Exam (elaborations) .M22058 Course Code: 2410213

Pharmacology is a medical science that forms a backbone of the medical profession as drugs form the corner stone of therapy in human diseases. Therefore, it is of utmost importance to describe the pharmacological basis of therapeutics in order to maximize the benefits and minimize the risks of drugs to recipients. This lecture note on pharmacology is primarily a note for undergraduate health science students such as health officer, nursing, midwifery and laboratory technology students. However, other health professionals whose career involves drug therapy or related aspects should also find much of the material relevant. The goal is to empower the practitioner through an understanding of the fundamental scientific principles of pharmacology. The effects of prototypical drugs on physiological and pathophysiological processes are clearly explained to promote understanding. Other related drugs are touched briefly. The selection of the drugs is based on the national drugs list for Ethiopia and on the accumulated experience of teaching pharmacology to many health profession students. The chapters open with a list of objectives to guide the reader, and most end with questions which challenge the reader’s understanding of the concepts covered with in the chapter. Most sections have an introduction that provides an overview of the material to be covered. Readers are encouraged to refer the references mentioned for further information and we hope that this material will be a valuable companion in our pursuit of a fundamental understanding in a most fascinating area of clinical knowledge, pharmacology. The Authors April 2004: iii Table of Contents Acknowledgment ................................................................................................................... i Introduction .......................................................................................................................... ii Table of Contents .................................................................................................................. iii Abbreviation .......................................................................................................................... vi Chapter one: General pharmacology ................................................................................... 1 Learning objectives ..................................................................................... 1 Introduction ................................................................................................. 1 Pharmacodynamics..................................................................................... 2 Pharmacokinetics ........................................................................................ 5 Theoretical pharmacokinetics ..................................................................... 17 Drug safety and effectiveness ..................................................................... 19 Development and evaluation of new drugs ................................................. 26 Exercise ...................................................................................................... 29 Chapter two: Drugs acting on autonomic nervous system ................................................. 30 Learning objectives ..................................................................................... 30 Introduction ................................................................................................. 30 Autonomic drugs ......................................................................................... 35 Cholinergic drugs ........................................................................................ 36 Anticholinergics ........................................................................................... 40 Adrenergic drugs ......................................................................................... 42 Adrenergic blockers .................................................................................... 47 Exercise ..................................................................................................... 50 Chapter three: Cardiovascular-renal drugs .......................................................................... 51 Learning objectives ..................................................................................... 51 Introduction ................................................................................................. 51 Antihypertensive drugs ............................................................................... 51 Drugs used in heart failure .......................................................................... 57 Pharmacotherapy of angina pectoris .......................................................... 60 Anti-arrhythmics .......................................................................................... 62 Diuretics ...................................................................................................... 64 Drugs used in hypotensive states and shock ............................................. 66 Exercise ..................................................................................................... 68 Chapter four: Autacoids and their antagonists .................................................................... 69 Learning objectives ..................................................................................... 69 Introduction ................................................................................................ 69 Hisamine ..................................................................................................... 69 iv 5-hydroxytryptamine.................................................................................... 72 Prostaglandins ............................................................................................ 73 Exercise ..................................................................................................... 75 Chapter five: Drugs Action on the Respiratory System .......................................................... 76 Learning objectives .......................................................................................... 76 Introduction ..................................................................................................... 76 Pharmacotherapy of bronchial asthma ............................................................ 77 Antitussives ...................................................................................................... 82 Expectorants & Mucolytics ............................................................................... 83 Decongestants ................................................................................................. 83 Exercise .......................................................................................................... 85 Chapter six: Drugs used in Gastrointestinal Diseases ............................................................ 86 Learning objective ............................................................................................ 86 Introduction ....................................................................................................... 86 Drugs used in acid-peptic diseases ................................................................... 86 Purgatives .......................................................................................................... 90 Antidiarrhoeals ................................................................................................... 91 Antiemetics ........................................................................................................ 92 Drugs used to induce vomiting (emetics) .......................................................... 94 Antihaemorrhoidal agents .................................................................................. 94 Drugs used in inflammatory bowel disease ....................................................... 94 Chapter seven: Drugs used to treat the diseases of blood, inflammation and gout ................ 95 Learning objectives ........................................................................................ 95 Introduction ..................................................................................................... 95 Agents used in anemias ................................................................................. 95 Drugs used in disorders of blood coagulation ................................................ 101 Nonsteroidal antiinfammatory agents ............................................................. 104 Drugs used in gout ......................................................................................... 108 Exercise .......................................................................................................... 112 Chapter eight: Drugs acting in the central nervous system ................................................... 113 Learning objectives ........................................................................................ 113 Introduction ..................................................................................................... 113 General anesthetics ....................................................................................... 114 Sedative and hypnotic drugs .......................................................................... 115 Drugs used in Parkinsonism .......................................................................... 116 Antipsychotic drugs ........................................................................................ 117 Antidepressant agents .................................................................................... 121 Opioid analgesics ........................................................................................... 122 CNS stimulants ............................................................................................... 125 v Local anesthetics ............................................................................................ 126 Exercise .......................................................................................................... 128 Chapter nine: Endocrine Drugs ............................................................................................... 129 Learning objectives ........................................................................................ 129 Introduction ..................................................................................................... 129 Antidiabetic drugs ........................................................................................... 129 Oxytocics ........................................................................................................ 133 Female sex hormones and hormonal contraception ...................................... 134 Adrenocortical hormones ............................................................................... 138 Exercise .......................................................................................................... 143 Chapter ten: Chemotherapeutic Agents .............................................................................. 144 Learning objectives ........................................................................................ 144 Introduction ..................................................................................................... 144 Antibacterial drugs .......................................................................................... 146 Antifungal agents ............................................................................................ 165 Antiviral agents ............................................................................................... 169 Antineoplastic agents ..................................................................................... 177 Treatment of protozoal infection .................................................................... 178 Treatment of helminthic infections ................................................................. 188 Exercise .......................................................................................................... 195 Chapter eleven: Toxicology ...................................................................................................... 196 Learning objectives ....................................................................................... 196 Introduction ................................................................................................... 196 General measures in poisoning .................................................................... 196 Exercise ........................................................................................................ 199 Chapter twelve: Prescription writing and rational use of drugs ............................................... 200 Learning objective ......................................................................................... 200 Introduction ................................................................................................... 200 Prescription writing ...............