Drug Safety in Clinical Practice by Peter I. FolbDrug Safety in Clinical Practice by Peter I. Folb

Drug Safety in Clinical Practice

byPeter I. Folb

Paperback | December 1, 1983

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Drugs may cause disease, or they may aggravate the morbidity of the condition for which they are prescribed, and certain patients may for one or other reason be particularly liable to drug injury. The inextricable relationships between the toxic profiles of drugs, the natural history of the diseases for which they are given, and the adverse drug effects that may develop in the course of such diseases are of considerable interest. It is the study of these rather neglected aspects of pharmacology and therapeutics which has formed the basis of this book. An explanation is required of the approach and the style which have been followed. The monograph does not purport to be comprehensive. Only important drug groups which are commonly used in practice are considered. Emphasis has been placed on achieving maximum benefit and safety of the appropriate drugs in the management of common illnesses. When treatment fails, either ab initio or subsequent to an initial response, the risk-benefit relationship of drugs inevitably alters. For this reason the main factors responsible for treatment failure have been considered, with special attention to the possible contribution of or implications for drug therapy in such a situation. Finally, proposals have been put forward for improving the diagnosis and reporting of adverse drug effects. In order to be practical and, as far as possible, constructive it has been necessary for me to "take a position" on numerous issues.
Title:Drug Safety in Clinical PracticeFormat:PaperbackPublished:December 1, 1983Publisher:Springer LondonLanguage:English

The following ISBNs are associated with this title:

ISBN - 10:3540128115

ISBN - 13:9783540128113

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Table of Contents

1 Drugs in Common Use.- 1.1 Antibiotics.- Topical antibiotics; beta-lactamases; side-effects; renal elimination; hepatic disease and failure.- 1.2 Antihistamines.- Use in the common cold and upper respiratory tract infections; special problems; interaction with other drugs; adverse effects on the nervous system; topical use; acute poisoning.- 1.3 Histamine2-Receptor Blocking Agents.- Cimetidine; ranitidine.- 1.4 Antacids.- Aluminium toxicity; chronic aluminium toxicity; bismuth encephalopathy and neuropathy.- 1.5 Laxatives.- Safety profiles; cathartic syndrome; chronic hypokalaemia; mineral oil deposits; phenolphthalein.- 1.6 Antidiarrhoeal Agents.- Kaolin; pectin; bismuth, anticholinergics; opiates; diphenoxylate and atropine; iodochlorhydroxyquin; antidiarrhoeal/antibiotic combinations.- 1.7 Aspirin and the Acidic Non-steroidal Anti-inflammatory Agents.- Gastrointestinal injury; sensitivity reactions; analgesic nephropathy; redistributional drug interactions; general considerations for use in chronic rheumatic conditions.- 1.8 Digitalis.- Clinical signs of digitalis toxicity; early recognition of cardiotoxicity; contraindications to digitalis therapy; massive digitalis intoxication; digoxin and Quinidine.- 1.9 Sympathomimetic Drugs.- Adrenaline; ephedrine; phenylpropanolamine; noradrenaline; isoprenaline; beta2-selective agents; dopamine and dobutamine; clonidine.- 1.10 Alpha-Adrenoreceptor Blocking Agents.- Phenoxybenzamine; prazosin; indoramin.- 1.11 Beta-Adrenoreceptor Blocking Agents.- 1.12 Potassium Supplements.- 1.13 Nitrates.- Adverse Effects; Tolerance.- 1.14 Calcium Antagonists.- Verapamil; nifedipine; perhexilene; prenylamine; diltiazem.- 1.15 Benzodiazepines.- Guidelines for use; dependence.- 1.16 Tricyclic Antidepressants.- Cardiotoxicity; postural hypotension; anticholinergic effects; epilepsy; acute withdrawal effects.- 1.17 Methylphenidate.- 1.18 Anorectic Agents.- Sympathomimetic amines; safety; fenfluramine; phenylpropanolamine; comparative pharmacological effects.- 1.19 Addition of Drugs to Intravenous Fluids.- 1.20 Parenteral Nutrition.- Micronutrient deficiencies; metabolic bone disease; hepatic dysfunction; fat overload syndrome.- >1.21 Topical Corticosteroids.- Potency; activity; local toxicity; systemic toxicity; minimising risks of adverse effects; use in ophthalmology.- 1.22 Methylene Blue.- Use in methaemoglobinaemia; toxicity.- 1.23 Vitamins.- Vitamin A (retinol): requirements; hypervitaminosis A.- Vitamin B12 and folic acid.- Vitamin C: antiscorbutic activity; toxicity.- Vitamin D: Normal requirements; individual susceptibility; hypervitaminosis D.- Vitamin K: adverse effects; treatment of hypoprothrombinaemia.- 2 Drug Safety in Some Common Medical Conditions.- 2.1 Heart Failure.- Excessive diuresis; diuretic escape; hypokalaemia; digitalis toxicity; myocardial ischaemia; adverse drug-drug interactions; lack of response to therapy.- 2.2 Hypertension.- Stepped approach to drug treatment; captopril; methyldopa; beta-adrenoreceptor blocking agents; frusemide; prazosin; minoxidil; drug treatment in the elderly.- 2.3 Cough.- Codeine; mucolytic agents; antihistamines.- 2.4 Bronchial Asthma.- Methylxanthines; combination anti-asthmatic preparations.- 2.5 Tuberculosis and Other Mycobacterial Infections.- Drugs of choice; treatment failure; toxicity profiles; renal failure; hepatotoxicity; pregnancy.- 2.6 Fungal Infections.- Amphotericin B; 5-fluorocytosine.- 2.7 Malaria.- Cerebral malaria; adverse effects of antimalarial agents; prophylaxis in pregnancy.- 2.8 Urinary Tract Infections.- Antimicrobial therapy of uncomplicated infections; repeated infections; catheter-associated infections; treatment in renal failure; nalidixic acid; nitrofurantoin.- 2.9 Cancer Chemotherapy.- Resistance to cytotoxic agents; general guidelines.- 2.10 Iron-Deficiency Anaemia.- Contraindications to iron; failed response; choice of an oral iron preparation; adverse effects of oral therapy; hazards of parenteral therapy; iron supplements.- 2.11 Diabetes Mellitus.- Insulin allergy; insulin lipoatrophy and lipohypertrophy; insulin resistance; insulin hypoglycaemic reactions; the Somogyi effect; beta-adrenoreceptor blocking drugs and blood sugar control; sulphonylureas; lactic acidosis; chlorpropamide-alcohol flush.- 2.12 Gout.- Colchicine; indomethacin; uricosuric agents; allopurinol.- 2.13 Myasthenia Gravis.- Anticholinesterases; atropine; corticosteroids; other drugs affecting the myoneuronal junction.- 3 Patients at Special Risk.- 3.1 Pregnant Women.- Drug injury to the fetus: drug usage in pregnancy Drug treatment of important medical conditions in pregnancy: severe vomiting and hyperemesis gravidarum; epilepsy; rheumatic conditions; tuberculosis; ulcerative colitis; anticoagulation; depression.- 3.2 Breast-Feeding mothers.- 3.3 The Elderly.- Disinhibition reactions; neuropsychiatric syndromes; tranquilliser dependence; anticholinergic syndrome; hypoglycaemic syndromes; ocular effects; special issues in drug treatment; guidelines.- 3.4 Motor Vehicle Drivers.- 3.5 Porphyrics.- Clinical guidelines; management of an acute attack; prediction.- 4 Drug Injuries.- 4.1 Drug Fever.- Causes; pathogenesis; clinical features; predisposing factors; diagnosis; management; Herxheimer reaction; malignant hyperthermia; neuroleptic malignant syndrome.- 4.2 Anaphylaxis and Anaphylactoid Reactions.- Pathogenesis; symptomatology; prediction and prevention; differential diagnosis; Hoigne's syndrome; serum sickness reactions; classification of allergic drug reactions.- 4.3 Drug-Induced Diseases of the Skin.- Diagnosis and natural history; management of hypersensitivity.- 4.4 Drug-Induced Vasculitis.- Clinical features; allopurinol hypersensitivity.- 4.5 Drug-Induced Vomiting.- Metoclopramide; cannabinoids.- 4.6 Central Anticholinergic Syndromes.- Toxic confusional state; disorders of temperature control; neuroleptic malignant syndrome; physostigmine.- 4.7 Drug-Induced Ototoxicity.- Diagnosis; aminoglycosides; salicylates; non-steroidal anti-inflammatory agents; antimalarials; loop diuretics.- 5 Diagnosing Adverse Drug Reactions.- Classification; probability of association; severity; Berkson's bias.