P

Packaging, compliance, 22
PAE (pro-antibiotic effect), antimicrobial drugs, 163
Paediatric patients
adrenal steroids, 566
anaesthesia, 309
antiepilepsy drugs, 351, 353
drug effects, 103–104
meningitis, 197
psychotropic drugs, 346–347
PAF (platelet-activating factor), inflammation, 241, 241f
Paget's disease of bone, 624
PAI-1 (plasminogen activator inhibitor 1), 491
Pain, 277–293
acute, 280–281
cancer-related, 281
chronic, 281
classification, 280–281
definition, 278–279, 279f
evaluation, 281
treatment See Analgesics
Paliperidone, 326t
Palivizumab, 222
Palliative therapy, neoplastic disease, 510
Pamaquin, 162
Pamidronate, 621
hypercalcaemia treatment, 619
Paget's disease of bone, 624
Pancreas, 555
Pancreatin (Cotazym/Nutrizyme), 555
Pancreatitis, acute See Acute pancreatitis
Pancuronium, 303
Panic disorder (PD), 331
treatment, 332t
Pantoprazole, 530
Papaveretum, 287
Papaverine, 401, 465–466
Para-aminosalicylic acid (PAS), 209
Paracentesis, abdominal, 550
Paracetamol (acetaminophen), 246, 282
migraine therapy, 293
overdoses, 122
plasma half-life, 84t
Paraesthesia, 281
Paraldehyde, 325
Parallel-group clinical trials, 47
Parallel groups, placebo-controlled trials, 39
Paranasal sinus bacterial infections, 192
Paranoia, cannabis, 157
Paraquat poisoning, 132–133
Parasitic infections
skin, 275 See also Helminth infestations specific diseases/disorders
Parasomnias, 337, 343–344
Parasympathetic nervous system, 373
Parasympathomimetic drugs, 464
Parathyroid hormone (PTH), 621
osteoporosis, 623
Parenteral administration, 85, 88–89
androgens, 601
inhalation, 88–89
intramuscular, 88
intravenous, 88
iron, 498
iron chelators, 500
morphine, 297
opioids, 285
subcutaneous, 88
Paricalcitol, 619
Parkinsonism, drug-induced, 366
Parkinson's disease, 359–366
comorbidities, 361
conservative therapy, 361
definition, 359
dopamine, 360
dopaminergic neurotransmission, 360
drug therapy, 361–366
cholinergic drugs, 361
dopaminergic drugs, 361–365 see also specific drugs
non-motor symptoms, 361
pathophysiology, 359–360, 360f
surgical therapy, 361
therapeutic objectives, 360–361
Paromomycin, 236
Paroxetine, 335
Paroxysmal supraventricular tachycardia, 438–439
Partial agonists
opioids, 287
receptors, 75–76
Partial seizures, 350
PASS (post-authorisation surveillance studies), 65
Passive diffusion, cell membrane passage, 79–80
Pastes, 262
Patient compliance, 21–23
evaluation, 23
  Page 656 
identification, 21
non-compliance, 22
over-compliance, 23
Patient–doctor relationship, non-compliance, 22
Patient effects, 103–107
age, 103–106
Patient information
appropriate, 20
prescribing drugs, 6
Patient Information Leaflets (PIL), 20–21, 64–65
Payment, human studies, 40
PBC (primary biliary cirrhosis), 551–552
PCI (primary coronary angioplasty), STEMI, 412
PCOS (polycystic ovary syndrome), 606
PD See Panic disorder (PD)
Pediculosis (lice), 269t
Pegfilgrastim, 508
Pegvisomant, 598
Pegylated interferons, 222
Pelvic inflammatory disease (PID), 201
PEM (Prescription Event Monitoring), 65
Pemphigoid, 269t
Pemphigus, 269t
drug adverse effects, 268
Penems, 179
Penicillamine, 130
as antidote, 128t
induced neuromuscular transmission disorders, 379
Penicillin, procaine, 175
Penicillin G See Benzylpenicillin (penicillin G)
Penicillins, 174–175
adverse effects, 174–175
antipseudomonal, 176
antistaphylococcal, 175
broad-spectrum, 175–176
cell wall inhibition, 173
cephalosporin cross-allergy, 177
endocarditis prophylaxis, 196
mode of action, 174
narrow-spectrum, 175
pharmacokinetics, 174 see also specific penicillins
Pentaerithrityl tetranitrate (Peritrate), 396
Pentamidine, 236
Pentazocine, 287
Pentostam (sodium stibogluconate), 236
Pentoxifylline (Trental)
alcoholic hepatitis, 552
intermittent claudication, 402
Peptic ulceration, 533, 533f
adrenal steroids, 564
Peramivir, 221
Percentages, 28
Pergoline, 363
Perindopril, 400
metabolism, 92t
Peripheral antitussives, 467–468
Peripheral arterial occlusion, 490
Peripheral blood flow, β-adrenoceptor-blocking drugs, 407
Peripheral decarboxylase inhibitors, 362
Peripheral neuropathies, 369
Peripheral sites, cough, 467
Peripheral sympathetic nerve terminals, 409–410
neurotransmitter synthesis inhibition, 410
Peripheral tissues, levodopa, 362
Peripheral vascular resistance, 404
Peritoneal dialysis, 127
Peritonitis, 199
subacute bacterial, 550
Peritrate (pentaerithrityl tetranitrate), 396
Permanently ionised drugs, 80–81
Pernicious anaemia, vitamin B12 deficiency, 501
Pesticide poisoning, 132–133
PET (positron emission tomography), 18
Pethidine (meperidine), 285t, 287–288
obstetric anaesthesia, 308
Phaeochromocytomas, 419–420
β-adrenoceptor-blocking drugs, 407
Phagocytes, inflammation, 241
Pharmaceutical Affairs Bureau (Japan), 63–64
Pharmacodynamics, 74–79
animal studies, 33
bioassay, 78
definition, 3
in disease, 106
dose–response relationships, 77, 77f
elderly, 105
ethanol, 143–145
liver disease, 546
mechanisms, 75
nicotine, 150–151
paediatric patient, 103
qualitative aspects, 74–77
quantitative aspects, 77–79
receptors, 75
standardisation, 79
tolerance, 78
Pharmacoeconomics, 24–26
economists' objective, 25
Pharmacoepidemiology, 51–53
adverse drug reactions, 112–114
case–control studies, 52
observational cohort studies, 51–52
prescription event monitoring, 51
surveillance systems, 52–53
Pharmacogenetics
drug discovery and development, 30
label information, 104t
Pharmacogenomics, 42
drug efficacy, 102
genome-wide association studies, 101–102
immune-mediated drug reactions, 102, 102t
single nucleotide polymorphisms, 101–102
toxicity, 102–103
variation sources, 101–102, 101f
Pharmacokinetics, 79–85
animal studies, 33
cell membrane passage, 79–81
carrier-mediated transport, 81
filtration, 81
ionisation at environmental pH, 80
passive diffusion, 79–80
permanently ionised drugs, 80–81
un-ionised drugs, 80
concentration time course, 83–85
definition, 3
in disease, 106
elderly, 105
ethanol, 142–143
food, 107
missed dose importance, 24
nicotine, 150
order of reaction, 81–83
first-order (exponential) process, 81–82
half-life, 83
zero-order (saturation kinetics) process, 82–83, 82f
plasma half-life, 83–84
cessation, 84
change of dosing, 83f, 84
constant dosing, 83, 83f
intravenous bolus injection, 82f, 83
in pregnancy, 106
skin, 260–267, 261f
steady-state concentration, 83–84 see also specific processes
Pharmacological efficacy, 78
Pharmacovigilance, 52–53
adverse drug reactions, 112–114
Pharyngeal gonorrhoea, 201
Pharyngitis, 192
chemoprophylaxis, 193
Phase 1 drug discovery and development, 40
Phase I metabolism, 92–93
  Page 657 
Phase 2 drug discovery and development, 41
Phase II metabolism, 93
Phase 3 drug discovery and development, 41
Phase 4 drug discovery and development, 41
Phenobarbital
antiepilepsy effects, 358
dosages, 355t
mode of action, 354
Phenoxybenzamine, 403
as antidote, 128t
phaeochromocytomas, 420
Phenoxy herbicide poisoning, 132
Phenoxymethylpenicillin, 193
Phentolamine, 128t, 403
phaeochromocytomas, 420
Phenycycline (angel dust), 153
Phenylalkylaimes, 396
Phenylpropanolamine (norephedrine), 389
Phenytoin
adjuvant analgesics, 291
anti-epileptic effects, 356–357
dosages, 355t
hormonal contraception interactions, 610
mode of action, 354
plasma protein binding, 91t
Pholcodine, 468
Phosphate
hypercalcaemia treatment, 621
inorganic, 621
Photoallergy, 266–267
Photophobia, chloroquine, 232
Photosensitivity, 266–267
tetracyclines, 182
Phototoxicity, 266
pH partition hypothesis, 80
Physical (physiological) dependence
definition, 137
tobacco smoking, 150
Physical examination, pain evaluation, 281
Physical factors, insomnia, 338b
Physician-induced (iatrogenic) disease, 9–10
Physiological (functional) antagonism, receptors, 76
Physiological dependence See Physical (physiological) dependence
Physostigmine, 375
Phytomenadione (Konakion), 484
as antidote, 128t
PID (pelvic inflammatory disease), 201
Pigmentation, drug adverse effects, 268
Pilocarpine, 375
Pimecrolimus, 274
Pindolol
chronic orthostatic hypotension, 391
therapeutic dose, 405t
Pioglitazone, 579t, 580
Piperacillin, 176
Piperazine, 238
Piretanide, 455
loop of Henle, 453–454
Piroxicam, 84t
Pityriasis capitis, 269t
Pityriasis rosea, 269t
Pivmecillinam, 176
urinary tract infections, 200
Pizotifen, 294
Placebo-controlled trials
crossover studies, 39
ethics, 39
homeopathy, 17
parallel groups, 39
utility of, 39
Placebo-reactors, 18
Placebos, 17–18
cure by suggestion, 18
definition, 17
negative reactors, 18
positron emission tomography, 18
psychological component, 17
Placenta, ionised drug pharmacokinetics, 81
Plant poisoning, 133, 133t
Plasma concentration
disease effects, 91
poisoning resuscitation, 124
therapeutic drug monitoring, 84–85
Plasma half-life, pharmacokinetics See Pharmacokinetics
Plasma lipoproteins, β-adrenoceptor-blocking drugs, 407
Plasma proteins
distribution, 90–91
drug binding, 547
oral combined contraceptive, 608
Plasma pseudocholinesterase, 304
Plasminogen activator(s), 483f
Plasminogen activator inhibitor(s), 491
Plasminogen activator inhibitor 1 (PAI-1), 491
Plasmodium falciparum infection See Malaria
Plasmodium infections See Malaria
Plasmodium malariae, 231
Plasmodium ovale, 231
Plasmodium vivax, 231
Platelet(s), 492–495
activation, 490f, 492
antidepressant effects, 319
membrane receptors, 492
Platelet-activating factor (PAF), inflammation, 241, 241f
Platinum drugs, 512t, 515
Pleura, bacterial infections, 193–195
Pneumococcal meningitis, 198
Pneumocystis, 223
Pneumonias, 194–195
anaerobic microorganisms, 195
atypical cases, 194
chronic lung disease, 194–195
community-acquired, 191, 194
following influenza, 194
hospital-acquired, 194
immunocompromised patient, 195
lobar, 194
segmental, 194
Poisoning
absorption prevention, 125–126
accidental, 122–123
biological substances, 133
chelating agents, 129–132
deliberate self-harm, 122
elimination acceleration, 126–127
gut decontamination, 125–126
heavy metals, 129–132
herbicides, 132–133
incapacitating agents, 133
initial assessment, 123
non-drug chemicals, 129–133
pesticides, 132–133
psychiatric assessment, 127–129
resuscitation, 123–124
shock, 390
social assessment, 127–129
specific antidotes, 127, 127t, 128t
supportive treatment, 124–125 See also Overdoses specific poisons
Polycystic ovary syndrome (PCOS), 606
Polycythaemia vera, 506
Polyenes, 223–225
Polymyalgia rheumatica, 258
Polymyxin B, 190
Polyneuropathies, inflammatory demyelinating, 369
Polypeptide antibiotics, 189–190 see also specific drugs
Polytherapy, antiepilepsy drugs, 351
Polythiazide, 456
PONV (postoperative nausea and vomiting), general anaesthesia, 297
Porcine insulin, 573
Pork tapeworm (Taenia solium), 237t
Porphyrias, adverse drug reactions, 114
Portal hypertension, hepatic, 406
Portal pressure, cirrhosis, 548
Posaconazole, 225, 226
Positron emission tomography (PET), 18
  Page 658 
Possible conviction, adverse drug reactions, 111
Post-authorisation surveillance studies (PASS), 65
Postcoital contraception, 610
Posterior pituitary hormones, 599
Posterior subcapsular cataract, 564
Post-licensing (marketing) studies, 65–66
drug discovery and development, 30
Postoperative nausea and vomiting (PONV), general anaesthesia, 297
Post-registration phase, therapeutic evaluation, 42, 43t
Post-traumatic stress disorder (PTSD), 334
treatment, 332t
Postural hypotension, labetalol, 409
Potassium
diabetes ketoacidosis, 583
diuretic drugs, 416
Potassium citrate, nephrolithiasis, 463
Potency, 78
Potentiation, drug interactions, 108
Powders, inhalational administration, 88–89
Power
clinical trials, 48
statistics, 45
PPIs See Proton pump inhibitors (PPIs)
Practolol, withdrawal, 63
Pragmatic trials, 43
Pralidoxime, 128t
Pramipexole, 363–364
Prasugrel, 493
Praxilene (naftidrofuryl), 402
Praziquantel, 238
Prazosin, 403
Precision, statistics, 45
Preclinical trials, regulatory reviews, 64
Prednisolone, 563
acute severe asthma, 477
alcoholic hepatitis, 552
asthma treatment, 477
myasthenia gravis treatment, 378
relative potencies, 562t
Pre-emptive suppressive therapy, antimicrobial drugs, 167
Pre-excitation syndromes, 441–442
Pregabalin (Lyrica)
adjuvant analgesics, 291
antiepilepsy drugs, 358
anxiety disorders, 336t
dosages, 355t
Pregnancy
adrenal steroids, 564
β-adrenoceptor-blocking drugs, 408
antimalarial drugs, 232
antiretroviral therapy, 216
antithyroid drugs, 590
benzodiazepines, 341
diabetes mellitus, 582
dopamine agonists, 599
epilepsy, 352
ethanol consumption, 148
folic acid deficiency, 503
hypertension, 417
hypothyroidism, 589
ketamine, 301
oral combined contraceptive, 607
pharmacokinetics, 106
prescribing drugs, 6
tobacco smoking, 152
tuberculosis therapy, 205
Preload, 420
reduction in heart failure, 423
Prematurity, folic acid deficiency, 503
Premenstrual tension, 612
Pre-registration phase, therapeutic evaluation, 42, 43t
Prescribing, 6–7
computer-issued prescriptions, 27
correct methods, 6
drug dependence (abuse), 139
elderly, 105–106
essential drugs, 18–21
guidelines, 18–21
improvement of, 12
insulin, 574–576
legal obligations, 21
liver disease, 547
problems/incorrect methods, 6–7, 7t
renal disease, 462–463
repeat prescriptions, 20
special risk groups, 100
warnings, 20–21
Prescription event monitoring
pharmacoepidemiology, 51
pharmacovigilance, 52–53
Prescription Event Monitoring (PEM), 65
Pressurised aerosols, 475–476
Presystemic (first-pass) elimination, gastrointestinal system, 87
Prevention (prophylaxis)
definition, 9
secondary, 9
Priadel, 329
Prilocaine
dosage, 307t
local anaesthesia, 306
Primaquine
malaria therapy, 230t, 233
mechanism of action, 228
non-falciparum malaria, 231
pharmacogenetics, 104t
Primary adrenocortical insufficiency, chronic, 566
Primary biliary cirrhosis (PBC), 551–552
Primary coronary angioplasty (PCI), STEMI, 412
Primary endpoint, human studies, 43
Primary infections, antimicrobial chemoprophylaxis, 167
Primary prevention, 9
Primary sclerosing cholangitis (PSC), 552
Primary syphilis, 201
Primary therapy, 9
Primidone, 358
Pro-antibiotic effect (PAE), antimicrobial drugs, 163
Probable conviction, adverse drug reactions, 111
Pro-Banthine (propantheline), 381
Procaine penicillin, 175
Procalcitonin, 166
Procoagulant drugs, 483–485 see also specific drugs
Production line approach, drug discovery and development, 30
Progesterone, 605
Progestogen-only contraception, 609–610
Progestogens, 605
breast cancer, 518
menorrhalgia, 611
Proguanil (chloroguanide)
malaria prophylaxis, 231, 232
malaria therapy, 230t, 233–234
mechanism of action, 228
Prolactin, 598–599
antipsychotic effects, 327
Prolonged-release melatonin, insomnia treatment, 340t
Promethazine, 472
insomnia treatment, 340t
Promotion (of drugs), restraint in, 12
Propafenone, 431t, 433
Propantheline (Pro-Banthine), 381
Propiverine, 381
micturition, 464
Propofol, 300
Proportions, 28
Propranolol, 408–409
antiarrhythmia, 431t
as antidote, 128t
pharmacogenetics, 104t
therapeutic dose, 405t
Proprietary (brand) name, 70, 71
Propylthiouracil (PTU), 589, 590
Prostaglandins, 612–613
gastric acid secretion, 529
inflammation, 241
Prostaglandin synthesis, antihypertensive effects, 417
  Page 659 
Prostanoids, 282
Prostate cancer
cyproterone, 602
hormonal agents, 518
Prostatitis, 200
Prostheses insertion, antimicrobial chemoprophylaxis, 168
Protamine, 128t, 489
Protease inhibitors
antiretroviral therapy, 216t, 218–219
neoplastic disease, 521 see also specific drugs
Protein(s), drug discovery and development, 31
Protein binding, disease effects, 91, 91t
Protein kinase receptors, drug mechanisms, 75
Protein malnutrition, pharmacokinetics, 107
Protein metabolism, adrenal steroids, 559
Protein restriction, hepatic encephalopathy, 551
Protein synthesis inhibition
antibacterial drugs, 173, 180–186
antimicrobial drugs, 164
Prothionamide, 208
leprosy, 209
Proton pump inhibitors (PPIs), 530
NSAIDs with, 245 see also specific drugs
Protozoal infections, 213, 227–236 see also specific infections
Proximal myopathy, adrenal steroid effects, 564
Pruritus, 263
drug adverse effects, 268
generalised, 263
localised, 263
Pruritus ani, 263
Prussian blue, 128t
PSC (primary sclerosing cholangitis), 552
Pseudo-allergic reactions, 118–119
Pseudocholinesterases, 309, 375
Pseudomonads, superinfection, 170
Psilocybin, 153
Psoralens, photosensitivity, 266
Psoriasis, 269–273, 619
drug adverse effects, 268
vitamin A, 616
Psoriatic arthritis, 258
Psychiatric assessment, poisoning, 127–129
Psychiatric disorders
diagnostic issues, 311
insomnia, 338b see also specific diseases/disorders
Psychodysleptic dependence, 152–157
experiences, 153 see also specific drugs
Psychological dependence, 137
Psychological effects
cannabis, 156–157
insomnia, 338b
placebos, 17
Psychoses, adrenal steroids, 564
Psychostimulants, 157–159
Psychotic illness, 311
Psychotropic drugs, 311–347
anaesthesia interactions, 308
paediatric patients, 346–347
psychological treatment vs., 311–312 see also specific drugs
Pteroylglutamic acid See Folic acid
PTH See Parathyroid hormone (PTH)
PTSD See Post-traumatic stress disorder (PTSD)
PTU (propylthiouracil), 589, 590
Publication bias, 56
Public view (of drugs), 12
Pulmonary abscess, pneumonia, 195
Pulmonary arterial hypertension, idiopathic (primary), 419
Pulmonary elimination, 95
Pulmonary embolism, thrombolytic drugs, 491
Pulmonary hypertension, 418–419
Pulmonary surfactant, 470
Pulmonary tuberculosis, 202–206
Purgatives, 540
Purine antagonists, 515
Purpura, drug adverse effects, 268
Pyoderma gangrenosum, 269t
Pyrantel, 238
Pyrazinamide, 207
tuberculosis, 202
Pyridostigmine, 375
Pyridoxine (vitamin B6), 616
Pyrimethamine
dapsone and, 234
malaria therapy, 230t, 234
sulfadoxine and, 234
Pyrimidine antagonists, 515