Modern pharmacology with clinical applications by Craig C.R., Stitzel R.E. (eds.)

By Craig C.R., Stitzel R.E. (eds.)

Development at the strengths of prior variants, the 6th version of contemporary Pharmacology with medical functions maintains to supply an updated and finished textbook for college students of pharmacology. targeting the scientific software of gear inside of a context of the main rules of pharmacology, this article offers either scholars and school with an advent to fashionable pharmacotherapeutics.

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Drugs that are highly bound to plasma proteins may distribute less widely because they remain trapped in the peripheral vasculature, since the plasma proteins themselves cannot tra- verse into the extravascular space. , fat, muscle) is greater than the affinity for plasma proteins, widespread distribution can occur despite a high degree of plasma protein binding. Albumin Of the plasma proteins, the most important contributor to drug binding is albumin. Although albumin has a net negative charge at serum pH, it can interact with both positive and negative charges on drugs.

This observation is demonstrated in the following examples: 1. Kidney. Since the kidneys receive 20 to 25% of the cardiac output, they will be exposed to a relatively large amount of any systemically administered drug. The kidney also contains a protein, metallothionein, that has a high affinity for metals. This protein is responsible for the renal accumulation of cadmium, lead, and mercury. 2. Eye. Several drugs have an affinity for the retinal pigment melanin and thus may accumulate in the eye.

At least 17 variant alleles of this enzyme have been identified, most being associated with a deficiency in the ability to carry out CYP2D6-mediated oxidation reactions. Approximately 7% of the caucasian population is CYP2D6 deficient, 39 whereas only 1–3% of African Americans and Asians are deficient in this enzyme. 2) and exhibits this polymorphism. Likelihood of adverse events, such as the dyskinesias associated with certain antipsychotic agents, have been linked to this polymorphism, since individuals who are CYP2D6 deficient have a higher incidence of these side effects.

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