Includes Index

Medical pharmacology is a unique blend of basic pharmacology, clinical pharmacology and
pharmacotherapeutics. The subject is highly dynamic with concepts and priority drugs changing
rapidly. Innovations and developments are happening at an unprecedented pace. Several new
molecular targets for drug action have been identified and novel drugs produced to attack them.
On the other hand, a huge body of evidence has been generated to quantify impact of various
drugs and regimens o n well defined therapeutic end points, so that practice of medic ine is
transforming from ' impression based' to 'evidence based'. The present edition focuses on evidence
based medicine by referring to numerous large randomized trials and other studies which have
shaped current therapeutic practices. By evaluating such evidences, professional bodies, eminent
health institutes, expert committees and WHO have formu lated therapeutic guidelines for treating
many conditions, as well as for use of specific drugs. The latest guidelines have been summarized
and included in the present edition along with other developments and the core content.
Adopting the 'prototype drug' approach and a structured, systematic and user-friendly
format, all chapters have been thoroughly revised and updated. In this edition, drug classifications
have been presented as eye-catching charts which help create pictorial memory. A new chapter on
'Nitric Oxide and Vasoactive Peptide Signal Molecules' has been added along with some recently
introduced drugs which act through receptors for these molecules or by altering their turnover.
Priority has been accorded to drugs that are marketed in India, and their leading brand names
are mentioned along with dosage forms. All recently released drugs are included, while those
not commercially available or infrequently used have been excluded or described in small type.
India specific information on drugs and diseases finds a place in relevant topics. Treatment
of diseases like TB, leprosy, HIV-AI DS, malaria, Kala-azar which are covered under WHO
and National Health Programmes arc described as per the latest recommendations of these
organizations. Several new figures, charts, tables and highlight boxes have been added and many
older ones have been revised/improved. The recent material and data has been authenticated by
quoting its source. A brief list of useful references for further reading is provided at the end
of the book. The 'Problem Directed Study' at the end of most chapters provides an exercise
in therapeutic decision making.
1 thank my colleagues and students for providing valuable inputs and raising thoughtful queries.
As ever, the driving force behind this book has been Shri Jitendar P Vij (Group Chairman) and
Mr Ankit Vij (Managing Director) of M/s Jaypee Brothers Medical Publishers (P) Ltd, New
Delhi, India. The staff of Jaypee Brothers, especially Ms Sunita Katia (Executive Assistant to
Group Chairman and Publishing Manager), Ms Geeta Srivastava (Proof Reader), Mr Manoj Pahuja
(Graphic Designer) and Mr Kapil Dev Sharma (DTP Operator) deserve special commendation for
excellent production of this text. Cooperation and participation of my wife has been pivotal.

Phannacology is both a basic and an applied science. It forms the backbone of rational therapeutics. Whereas the medical student and the prescribing physician are primarily concerned
with the applied aspects, correct and skilful application of drugs is impossible without a proper
understanding of their basic pharmacology. Medical pham1acology, therefore, must include both
fundamental background and clinical pharmacological information. Objective and quantitative
data on the use of drugs in man, i.e., relationship between plasma concentration and intensity
of therapeutic/toxic actio ns, plasma half lives, relati ve efficacy of different medications and
incidence of adverse effects etc., are being obtained with the aim of optimising drug therapy.
The concepts regarding mechanism of action of drugs are changing. In addition, new drugs
are being introduced in different countri es at an explosive pace. A plethora o f information
thus appears to be important. However, trying to impart all this to a medical student would
be counter-productive.
One of the important aims of this book is to delineate the essential information about drugs.
The opening sentence in each chapter defines the class of dmgs considered. A 'prototype' approach has been followed by describing the representative drug of a class followed by features
by which individual members differ from it. Leading trade names have been included. Clinically
relevant drug interactions have been mentioned. Clear-cut guidelines on selection of drugs and
their clinical status have been outlined on the basis of current information. Original, simple
and self-explanatory illustrations, tables and flowcharts have been used with impunity. Selected
chemical structures are depicted. Recent developments have been incorporated. However, discretion has been used in including only few of the multitude of new drugs not yet available in
India. T his is based on the ir likelihood of being marketed soon. The information and views
have been arranged in an orderly sequence of distinct statements.
I hope this manageable volume book would serve to di spel awe towards pharmacology
from the minds of medical students and provide a concise and uptodate information source for
prescribers who wish to remain informed of the current concepts and developments concerning
drugs.
My sincere thanks are due to my colleagues for their valuable comments and suggestions.