Myambutol
By J. Rozhov. Oklahoma Wesleyan University.
Medical records were sought for all cases and controls buy myambutol 800 mg with visa bacteria nitrogen fixation, and information on vitamin K administration taken from these records was supplemented by data from the birth survey, which was available for most but not all of the period of study. This added three further hospitals to the study, all of which had selective policies of vitamin K administration, and 74 cases. In the combined data (16 maternity units in England and Wales and the three hospitals included in the survey in South Glamorgan), the relative risk for childhood cancer of all types associated with intramuscular vitamin K administration was 1. In the data for the 16 maternity units in England and Wales, the relative risk was 1. For the combined data and for the data from South Glamorgan, mode of delivery (forceps, vacuum extraction, breech or caesarean) was a statistically signifi- cant confounding variable, and adjustment for this reduced the relative risks to 1. In the South Glamorgan data, none of the potential confounders that were adjusted for reduced the magnitude of the relative risk. Ecological studies on childhood cancer and vitamin K administered intramuscularly during the perinatal a period as Konakian Area and period of Age group Method of Prevalence of Group or Total no. Cancers diagnosed within 30 days of birth were regarded as congenital and were excluded from the analysis. Routines for administration of vitamin K were obtained from all 95 maternity hospitals and validated for a subset of 102 children with cancer and 100 control children randomly selected from among those who, according to the information on routine exposure, received intramuscular vitamin K, and 94 children with cancer and 100 control children from among those who should have received oral vitamin K. The doses of vitamin K given in Sweden were similar to those given in the United Kingdom, and the same preparation was used (phylloquinone, Konakion, see Table 6). When the method of administration of vitamin K was recorded, it agreed with the stated routine method of administration in 92% of the 235 cases for which individual information could be found. The relative risk for all childhood cancer associated with a hospital policy of intramuscular administration of vitamin K as compared with oral administration was 1. There was a small increase in risk for all tumour types combined, due mainly to lymphoma in boys and neuroblastoma in boys and girls. The preparation was the same as that used in the United Kingdom (Draper & McNinch, 1994). In addition to the case–control study in northern England described above, Parker et al. As described above, information on hospital policy was obtained separately and independently by two people and then cross-validated. In units with a policy of selective prophylaxis, less than 30% of infants received intramuscular vitamin K at birth, while in units offering universal prophylaxis, sampling of case notes showed that more than 95% of babies received vitamin K. The risk for acute lymphoblastic leukaemia in children born in hospitals with a policy of universal prophylaxis relative to those born in hospitals with a policy of selective prophylaxis was 0. Information on hospital policy for neonatal vitamin K was obtained during the case–control studies of Passmore et. The observed numbers of cases in hospitals with universal and selective policies were compared with the numbers expected on the basis of national rates. Separate analyses were carried out for births in hospitals that followed one policy throughout the period of study and births in hospitals in which the policy changed during the period of study. The ratio tended to be smaller in hospitals with a selective policy than in those offering universal prophylaxis. Studies of Cancer in Experimental Animals No reports of studies specifically designed to investigate the carcinogenicity of vitamin K substances were available to the Working Group. One study on the initiating effects of menadione in an assay of liver foci in rats was available (Denda et al. Other Data Relevant to an Evaluation of Carcinogenicity and its Mechanisms The studies summarized in this section should be considered in the light of the differences between naturally occurring forms of vitamin K that have a lipophilic side- chain at the 3-position of the 2-methyl-1,4-naphthoquinone (menadione) ring structure (phylloquinone and menaquinones) and the synthetic forms which lack this side-chain (menadione and its water-soluble derivatives). Lack of this side-chain results in profound differences in the absorption, tissue distribution and metabolism of natural K vitamins. In the strict sense, menadione is a provitamin K, because it is biologically active for the synthesis of vitamin K-dependent proteins only after conversion to the naturally occurring menaquinone-4 (four prenyl units) in vivo. It is absorbed chemically unchanged from the proximal intestine after solubilization into mixed micelles composed of bile salts and the products of pancreatic lipolysis. In healthy adults, the efficiency of absorption of phylloquinone in its free form is about 80% (Shearer et al. Within the intestinal mucosa, phylloquinone is incorporated into chylomicrons, is secreted into the lymph and enters the blood via the lacteals (Shearer et al. After a phylloquinone-containing meal, the plasma concentration peaks between 3 and 6 h (Shearer et al. Once in the circulation, phylloquinone is rapidly cleared at a rate consistent with its continuing association with chylomicrons and the chylomicron remnants that are produced by lipoprotein lipase hydrolysis at the surface of capillary endothelial cells.
Pharmacodynamics Sodium chloride solution replaces deficiencies of the sodi- um and chloride ions in the blood plasma buy myambutol 600mg free shipping virus island walkthrough. Adverse A welcome infusion reactions Severe symptomatic sodium deficiency may be treated by I. Adverse reactions to Drug interactions sodium include: • pulmonary edema (if No significant drug interactions have been reported with sodium given too rapidly or in chloride. Alkalinizing and acidifying drugs Alkalinizing and acidifying drugs act to correct acid-base imbal- ances in the blood. Odd couple Alkalinizing and acidifying drugs have opposite effects: • An alkalinizing drug will increase the pH of the blood and de- crease the concentration of hydrogen ions. Some of these drugs also alter urine pH, making them useful in treating some urinary tract infections and drug overdoses. Alkalinizing drugs Alkalinizing drugs are used to treat metabolic acidosis and to in- crease blood pH. These include: • sodium bicarbonate • sodium citrate • sodium lactate • tromethamine. Metabolism and excretion Therefore, to raise Sodium citrate and sodium lactate are metabolized to the active the pH, you use an ingredient, bicarbonate. Pharmacodynamics Sodium bicarbonate separates in the blood, providing bicarbonate ions that are used in the blood buffer system to decrease the hy- Alkalinizing drogen ion concentration and raise blood pH. Hitching up with hydrogen Tromethamine acts by combining with hydrogen ions to alkalinize the blood; the resulting tromethamine–hydrogen ion complex is excreted in urine. Pharmacotherapeutics Alkalinizing drugs are commonly used to treat metabolic acidosis. Other uses include raising urine pH to help remove certain sub- stances, such as phenobarbital, after an overdose. Drug interactions The alkalinizing drugs sodium bicarbonate, sodium citrate, and sodium lactate can interact with a wide range of drugs to increase or decrease their pharmacologic effects. Adverse reactions to alkalinizing drugs Adverse reactions to alkalinizing drugs vary. Sodium lactate • Metabolic alkalosis (with overdose) Sodium bicarbonate • Extravasation • Bicarbonate overdose • Water retention or edema (in patient with • Cerebral dysfunction, tissue hypoxia, and kidney disease or heart failure) lactic acidosis (with rapid administration for diabetic ketoacidosis) Tromethamine • Water retention and edema • Hypoglycemia • Respiratory depression Sodium citrate • Extravasation • Metabolic alkalosis, tetany, or aggravation of • Hyperkalemia existing heart disease (with overdose) • Toxic drug levels (if given for more than • Laxative effect (with oral administration) 24 hours) Acidifying drugs When your Acidifying drugs are used to correct metabolic alkalosis. These stomach include: doesn’t feel quite right, you • acetazolamide (used in treatment of acute mountain sickness) might need • ammonium chloride. Absorption, metabolism, and excretion Orally administered ammonium chloride is absorbed completely in 3 to 6 hours. Break it down Acetazolamide inhibits the enzyme carbonic anhydrase, which blocks hydrogen ion secretion in the renal tubule, resulting in in- creased excretion of bicarbonate and a lower pH. Acetazolamide also acidifies urine but may produce metabolic acidosis in normal patients. Adverse • Ascorbic acid directly acidifies urine, providing hydrogen ions reactions to and lowering urine pH. Overdose may A patient with metabolic alkalosis requires therapy with an acidi- lead to acidosis. Acetazolamide • Drowsiness Safe and easy • Seizures Most patients receive both types of ions in oral or parenteral dos- • Anorexia es of ammonium chloride, a safer drug that’s easy to prepare. Ammonium chloride Oral forms of • Metabolic acidosis Drug interactions ammonium and loss of electrolytes, Acidifying drugs don’t cause clinically signifi- chloride are safer and especially potassium cant drug interactions. However, concurrent easier to (with large doses) use of ammonium chloride and spironolac- prepare. Hypokalemia is a common occurrence in conditions that increase potassium excretion or depletion, such as adminis- tration of glucocorticoid, I. Potassium should be used cautiously in patients re- ceiving potassium-sparing diuretics, such as amiloride, to avoid hyperkalemia. Drugs and cancer In the 1940s, antineoplastic (chemotherapeutic) drugs were de- veloped to treat cancer.
Administrative actions addressed a public generic 800mg myambutol with visa antibiotic mouthwash, even though that public may have been only a fgment of the bureaucrats’ imagination. Prussian bureaucrats got involved just as the public debate had produced a consensus: in various letters to the Reichsanzeiger, Reich’s insistence on material remuneration was questioned on moral grounds, because Reich – as an academic and a member of the republic of letters – was obliged to serve the public good. One commentator weighed „Professor Reich’s responsibilities to humanity“ against his „responsibilities to himself“ and society’s responsibilities to him. Consequently, here again it would be a mistake simply to reduce this enlightened public to the specifc readers of the Reichsanzeiger, i. Although it served a relatively small readership of only two to three thousand subscribers, it’s contributors still understood themselves as speaking for humanity as a whole. They wrote not as readers of the 30 The history of clinical trials remains inadequately researched. As Tröhler 1988 has shown, in Great Britain clinical trial dating back to the 18th century were employed by medical outsiders (Quakers, Scots, and Unitarians). These groups were unable to base their judgments on personal authority or scientifc recognition. The work of Tröhler’s students on numerical arguments in contemporary journals shows that most clinical observations were based at most on four cases (Ulrich Tröhler, Die wissenschaftliche Begründungen therapeutischer Entscheide - oder ‚Evidence-Based Medicines‘ - im Lauf der Geschichte. Results for trials at the Charité hospital have not yet been published (Hess, Engstrom and Thoms 2006). History of Science 36 (1998), 123-149; Harold Mah, Phantasies of the Public Sphere: Rethinking the Habermas of Historians. Journal of Modern History 7 ( 000), 15 -8 ; Thomas Broman, Wie bildet man eine Experten-Sphäre heraus? Instead, as voices of anonymous reason, the contributors lent their voice to the “reasonable and right thinking portions of the public. In this way, Reich’s claim to derive economic advantage from his fever cure was negotiated “under the eyes of the entire nation”, without distinguishing between general, exoteric vs. Ultimately, readers of the Reichsanzeigers agreed that Reich should be remunerated by way of a public subscription. This public in the Habermasian sense rejected state intervention as an illegitimate and arbitrary abuse of power: „The just claims of a humble and well-meaning man such as Prof. And indeed, the clinical trials for which Reich was summoned to Berlin were viewed suspiciously from the outset. The appointed commission made every effort to ensure impartiality and objectivity. Whereas the stable-boy from Torgau had been subject to rigorous scrutiny, Reich was more or less able to design his clinical trials as he saw ft: he oversaw the selection of probands, daily therapy, and the documentation of the treatments. The commission also insisted on the utmost secrecy once it had been informed by Reich of the composition of the remedy and the theoretical basis for its effectiveness. In its fnal report, the commission contributed only a general introduction, leaving it to Reich to write up the summary of the trials’ results. What’s more, the members of the royal commission didn’t even see to their responsibilities as state offcials: although they unanimously confrmed that Reich was a “learned physician and upstanding man” and hence a member of the critical public, they explicitly refrained from passing judgment on the trial results. They concluded that Reich’s remedy had produce “some good, some ambiguous, and some poor results. Indeed, thanks to the new media, the entire medical community participated directly in the trials, even though they were carried out behind the walls of the Charité hospital. The criteria that were laid out were geared toward transparency and public participation, regardless of whether the public was imagined to be a great danger (as was the case for Grabe) or whether it was evoked by the „remedy’s manufacturer” (as was the case for Reich’s fever remedy). Unlike the usual casuistic descriptions of the time, they differed in that they were serial in nature, they compensated for subjective factors, they verifed the results and ensured that they were correctly presented and published. Now criteria of inclusion and exclusion were clearly formulated, whereas before one relied on good fortune. Now only the course of the illness was documented, whereas before verbose interpretations of individual cases and detailed descriptions of every detail was common practice. Now every effort was made to exclude subjective factors, whereas before the personal authority of the observer had ensured the validity of the observation.
The main contemporary goal of high medical education is the personality and it‘s abilities orientation myambutol 400 mg on-line antibiotics for uti cause yeast infection. It updates the introduction of personally focused education at the training of physicians. To ground a pedagogics of personally focused education to the teaching discipline "Psychiatry and Narcology. There was used a complex of methods consisted of theoretical (a generalization of the scientific literature, the rationale of personally focused education) and empirical (questionnaires, interviews to explore the subjective experience of students; direct and indirect observation) ones. Yakimanskaya‘s viewpoint that the main function of education is to discover personality and to create conditions for it‘s development on the base of subjective individual experience, ensuring the formation of criticality, independency, initiativity, creativity and their implementation into ideation and behavior. The results of the survey of university teachers of Psychiatry and Narcology department show that the scientific and pedagogical staff is aware of contradictions between traditional and personally oriented education. The study of the responses at the survey and interviews revealed that the result of traditional teaching style is formalization of the relationship between students and teachers. In case of personally oriented education open relations between the subjects of study are possible together with an individual accounting of cognition, values and personal experience of the student. To make a personally oriented environment the departmental staff ellaborated some didactic complex for the "Psychiatry and Narcology" discipline. To ensure professionally significant motivation of the students by using the portfolio analysis we identified individual characteristics and the main features of subjective experience. Students were informed beforehand concerning necessity to create a portfolio (either printed or electronic form) during the first lesson. Implementation of portfolio to the education is provided an opportunity for teachers to realize the developmental level and abilities of student in ongoing 371 preparation of doctors of somatic profile. It also helps to outline future directions of incentives, to contribute quality of training improvement, to revitalize medical care to patients with mental disorders. We have accepted the statements of some scientists about the importance of personally oriented training to the educational process (in particular, the playing, the dialog). For example, an interactive teaching method was implemented during the binary lecture on the theme "Medical and social problems of psychoactive drug abuse. Game method of learning was implemented during the practical training in mental disorders as well as in independent work on the theme "History of Psychiatry Development and Addiction". Person-oriented nature of the practical lesson "Reaction to severe stress and adjustment disorders. Post-traumatic stress disorder" was granted thanks to the introduction of elements of training. Ukrainian researchers note that academic training is an intensive form of group work where the emphasis is not so much for the information how to receive personal experience of professional activities. Thanks to the introduction of elements of the training the students received the opportunity to become familiar with the peculiarities of using art-therapy methods for the accumulation of resources by the survivors of traumatic events. Analysis of literature and teaching experience allow to identify the main pedagogical conditions of introduction of person-oriented education in teaching discipline "Psychiatry and Narcology". The pedagogical conditions includes the creation of personality-oriented environment in the educational space of the university, the use of student-centered teaching methods, ensuring internal professionally significant motivation of the students during the study of the discipline. The questions of improvement of the health system in Ukraine according to market requirements have gained great importance at the present stage of development of Ukraine. It is possible to prepare such a specialist providing an appropriate learning environment which would include a system of independent study. Give haracteristics to different types, forms and methods of independent study in the discipline "Fundamentals of Economic Theory" at a Medical College. To solve the given problems we applied theoretical and empirical methods such as observation and discussion. Theoretical analysis of the term "independent students study" allows to consider it master educational material. Independent learning as a didactic form of teaching includes the following organization stages: planning, organization process and supervision; effective control and assessment.
Relationships of Pharmacokinetic Parameters and Intravenous Intermittent and Continuous Infusions… 59 Lesson 6 generic myambutol 800mg mastercard virus paralysis. Pharmacokinetic Variation and Model-Independent Relationships… 139 Practice Set 3… 153 Lesson 12. Glossary… 217 Index… 219 Acknowledgments The authors are indebted to George Francisco, Kim Brouwer, Stan Greene, Cecily DiPiro, William H. Reynolds for their review and suggestions during the preparation of the first and second editions. The third and fourth editions reflect the suggestions of many individuals who used the manual and recommended improvements. The rigorous effort and valuable suggestions provided by Dana Battaglia for this edition are greatly appreciated. Preface to the Third Edition This programmed manual presents basic pharmacokinetic concepts and procedures that are useful in pharmacy, medicine, and other health professions. Although this text is not intended to create a practitioner fully competent in clinical pharmacokinetics, it will provide an orientation to the concepts involved. After completing this text, the reader should be prepared to begin learning the pharmacokinetic techniques for clinical situations. The reader should participate in structured educational settings, such as a formal clinical pharmacokinetics course or a clerkship under an experienced clinical practitioner, to develop clinical skills related to pharmacokinetics. Readers who want in-depth understanding of the derivations of pharmacokinetic equations should consult an appropriate text. In this third edition, the manual is divided into 15 lessons to allow progression on a typical semester schedule of 15 weeks. The first 11 lessons include pharmacokinetic and pharmacodynamic principles as well as an overview of biopharmaceutic principles. Each of these lessons begins with a list of educational objectives and concludes with a series of questions. Answers and feedback for incorrect responses have been provided for the short-answer questions. Lessons 12 through 15 present brief patient case studies with aminoglycosides, theophylline, vancomycin, digoxin, and phenytoin so the reader can practice the use of pharmacokinetic equations. This edition will be accompanied by a Web-based version that will provide lessons to parallel each of the lessons in the print version. The Web-based version will include dynamic figures and simulators, calculators for applying pharmacokinetic equations, links to important Web pages, and interactive capability for discussion questions. Although the print version may be used independently, we believe that concurrent use of both versions will enhance learning. Pruemer January 2002 Preface to the Fourth Edition Although the fourth edition of Concepts in Clinical Pharmacokinetics continues to provide basic pharmacokinetic concepts and procedures that are useful in pharmacy, medicine, and other health professions, this new edition has been revised to be, we anticipate, even more instructive and user- friendly for the reader. All of the chapters are revised, with many new clinical correlates and some new figures. All similar equations are cross-referenced throughout the book to allow the student to compare the various equations. A new appendix, Basic and Drug-Specific Pharmacokinetic Equations, summarizes and lists all equations needed to dose selected drugs (aminoglycoside, vancomycin, theophylline, digoxin, and phenytoin). In addition, more in-depth answers and feedback for incorrect responses are provided for the short-answer questions. All features are designated with specific design elements for easy navigation throughout the chapters. The American Society of Health-System Pharmacists is accredited by the Accreditation Council for Pharmacy Education as a provider for continuing pharmacy education. Identify factors that cause interpatient variability in drug disposition and drug response. Describe situations in which routine clinical pharmacokinetic monitoring would be advantageous.
Ginseng • Fatigue • Ginseng may cause severe adverse reactions when taken in large • Improve concentration doses (more than 3 g per day for 2 years) generic 600 mg myambutol with visa antibiotic allergy, such as increased motor and • Treat atherosclerosis cognitive activity with significant diarrhea, nervousness, insomnia, hy- • Also believed to strengthen pertension, edema, and skin eruptions. John’s wort • Mild to moderate depression • Effects may take several weeks; however, if no improvement occurs • Anxiety after 4 to 6 weeks, consider alternative therapy. John’s wort shouldn’t be used in combination with prescription • Viral infections antidepressants or antianxiety medications. Therapies for Glaucoma,” Expert Opinion on Emerg- ing Drugs 10(1):109-18 February 2005. Philadel- cine in an Outpatient Oncology Center,” Clinical phia: Lippincott Williams & Wilkins, 2007. Introductory Clinical Pharma- out Parathyroid Glands,” Endocrinology 146(2):544- cology, 8th ed. Clinical Geriatric Psychopharmacology, 4th physiologic Basis of Drug Therapy, 2nd ed. Adrenergic blocking drugs, 40-47 Aminophylline, 183-185 Anticholinergic drugs, 27-32, 60-62, topical, 416t Amiodarone, 131-132 177-178 Adrenergic drugs, 32-39 Amitriptyline, 322-325 Anticholinesterase drugs, 24-27 classifying, 32 Amlodipine, 138-140 differentiating toxic response to, mechanism of action of, 33i Ammonium chloride, 368-369 from myasthenic crisis, 24 Adsorbent drugs, 204-205 Amobarbital, 316-317 mechanism of action of, 22i Adverse drug reactions, 17-19 Amoxapine, 322-325 Anticoagulant drugs, 161-171 dose-related, 17-18 Amoxicillin, 196-197, 241-243 Anticonvulsant drugs, 68-85 patient sensitivity–related, 18-19 Amphetamine salts, mixed, 336-337 Antidepressants, 320-329 Agonist, 12 Amphotericin B, 280-283, 418t risks of, 322 Albuterol, 37-39, 176-177 Ampicillin, 241-243 Antidiabetic drugs, 339-345 Alclometasone, 419t Amprenavir, 272-275 Antidiarrheal drugs, 208-210 Aldesleukin, 408-409 Amylase, 206 Antidiuretic hormone, 350-352 Aldosterone, 301 Amyl nitrite, 135-136 Antiemetics, 216-219 Alemtuzumab, 398-399 Anakinra, 302-306 Antiestrogens, 388-390 Alfuzosin, 40-43 Anastrozole, 387-388 Antiflatulent drugs, 205 Alkalinizing drugs, 366-368 Androgens, 390-391 Antifungal drugs, 280-289 Alkylating drugs, 371-379 Anesthetic drugs, 108-115 dermatologic, 418t mechanism of action of, 373i ophthalmic, 414t Antigout drugs, 306-309 otic, 417t Antihistamines, 216-219, 294-297 i refers to an illustration; t refers to a table. Carboplatin, 378-379 Atazanavir, 272-275 Biperiden, 60-62 Carboxamides, 80-81 Atenolol, 43-47, 137-138 Bisacodyl, 214-215 Carboxylic acid derivatives, 76-78 Atorvastatin, 149-150 Bisoprolol, 43-47 Cardiac glycosides, 120-122 Atracurium, 56-58 Bistriazole antimycotic drug, 285-287 Cardiovascular drugs, 119-152 Atropine, 27-32, 30i, 416t Bitolterol, 37-39 Carisoprodol, 50-52 Atypical antipsychotics, 331-332 Bivalirudin, 169-170 Carmustine, 375-376 Autonomic nervous system drugs, Bleomycin, 385-386 Carteolol, 43-47, 416t 21-47 Boric acid, 417t Carvedilol, 43-47, 141-142 Azaspirodecanedione derivatives, 319 Bortezomib, 400-402 Caspofungin, 287-288 Azatadine, 294-295, 297 Brimonidine, 416t Castor oil, 214-215 Azathioprine, 302-306 Brinzolamide, 416t Catecholamines, 33-37 i refers to an illustration; t refers to a table. See also inhibitors, 66-68 mechanism of action of, 22i Nonsteroidal anti-inflammatory Cefaclor, 243-246 Choline salicylate, 94-96 drugs. See Dactinomycin, 385-386 Centrally acting skeletal muscle relax- also Calcium channel blockers. Dalteparin, 161-164 ants, 50-52 Clemastine, 294-295, 297 Dantrolene, 52-53 Central nerve block, 113i Clindamycin, 248-249, 418t, 420t Darbepoetin alfa, 160-161 Cephalexin, 243-246 Clioquinol, 281 Darifenacin, 230-231 Cephalosporins, 243-246 Clobetasol, 419t Darunavir, 272-275 mechanism of action of, 245i Clocortolone, 419t Daunorubicin, 385-386 Cerumenolytics, 417t Clomipramine, 322-325 Decongestants, 191-193 Cetirizine, 294-295, 297 Clonazepam, 74-76, 312-313, 314i, 315 Delavirdine, 270-271 Cevimeline, 21-24 Clonidine, 141-142 Demecarium, 24-27 Chamomile, 423t Clopidogrel, 165-169 Demeclocycline, 247-248 Chemical weapons exposure, treat- Clorazepate, 74-76, 312-313, 314i, 315 Depolarizing blocking drugs, 58-59 ment and antidotes for, 422t Clotrimazole, 281, 418t Dermatologic drugs, 418-420t Chloral hydrate, 317-318 Clove oil, 114-115 Desflurane, 109-110 Chlorambucil, 372-374 Clozapine, 331-332 Desipramine, 322-325 Chloramphenicol, 417t, 421t Cocaine, 112-115 Desloratadine, 294-295, 297 Chlordiazepoxide, 312-313, 314i, 315 Codeine, 102-105, 188-189 Desmopressin, 350-352 Chloroprocaine, 112-114 Colchicine, 307-309 Desonide, 419t Chlorothiazide, 224-225 Colesevelam, 147-148 Desoximetasone, 419t Chlorpheniramine, 294-295, 296i, 297 Colestipol, 147-148 Dexamethasone, 298-300, 415t, Chlorpromazine, 216-219, 333-336 Colistin sulfate, 417t 417t, 419t Chlorpropamide, 342-345 Competitive drugs, 56-58 Dexchlorpheniramine, 294-295, 297 Chlorthalidone, 224-225 Competitive inhibition, 107 Dextroamphetamine, 336-337 Chlorzoxazone, 50-52 Corticosteroids, 178-180, 297-301 Dextromethorphan, 188-189 Cholesterol absorption inhibitors, 152 special population concerns Diazepam, 53-55, 74-76, 312-313, 314i, Cholestyramine, 147-148 and, 179 315, 422t Choline magnesium trisalicylate, 94-96 Corticotropin, 349-350 Diazoxide, 142-143 Cholinergic agonists, 21-24 Corticotropin repository, 349-350 Dibucaine, 114-115 mechanism of action of, 22i Cortisone, 298-300 Diclofenac, 98-100, 415t Cholinergic blocking drugs, 27-32, Cosyntropin, 349-350 Dicloxacillin, 241-243 60-62, 177-178 Co-trimoxazole, 257-259 Dicyclomine, 27-32 i refers to an illustration; t refers to a table. Pirbuterol, 37-39, 176-177 Psyllium hydrophilic mucilloid, 212-213 Paromomycin, 238-240 Piroxicam, 98-100 Purine analogues, 383-384 Paroxetine, 320-322 Pituitary drugs, 348-352 Pyrazinamide, 276-280 Partial agonists, 44 Plants as drug sources, 3 Pyridostigmine, 24-27 Passive transport, 7 Podophyllotoxins, 396-397 Pyrimidine analogues, 381-383 Pathogen resistance, preventing, Polycarbophil, 212-213 mechanism of action of, 382 237-238 Polyenes, 280-283 Pyrophosphate analogues, 264 Patient sensitivity–related reactions, Polyethylene glycol, 211-212 Pyrrolidines, 84-85 18-19 Polymyxin B sulfate, 417t Patient’s response to drug, factors that Polythiazide, 224-225 Q affect, 15 Polyvinyl alcohol, 415t Quazepam, 312-313, 314i, 315 Peak concentration, 11-12 Positive inotropic effect, 119-120 Quetiapine, 331-332 Pediculicides, 420t Posterior pituitary drugs, 350-352 Quinapril, 144-145 Pegaspargase, 404 Potassium replacement, 360-361 Quinidine, 124-125 Penbutolol, 43-47 Potassium-sparing diuretics, 227-228 Penciclovir, 418t R Potentiation, 16 Penicillin-binding proteins, 241-242 Rabeprazole, 201-202 Pramipexole, 62-66 Penicillins, 241-243, 421t Radioactive iodine, 355-356 Pramoxine, 114-115 Pentazocine, 105-107 Ramelton, 317-318 Pravastatin, 149-150 Pentobarbital, 316-317 Ramipril, 144-145 Prazosin, 40-43, 141-142 Pentostatin, 383-384 Ranitidine, 199, 200i, 201 Prednisolone, 178-180, 298-300, 415t Peptic ulcer drugs, 195-203 Rasagiline, 62-66 Prednisone, 178-180, 298-300 Peripheral vascular resistance, 136 Recombinant human activated protein Prilocaine, 112-114 Permethrin, 420t C, 289-290 Primidone, 70-72 Perphenazine, 216-219, 333-336 Rectal route of administration, 5 Probenecid, 306-307 Pharmacodynamics, 12-13, 14i Remifentanil, 102-105 Procainamide, 124-125 Pharmacokinetics, 7-12 Repaglinide, 342-345 Procaine, 112-114 Pharmacologic class, 2 Replacement therapy, 15 Procarbazine, 405 Pharmacotherapeutics, 14-15 Reserpine, 141-142 Prochlorperazine, 216-219 Phenazopyridine hydrochloride, Respiratory drugs, 175-193 Procyclidine, 60-62 100-101 Respiratory route of administration, 5 Prodrug, 10 Progestins, 392-393 i refers to an illustration; t refers to a table. Yohimbine, 424t Triptorelin, 393-395 Tromethamine, 366-368 Z Tropicamide, 416t Zafirlukast, 180-182 Trospium, 230-231 Zaleplon, 317-318 Tuberculosis Zidovudine, 266-270, 268i directly observable therapy for, 276 Zileuton, 180-182 drug regimens for treating, 276-280 Ziprasidone, 331-332 Typical antipsychotics, 333-336 Zolmitriptan, 86-88 i refers to an illustration; t refers to a table. Professor and Executive Dean, South Carolina College of Pharmacy, The University of South Carolina, Columbia, Medical University of South Carolina, Charleston, South Carolina William J. Professor and Dean, School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina Jane M. The information presented herein reflects the opinions of the contributors and reviewers. Drug information and its applications are constantly evolving because of ongoing research and clinical experience and are often subject to professional judgment and interpretation by the practitioner and to the uniqueness of a clinical situation. However, the reader is advised that the publisher, author, contributors, editors, and reviewers cannot be responsible for the continued currency or accuracy of the information, for any errors or omissions, and/or for any consequences arising from the use of the information in the clinical setting. Acquisition Editor: Hal Pollard Managing/Development Editor: Dana Battaglia Production: Silverchair Science + Communications, Inc. Library of Congress Cataloging-in-Publication Data Concepts in clinical pharmacokinetics / Joseph T. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, microfilming, and recording, or by any information storage and retrieval system, without written permission from the American Society of Health-System Pharmacists. Intravenous Bolus Administration, Multiple Drug Administration, and Steady-State Average Concentrations… 45 Lesson 5. Relationships of Pharmacokinetic Parameters and Intravenous Intermittent and Continuous Infusions… 59 Lesson 6. Pharmacokinetic Variation and Model-Independent Relationships… 139 Practice Set 3… 153 Lesson 12. Glossary… 217 Index… 219 Acknowledgments The authors are indebted to George Francisco, Kim Brouwer, Stan Greene, Cecily DiPiro, William H. Reynolds for their review and suggestions during the preparation of the first and second editions. The third and fourth editions reflect the suggestions of many individuals who used the manual and recommended improvements. The rigorous effort and valuable suggestions provided by Dana Battaglia for this edition are greatly appreciated. Preface to the Third Edition This programmed manual presents basic pharmacokinetic concepts and procedures that are useful in pharmacy, medicine, and other health professions.
