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The descriptions that follow are not intended to give a comprehensive account of all anti-cancer drugs available, rather to explain the modes of action and to give examples from each group. Toxic effects with all cytotoxic drugs are severe nausea and vomiting, hair loss and bone marrow depression. Alkylating agents act by forming bonds with guanine in DNA. This interferes with the normal base pairing of guanine with cytosine and allows cross-linking of guanine with other guanine molecules in the same strand and opposite strand of DNA. This denatures the DNA and as a result transcription of DNA for protein synthesis and replication of DNA for cell division are disrupted.

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The book is arranged into three parts. In the first part, Principles of Pharmacology, two chapters cover administration, absorption, distribution, metabolism and excretion of drugs and adverse drug reactions, drugdrug interactions, individual response to drugs and targets for drug action.

  • They are known as contrast agents or contrast media and are usually based on iodine, barium or gadolinium containing compounds.
  • Resistance to antimalarial drugs is now common.
  • These are used prophylactically postoperatively and in people who have already had a thrombotic episode.
  • Systemic fungal infections have become more common due to overuse of antibiotics and increase in numbers of immunocompromized patients.
  • Inhibition of this enzyme allows the concentration of these monoamines to increase in the brain, thereby producing an antidepressant effect.
  • Adverse effects of aspirin are dyspepsia or gastritis and it can cause gastric ulceration.
  • This is best achieved by a health care professional prescribing for an individual patient on a one-to-one basis.

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The Review recommended that there should be provision for regular clinical review by the assessing clinician (note: dependent prescriber is now referred to as a supplementary prescriber, Following the Health and Social Care Act to a wider group of health care professions. New types of prescriber were recognized, including the concept of a supplementary prescriber.

Nevertheless, iodine contrast agents must be used with caution in patients with thyroid disease and in those with known hypersensitivity to iodine or allergies to food and other drugs. Premedication with corticosteroids is recommended for such patients. Cautious use of contrast agents is 5 mg valium orange in patients with epilepsy, hepato-renal syndrome, severe respiratory disease and diabetes. They should not be administered to patients who are taking metformin for Type agents can increase the risk of lactic acidosis. Adverse reactions to iodine contrast agents are rare, especially with the newer non-ionic dimers of low osmolality.

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Dipyridamole has a similar effect on cyclo-oxygenase as aspirin. Clopidrogel is another platelet inhibitor that works by inhibiting ADP-induced aggregation. Apart from haemorrhaging, gastrointestinal irritation and bronchospasm are adverse reactions seen with platelet inhibitors. These drugs are used to destroy thrombi that are occluding blood vessels. They are most effective given soon after the thrombus has formed, for example within of a myocardial infarction. All of the drugs in use activate plasminogen resulting in the production of the active enzyme plasmin.


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The mesolimbic and mesocortical pathways are dopamine-containing neurones that run from an area in the midbrain called the ventral tegmentum to the limbic system and the prefrontal area of the cerebral cortex respectively.

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When a drug is administered, it does not achieve an equal concentration throughout the body. Unless a drug is injected directly into the blood stream it will be absorbed from its site of administration, then enter the systemic circulation and be transported to the tissues in plasma.

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