Book structure
In our view, understanding pharmacology is made easier by an appreciation of the relevant underlying physiology, biochemistry and pathology. As with the first edition, this book is divided into Units, each of which begins with an overview of the physiological and biochemical processes that underpin the subsequent pharmacology chapters. We still believe this enhances understanding of the cellular and molecular aspects of drug action, the rationales for the application of drugs in particular disease processes, and the clinical use of drugs with their therapeutic and adverse effects and drug interactions. As seemed most appropriate, in some chapters information is based on drug groups, with relevant details of the diseases for which they may be indicated, whereas in others the flow of information starts with the disease or condition and leads on to a discussion of the drug groups relevant to treatment.
Units 1 and 2 introduce general aspects of the clinical use of drugs and principles of pharmacology. Units 3–12 consider drugs acting on the major systems of the body, from the autonomic nervous system through to the reproductive system. Units 13–15 cover drugs affecting general pathological conditions, including neoplasia, infections and inflammations, and Unit 16 includes discussions of drugs used in sport and in the treatment of obesity, and a chapter on envenomation and antivenoms.
Terms and spelling
With our rich Australasian heritage of language, it is inevitable that there are many spellings and terminologies about which people feel strongly. We have agreed on the following usages, and apologise to those we offend:
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Arrhythmia: as the terms arrhythmia and antiarrhythmic drugs are in common usage they have been retained in this book. It is acknowledged that the prefix ‘a’ means ‘without’ and, in that regard, the only arrhythmia is asystole. The correct term is ‘dysrhythmia’; the prefix dys meaning ‘difficulty with’.
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We have now adopted the generally accepted spelling ‘fetus’ rather than ‘foetus’ as used in the first edition.
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Gonadotrophin, etc: the suffix ‘trophic’ means bringing nourishment, whereas ‘tropic’ means turning or moving in response to a stimulus; they appear to have become interchangeable in words like gonadotrophin. There is an understanding that the English term is ‘-trophin’ whereas ‘-tropin’ is American usage. We have standardised on the English form -trophin except where the approved name for a hormone or drug is otherwise, as in somatropin and follitropin.
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Receptor: because many drugs interact with molecular targets (e.g. enzymes, ion channels and receptors), we have chosen to standardise the use of the term ‘receptor’ in accordance with the IUPHAR Committee on Receptor Nomenclature and Drug Classification 1998 (see
Chapter 5).
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5-Hydroxytryptamine: in line with accepted terminology, the term ‘5-hydroxytryptamine’, abbreviated as 5-HT, is used throughout this book. Use of the term ‘serotonin’ is restricted to the first mention of 5-HT in a chapter (as a reminder that this is synonymous with 5-HT) and in reference to specific drug groups, e.g. selective serotonin reuptake inhibitors.
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Drug names: throughout the text, Australian approved (generic) drug names are used; when these are markedly different from American and/or Canadian names, this may be noted for clarity; thus ‘ … paracetamol, known as acetaminophen in the USA …’. Since a drug may be marketed under many trade names and subject to frequent changes or deletions, we have not included trade names except in instances where readers may be so familiar with a trade name as to identify most readily with it, e.g. diazepam, marketed as Valium, paracetamol as Panadol, or sildenafil as Viagra.
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Although the terms ‘adverse effect’, ‘adverse reaction’ and ‘adverse event’ are often used (mistakenly) interchangeably, we have standardised the use of these terms throughout the book. Simply stated, a drug causes an
adverse effect, a patient suffers an
adverse reaction to a drug, and an
adverse event occurs while a person is taking a drug but it is not necessarily due to the drug (see
Chapter 10 for full explanations).
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Drugs affecting (a system): we have used this term purposely at times, e.g. ‘Drugs Affecting the Skin’, to include not only drugs used in treatment of conditions of the organ or system, but also drugs that may have adverse effects particularly in that system, or may be administered to that tissue to have an action elsewhere in the body.