Neurological Drugs is an attempt to update postgraduates and practicing doctors about the neurological drug therapy. It is a unique compilation of Neurology Drug Reference in India. In this small but comprehensive book, the author has been able to successfully combine the Art and Science used in treatment of Neurological Disorders. This book is the first of its kind for Indian subcontinent and will go a long way in providing first hand knowledge to budding physicians, neurologists and psychiatrists alike.
• Presents the principles and practice of neurological drug therapy in a simplified way
• Gives an overview of common diagnostic entities and evidence-based therapy guidelines about the neurological conditions, especially emphasizes on headache, epilepsy, Parkinson's disease, dementia, etc.
• Includes the special chapters on adverse drug reactions, genetic disorders and rare neurological illnesses
• It is an attempt to ensure both basic and advanced learners in neuropharmacology get a fair idea about the drug treatment
• Encourages rational basis of pharmacotherapy.
• Primary: Practicing Neurologists and Postgraduates (MD in Neurology), Psychiatrists and Physicians
Table of Contents
1. Drugs in Neurological Practice 1
• Neurological Drugs:
Challenges and Opportunities 1
2. Neural Basis of Neurological Disorders 4
• Neurological Disorders at a Glance 4
3. Therapeutic Targets in Neuropharmacology 16
• Get Started 17
• Receptors as Drug Targets 17
• Receptor Sensitization 21
• Receptor Desensitization 22
4. Clinical Pharmacokinetics 26
• Absorption 26
• Distribution 27
• Metabolism 29
• Elimination 31
• Half-Life 32
• Special Issues in Pharmacokinetics
in Neurology 32
5. Clinical Pharmacodynamics 35
• History of Drug Action in Central
Nervous System 35
• Mechanisms 35
• Synapses as the Main Site of
Action in Neurology 36
• Synergistic Drug Action 39
• Dose-Response Curve 40
• Factors Affecting Drug Action 40
• Drug Discovery and Development 42
• Indian Pharmacopoeia 43
• Rational Drugs Use in Neurology 44
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6. Drug Treatment of Headaches 48
• Principles of Headache Treatment 48
• Secondary Headaches 49
• Primary Headaches 49
• Diagnosis of Headache 50
• Diagnose Headache Type 50
• Medication Overuse Headache 59
• Tension Headache 59
• Cluster Headache 61
• Chronic Daily Headache 62
• Trigeminal Neuralgia 62
7. Myasthenia Gravis 66
• Diagnosis 67
• Treatment 68
• Immunomodulating Therapies 69
• Diet in Myasthenia Gravis 69
• Physical Activity in Myasthenia Gravis 69
8. Drug Treatment of Movement Disorders 72
• Evaluation 73
• Dystonia 74
• Tics 74
• Tremors 75
• Chorea 75
• Dystonia 76
• Athetosis 77
• Myoclonus 78
• Stereotypies 78
• Benign Movement Disorders 78
• Tourette Syndrome 78
• Sydenham’s Chorea 79
• Opsoclonus-Myoclonus Syndrome 80
• Rett Syndrome 80
• Parkinson’s Disease 81
9. Drug Treatment of Neurodegenerative
Disease 87
• Neurodegeneration 87
• Dementia 88
Contents xvii
10. Drug Treatment of Stroke 99
• Stroke 99
• Types of Stroke 100
• Management of Stroke 101
• Hemorrhagic Stroke 107
• Prophylaxis of Stroke 107
• Venous Stroke 108
11. Drug Treatment of Neuropathies 110
• Treating Chronic Pain 112
• Sensory Symptoms in Neuropathic Pain 114
• Pathophysiology of Chronic Pain 114
• Goals of Treating Pain 114
• Management of Neuropathic Pain 115
• Topical Treatment 121
• Interventional Treatment 121
• Recent Advances 122
12. Drug Treatment of Demyelinating Diseases 124
• What is Multiple Sclerosis? 124
• Epidemiology 124
• Pathophysiology 124
• Types of Multiple Sclerosis 125
• Clinical Features 127
• Diagnosing Multiple Sclerosis 128
• Treatment 128
• Indian Academy of Neurology Guidelines of
Multiple Sclerosis 132
• Multiple Sclerosis in Pregnancy 133
13. Drug Treatment of Traumatic Head
Injury/Spinal Cord Injury 135
• Types of Head Injury 135
• Diagnosis 136
• Open and Closed Head Injuries 136
• Effects of Head Injury 137
• Assessing Head Injury 138
• Management 138
• Recovery 140
• Spinal Cord Injury 142
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14. Drug Treatment of Cervical Spondylosis,
Low Backache 145
• Cervical Spondylosis 145
• Cervical Radiculopathy 147
• Cervical Myelopathy 149
• Back Pain 156
15. Drug Treatment of Central Nervous
System Infections 162
• Pathogenesis 162
• Therapeutic Aims in Acute Central
Nervous System Infections 163
• Clinical Assessment 163
• Diagnosis 163
• Treatment 166
• Viral Meningitis 170
• Brain Abscess Treatment 171
• Tubercular Meningitis 171
• Neonatal Meningitis 172
• Viral Meningitis 173
• Fungal Meningitis 173
• Encephalitis 174
• Prion Diseases 175
• Guillain-Barré Syndrome 175
• Congenital Infections 176
• Neurocysticercosis 176
• Neurosyphilis 177
16. Analgesics in Neurological Practice 180
• Drugs for Mild to Moderate Pain:
Nonsteroidal Anti-inflammatory Drugs 180
• Opioids 190
17. Drug Treatment of Complex Regional
Pain Syndrome 197
• History 197
• Terminology 197
• International Society of Study of
Pain Definition 198
• Clinical Features 199
Contents xix
• Pathophysiology 200
• Diagnosis 201
• Treatment 202
• Recent Advances 205
18. Treatment of Cerebral Palsy 208
• Incidence 208
• Etiology 209
• Clinical Features 209
• Management 210
• Prevention 212
19. Drug Treatment of Myositis/Myopathies 214
• Statin-induced Myopathy 214
• Inflammatory Myopathies 215
20. Drugs for Genetic Disorders 219
• Background 219
• Introduction to Genetic Medicine 219
• Cerliponase Alfa 220
• Zinc Acetate 221
• Rufinamide 221
• Velaglucerase Alfa 222
• Taliglucerase Alfa 222
21. Adverse Drug Reactions in
Neurological Practice 225
• Classification of Adverse
Drug Reactions 226
• Factors Predisposing to Adverse
Drug Reactions 226
• Reporting Adverse Drug Reactions 228
• Drug Interactions 228
22. Anticancers in Neurology 235
• Brain Tumors 235
• Anticancer Drugs in Neurology 237
• Alkylating Agents 238
• Antimetabolites 240
• Antiestrogen 241
xx Neurological Drugs
23. Drug-induced Neurological Disorders 245
• Seizures 246
• Stroke 246
• Headache 246
• Encephalopathy 247
• Dementia 248
• Extrapyramidal Disorders 248
• Tremors 250
• Myoclonus and Nystagmus 250
• Neuropathy 250
Index 253