Index

Abdominal hysterectomy, prophylactic antibiotics in, 260

Absorption, 4-6 Acetazolamide, 190 Acetohexamide, overdose of, 425 Adrenergic stimulant, overdose of,

436-442 Afterload reduction, 135-150; see

also Congestive heart failure Agoraphobia, 368 Airflow obstruction

acute reversible, 352-357 assessment and treatment in,

353-354 comprehensive care on

recovery in, 355-356 death in, 352-353 IPPB in, 353 manifestations of, 353 mechanical ventilation in, 355 metered-dose inhaler in, 354 steroids in, 354

chronic, 358-366 airflow assessment in, 359 anticholinergics in, 364 bronchodilator strategies in,

363-364 bronchodilators in, 359-362 consolidation strategy in, 365 corticosteroids in, 362-363 cromolyn in, 364 definitions of, 358 ephedrine in, 362 inhaled beta agonists in, 360 nonspecific bronchial

hyperreactivity in, 358 oral beta agonist vs

theophylline in, 361-362

oral beta agonists in, 360 oral methylxanthines in, 361

Alpha-adrenergic receptor, overdose of,436-437

Alpha-l agonist, overdose of, 446-447

Alpha-2 agonist, overdose of, 446-447

Aluminum hydroxide, in peptic ulcer disease, 154

Amantadine, overdose of, 452-453 Amikacin, 254 Amiloride, 191

in hypokalemia, 180-182 Aminoglycoside, 254

in central nervous system infection, 243-244

Aminoglycoside therapy pharmacokinetics, 35-39

clinical problem in, 35-36 general results of, 36-38 hemodialysis and, 38-39

Amitriptyline, in depression, 376 Amoxapine, in depression, 377-378 Amphetamine

abuse of, 482-484 overdose of, 437-439

Ampicillin, in central nervous system infection, 238-239

Angina, 83-107 beta blockers in, 91-95 calcium channel blockers in, 95-

101 Heberden's, 101-102 nitrate esters in, 88-91 postinfarction, medical

management of, 103-104 Prinzmetal's variant, 103 stable, 101-102

unstable, 102-103 Angiotensin-converting enzyme

inhibitors, in hypokalemia, 183-184

Antacids, in peptic ulcer disease, 151-154

Anticholinergics in chronic airflow obstruction,

364 overdose of, 442-446 in peptic ulcer disease, 154-

156 Antidepressants, in peptic ulcer

disease, 166 Antidiuretic hormone secretion,

syndrome of inappropriate, diuretics in, 194

Antihistamines, overdose of, 453-455

Antimalarial drug, in rheumatoid arthritis, 310-311

in systemic lupus erythematosus, 342

Antiplatelet agents, in myocardial infarction, 127-128

Antithrombotic therapy, in myocardial infarction, 123-128

Anxiety, 367-373 antianxiety drugs in, 369-373

adverse effects of, 373 classes of, 369 clinical use of, 370-373 dosage in, 372 indications for, 370-371 metabolism of, 370 overdose of, 373 pharmacokinetic differences in,

370

Index

Anxiety (cont.) pharmacologic actions of, 369-

370 treatment in, 372

classification of, 368-369 generalized, 368 manifestations of, 367 nondrug treatment of, 372-373 pathophysiology of, 367 performance, 369

Apheresis, in rheumatoid arthritis, 314-315

Appendectomy, prophylactic antibiotics in, 261

Artificial joints, prophylactic antibiotics in, 258

Asthma, 352-357; see also Airflow obstruction, acute reversible

Atenolol intravenous, in acute-phase MI,

118 overdose of, 451

Atropine, overdose of, 434, 445 Azathioprine, in rheumatoid

arthritis, 312 Azlocillin, 250

Barbiturates abuse of, 484-487 overdose of, 414-416

Benzimidazoles, in peptic ulcer disease, 165-166

Benzodiazepine abuse of, 487-488 overdose of, 421-424

Beta adrenergic receptor, overdose of,437

Beta agonist inhaled, in chronic airflow

obstruction, 360 oral,360

Beta blockers in angina, 91-95 in essential hypertension, 207-

208 in experimental ischemia!

infarction, 114-115 in hypokalemia, 183 intravenous, in acute-phase MI,

116-119 intrinsic sympathomimetic

activity of, 93 lipid solubility of, 94 membrane stabilizing effect of,

94

in myocardial infarction, 113-119

myocardial oxygen supply and demand and, 92

oral, in long-term post-MI cardioprotection, 115-116

overdose of, 449-452 platelet aggregation and, 92 rebound effect after, 95 selective beta-l blockade by, 93 side effects of, 95 types of, 92-93, 93t water solubility of, 94-95

Beta stimulants, overdose of, 447-449

Biliary surgery, prophylactic antibiotics in, 259

Bordetella pertussis, prophylactic antibiotics in, 281

Brain, antibiotic penetration into, 245

Bretylium, in myocardial infarction, 112

Bumetanide, 190 Butorphanol, overdose of, 436

Caffeine, overdose of, 449 Calcium carbonate, in peptic ulcer

disease, 153-154 Calcium channel

myocardial contraction and, 96-97

myocardial depolarization and, 95-96

vascular smooth muscle contraction and, 97

voltage- vs receptor-dependent, 97-98

Calcium channel blockers in angina, 95-101 in congestive heart failure, 144-

145 general properties and effects of,

98-99 in myocardial infarction, 122

Captopril, in congestive heart failure, 143-144

Carbenoxolone sodium, in peptic ulcer disease, 167

Cardiac surgery, prophylactic antibiotics in, 257

Cefamandole, 253 Cefazolin, 252 Cefonocid, 252 Cefoperazone, 253 Cefotaxime, 253

Cefoxitin, 253 Ceftizoxime, 253 Cefuroxime, 253

511

Central adrenergic inhibitors, in essential hypertension, 208

Central nervous system, pharmacological aspects of, 234-237

active transport mechanisms and, 237

lipid solubility and ionization in, 235-236

molecular size and protein binding in, 235

permeability alterations and, 236-237

Central nervous system infection, 234-249

aminoglycoside in, 243-244 ampicillin in, 238-239 anti staphylococcal penicillin and

vancomycin in, 242-243 bacterial etiology of, 234 cephalosporin in, 239-242 chloramphenicol in, 237-238 metronidazole in, 245 penicillin Gin, 238-239 trimethoprim-sulfamethoxazole

in, 245 Cephalosporin, 250-254

in central nervous system infection, 239-242

first-generation, 252-253 second-generation, 253 third-generation, 253-254 toxicity of, 252

Cephalothin, 252 Cephapirin, 252 Cephradine, 252 Cesarean section, prophylactic

antibiotics in, 259-260 Chemotherapy, prophylactic

antibiotics in, 278-280 Chloral hydrate, overdose of, 416-417 Chloramphenicol, in central nervous

system infection, 237-238 Chlordiazepoxide, overdose of, 422 Chlorpropamide, overdose of, 425-

426 Chlorthalidone, 191 Cimetidine

absorption of other drugs and, 160--161

drug metabolism and, 161 in duodenal ulcer, 157-161 in erosive gastritis and

duodenitis. 158

512

in gastric cancer, 161 in gastric ulcer, 157 in gastrinoma (Zollinger-Ellison

syndrome), 157-158 in gastrointestinal hemorrhage,

158-159 overdose of, 454-455 pharmacology of, 159 ranitidine vs, 164 in recurrent ulcer, 157 in reflux esophagitis, 158 side effects of, 159-160

Cirrhosis with ascites, diuretics in, 192-193

Clavulinic acid, 250 Clearance, 3-4 Clindamycin, 254 Clonazepam, overdose of, 422 Clonidine, overdose of, 446 Clorazepate, overdose of, 423 Cocaine, overdose of, 440-442 Codeine, overdose of, 432 Colloidal bismuth subcitrate, in

peptic ulcer disease, 166-167

Colon resection, prophylactic antibiotics in, 261

Coma scales, 405-406 Congestive heart failure, 135-150

calcium channel blockers in, 144-145

captopril in, 143-144 diuretics in, 191-192 dopaminergic agonists in, 145 enalapril in, 144 hydralazine in, 140-141 mechanisms of, 136-137 minoxidil in, 141 nitrate esters in, 139-140 nitroglycerin in, 139-140 pathophysiology of, 135-137 phentolamine on, 141-142 prazosin in, 142-143 prostaglandins in, 145 sodium nitroprusside in, 138-139 trimazosin in, 143 vasodilator treatment of, 137-

145

Converting enzyme inhibitors, in essential hypertension, 208-209

Coronary artery disease incidence of, 83 therapy for, 83

Coronary blood flow, 84-88 autoregulation of, 85 exercise and, 86

myocardial oxygen consumption and, 84

myocardial oxygen demand and, 84

myocardial oxygen supply and, 84-85

obstruction of, 86-88 Coumarin, in myocardial infarction,

127 Cromolyn, in chronic airflow

obstruction, 364 Cyclophosphamide, in rheumatoid

arthritis, 313-314

D-penicillamine, in rheumatoid arthritis, 308-309

Decay factor, 1-3 Depression, 373-381

drug therapy in, 374-381; see also individual drugs

adverse effeCts of, 379-380 doses in, 378-379 drug choice in, 378 indications for, 378 maintenance therapy in, 379 MAO inhibitors in, 376-377 mechanism of action in, 374-

375 overdoses of, 380-381 plasma concentration in, 379 refractory patients and, 379 second-generation drugs in, 377-

378 sympathomimetics in, 377 tricyclics in, 375-376

Desipramine, in depression, 375 Dextroamphetamine

in depression, 377 overdose of, 440

Diabetes insipidus, nephrogenic, diuretics in, 194

Diarrhea, traveler's, prophylactic antibiotics in, 274-275

Diazepam, overdose of, 423 Diethylpropion, overdose of, 440 Digitoxin and digoxin therapy,

pharmacokinetics of, 57-79 in atrial fibrillation and flutter,

64 case studies of digitalis toxicity

in, 68-72 clinical judgment in,77-79 digitoxin as preferred glycoside

and,76-77 digoxin-quinidine interaction in.

65-68

Index

loading dose and period of doubt in, 62-63

management of digitalis toxicity in, 72

mechanisms of digitalis toxicity in, 68

omitting loading dose in, 60-62 patterns of presentation of

digitalis toxicity in, 60 peripheral compartment control

and, 58 prevention of digitalis toxicity in,

73-76 representative digoxin program

in, 58-60 in sinus rhythm, 63-64 therapy goals in, 63

Diltiazem, in angina, 101 Dimethoxy-methylamphetamine,

overdose of, 458-459 Dimethyltryptamine, overdose of,

458 Diphenoxylate, overdose of,

434 Diuretics, 187-199; see also

individual types distal tubule effects of, 189-190 in essential hypertension, 205-

207 indications and uses of, 191-194 loop, 190 loop of Henle effects of, 189 pharmacokinetic drug interactions

with, 197 pharmacologic drug interactions

with, 196-197 potassium-sparing, 191 proximal tubule effects of, 188-

189 side-effects of, 195-196 site and mechanism of action of,

188-190 thiazide-like, 191

Dobutamine in myocardial infarction, 122-

123 in shock, 227-228

Dopamine hemodynamic effects of, 229-

230 increased urine output with, 231 in myocardial infarction. 122-

123 in shock, 227 volume expansion with, 229

Dopamine stimulant, overdose of, 452-453

Index

Dopaminergic agonists, in congestive heart failure, 145

Doxepin, in depression, 376 Drug distribution, I

delayed, 6-7 Drug overdose, 405-476

assessing degree of intoxication in, 405-406

clinical studies of, 465 coma scales in, 405-406 diuresis in, 412 general management principles

in, 409-412 grand mal seizure in, 411 hallucinogenic, 455-460

autonomic disturbance in, 457 panic reactions in, 457 patterns of intoxication in,

456-457 psychedelic pattern of, 456-

457 psychic depression in, 457 serotonin effects of, 455-456

history in, 407-408 hyperpyrexia in, 411 hypotension and hypertension in,

410 hypothermia in, 410-411 laboratory tests in, 412 narcotic, 427-436; see also

individual drugs agonist/antagonist type, 435-

436 meperidine and derivatives in,

433-435 methadone and derivatives in,

432-433 morphine and derivatives in,

431-432 naloxone in, 428-429 principles of treatment in,

429-430 pulmonary edema in, 430 vital signs in, 427-428

neuroleptic malignant syndrome in, 463-464

organic catatonic syndrome in, 462-463

patient evaluation in, 406-409 physical examination in, 408-409 prevention of Gl tract drug

absorption in, 411-412 removal of unabsorbed drug from

intestines in, 411 removal of unabsorbed drug from

stomach in, 411 respirations in, 409-410

sedative/hypnotic, 413-427; see also individual drugs

ancillary signs in, 414 barbiturates in, 414-416 benzodiazepines, 421-424 hypoglycemic agents, 424-427 motor signs in, 414 nonbarbiturates in, 416-421 sensorium in, 413-414 vital signs in, 413

seizure-coma pattern in, 460-462 unknown drug and, 461-462

stimulant, 436-453 adrenergic stimulants, 436-442 alpha-2 or alpha-I agonist,

446-447 anticholinergics, 442-446 beta-adrenergic blocker, 449-

452 beta-adrenergic stimulant, 447-

449 dopamine, 452-453

support of vital signs in, 409-411 toxicology tests in, 464-465

Drug reactions, adverse, 397-404 data on, 399-400 drug usage and, 398-399 formal studies of, 401 -402 frequency of, 398 in-hospital morbidity and

mortality in, 400-401 out-of-hospital morbidity in, 401 severity of, 398 time of onset of, 398

Drug-drug interactions, 382-396 clinical characteristics of, 382-

383 combined toxicity in, 385 mechanisms of, 383-385 pharmacodynamics of, 385 pharmacokinetics of, 383-384 types of, 385-396

Duodenal ulcer, cimetidine in, 157-161

Duodenitis, cimetidine in, 158

Edema idiopathic cyclic, diuretics in,

193 in pregnancy, diuretics in, 193

Enalapril, in congestive heart failure, 144

Endocarditis, bacterial, prophylactic antibiotics in, 272-274

Ephedrine, in chronic airflow obstruction, 362

513

Epinephrine, in shock, 227 Esophagitis, reflux, cimetidine in,

158 ranitidine in, 163

Ethacrynic acid, 190 Ethanol, overdose of, 418-419 Ethchlorvynol, overdose of, 417-

418 Etintidine, in peptic ulcer disease,

164-165 Exercise, coronary perfusion and,

86

Famotidine, in peptic ulcer disease, 165

Felty's syndrome, 291, 315 Flurazepam, overdose of, 423 Furosemide, 190

Gastric cancer, cimetidine and, 161 Gastric ulcer

cimetidine in, 157 ranitidine in, 162

Gastrinoma cimetidine in, 157-158 ranitidine in, 163

Gastritis, erosive, cimetidine in, 158

Gastroduodenal surgery, prophylactic antibiotics in, 259

Gastrointestinal hemorrhage cimetidine in, 158-159 ranitidine in, 162-163

Glibenclamide, overdose of, 426 Glutethimide, overdose of, 419-420 Gold compounds, in rheumatoid

arthritis, 306-308 Gonorrhea, prophylactic antibiotics

in, 281

Head and neck surgery, prophylactic antibiotics in, 258-259

Heparin, in myocardial infarction, 127

Heroin, overdose of, 431-432 Histamine H2-receptor antagonists,

in peptic ulcer disease, 156-165

Histamines, overdose of, 453 Hydralazine

in congestive heart failure, 140-141

514

in essential hypertension, 209 Hypercalcemia, diuretics in, 194 Hypercalciuria, idiopathic, diuretics

in, 194 Hypertension

diuretics in, 193-194 essential, 200-215

beta-adrenergic blockers in, 207-208

central adrenergic inhibitors in, 208

compliance to therapy in, 202 converting enzyme inhibitors

in, 208-209 diuretics in, 205-207 hydralazine in, 209 indications for treatment of,

200-201 isolated systolic, 201 medication stepdown in, 203 minoxidil in, 210 pharmacologic treatment of,

201-203 prazosin in, 209-210 reserpine in, 207 resistance to therapy in, 202-

203 Step 1 pharmacologic agents

in, 203-204 Step 2 pharmacologic agents

in, 204-205 Step 3 pharmacologic agents

in, 205 Step 4 pharmacologic agents

in, 205 thiazide in, 205-207

malignant, 216--224 emergency vs crisis in, 217 grade III and IV retinopathy

in, 217 initial treatment of, 218-220 maintenance therapy in, 220 rapid oral titration of

antihypertensive drugs in, 220-221

urgency of treatment in, 216-217

Hyperviscosity syndrome, 291, 316 Hypoglycemic agents, overdose of,

424-427 Hypokalemia, 175-186

amiloride in, 180-182 angiotensin-converting enzyme

inhibitors in, 183-184 beta-adrenergic blockers in, 183 clinical manifestations of, 175-

176

etiologic factors in, 176-177 potassium-sparing agents in,

180-185 potassium supplements in, 177-

180 prevention of, 177 salt substitutes in, 179 spironolactone in, 182-183 triamterene in, 182 trilostane in, 184

Hysterectomy abdominal, prophylactic

antibiotics in, 260 vaginal, 259

Imipramine, in depression, 375 Indapamide, 191 Influenza, prophylactic antibiotics

in, 277-278 Insulin, overdose of, 425 Intermittent infusion kinetics, 4 Intoxication, 405-406 Isoproterenol

hemodynamic effects of, 229-230

in hidden volume deficit, 230-231

in shock, 228

Labetalol, overdose of, 451 Lidocaine therapy

in myocardial infarction, 110-111 pharmacokinetics of, 47-56

achieved serum levels and, 48-49

clinical outcome evaluation in, 49-50

computer program feedback approach to, 52-54

feedback approaches to, 52 serum level goals in, 54-56 smart infusion apparatus in,

56-57 timing of serum levels in, 50-

51 Loperamide, overdose of, 434-435 Lorazepam, overdose of, 424 Lupus erythematosus, systemic,

328-351 antimalarial drugs in, 342 arthritis in, 329 carditis in, 333 central nervous system

involvement in, 346 in children, 336

clinical picture in, 328 contraception and, 335 course of, 336

Index

cutaneous signs in, 328-329 death in, 333-334 definition of, 328 diagnosis and differential

diagnosis of, 336 drug-induced, 336--337 etiology and pathogenesis of,

338-339 female reproductive system and

pregnancy in, 334-336 gastrointestinal involvement in,

333 hematologic involvement in,

332-333 infections in, 336 laboratory-findings in, 337-338 mild, 340-343 moderate severity, 343 myositis in, 333 neonatal, 335-336 nephritis in, 329-331, 344-346 neuropsychiatric manifestations

in, 331-332 nonsteroidal antiinflammatory

drugs in, 341-342 patient and family education in,

339-340 pleuropulmonary manifestations

of,333 pregnancy, delivery, and

postpartum period in, 346-347

reconstructive surgery in, 347 severe, 343-347 social, physical medicine,

rehabilitation services in, 340

subsets, antinuclear antibodies, genetics in, 334

sunscreens in, 342 survival in, 347 systemic steroids in, 342-343 therapy in, 339-347 topical steroids in, 342

Lymphoid irradiation, total, in rheumatoid arthritis, 315

Lysergic acid diethylamide, overdose of, 457-458

Magnesium hydroxide, in peptic ulcer disease, 154

Malaria, prophylactic antibiotics in, 267-268

Index

Maprotiline, in depression, 378 Meningitis

H. influenzae type B, prophylactic antibiotics in, 269-270

meningococcal, 269 Meperidine, overdose of, 433-434 Meprobamate, overdose of, 420 Mescaline, overdose of, 459 Methadone, overdose of, 432-433 Methamphetamine, overdose of,

440 Methaqualone, overdose of, 420 Methotrexate, in rheumatoid

arthritis, 312-313 p-Methoxyamphetamine, overdose

of,459 Methprylon, overdose of, 421 Methylene-dioxyamphetamine,

overdose of, 459 Methylprednisolone, pulse, in

rheumatoid arthritis, 314 Methylxanthine, oral, in chronic

airflow obstruction, 361 Metolazone, 191 Metoprolol

intravenous, in acute-phase MI, 117-118

overdose of, 451 Metoptolol, oral, in long-term post­

MI cardioprotection, 116 Metronidazole, 254

in central nervous system infection, 245

MezlociIIin, 250

Minoxidil in congestive heart failure, 141 in essential hypertension, 210

Morning glory seeds, overdose of, 458

Morphine, overdose of, 431 Moxalactam, 253 Muscarinic cholinegic receptors,

overdose of, 442-443 Myocardial contraction, calcium

channels and, 96--97 Myocardial depolarization, calcium

channels and, 95-96 Myocardial infarction, 108-134

antiarrhythmic therapy in, 110-113

antiplatelet agents in, 127-128 anxiety relief in, 108 beta-adrenergic blockers in, 113-

119 bretylium in, 112 calcium channel blockers in, 122

chest pain relief in, 108 congestive failure relief in, 108-

109 coumarin in, 127 dobutamine in, 122-123 dopamine in, 122-123 general principles of therapy in,

108-110 heparin in, 127 infarct size reduction in, 109 lidocaine in, II 0-1l1 nifedipine in, 122 nitroglycerin in, 119-120 nitroprusside in, 120-122 procainamide in, 11l-1l2 secondary prevention, post-MI in,

109-110 streptokinase in, 124-127 thrombolytic and antithrombotic

therapy in, 123-128 tissue plasminogen activator in,

127 vasodilator therapy in, 119-122 vasopressor/inotropic agents in,

122-123 ventricular arrhythmias in, 112-

113 Myocardial oxygen consumption,

84 Myocardial oxygen demand, 84

beta blockers and, 92 nitrate therapy and, 89

Myocardial oxygen supply, 84-85 beta blockers and, 92 nitrate therapy and, 89

Myocardial performance, determinants of, 135-136

Nadolol, overdose of, 451 Nalbuphine, overdose of, 436 Naloxone, 428-429 Neonatal gonococcal ophthalmia,

prophylactic antibiotics in, 280-281

Nephrotic syndrome, diuretics in, 193

Netilmycin, 254 Neuroleptic malignant syndrome,

463-464 Neurosurgery, prophylactic

antibiotics in, 257-258 Nicotinic cholinegic receptors,

overdose of, 443 Nifedipine

in angina, 99-100 in myocardial infarction, 122

515

Nitrate esters in angina, 88-91 as arterial dilators, 89-90 as coronary artery dilators, 90 as systemic venodilators, 89 in congestive heart failure, 139-

140 tolerance of, 91 various preparations of, 90-91

Nitrazepam, overdose of, 424 Nitroglycerin

in congestive heart failure, 139-140

in myocardial infarction, 119-120

vs nitroprusside, 120-122 Nitroprusside

in myocardial infarction, 120-122

vs nitroglycerine, 120-122 Nonmedical prescription drug use,

477-493 aftercare strategy in, 491-492 amphetamine and stimulant abuse

in, 482-484 barbiturate and sedative-hypnotic

abuse in, 484-488 definitions of, 479-480 diagnostic principles in, 480 impaired functioning in, 480-481 multiple-drug abuse in, 481 opiate abuse in, 488-490 patterns of, 477-479 substance abuse crisis in, 490-

491 underlying psychopathology in,

481-482 Nonsteroidal antiinflammatory

drugs, 298-304 administration of, 298-301 efficacy of, 30 I mechanism of action of, 298 pharmacokinetics of, 298 side effects of, 301-304

central nervous system, 303 drug interactions, 304 gastrointestinal, 301-302 hepatotoxicity, 303 hypersensitivity, 303-304 platelet. 303 renal, 302-303

in systemic lupus erythematosus, 341-342

Norepinephrine hemodynamic effects of, 229-

230 in shock, 227

516

Nortriptyline, in depression, 376 Nutmeg, overdose of. 459-460

Obsessive-compulsive disorders, 369

Opiate, abuse of, 488-490 Organic catatonic syndrome, 462-

463 Organomercurials, 190 Otitis media, prophylactic

antibiotics in, 277 Oxazepam, overdose of, 424 Oxmetidine, in peptic ulcer disease,

164 Oxprenolol, oral, in longer-term

post -MI cardioprotection, 116

Panic disorders, 368 Penicillin, anti staphylococcal , in

central nervous system infection, 242-243

Penicillin G, in central nervous system infection, 238-239

Pentazocine, overdose of, 435-436 Peptic ulcer disease, 151-174

aluminum hydroxide in, 154 antacids in, 151-154 anticholinergics in, 154-156 antidepressants in, 166 calcium carbonate in, 153-154 carbenoxolone sodium in, 167 cimetidine in, 157-161 colloidal bismuth subcitrate in,

166-167 etintidine in, 164-165 famotidine in, 165 histamine H2-receptor antagonists

in, 156-165 magnesium hydroxide in, 154 oxmetidine in, 164 pirenzepine in, 155 prostaglandins in, 168-169 ranitidine in, 161-164 sodium bicarbonate in, 153 substituted benzimidazoles in,

165-166 sucralfate in, 167-168 tiotidine in, 164

Performance anxiety, 369 Pharmaceutical industry, 500-509

future perspectives of, 508-509 innovation in, 504-506 marketing contribution and, 507-

508

physician collaboration with, 500-502

planning and research in, 506-507

research and, 502-504 Pharmacokinetics

absorption in, 4-6 clearance in, 3-4 clinical applications of, 26-82

adequate vs optimal care in, 32-33

aminoglycoside therapy and, 35-39

digitoxin and digoxin therapy, 57-79

initial dosage regimen in, 29-31 initial therapeutic goal and, 31 least-squares fitting procedure

in, 33-34 lidocaine therapy and, 47-56 maximum a-posteriori

probability Bayesian fitting procedure in, 34-35

physician and clinical pharmacist and, 46-47

renal function evaluation and, 26-29

therapeutic drug monitoring and,39-46

traditional therapeutic ranges and,31-32

upper acceptable risk of adverse reactions in, 32

decay factor in, 1-3 delayed drug distribution in, 6-7 dosing modification in renal

impairment and, 7-8 drug distribution in, I intermittent infusion kinetics in, 4 multiple compartment model in,

6-7 nonlinear, 8-9 principles of, 1-12

Phenelzine, in depression, 376-

377 Phenmetrazine, overdose of, 440 Phentermine resin complex,

overdose of, 440 Phentolamine, in congestive heart

failure, 141-142 Phenylpropanolamine, overdose of,

440 Phobias, 368 Pindolol, overdose of, 452 Piperacillin, 250 Pirenzepine, in peptic ulcer disease,

155-156

Index

Platelet aggregation, beta blockers and,92

Pneumocystis carinii, prophylactic antibiotics in, 270-271

Potassium sources, dietary, 177-178

Potassium-sparing agents, in hypokalemia, 180-185

Potassium supplements, in hypokalemia, 177-180

Prazosin in congestive heart failure, 142-

143 in essential hypertension, 209-

210 Pregnancy

rheumatoid arthritis in, 316 systemic lupus erythematosus

and, 334-336, 346-347 Prescribing practices, 494-499

current research on, 497-498 nonscientific determinants of,

494-496 social basis for, 496

Procainamide, in myocardial infarction, 1l1-112

Prophylactic antibiotics, 250-287 . medical, 265-282 newer antimicrobials as, 250-254 in surgery, 254-265 clean contaminated surgery, 258-

260 clean surgery, 256-258 contaminated surgery, 260-261 cost of drugs and, 264 dirty surgery, 261-262 duration of therapy and, 263-264 pharmacokinetics and, 262-265 principles of, 255 randomized trials and, 264 rationale for, 255-256 route of administration and, 264 spectrum of drug activity and,

262-263 Propoxyphene, overdose of, 433 Propranolol

intravenous, in acute-phase Ml, 118-119

oral, in long-term post-MI cardioprotection, 115-116

overdose of, 452 postinfarction, 103-104

Prostaglandins in congestive heart failure, 145 in peptic ulcer disease, 168-169

Protriptyline, in depression, 376 Psilocybin, overdose of, 458

Index

Quinethazone, 191

Ranitidine cimetidine vs, 164 in gastric ulcer, 162 in gastrinoma, 163 in gastrointestinal hemorrhage,

162-163 in peptic ulcer disease, 161-164 pharmacology in, 163 in reflus esophagitis, 163 side effects of, 163-164

Reflux esophagitis cimetidine in, 158 ranitidine in, 163

Renal failure, acute, diuretics in, 194

Renal function evaluation, in pharmacokinetics, 26-29

Renal impairment, dosing modification in, 7-8

Reserpine, in essential hypertension, 207

Rheumatic fever, prophylactic antibiotics in, 268-269

Rheumatoid arthritis, 288-327 aggressive, 305-311

antimalarial drugs in, 310-311 D-penicillamine in, 308-309 gold compounds in, 306-308 oral steroids in, 311 slow-acting, remittive

antirheumatic drugs in, 305-311

course of, 293 diagnosis and differential

diagnosis of, 292-293 early and mild, 297-305

intraarticular steroid injections in, 304-305

nonsteroidal antiinflammatory drugs in, 298-304

physical medicine measures in, 305

etiology of, 294-295 evaluation of, 293 evolution and complications of

joint involvement in, 289 extraarticular, 289-291 juvenile, 291-292, 317-318 laboratory findings in, 293-294 pathogenesis of, 295 patient and family education in, 296

in pregnancy, treatment of, 316 presentation and joint

involvement in, 288-327

radiographic evaluation in, 294 reconstructive surgery in, 317 refractory, 311-315

apheresis in, 314-315 azathioprine in, 312 cyclophosphamide in, 313-314 cytotoxic agents in, 312 immunomodulator drugs in,

314 methotrexate in, 312-313 methylprednisolone in, 314 total lymphoid irradiation in,

315 sex hormones, pregnancy and,

293 Still's disease in, 288-289 therapy in, 295-318

Rheumatoid nodules, 290 Rheumatoid vasculitis, 290, 315

Salt substitutes, in hypokalemia, 179

Scopolamine, overdose of, 445 Sedative-hypnotics, abuse of, 484-

487 Shock

dobutamine in, 227-228 dopamine in, 227 epinephrine in, 227 isoproterenol in, 228 norepinephrine in, 227 sympathomimetic amines alone or

in combination in, 228-231 sympathomimetic amines in,

225-233 Sjogren's syndrome, 291,316 Sodium bicarbonate, in peptic ulcer

disease, 153 Sodium nitroprusside, in congestive

heart failure, 138-139 Spironolactone, 191

in hypokalemia, 182-183 Steroids

in acute reversible airflow obstruction, 354

in chronic airflow obstruction, 362-363

injections, intraarticular, in rheumatoid arthritis, 304-305

oral, in rheumatoid arthritis, 311

systemic, in systemic lupus erythematosus, 342-343

topical, 342 Still's disease, 288-289

517

Stochastic control of pharmacokinetic systems, 13-25

one-stage decision problems in, 13-17

cost functions in, 14-15 deterministic models I, 13-14 optimal control strategies in,

15-16 separation principle control in, 16 uncertain dynamics I in, 16-17 uncertain parameters in, 14

two-stage decision problems in, 17-24

closed loop control in, 19-20 deterministic models II in, 17 LQG control and, 22-23 multiple model adaptive

control, 23-24 open loop control in, 17-18 open loop feedback control in,

18-19 separation principle in, 19 the lady or the tiger?, 20-22 uncertain dynamics II and, ~2-23 uncertain measurements in,

18-19 uncertain parameters in, 17-18

Streptokinase intracoronary, in myocardial

infarction, 124-126 intravenous, 126-127

Sucralfate, in peptic ulcer disease, 167-168

Sulbactam, 250 Sulfonylurea, overdose of. 425 Sympathomimetic amines

alone or in combination, in shock, 228-231

alpha adrenoceptors as, 225 beta-I adrenoceptors as, 225 beta-2 adrenoceptors as, 225 clinical use of, 226-227 DA-I receptors as, 225-226 DA-2 receptors as, 226 overdose of, 440-442 pharmacologic actions of. 227-

228 in shock, 225-233 spectrum of activity of. 226

Syphilis, prophylactic antibiotics in, 281

Theophylline in chronic airflow obstruction,

361-362

518

overdose of, 447-448 Therapeutic drug monitoring, 39-46

amount of serum levels in, 39-42 timing of serum levels in, 42-46

Thiazide, 190-191 in essential hypertension, 205-

207 Thoracic surgery, noncardiac,

prophylactic antibiotics in, 259

Thrombolytic therapy, in myocardial infarction, 123-128

Timolol intravenous, in acute-phase MI,

118 oral, in long-term post-MI

cardioprotection, 115 overdose of, 452 postinfarction, 103-104

Tiotidine, in peptic ulcer disease, 164

Tissue plasminogen activator, in myocardial infarction, 127

Tolazamide, overdose of, 426 Tolbutamide, overdose of, 426

Tranylcypromine, in depression, 377

Traveler's diarrhea, prophylactic antibiotics in, 274-275

Trazodone, in depression, 378 Triamterene, 191

in hypokalemia, 182 Triazolam, overdose of, 424 Trilostane, in hypokalemia, 184 Trimazosin, in congestive heart

failure, 143 Trimethoprim-sulfamethoxazole, in

central nervous system infection, 245

Tuberculosis, prophylactic antibiotics in, 271-272

Urinary tract infection, prophylactic antibiotics in, 275-277

Urine formation, physiology of, 187-188

Urologic surgery, prophylactic antibiotics in, 260

Vaginal hysterectomy, prophylactic

Index

antibiotics in, 259 Vancomycin, in central nervous

system infection, 242-243 Vascular smooth muscle

contraction, calcium channels and, 97

Vascular surgery, prophylactic antibiotics in, 257

Vasodilator in congestive heart failure, 131-

145 in myocardial infarction, 119-

122 Vasopressor/inotropic agents, in

myocardial infarction, 122-123

Ventricular arrhythmia, in myocardial infarction, 112-113

Verapamil, in angina, 100-101

Yohimbine, overdose of, 442

Zollinger-Ellison syndrome, cimetidine in, 157-158