Pharmacology [antikvár]

PrefaceFor Ihis fifth edition, as in the previous four, our approach has been not just to describe what drugs do, but to emphasise the mechanisms by which they act where possible at the cellular and molecular level. Therapeutic agents have a high rate of obsolescence and new ones appear each year. An appreciation of the mechanisms of action of the class of drugs to which a new agent belongs provides a good starting point for understanding and using the new compound intelligently.Pharmacology is a lively scientific discipline in its own right, with an importance beyond that of providing a basis for the use of drugs in therapy. We have therefore, where appropriate, included brief coverage of the use of drugs as probes for elucidating cellular and physiological functions, even when the compounds have no clinical uses.We have retained the short summaries of relevant physiological and biochemical processes, placed at the beginning of most chapters, to form a basis for the subsequent discussion of phanmacological actions. As before, short sets of key points are placed in boxes throughout the text. These are not intended as comprehensive summaries but rather to highlight pharmacological information that we consider important. Factual knowledge in pharmacology is so extensive and expanding so rapidly that students can easily find the information load daunting, and these key points are intended to make it easier for students to gets to grips with the essentials of the subject. And as in the fourth edition, the therapeutic use of drugs has been given prominence by setting it out in easily identified 'clinical boxes'.In this edition, as will already be apparent to the astute observer, we have gone into riotous colour. Most diagrams have been updated, all have been redrawn in colour, and many new figures have been added. Continuing the approach used in earlier editions, we have, wherever feasible, used real data in our diagrams rather than notional information. As previously, we have put emphasis on the chemical structures of drugs where this information helps in understanding how the drugs act, and we have omitted many chemical structures that do not add to pharmacological understanding in favour of diagrams that do.All chapters have been updated and an 'overview' section has been introduced at the beginning of each to help the reader get a flying start on that topic. In including new material, we have taken into account not only new agents but also recent extensions of basic knowledge which presage further drug development, and, where possible, we have given a brief outline of new treatments in the pipeline. New 'small print' sections have beenincluded in many chapters. These contain more detailed, sometimes speculative material, which can be skipped by the reader in a hurry without losing the main thread, but will be of interest to readers wishing to go into greater depth.As before, we have included fairly extensive sections on 'References and further reading' at the end of each chapter. Because the medical curriculum stresses project work and the preparation of special study modules, references have been annotated to emphasise the main aspects of their coverage and so make the Reference section easier for students to use.Section 1 now includes a new introductory chapter, and two new chapters on the cellular mechanisms that are affected by many important drugs described in later parts of the book. Chapter 4 deals with mechanisms involved in short term reactions such as excitation, contraction and secretion, which underlie the rapid actions of many drugs that affect the cardiovascular, nervous, respiratory and endocrine systems. Chapter 5 deals with cell proliferation and apoptosis: reactions that occur rather more slowly and are involved in more gradually developing phenomena, such as inflammation, immune responses, tissue repair and malignancies, and are affected by drugs used for these conditions. These chapters bring together, update and extend information that was previously scattered throughout the book, and are intended to establish the common ground on which many, at first sight very different, drug effects are based, not only drugs in use but drugs in development or being planned.A new chapter on 'Drug discovery' looks at the rapid progress that is occurring in this field, driven by advances in molecular biology. It contains a brief account of the regulatory controls involved in putting a new drug on the market.In addition to these new chapters, and extensive updating throughout, the following new information has been included:The use of disease models, including transgenic animal models, in drug testing (Ch. 6).The role of innate immunity and of the significance of the two wings of the adaptive immune responsenew knowledge likely to be important for drug treatment in the future (Ch. 15).The molecular control of nitric oxide biosynthesis, and the more controversial issues of transport and export of biologically active nitric oxide by red blood cells (Ch. 14).Endothelium-derived mediators, including endothelin and the elusive endothelium-derived hyperpolarising factor (Ch. 18).