberculosis, drugs used for, 615

names of, 636b-637b
Tubocurarine, 136

action and structural formula of, 140,
141f

historical use of, 141
pharmacologic properties of, 142t

Tubular reabsorption, in renal excretion of
drugs, 40

Tumor killing, cytokines in, functional
relationships of, 663t

Tumor resistance, chemotherapeutic
approaches to, 708

Tumor suppressor genes, in chemical
carcinogenesis, 58

Tyramine
monoamine oxidase inhibitors and, 114-115,

177
structure-activity relationships of, 92t
tachyphylaxis and, 52-53

Tyrosine
biosynthesis of, 85f
enzyme-linked receptor action and, 4

Tyrosine hydroxylase, in catecholamine
synthesis, 82

Tyrosine kinase inhibitors, for cancer, 704-706,
704f, 705t

U
Ubiquitin, in antigen processing, 665
Ulcer(s)

oral, glucocorticoids for, 553
peptic. See also Peptic ulcer disease (PUD).

treatment of, 525-530
Ulcerative gingivitis, acute recrotizing,

microbiology of, 602
Unconsciousness, definition of, 267
Unified Parkinson’s Disease Rating Scale

(UPDRS), 233-234
scores on, effects of anti-Parkinson drugs on,

235t
United States Pharmacopeia (USP), 65-66, 862
Unresponsiveness, definition of, 267
Uracil, structural formula of, 694f
Urea, volume of distribution of, 28t
Ureidopenicillins, 606t-607t
Uric acid, in gout, 352
Uridine diphosphate glucuronosyltransferase

polymorphism, 73
Urinary antiseptics, 634-635
Urinary bladder, endogenous catecholamine

effects on, 94-95
Urinary tract

antimuscarinic drug effects on, 132-133
cholinergic drug effects on, 120
ganglionic blocking drug effects on, 139

Urine
alkalinization of, for toxicity treatment, 40
mercury concentrations in, 821, 821f
pH of, in renal excretion, 40

Urofollitropin, 576
Urokinase, for emergency use, 849
Urokinase plasminogen activator, in

fibrinolysis, 498-500, 499f
Urticaria, H1 antihistamines for, 366
Use-dependent block, by local anesthetics,

250-252
USP Dispensing Information, drug information

in, 66
Uterus

endogenous catecholamine effects on,
94-95

relaxation of, adrenergic agonists for, 100

V
Vaccination, 671
Vaccine(s)

caries, 672
herpes zoster, 652-653
human immunodeficiency virus, 656
human papillomavirus, 648t
influenza, 648t, 649
subunit, 663

Vagus nerve
in pain transmission, 300

Valacyclovir
for herpes virus infections, 648t, 651-652
for oral HSVons, 787

Valdecoxib
COX inhibitory activity of, 331f
for inflammatory conditions, 345
structural formula of, 343f

Valerian, pharmacologic profile of, 870t-871t
Valganciclovir, for CMV infections, 652
Valproic acid, 220-221

absorption, fate, and excretion of, 221
adverse effects of, 219t, 221
discovery of, 214-215
drug interactions with, 227
interactions of, with barbiturates, 195t
for mania, 185

mechanisms of action and therapeutic uses
of, 216t

pharmacologic effects of, 221
side effects of, 56t
structural formula of, 217f
for trigeminal neuralgia, 387-388

Valsartan, for chronic heart failure, 413
Van der Waals forces, in drug-receptor

interactions, 5f, 6
Vancomycin, 630

adverse effects of, 630
antibacterial spectrum of, 630
for C. difficile diarrhea, 596
drug interactions with, 630
mechanism of action of, 630
microbial resistance to, 586-587, 630
therapeutic uses of, 630

Vanilloid receptor channels, on nociceptive
neurons, 301

Vapor, elemental mercury, 821
Vaporizer, temperature-compensated,

variable-bypass, for inhalation anesthetics,
278, 278f

Variant angina, 422
Varicella-zoster virus, drugs active against,

652-653
famciclovir as, 652
herpes zoster vaccine as, 652-653

Varicella-zoster virus infection, in cancer
patients, 787

Varnish, fluoride, 726
Vascular effects

of anticholinesterases, 123
of endogenous catecholamines, 93-94
of isoproterenol, 97

Vascular smooth muscle
cholinergic drug effects on, 119-120
relaxation of, by nitrovasodilators, 424

Vasculature
peripheral, local anesthetic action and,

255
systemic, digoxin administration and, 416

Vasoconstriction
endogenous catecholamine-induced, 93-94
in hemostasis, 487
histamine effects on, 361

Vasoconstrictor(s)
adrenergic, 99

for bleeding control, 495
in dentistry, 101-103, 101t
names of, 103b-104b

for emergency use, 849
ergotamine as, 379
in local anesthetics

drug interactions with, 258, 455-456
effects of, 255-256
local tissue responses to, 257

names of, 103b-104b, 509t
Vasodilation

calcium channel blockers and, 427
cerebral, morphine administration and, 313
histamine effects on, 361-362
muscarinic receptor stimulation and, 118,

119f
nitrites/nitrates in, 424

Vasodilator(s)
direct

for hypertension, 452-454
names of, 456b-457b

directly acting, for congestive heart failure,
420

for emergency use, 846t, 849
Vasopressin, 431, 538. See also Antidiuretic

hormone (ADH).
for emergency use, 846t-848t, 848-849

Vasopressors, for emergency use, 849
Vectors, for breaching blood-brain barrier, 27
Vecuronium

pharmacologic properties of, 142t
toxic extension of therapeutic effect of, 55t

Venable, James, 266
Venlafaxine, 180

adverse effects of, 176t
for chronic pain syndromes, 383
structural formula of, 178f

Tricyclic antidepressants (Continued) Valproic acid (Continued)

Page 957

L1

942 Index

Ventilation
mechanical, neuromuscular blocking drugs

in, 144
pulmonary, for acute opioid intoxication,

313
Ventricular fibrillation, electrocardiographic

appearance of, 396-397, 397f
Ventricular tachycardia, electrocardiographic

appearance of, 396-397, 397f
Verapamil

actions of, 400t
benzodiazepine interactions witn, 195
cardiovascular effects of, 427, 428t
for cluster headache, 384
digoxin and, 419
for emergency use, 846t-848t, 848
for hypertension, 447-448
indications for, 407t
pharmacokinetic properties of, 401t
structural formula of, 427f

Vertigo, H1 antihistamines for, 366-367
Vesicles, synaptic, in nerve stimulation, 149
Vestibular function, antimuscarinic drug

effects on, 132
Vidarabine

for herpes virus infections, 648t, 650-651
mechanism of action of, 650f
structural formula of, 650f

Vigabatrin
adverse reactions to, 219t
clinical toxicology of, 215
mechanisms of action and therapeutic uses

of, 216t
for seizures, 223-224
structural formula of, 223f

Vildagliptin, for diabetes, 563-564
Vinblastine

for cancer, 686t-692t, 698
structural formula of, 698f

Vinca alkaloids, for cancer, 686t-692t, 698
Vincent’s infection, microbiology of, 602
Vincristine

for cancer, 686t-692t, 698
structural formula of, 698f

Vinorelbine, for cancer, 686t-692t, 698
Viral hepatitis, in drug-abusing patient, 811
Virulence, microbial, factors affecting, 594
Virus(es)

inactivation of, in therapeutic blood
products, 497

infections due to
antibiotics for, 610t-611t
antiviral agents for, 647-656, 648t

names of, 657b
oral, in immunosuppressed patients,

787-788
transmission of, in hemophiliacs, 508

Vitamin B12, 477-479
deficiency of

megaloblastic anemia from, 476-477
pathophysiologic characteristics of,

478-479
dietary sources of, 477
metabolic pathways of, 481f
physiologic characteristics of, 477-478
preparations of, names of, 485t

Vitamin D, 543-544
effects of, 544t

on bone, gastrointestinal tract, and kidney,
544t

preparations of, names of, 546b-547b
structural formula of, 544f

Vitamin K
coumarin-indandione action and, 502, 504
deficiency of, hemorrhage and, 503

Vitamin K-dependent clotting factors, 490

Vitamin K epoxide reductase, inhibition of, by
coumarin-indandiones, 502, 503f

Volatile solvents, abuse of, 810
Voltage-gated ion channels, 2

anesthetic action and, 270
Volume depletion

loop diuretics and, 437
thiazide diuretic action and, 435

Volume of distribution
of drugs, 28, 28f, 28t
in renal drug excretion, 40
of various agents, 28t

Vomiting. See also Antiemetics.
antihistamines for, 366-367
cancer chemotherapy-induced, 531, 789-790
digoxin administration and, 417
morphine-induced, 312

von Willebrand factor, in platelet adhesion,
487, 488f

von Willebrand’s disease, 496-497
treatment of, 497-498

Voriconazole
for fungal infections, 644
introduction of, 596
structural formula of, 643f

Vorinostat, for cancer, 705t


Warfarin

chloral hydrate with, 202
drug interactions with, 504
interactions of

with barbiturates, 190t
with chloral hydrate, 190t

for myocardial infarction prevention, 429
structural formula of, 503f, 831f
toxicity of, 830

Warren, John C., 267
Water

body, glucocorticoid effects on, 551
renal reabsorption of, 431-432
supplies of, fluoridated, 721-724, 722f

safety of, 722-724
of schools, 724

Water solubility, of drugs
drug access to central nervous system and,

27
membrane penetration and, 17
placental transfer and, 27-28
volume of distribution and, 28, 28f

Waxman-Hatch Act, 863
Wedensky inhibition, by local anesthetics,

250
Weight, body

drug effects and, 49
gain of, with antipsychotic drugs, 170-172,

171t
loss of, sympathomimetic anorexic drugs for,

101
Weights and measures, for drugs, 861-862,

862t
Wells, Horace, 266
Wetting agents, as laxatives, 532, 532f
Wilson’s disease, drugs used for, 242
Withdrawal

from alcohol, benzodiazepine therapy for,
197-198

amphetamine, 805
of antihypertensive drugs, 455
from benzodiazepines, 194, 197
from cocaine, 806
from marijuana, 809
from opioid analgesics, 801-802
from sedative-hypnotics, 803-804

Withdrawal syndrome, definition of, 800
Women, iron stores in, 472

World Health Organization, regulations of, for
occupational mercury exposure, 821-822

Wound healing, phenytoin for, 227


Xanthines, for asthma, names of, 522b-523b
Xenogeneic antibodies, oral administration of,

674
Xerostomia

adrenergic agonists and, 115
antidepressant use and, 183
antihypertensive use and, 456
antimuscarinic drugs and, 134-135
from cancer radiation therapy, 793

palliation of, 794
caries and, 794
causes and characteristics of, 125-126
dental practice and, 173
in drug-abusing patients, 811
in elderly, 837
in Parkinson’s disease, 242

xPharm, 67
Xylitol, for salivary gland stimulation, 793


Young’s rule, for drug dosage calculations,

861


Zafirlukast, for asthma, 517
Zalcitabine

for human immunodeficiency virus infection,
655

structural formula of, 650f
Zaleplon, 198

for oral sedation, 765
Zanamivir, for influenza, 647-649, 648t
Zero-order kinetics, of absorption and

elimination, 41
Zidovudine

for HIV and AIDS, 654
side effects of, 56t
structural formula of, 650f

Zileuton, for asthma, 517-518
Zinc phosphide, toxicity of, 829
Zinc supplements, for taste dysfunction in

cancer radiation therapy, 793
Ziprasidone

antipsychotic activity of, 167
metabolism of, 172t
relative potency of receptor antagonist

affinities in, 166t
side effects of, 171t

Zoledronic acid, 544. See also Bisphosphonates.
Zollinger-Ellison syndrome, H2 antihistamines

for, 369
Zolmitriptan

dosage forms and Tmax of, 380t
for migraine, 381

Zolpidem, 198, 198f
in dentistry, 207
for oral sedation, 765
toxic extension of therapeutic effect of, 55t

Zona fasciculata, hormones produced by, 549,
550f

Zona glomerulosa, hormones produced by,
549, 550f

Zona reticularis, hormones produced by, 549,
550f

Zonisamide
adverse reactions to, 219t
mechanisms of action and therapeutic uses

of, 216t
for seizures, 225
structural formula of, 223f

Zopiclone, 198

Similer Documents