Principles of Drug Therapy in Neurology

Hardcover | April 23, 2008

byMichael V. Johnston, Robert L. Macdonald

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Principles of Drug Therapy, Second Edition provides comprehensive coverage of current drug therapy in neurology while providing the background information that neurologists and other clinicians need to understand its rationale. The range of new drugs available for treatment of neurologicaldisorders is expanding rapidly along with rapid advances in the neurosciences that are uncovering disease mechanisms. Although there are many sources of drug information, most are limited to basic information about indications, dose and side effects. However the complexity of the nervous system isenormous and the information needed to understand drug effects is accordingly often not readily available in a single source. The book addresses that issue by presenting 18 focused, disease-related chapters by authors who are expert clinical sub-specialists as well as experts on drug therapy. The first chapter on fundamentals of drug therapy in neurology provides a readable synopsis of how the classic pharmacology concepts such as pharmacodynamics and pharmacokinetics are related to therapy in neurology. This section also discusses the pathogenesis of potentially serious side effectssuch as skin rashes and liver disorders, and the role of pharmacogenetics in both drug effect and side effects. Outstanding chapters on movement disorders, epilepsy, and headaches cover major areas of drug treatment in neurology practice. Additional chapters cover stroke, increased intracranialpressure in the intensive care unit, dementia, multiple sclerosis, spinal cord injury and spasticity, neuromuscular disorders and pain. Sleep, central nervous system infections and HIV, and drug intoxications are also covered. Areas of special interest to child neurologists covered in the bookinclude treatment of genetic metabolic disorders and use of stimulants and other medications for childhood cognitive disorders. An excellent chapter is also provided on drug treatment of psychiatric disorders because of the important of psychiatric drugs in neurology practice. This edition has beencompletely re-written from the successful edition published in the 90s and enlarged commensurate with the exciting progress in treatment in neurology.

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Principles of Drug Therapy, Second Edition provides comprehensive coverage of current drug therapy in neurology while providing the background information that neurologists and other clinicians need to understand its rationale. The range of new drugs available for treatment of neurologicaldisorders is expanding rapidly along with rapid...

Michael V. Johnston, M.D., is Professor of Neurology, Pediatrics and Physical Medicine and Rehabilitation at the Johns Hopkins University School of Medicine. He is also the Chief Medical Officer at the Kennedy Krieger Institute. Robert A. Gross MD, PhD, is Professor of Neurology and of Pharmacology and Physiology at the University ...

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Format:HardcoverDimensions:512 pages, 10 × 7.1 × 1.3 inPublished:April 23, 2008Publisher:Oxford University PressLanguage:English

The following ISBNs are associated with this title:

ISBN - 10:0195146832

ISBN - 13:9780195146837

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Table of Contents

1.1. OVERVIEW OF DRUG THERAPY IN NEUROLOGY, Michael Johnston and Robert GrossMOLECULAR TARGETS OF DRUG ACTION IN THE NERVOUS SYSTEMABSORPTION, DISTRIBUTION, METABOLISM AND ELIMINATION PHARMACOGENETICSTOXICITY OF NEUROACTIVE DRUGSINFLUENCE OF AGE ON DRUG ACTION2. MOVEMENT DISORDERS, Samuel A. Frank and Anna Depold HohlerINTRODUCTIONNEUROCHEMICAL ANATOMY OF THE BASAL GANGLIABasal Ganglia Structures BLStriatal AfferentsPARKINSON'S DISEASEClinical Manifestations BLNeurotransmitter and Receptor Changes BLSelective Vulnerability BLGenetic Influence BLEnvironmental Exposures BLRational For Therapy of Motor Symptoms BLSurgical Treatment BLTreatment Approaches BLParkinson's Disease Associated Symptoms and Treatment OptionsPARKINSON'S PLUS SYNDROMESMultiple Systems Atrophy BLProgressive Supranuclear Palsy Cortical-basal Degeneration BLDementia with Lewy BodiesHUNTINGTON'S DISEASEClinical Manifestations BLNeurotransmitter and Receptor Changes BLSelective Vulnerability BLRationale for TherapyWILSON'S DISEASEClinical Manifestations BLNeurotransmitter and Receptor Changes BLRationale for TherapyESSENTIAL TREMORClinical Manifestations BLSelective Vulnerability BLRationale for TherapyATAXIAClinical Manifestations BLNeurotransmitter and Receptor Changes BLSelective Vulnerability and Rational for TherapyDYSTONIAClinical Manifestations BLNeurochemical Pathology BL Rationale for TherapyCONCLUSIONSEPILEPSYRobert Gross, Craig Henry, Bill TrescherINTRODUCTIONCLASSIFICATION OF SEIZURES, EPILEPSY AND ANTISEIZURE DRUGSClassification of Antiseizure Drugs BLMechanisms of Action BLAntiseizure Drug Mechanism of Action- General ConsiderationsCLINICAL USE OF ANTISEIZURE DRUGSChoice of Antiseizure Medication - Efficacy for IndicationChoice of Antiseizure Medication - Safety and TolerabilityChoice of Antiseizure Medication - Pharmacokinetic ProfileContinuing and Revising TreatmentSPECIAL CONSIDERATIONS IN EPILEPSY PHARMACOTHERAPYWomen and Pregnancy BLBone Health BLTreatment of Epilepsy in the Elderly BLPsychiatric Disorders BLIntellectual and Developmental Disabilities BLStatus EpilepticusCONCLUSION4. MIGRAINE, Stephen J. PeroutkaINTRODUCTIONPhysiological Stress and Migraine BLGenetic Basis of MigraineTHEORIES OF MIGRAINE PATHOPHYSIOLOGYVascular Theory of Wolff BLCortical Spreading Depression (i.e., Spreading Depression of Leao) BLThe Trigeminovascular System in Migraine BLThe Sympathetic Nervous System in Migraine BLOther Hypotheses BLConclusionsCLINICAL FEATURES OF MIGRAINEMigraine Without Auro (Common Migraine) BLMigraine With Aura (Classic Migraine) BLBasilar MigraineTREATMENT OF MIGRAINENon-pharmacologic Approaches BLAcute Pharmacological Treatment of Migraine BLProphylactic Treatment of MigraineCHAPTER SUMMARY5. ISCHEMIC STROKE, Michael Jacewicz, Thaddeus S. Nowak, Jr., Elias A. Giraldo, William A. PulsinelliINTRODUCTIONMECHANISMS OF ISCHEMIC STROKECellular Pathophysiology and Targets For Therapy BLVascular and Hematologic Pathophysiology and Target for TherapyDRUGS AND THEIR MECHANISMS OF ACTIONThrombolytic Agents BLAntiplatelet Agents BLAnticoagulants BLNeuroprotectantsACUTE MANAGEMENT OF ISCHEMIC STROKEGeneral Conditions BLVascular Recanalization and Cerebral Reperfusion BLAntiplatelet Agents BLAnticoagulantsSUMMARYREFERENCES6. MANAGEMENT OF ELEVATED INTRACRANIAL PRESSURE, Michael T. FroehlerINTRODUCTIONPHYSIOLOGYMonro-Kellie Doctrine BLCerebrospinal Fluid Dynamics BLCerebral Blood Flow Dynamics BLBlood-Brain BarrierPATHOPHYSIOLOGYCerebral Perfusion BLBrain Edema BLClinical SyndromesICP MONITORINGIndications BLICP Monitoring Devices BLWaveform DynamicsMEDICAL MANAGEMENTGeneral Principles BLHyperventilation BLPositioning BLHyperosmolar Therapies BLCorticosteroids BLGeneral Anesthesia BLOther TherapiesSURGICAL INTERVENTIONSCSF Diversion and Drainage BLHemicraniectomy BLRemoval of Mass LesionsSUMMARY7. DEMENTIA AND RELATED DISORDERS, Michael V. JohnstonINTRODUCTIONDEMENTIA AND RELATED DISORDERSAlzheimer's Disease BLMild Cognitive Impairment BLVascular Cognitive Impairment BLOther Causes of Dementia BLCognitive Impairment from Drugs or Metabolic DisordersPATHOGENESIS OF ALZHEIMER'S DISEASEAmyloid-? Peptide Accumulation BLInvolvement of Cholinergic Neurons BLAmino Acid Neurotransmitter Abnormalities in AD BLDeficits in Catecholamines in Cerebral Cortex BLSerotonin Deficits in AD BLNeuropeptides BLMembrane Phospholipids BLOxidative StressTHERAPY FOR ALZHEIMER'S DISEASECholinesterase Inhibitors BLCholinesterase Inhibitors BLThe NMDA Antagonist Memantine BLTherapy for Behavioral Disorders BL?-Amyloid-Directed Therapies BLAntioxidants and Vitamins BLErgoloid Mesylates BLAnti-Inflammatory Drugs BLHormonal Therapy BLStatins BLTrophic FactorsCONCLUSION8. MULTIPLE SCLEROSIS AND RELATED DISORDERS, Michael V. JohnstonINTRODUCTIONDIAGNOSIS AND CLASSIFICATIONPATHOGENESISDRUG THERAPIESCorticosteroids BLDisease Modifying Therapies BLOther Immunosuppressive AgentsGUIDELINES FOR DISEASE MODIFYING THERAPY OF MSCONCLUSION9. SPINAL CORD INJURY AND SPASTICITYJohn McDonald, Christina SadowskyTHE PROBLEM SPINAL CORD INJURYMECHANISMS OF SPINAL CORD INJURY AND CHANGING TREATMENT GOALSPrimary Injury BLSecond Temporal Wave Cell Death BLGoals of RestorationPATHOPHYSIOLOGY OF SPASTICITYMechanisms for Spasticity BLMajor Targets for TherapyDRUG THERAPY FOR SPASTICITYChallenges to Therapy for Spasticity BLSystemic Changes that Affect Therapy BLDrugs Used to Treat SpasticityCONCLUSION10. NEUROMUSCULAR DISEASE, Chad Heatwole, Richard MoxleyINTRODUCTIONTHE CLASSIFICATION OF CURRENT NEUROMUSCULAR DRUG THERAPIESIMMUNE MODULATION MEDICATIONSRepresentative Diseases Which Use Immune Modulation Medications BLImmune Modulating MedicationsNEUROMUSCULAR JUNCTION AGENTSRepresentative Diseases Which Benefit From Medications Affecting the Neuromuscular Junction BLMedications Affecting Transmission at the Neuromuscular JunctionGLUTAMATE INHIBITING AGENTSRepresentative Disease Which Uses Glutamate Inhibiting Agents BLGlutamate Inhibiting Agents VITAMIN SUPPLEMENTSRepresentative Diseases Which Use Vitamin Supplementation BLRepresentative Vitamin SupplementsENZYMATIC REPLACEMENTSRepresentative Diseases Which Use Enzymatic Replacements BLEnzymatic ReplacementsPREVENTATIVE VACCINESRepresentative Diseases Which Use Preventative Vaccines BLRepresentative Preventative VaccinesTOXIN REDUCING AGENTSRepresentative Diseases Which Use Toxin Reducing Agents BLToxin Reducing AgentsCHANNELOPATH ALTERING AGENTSRepresentative Diseases Which Use Channelopathy Altering AgentsANTIMICROBIAL REGIMENSAntimicrobial Agents BLRepresentative Diseases Which Use Antimicrobial Agents BLAntimicrobial AgentsANTIMYOTONIC MEDICATIONSRepresentative Disease Which Uses Antimyotonic Medication BLAntimyotonic AgentsDUCHENNE MUSCULAR DYSTROPHY ALTERING AGENTSDuchenne Muscular Dystrophy (DMD) BLDuchenne Muscular Dystrophy Altering AgentsDIET SUPPLEMENTSRepresentative Diseases Which Use Diet Supplements BLDiet SupplementsCONCLUSION11. PAIN, Gavril W. PasternakTYPES OF PAINSomatic Pain BLVisceral Pain BLDeafferentation PainACUTE VERSES CHRONIC PAINANATOMY AND PHYSIOLOGY OF CENTRAL NOCICEPTIVE SYSTEMSNociceptors BLDorsal Horn and Spinothalamic Tracts BLMechanisms of Facial Sensation BLThe Cortex and PainANTINOCICEPTIVE SYSTEMS IN THE CNSEndogenous Opioid Systems BLOpioid Receptors BLOpiate ActionsPHARMACOLOGIC MANAGEMENT OF PAINClinical Use of Opioid AnalgesicsGENERAL GUIDELINES IN THE USE OF OPIOID ANALGESICSSUMMARY12. NEUROLOGIC METABOLIC DISEASES, Tyler ReimschiselADRENOLEUKODYSTROPHYBIOTINIDASECOGENITAL DISORDERS OF GLYCOSYLATIONCREATINE DEFICIENCY SYNDROMESFABRY DISEASEGLUCOSE TRANSPORTER DEFICIENCY SYNDROMEGLUTARIC ACIDURIA TYPEHOMOCYSTINURIALESCH-NYHAN DISEASEMAPLE SYRUP URINE DISEASEMETHYLMALONIC ACIDURIA SYNDROMESMITOCHONDRIAL CYTOPATHIESNONKETOTIC HYPERGLYCENEMIAPHENYLKETONURIAPROPIONIC ACIDEMIAPYRIDOXINE-RESPONSIVE SEIZURE DISORDERUREA CYCLE DEFECTS ASSOCIATED WITH ACUTE HYPERAMMONEMIC CRISES13. PSYCHIATRIC DISORDERS, Joseph T. Coyle, Eben S. DraperCLINICAL PHARMAPSYCHOLOGYANTIPSYCHOTICSSchizophrenia BLSite of Action of Antipsychotics BLClozapine and the Second Generation Anitpsychotics BLClinical Use of Antipsychotics BLSide-Effects of AntipsychoticsANTIDEPRESSANTSMajor Depressive Disorder BLAntidepressants BLSide Effects of SSRIs BLClinical Use BLCognitive-Behavioral Therapy (CBT)MOOD STABILIZERSBipolar Affective Disorder BLClinical UseBENZODIAZEPINESCONCLUSION14. CHILDHOOD COGNITIVE DISORDERS, Paul LipkinINTRODUCTIONClassification and Description of Major Disorders BLEpidemiologyMECHANISMS OF DISEASEDRUGS AND THEIR MECHANISMS OFAttention-targeted Medications BLNootropic AgentsMEDICATION MANAGEMENT OF THE CHILDHOOD COGNITIVE DISORDERS15. SLEEP DISORDERS, Lynn LiuBASIC MECHANISMS OF SLEEP WAKE STATESWake BLNREM Sleep BLREM Sleep BLCircadian InfluencesDRUGSSleep-inducing Drugs (Hypnotics) BLWake-promoting Drugs BLAnticataplectic Medications BLDrugs to Treat Sleep Related MovementsSLEEP SPECIFIC DISORDERSInsomnias BLSleep Related Breathing Disorders BLHypersomnia Syndromes BLCircadian Rhythm Sleep Disorders BLParasomnias BLSleep Related Movement Disorders16. CNS INFECTIONS, Nicholas King, Karen RoosINTRODUCTIONLUMBAR PUNCTUREBACTERIAL MENINGITISEmpirical Antibiotic Therapy BLSpecific Antibiotic Therapy BLAdjunctive TherapyBACTERIAL ABSCESS AND EMPYEMABacterial Abscess BLIntracranial Epidural Abscess and Subdural EmpyemaPERINATAL INFECTIONSCytomegalovirus BLHerpes Simplex Virus BLVaricella-zoster Virus BLNonpolio Enteroviruses BLLymphocytic Chroiomeningitis Virus BLRubella BLToxoplasmosisVIRAL MENINGITISFUNGAL MENINGITISAntifungal Agents BLSpecific Fungal InfectionsHERPES ENCEPHALITISHerpes Simples Virus-1 BLVaricella-zoster Virus BLCytomegalovirus BLHuman Herpes Virus Type 6 and 7 BLEpstein-Barr VirusTOXOPLASMOSIS ENCEPHALITISPROGRESSIVE MULTIFOCAL LEUKOENCEPHALOPATHYHIV NEUROPATH, MYELOPATHY, ENCEPHALITISTUBERCULOUS MENINGITISNEUROSYPHILISLYME DISEASENEUROCYSTICERCOSISCONCLUSION17. Neuro-HIV, Jeffry RumbaughINTRODUCTIONHIV Associated Dementia BLOther HIV-Related Neurological DiseasePATHOLOGYActivated Macrophages and Microglia BLAstrocytes BLLoss of Neurons BLDifferential Effects on Specific Brain Regions and Neuronal Populations BLState of the Blood Brain BarrierROLE OF VIRAL PROTEINSTat BLGp120 BLNef BLVirotoxin Associated PhenomenaINFLAMMATORY HOST FACTORSChemokines BLCytokines BLMatrix Metalloproteinases BLOxidative and Nitrosative Stress BLCyclooxygenases and ProstaglandinsOTHER HOST FACTORSGrowth Factors BLLipids and Apolipoprotein EIMPLICATIONS FOR HAARTNucleoside Reverse Transcritase Inhibitors BLNon-Nucleoside Reverse Transcritase Inhibitors BLPRotease Inhibitors BLFusion Inhibitors BLImplications for HAART in the Treatment of HIV Associated Neurological Complications BLImpact of HAART on Cognitive Function in HIV Infected Patients BLDrugs the MayExacerbate HIV DementiaIMPLICATIONS FOR DRUG DEVELOPMENTAnti-Oxidants BLAnti-TNF Therapies BLMMP Inhibitors BLMonoclonal Antibodies BLSmall Interfering RNA BLNeurotransmitter-Based Therapies BLTargeting Tat and Gp 120 BLDevelopments in the Treatment of HIV Associated Peripheral NeuropathyOPPORTUNISTIC CNS INFECTIONSCryptococcal Meningitis BLCytomegalovirus BLProgressive Multifocal Leukoencephalopathy BLToxoplasmosis BLImmune Reconstitution Inflammatory SyndromeCONCLUSIONS18. DRUG INTOXICATIONS, George A. Ricaurte, Una D. McCann GENERAL CONSIDERATIONS INITIAL MEASURES HEROIN COCAINE METHAMPHETAMINE METHYLENEDIOXYMETHAMPHETAMINE Malignant Hypothermia BLHyponatremia BLCK Elevation BLHepatotoxicity KETAMINE GAMMAHYDROXYBUTYRATE (GHB) AND ITS ANALOGS CONCLUSION