Smith / Rawlins Variability in Human Drug Response

1. Auflage 2013
ISBN: 978-1-4831-6511-0
Verlag: Elsevier Science & Techn.
Format: PDF
Kopierschutz: 1 - PDF Watermark

E-Book, Englisch, 180 Seiten, Web PDF

Variability in Human Drug Response examines why individual patients differ significantly in their response to drug administration. This book is devoted mainly to pharmacokinetics and covers topics such as drug absorption, distribution, metabolism, and excretion. The sensitivity of tissues of the body to drugs and the importance of monitoring drug therapy are also discussed. This book is comprised of 10 chapters and begins with an introduction to variability in clinical response to administration of defined drugs, as well as the importance of closely matching dosage to the individual patient's requirement to achieve an optimal response to drug administration. The chapters that follow highlight the pharmacokinetic origin of most variability in the clinical response to drugs, along with the difficulties inherent in predicting the effect of drug administration in an individual patient. The role of genetic and environmental factors, disease, and the concomitant administration of other drugs in determining an individual's response to any therapeutic maneuver is also examined. The last chapter describes two methods of monitoring drug therapy: monitoring drug effects or monitoring the plasma levels of drugs. This monograph will be of interest to practicing clinicians and senior medical students.

Autoren/Hrsg.

Smith, Stephen E.

Rawlins, Michael D.

Inhaltsverzeichnis

1;Front Cover;1
2;Variability in Human Drug Response;4
3;Copyright Page;5
4;Table of
Contents;6
5;Preface;8
6;CHAPTER 1.
Introduction;10
7;CHAPTER 2.
Pharmacokinetics;17
7.1;Drug absorption;17
7.2;Drug elimination;19
7.3;Drug distribution;23
7.4;Multi-compartmental drug distribution;25
7.5;Multiple-dose kinetics;28
7.6;Kinetics of pharmacological effects;29
7.7;References;32
8;CHAPTER 3.
Drug Absorption;34
8.1;Reliability or unreliability of drug taking;35
8.2;Drug formulation;36
8.3;pH of the gastric contents;41
8.4;Presence of food and other substances in the lumen;41
8.5;Gastrointestinal motility;44
8.6;Intestinal absorptive function;44
8.7;References;45
9;CHAPTER 4.
Drug Distribution;50
9.1;Lipid solubility;52
9.2;Regional blood flow;53
9.3;Binding of drugs;54
9.4;Active transport of drugs;61
9.5;Placental drug transfer;62
9.6;References;62
10;CHAPTER 5.
Drug Metabolism: General Principles;68
10.1;Pathways of drug metabolism;69
10.2;Hepatic drug metabolism;69
10.3;Drug metabolism in other sites;75
10.4;Influence of age on drug metabolism;75
10.5;Tests of microsomal enzyme function;76
10.6;References;78
11;CHAPTER 6.
Drug Metabolism: Genetic Factors;82
11.1;Genes of large effect;83
11.2;Genes of small effect;88
11.3;References;90
12;CHAPTER 7.
Drug Metabolism: Environmental Influences;93
12.1;Enzyme induction;93
12.2;Enzyme inhibition;103
12.3;Liver disease;108
12.4;Renal disease;109
12.5;References;109
13;CHAPTER 8.
Drug Excretion;119
13.1;Renal excretion;119
13.2;Drugs in renal failure;124
13.3;Biliary excretion;126
13.4;Other routes of excretion;127
13.5;References;127
14;CHAPTER 9.
Tissue Sensitivity;131
14.1;Quantitative differences in drug response;132
14.2;Abnormal drug responses;135
14.3;References;138
15;CHAPTER 10.
Monitoring Drug Therapy;141
15.1;Monitoring of drug effects;141
15.2;Monitoring of plasma levels - a pharmacokinetic approach;142
15.3;References;153
16;APPENDIX A:
Calculation of Drug Dosage in Renal Failure on the Basis of Creatinine Clearance;158
17;APPENDIX .:
Antibiotic Dosage in
Renal Failure;161
18;Index;176