, a LANGE medical book
Katzung & Trevor’s
Pharmacology
Examination
& Board Review
Twelfth Edition
Bertram G. Katzung, MD, PhD
Professor Emeritus of Pharmacology
Department of Cellular & Molecular Pharmacology
University of California, San Francisco
Marieke Kruidering-Hall, PhD
Professor & Academy Chair of Pharmacology Education
Department of Cellular & Molecular Pharmacology
University of California, San Francisco
Anthony J. Trevor, PhD
Professor Emeritus of Pharmacology and Toxicology
Department of Cellular & Molecular Pharmacology
University of California, San Francisco
New York Chicago San Francisco Athens London Madrid Mexico City
Milan New Delhi Singapore Sydney Toronto
Trevor_FM_p0i-vi.indd 1 7/19/18 2:42
,Copyright © 2019 by McGraw-Hill Education. All rights reserved. Except as permitted under the United States Copyright Act of 1976,
no part of this publication may be reproduced or distributed in any form or by any means, or stored in a database or retrieval system,
without the prior written permission of the publisher.
ISBN: 978-1-25-964101-5
MHID: 1-25-964101-5
The material in this eBook also appears in the print version of this title: ISBN: 978-1-25-964102-2,
MHID: 1-25-964102-3.
eBook conversion by codeMantra
Version 1.0
All trademarks are trademarks of their respective owners. Rather than put a trademark symbol after every occurrence of a trademarked
name, we use names in an editorial fashion only, and to the benefit of the trademark owner, with no intention of infringement of the
trademark. Where such designations appear in this book, they have been printed with initial caps.
McGraw-Hill Education eBooks are available at special quantity discounts to use as premiums and sales promotions or for use in corpo-
rate training programs. To contact a representative, please visit the Contact Us page at www.mhprofessional.com.
Notice
Medicine is an ever-changing science. As new research and clinical experience broaden our knowledge, changes in treatment and drug
therapy are required. The authors and the publisher of this work have checked with sources believed to be reliable in their efforts to
provide information that is complete and generally in accord with the standards accepted at the time of publication. However, in view
of the possibility of human error or changes in medical sciences, neither the authors nor the publisher nor any other party who has been
involved in the preparation or publication of this work warrants that the information contained herein is in every respect accurate or com-
plete, and they disclaim all responsibility for any errors or omissions or for the results obtained from use of the information contained in
this work. Readers are encouraged to confirm the information contained herein with other sources. For example and in particular, readers
are advised to check the product information sheet included in the package of each drug they plan to administer to be certain that the
information contained in this work is accurate and that changes have not been made in the recommended dose or in the contraindications
for administration. This recommendation is of particular importance in connection with new or infrequently used drugs.
TERMS OF USE
This is a copyrighted work and McGraw-Hill Education and its licensors reserve all rights in and to the work. Use of this work is subject
to these terms. Except as permitted under the Copyright Act of 1976 and the right to store and retrieve one copy of the work, you may
not decompile, disassemble, reverse engineer, reproduce, modify, create derivative works based upon, transmit, distribute, disseminate,
sell, publish or sublicense the work or any part of it without McGraw-Hill Education’s prior consent. You may use the work for your
own noncommercial and personal use; any other use of the work is strictly prohibited. Your right to use the work may be terminated if
you fail to comply with these terms.
THE WORK IS PROVIDED “AS IS.” McGRAW-HILL EDUCATION AND ITS LICENSORS MAKE NO GUARANTEES OR WAR-
RANTIES AS TO THE ACCURACY, ADEQUACY OR COMPLETENESS OF OR RESULTS TO BE OBTAINED FROM USING
THE WORK, INCLUDING ANY INFORMATION THAT CAN BE ACCESSED THROUGH THE WORK VIA HYPERLINK OR
OTHERWISE, AND EXPRESSLY DISCLAIM ANY WARRANTY, EXPRESS OR IMPLIED, INCLUDING BUT NOT LIMITED
TO IMPLIED WARRANTIES OF MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE. McGraw-Hill Education
and its licensors do not warrant or guarantee that the functions contained in the work will meet your requirements or that its opera-
tion will be uninterrupted or error free. Neither McGraw-Hill Education nor its licensors shall be liable to you or anyone else for any
inaccuracy, error or omission, regardless of cause, in the work or for any damages resulting therefrom. McGraw-Hill Education has no
responsibility for the content of any information accessed through the work. Under no circumstances shall McGraw-Hill Education and/
or its licensors be liable for any indirect, incidental, special, punitive, consequential or similar damages that result from the use of or
inability to use the work, even if any of them has been advised of the possibility of such damages. This limitation of liability shall apply
to any claim or cause whatsoever whether such claim or cause arises in contract, tort or otherwise.
, Contents
Preface v
part IV
part I DRUGS WITH IMPORTANT ACTIONS
BASIC PRINCIPLES 1 ON SMOOTH MUSCLE 145
1. Introduction 1 16. H
istamine, Serotonin, Drugs Used in
Obesity, & the Ergot Alkaloids 145
2. Pharmacodynamics 16
17. Vasoactive Peptides 155
3. Pharmacokinetics 26
18. Prostaglandins & Other Eicosanoids 161
4. Drug Metabolism 35
19. Nitric Oxide, Donors, & Inhibitors 168
5. Pharmacogenomics 41
20. D
rugs Used in Asthma & Chronic
part II Obstructive Pulmonary Disease 172
AUTONOMIC DRUGS 47
part V
6. Introduction to Autonomic Pharmacology 47 DRUGS THAT ACT IN THE CENTRAL
NERVOUS SYSTEM 181
7. Cholinoceptor-Activating
& Cholinesterase-Inhibiting Drugs 60
21. Introduction to CNS Pharmacology 181
8. Cholinoceptor Blockers & Cholinesterase
Regenerators 69 22. Sedative-Hypnotic Drugs 188
9. Sympathomimetics 76 23. Alcohols 196
10. Adrenoceptor Blockers 85 24. Antiseizure Drugs 203
25. General Anesthetics 212
part III
CARDIOVASCULAR DRUGS 93 26. Local Anesthetics 220
27. Skeletal Muscle Relaxants 225
11. Drugs Used in Hypertension 93
28. D
rugs Used in Parkinsonism &
12. D
rugs Used in the Treatment of Angina Other Movement Disorders 233
Pectoris 103
29. Antipsychotic Agents & Lithium 241
13. Drugs Used in Heart Failure 112
30. Antidepressants 249
14. Antiarrhythmic Drugs 122
31. Opioid Analgesics & Antagonists 257
15. D
iuretics & Other Drugs That Act on the
Kidney 134 32. Drugs of Abuse 266
iii
iii
Trevor_FM_p0i-vi.indd 3 7/19/18 2:42
Katzung & Trevor’s
Pharmacology
Examination
& Board Review
Twelfth Edition
Bertram G. Katzung, MD, PhD
Professor Emeritus of Pharmacology
Department of Cellular & Molecular Pharmacology
University of California, San Francisco
Marieke Kruidering-Hall, PhD
Professor & Academy Chair of Pharmacology Education
Department of Cellular & Molecular Pharmacology
University of California, San Francisco
Anthony J. Trevor, PhD
Professor Emeritus of Pharmacology and Toxicology
Department of Cellular & Molecular Pharmacology
University of California, San Francisco
New York Chicago San Francisco Athens London Madrid Mexico City
Milan New Delhi Singapore Sydney Toronto
Trevor_FM_p0i-vi.indd 1 7/19/18 2:42
,Copyright © 2019 by McGraw-Hill Education. All rights reserved. Except as permitted under the United States Copyright Act of 1976,
no part of this publication may be reproduced or distributed in any form or by any means, or stored in a database or retrieval system,
without the prior written permission of the publisher.
ISBN: 978-1-25-964101-5
MHID: 1-25-964101-5
The material in this eBook also appears in the print version of this title: ISBN: 978-1-25-964102-2,
MHID: 1-25-964102-3.
eBook conversion by codeMantra
Version 1.0
All trademarks are trademarks of their respective owners. Rather than put a trademark symbol after every occurrence of a trademarked
name, we use names in an editorial fashion only, and to the benefit of the trademark owner, with no intention of infringement of the
trademark. Where such designations appear in this book, they have been printed with initial caps.
McGraw-Hill Education eBooks are available at special quantity discounts to use as premiums and sales promotions or for use in corpo-
rate training programs. To contact a representative, please visit the Contact Us page at www.mhprofessional.com.
Notice
Medicine is an ever-changing science. As new research and clinical experience broaden our knowledge, changes in treatment and drug
therapy are required. The authors and the publisher of this work have checked with sources believed to be reliable in their efforts to
provide information that is complete and generally in accord with the standards accepted at the time of publication. However, in view
of the possibility of human error or changes in medical sciences, neither the authors nor the publisher nor any other party who has been
involved in the preparation or publication of this work warrants that the information contained herein is in every respect accurate or com-
plete, and they disclaim all responsibility for any errors or omissions or for the results obtained from use of the information contained in
this work. Readers are encouraged to confirm the information contained herein with other sources. For example and in particular, readers
are advised to check the product information sheet included in the package of each drug they plan to administer to be certain that the
information contained in this work is accurate and that changes have not been made in the recommended dose or in the contraindications
for administration. This recommendation is of particular importance in connection with new or infrequently used drugs.
TERMS OF USE
This is a copyrighted work and McGraw-Hill Education and its licensors reserve all rights in and to the work. Use of this work is subject
to these terms. Except as permitted under the Copyright Act of 1976 and the right to store and retrieve one copy of the work, you may
not decompile, disassemble, reverse engineer, reproduce, modify, create derivative works based upon, transmit, distribute, disseminate,
sell, publish or sublicense the work or any part of it without McGraw-Hill Education’s prior consent. You may use the work for your
own noncommercial and personal use; any other use of the work is strictly prohibited. Your right to use the work may be terminated if
you fail to comply with these terms.
THE WORK IS PROVIDED “AS IS.” McGRAW-HILL EDUCATION AND ITS LICENSORS MAKE NO GUARANTEES OR WAR-
RANTIES AS TO THE ACCURACY, ADEQUACY OR COMPLETENESS OF OR RESULTS TO BE OBTAINED FROM USING
THE WORK, INCLUDING ANY INFORMATION THAT CAN BE ACCESSED THROUGH THE WORK VIA HYPERLINK OR
OTHERWISE, AND EXPRESSLY DISCLAIM ANY WARRANTY, EXPRESS OR IMPLIED, INCLUDING BUT NOT LIMITED
TO IMPLIED WARRANTIES OF MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE. McGraw-Hill Education
and its licensors do not warrant or guarantee that the functions contained in the work will meet your requirements or that its opera-
tion will be uninterrupted or error free. Neither McGraw-Hill Education nor its licensors shall be liable to you or anyone else for any
inaccuracy, error or omission, regardless of cause, in the work or for any damages resulting therefrom. McGraw-Hill Education has no
responsibility for the content of any information accessed through the work. Under no circumstances shall McGraw-Hill Education and/
or its licensors be liable for any indirect, incidental, special, punitive, consequential or similar damages that result from the use of or
inability to use the work, even if any of them has been advised of the possibility of such damages. This limitation of liability shall apply
to any claim or cause whatsoever whether such claim or cause arises in contract, tort or otherwise.
, Contents
Preface v
part IV
part I DRUGS WITH IMPORTANT ACTIONS
BASIC PRINCIPLES 1 ON SMOOTH MUSCLE 145
1. Introduction 1 16. H
istamine, Serotonin, Drugs Used in
Obesity, & the Ergot Alkaloids 145
2. Pharmacodynamics 16
17. Vasoactive Peptides 155
3. Pharmacokinetics 26
18. Prostaglandins & Other Eicosanoids 161
4. Drug Metabolism 35
19. Nitric Oxide, Donors, & Inhibitors 168
5. Pharmacogenomics 41
20. D
rugs Used in Asthma & Chronic
part II Obstructive Pulmonary Disease 172
AUTONOMIC DRUGS 47
part V
6. Introduction to Autonomic Pharmacology 47 DRUGS THAT ACT IN THE CENTRAL
NERVOUS SYSTEM 181
7. Cholinoceptor-Activating
& Cholinesterase-Inhibiting Drugs 60
21. Introduction to CNS Pharmacology 181
8. Cholinoceptor Blockers & Cholinesterase
Regenerators 69 22. Sedative-Hypnotic Drugs 188
9. Sympathomimetics 76 23. Alcohols 196
10. Adrenoceptor Blockers 85 24. Antiseizure Drugs 203
25. General Anesthetics 212
part III
CARDIOVASCULAR DRUGS 93 26. Local Anesthetics 220
27. Skeletal Muscle Relaxants 225
11. Drugs Used in Hypertension 93
28. D
rugs Used in Parkinsonism &
12. D
rugs Used in the Treatment of Angina Other Movement Disorders 233
Pectoris 103
29. Antipsychotic Agents & Lithium 241
13. Drugs Used in Heart Failure 112
30. Antidepressants 249
14. Antiarrhythmic Drugs 122
31. Opioid Analgesics & Antagonists 257
15. D
iuretics & Other Drugs That Act on the
Kidney 134 32. Drugs of Abuse 266
iii
iii
Trevor_FM_p0i-vi.indd 3 7/19/18 2:42
