9781609137113

Table of Contents


SECTION 1	THE CONCEPTUAL FRAMEWORK OF PHARMACOLOGY
1	Introduction to Pharmacology	3
	Introduction	4
	Drug Sources	4
	Drug Classifications and Prototypes	4
	Drug Names	4
	Drug Marketing	5
	Pharmacoeconomics	5
	Access to Drugs	5
	Drug Approval Processes: Food and Drug Administration	7
	Safety in Drug Administration	9
	Sources of Drug Information	13
	Strategies for Studying Pharmacology	13
2	Basic Concepts and Processes	16
	Introduction	17
	Cellular Physiology	17
	Drug Transport Through Cell Membranes	18
	Pharmacokinetics	18
	Pharmacodynamics	23
	Variables that Affect Drug Actions	23
	Adverse Effects of Drugs	28
	Toxicology: Drug Overdose	30
3	Medication Administration and the Nursing Process of Drug Therapy	35
	General Principles of Accurate Drug Administration	36
	Legal Responsibilities	37
	Medication Errors and their Prevention	37
	Medication Orders	43
	Drug Preparations and Dosage Forms	44
	Calculating Drug Dosages	46
	Routes of Administration	47
	Nursing Process in Drug Therapy	53
	Integrating Evidence-Based Practice with the Nursing Process	60
	Herbal and Dietary Supplements	60
SECTION 2	DRUG THERAPY THROUGHOUT THE LIFESPAN
4	Pharmacology and the Care of the Infant and Pediatric Patient	69
	Introduction	70
	Drug Safety in Pediatrics	70
	Pharmacodynamics in Pediatrics	71
	Pharmacokinetics in Pediatrics	71
	Medication Administration in Pediatrics	72
5	Pharmacology and the Care of the Adult and Geriatric Patient	75
	Introduction	76
	Pharmacodynamics in Older Adults	76
	Pharmacokinetics in Older Adults	77
	Medication Adherence and Aging	78
	The Nursing Process	79
6	Pharmacology and the Pregnant or Lactating Woman	82
	Introduction	83
	Drug Therapy for Infertility	83
	Drugs Used in Pregnancy	84
	Fetal Therapeutics	88
	Maternal Therapeutics	88
	Drugs that Alter Uterine Motility: Tocolytics	91
	Drugs Used During Labor and Delivery at Term	93
	Lactation	95
	The Nursing Process	96
SECTION 3	DRUGS AFFECTING THE HEMATOPOIETIC AND IMMUNE SYSTEMS
7	Drug Therapy for Coagulation Disorders	101
	Introduction	102
	Overview of Coagulation Disorders	102
	Anticoagulant Drugs	104
	Heparins	104
	Vitamin K Antagonists	109
	Direct Thrombin Inhibitors	113
	Antiplatelet Drugs	114
	Adenosine Diphosphate Receptor Antagonists	114
	Other Antiplatelet Drugs	118
	Thrombolytic Drugs	119
	Drugs Used to Control Bleeding	123
	The Nursing Process	124
8	Drug Therapy for Dyslipidemia	128
	Introduction	129
	Overview of Dyslipidemia	129
	HMC-CoA Reductase Inhibitors	133
	Bile Acid Sequestrants	137
	Fibrates	139
	Cholesterol Absorption Inhibitor	141
	Miscellaneous Dyslipidemic Agent	142
	Combination Therapy Used to Treat Dyslipidemia	143
	The Nursing Process	144
9	Drug Therapy for Hematopoietic Disorders and to Enhance Immunity	147
	Introduction	148
	Overview of Hematopoiesis and Immune Function	148
	Erythrocyte Hematopoietic Drugs	151
	Granulocyte Colony-Stimulating Factors	153
	Interferons	157
	Adjuvant Medications Used to Stimulate the Immune System: Interleukins	159
	The Nursing Process	160
10	Drug Therapy: Immunizations	162
	Introduction	163
	Overview of Immunization	163
	Individual Immunizing Agents	163
	Keeping Up-to-Date with Immunization Recommendations	174
	The Nursing Process	175
11	Drug Therapy to Suppress Immunity	178
	Introduction	179
	Overview of Altered Immune Function	179
	Cytotoxic Immunosuppressive Agents	182
	Conventional Antirejection Agents	187
	Adjuvant Medications Used to Suppress Immune Function	190
	The Nursing Process	194
12	Drug Therapy for the Treatment of Cancer	197
	Introduction	198
	Overview of Cancer	198
	Cytotoxic Antineoplastic Drugs Used to Treat Cancer	201
	Adjuvant Medications Used to Treat Cancer	214
	The Nursing Process	222
SECTION 4	DRUGS AFFECTING INFLAMMATION AND INFECTION
13	Inflammation, Infection, and the Use of Antimicrobial Agents	227
	Introduction	228
	Overview of Inflammation	228
	Overview of Microorganisms	230
	The Nursing Process	239
14	Drug Therapy to Decrease Pain, Fever, and Inflammation	242
	Introduction	243
	Overview of Pain, Fever, and Inflammation	245
	Specific Conditions	245
	Salicylates	248
	Nonnarcotic Analgesic Antipyretic: Acetaminophen	252
	Nonsteroidal Anti-Inflammatory Drugs	255
	Selective COX-2 Inhibitor: Celecoxib	262
	Antigout Medication	263
	The Nursing Process	267
15	Drug Therapy With Corticosteroids	270
	Introduction	271
	Physiology of Endogenous Corticosteroids	271
	Pathophysiology of Adrenal Cortex Disorders	273
	Drug Therapy with Exogenous Corticosteroids	273
	The Nursing Process	287
16	Drug Therapy With Beta-Lactam Antibacterial Agents	291
	Introduction	292
	Penicillins	293
	Cephalosporins	298
	Carbapenems	305
	Monobactams	307
	The Nursing Process	309
17	Drug Therapy With Aminoglycosides and Fluoroquinolones	311
	Introduction	312
	Aminoglycosides	312
	Fluoroquinolones	316
	The Nursing Process	320
18	Drug Therapy With Tetracyclines, Sulfonamides, and Urinary Antiseptics	322
	Introduction	323
	Tetracyclines	323
	Sulfonamides	326
	Adjuvant Medications Used to Treat Urinary Tract Infections: Urinary Antiseptics	330
	The Nursing Process	331
19	Drug Therapy With Macrolides, Ketolides, and Miscellaneous Anti-Infective Agents	334
	Introduction	335
	Macrolides	335
	Ketolides	339
	Miscellaneous Anti-Infective Agents	341
	The Nursing Process	346
20	Drug Therapy for Tuberculosis and Mycobacterium avium Complex Disease	349
	Introduction	350
	Overview of Tuberculosis and Mycobacterium avium Complex Disease	350
	Isoniazid	354
	Rifamycins	357
	Adjuvant First-Line Antitubercular Drugs	360
	First-Line Drug Combinations Used to Treat Tuberculosis	362
	Second-Line Drugs Used to Treat Tuberculosis	362
	Drugs Used to Treat Mycobacterium avium Complex Disease	362
	Special Strategies to Increase Adherence to Antitubercular Drug Regimens	362
	The Nursing Process	363
21	Drug Therapy for Viral Infections	366
	Introduction	367
	Overview of Viruses and Viral Infections	367
	rugs for Herpesvirus Infections	370
	rugs for Respiratory Syncytial Virus	376
	rugs for Influenza	377
	rugs for Hepatitis: Nucleoside Analogs	380
	Drugs for Human Immunodeficiency Virus Antiretroviral Drugs)	382
	The Nursing Process	394
22	Drug Therapy for Fungal Infections	398
	Introduction	399
	Overview of Fungal Infections	399
	Polyenes	403
	Azoles	406
	Echinocandins	411
	Miscellaneous Antifungal Agents for Superficial Mycoses	412
	Pyrimidine Analog	414
	The Nursing Process	416
23	Drug Therapy for Parasitic Infections	419
	Introduction	420
	Overview of Parasitic Infections	420
	Amebicides	422
	Antimalarials	425
	Anthelmintics	428
	Scabicldes and Pediculicides	430
	The Nursing Process	431
SECTION 5	DRUGS AFFECTING THE CARDIOVASCULAR SYSTEM
24	Drug Therapy for Heart Failure	437
	Introduction	438
	Overview of Heart Failure	438
	Inotropes (Cardiac Clycosides)	441
	Phosphodiesterase Inhibitors (Cardiotonic-Inotropic Agents)	447
	Human B-Type Natriuretic Peptides	448
	Adjuvant Medications Used to Treat Heart Failure	450
	The Nursing Process	452
25	Drug Therapy for Dysrhythmias	456
	Introduction	457
	Overview of Dysrhythmias	457
	Class I Sodium Channel Blockers	460
	Class II Beta-Adrenergic Blockers	464
	Class III Potassium Channel Blockers	466
	Class IV Calcium Channel Blockers	469
	Unclassified Antidysrhythmic Drugs	471
	The Nursing Process	471
26	Drug Therapy for Angina	474
	Introduction	475
	Overview of Angina	476
	Organic Nitrates	477
	Beta-Adrenergic Blockers	483
	Calcium Channel Blockers	486
	Adjuvant Medications	489
	The Nursing Process	490
27	Drug Therapy to Enhance the Adrenergic Response	493
	Introduction	494
	Overview of the Adrenergic Response	494
	Adrenergic Drugs	497
	Toxicity of Adrenergics: Recognition and Management	505
	The Nursing Process	506
28	Drug Therapy for Hypertension	510
	Introduction	511
	Overview of Hypertension	511
	Angiotensin-Converting Enzyme Inhibitors	515
	Angiotensin II Receptor Blockers	524
	Adjuvant Medications Used to Treat Hypertension	527
	The Nursing Process	533
SECTION 6	DRUGS AFFECTING THE RESPIRATORY SYSTEM
29	Drug Therapy for Nasal Congestion	539
	Introduction	540
	Overview of Nasal Congestion and Other Respiratory Symptoms	540
	Nasal Decongestants	541
	Antitussives	545
	Expectorants	546
	Mucolytics	547
	Herbal Preparations	548
	Combination Products	548
	The Nursing Process	550
30	Drug Therapy to Decrease Histamine Effects and Allergic Response	553
	Introduction	554
	Overview of Histamine Release and the Allergic Response	554
	First-Generation H, Receptor Antagonists	558
	Second-Generation H, Receptor Antagonists	563
	The Nursing Process	565
31	Drug Therapy for Asthma and Bronchoconstriction	567
	Introduction	568
	Overview of Asthma	568
	Adrenergics	570
	Anticholinergics	576
	Xanthines	577
	Corticosteroids	580
	Leukotriene Modifiers	583
	Adjuvant Medications Used to Treat Asthma	585
	The Nursing Process	586
SECTION 7	DRUGS AFFECTING THE RENAL AND DIGESTIVE SYSTEMS
32	Drug Therapy for Fluid Volume Excess	591
	Introduction	592
	Renal Physiology	592
	Overview of Conditions Requiring Diuretic Agents	593
	Thiazide Diuretics	594
	Loop Diuretics	597
	Potassium-Sparing Diuretics	602
	Adjuvant Medications Used to Treat Fluid Volume Excess	604
	The Nursing Process	605
33	Nutritional Support Products, Vitamins, and Mineral Supplements	608
	Introduction	609
	Overview of Altered Nutritional States	609
	Fat-Soluble Vitamins	620
	Water-Soluble Vitamins	624
	Minerals	628
	Treatment of Mineral Excess	634
	Nutritional Products	635
	The Nursing Process	636
34	Drug Therapy for Weight Management	640
	Introduction	641
	Overview of Weight Management	641
	Adrenergic Anorexiants	646
	Lipase Inhibitors	648
	Other Drugs Used for Weight Management	650
	Herbal and Dietary Supplements Used for Weight Management	650
	The Nursing Process	650
35	Drug Therapy for Peptic Ulcer Disease and Gastroesophageal Reflux Disease	654
	Introduction	655
	Overview of Peptic Ulcer Disease and Gastroesophageal Reflux Disease	655
	Antacids	657
	Histamine; Receptor Antagonists	660
	Proton Pump Inhibitors	664
	Adjuvant Medications Used to Treat Peptic Ulcer Disease and Castroesophageal Reflux Disease	667
	The Nursing Process	669
36	Drug Therapy for Nausea and Vomiting	672
	Introduction	673
	Overview of Nausea and Vomiting	673
	Phenothiazines	674
	Antihistamines	677
	5-Hydroxytryptamine₃ (5-HT_}) or Serotonin Receptor Antagonists	679
	Substance P/Neurokinin 1 Antagonist: Aprepitant	681
	Miscellaneous Antiemetics	683
	Nonpharmacologic Management	684
	The Nursing Process	684
37	Drug Therapy for Constipation and Elimination Problems	687
	Introduction	688
	Overview of Constipation	688
	Laxatives	690
	Cathartics	693
	Miscellaneous Agents for Constipation	696
	The Nursing Process	697
38	Drug Therapy for Diarrhea	700
	Introduction	701
	Overview of Diarrhea	701
	Opiate-Related Antidiarrheal Agents	702
	Adjuvant Medications Used to Treat Diarrhea	706
	The Nursing Process	708
SECTION 8	DRUGS AFFECTING THE ENDOCRINE SYSTEM
39	Drug Therapy for Diabetes Mellitus	713
	Introduction	714
	Overview of Diabetes	714
	Insulins	718
	Sulfonylureas	730
	Alpha-Clucosidase Inhibitors	733
	Biguanides	734
	Thiazolidinediones	735
	Meglitinides	737
	Dipeptidyl Peptidase-4 (DPP-4) Inhibitors	739
	Amylin Analogs	740
	Incretin Mimetics	741
	Adjuvant Medications Used to Treat Diabetes	742
	The Nursing Process	743
40	Drug Therapy for Hyperthyroidism and Hypothyroidism	748
	Introduction	749
	Overview of the Thyroid Gland	749
	Antithyroid Drugs	752
	Thyroid Drugs	755
	The Nursing Process	759
41	Drug Therapy for Pituitary and Hypothalamic Dysfunction	762
	Introduction	763
	Overview of Pituitary and Hypothalamic Dysfunction	763
	Anterior Pituitary Hormone Drugs for Growth Deficiency in Children	766
	Posterior Pituitary Hormone Drugs for Diabetes Insipidus	770
	Hypothalamic Hormone Drugs	772
	The Nursing Process	775
42	Drug Therapy to Regulate Calcium and Bone Metabolism	778
	Introduction	779
	Overview of Calcium and Bone Metabolism	780
	Calcium Preparations	783
	Vitamin D	787
	Bisphosphonates	788
	Other Medications Used to Treat Bone Disorders and Hypercalcemia	790
	The Nursing Process	792
43	Drug Therapy for Addison�s Disease and Cushing�s Disease	794
	Introduction	794
	Overview of Addison�s Disease	795
	Overview of Cushing�s Disease	796
	Drugs Used to Treat Addison�s Disease	797
	Drugs Used to Treat Cushing�s Disease	801
	The Nursing Process	803
SECTION 9	DRUGS AFFECTING WOMEN�S AND MEN�S HEALTH
44	Drug Therapy for Women�s Health	809
	Introduction	810
	Overview of Reproduction in Women	810
	Estrogens	812
	Progestins	818
	Estrogen-Progestin Combinations	821
	The Nursing Process	827
45	Drug Therapy for Men�s Health	829
	Introduction	830
	Overview of Reproductive Health Problems in Men	830
	Androgens and Anabolic Steroids	833
	Phosphodiesterase Type 5 Inhibitors	836
	Adjuvant Medications Used to Treat Erectile Dysfunction	838
	Drugs for Benign Prostatic Hypertrophy	839
	The Nursing Process	842
SECTION 10	DRUGS AFFECTING THE AUTONOMIC AND CENTRAL NERVOUS SYSTEM
46	Drug Therapy for Myasthenia Gravis and Alzheimer�s Disease	847
	Introduction	848
	Overview of Myasthenia Gravis	848
	Indirect-Acting Cholinergics	849
	Overview of Alzheimer�s Disease	853
	Reversible Indirect-Acting Cholinergics	853
	Overview of Urinary Retention	856
	Direct-Acting Cholinergics	856
	Irreversible Anticholinesterase Toxicity	857
	The Nursing Process	858
47	Drug Therapy for Parkinson�s Disease and Anticholinergics	862
	Overview of Parkinson�s Disease	863
	Dopamine Receptor Agonists	864
	Catechol-O-Methyltransferase Inhibitors	870
	Catechol-O-Methyltransferase Inhibitor and Decarboxylase Inhibitor/Dopamine Precursor	872
	The Nursing Process	874
	Overview of Anticholinergic Drugs	874
	Belladonna Alkaloid and Derivatives	876
	Centrally Acting Anticholinergics	880
	Gastrointestinal Anticholinergics (Antisecretory/ Antispasmodic)	882
	Urinary Antispasmodics	883
	The Nursing Process	885
48	Drug Therapy With Opioids	888
	Introduction	889
	Overview of Pain	889
	Opioid Agonists	891
	Opioid Agonists/Antagonists	900
	Opioid Antagonists	902
	The Nursing Process	904
49	Drug Therapy With Local Anesthetics	907
	Introduction	908
	Overview of Local Anesthesia	908
	Amides	908
	Esters	912
	The Nursing Process	913
50	Drug Therapy With General Anesthetics	915
	Introduction	916
	Overview of General Anesthesia	916
	Inhalation Anesthetics	917
	Intravenous Anesthetics	920
	Neuromuscular Blocking Agents	923
	Adjuvant Medications Used in General Anesthesia	927
	The Nursing Process	927
51	Drug Therapy for Migraines and Other Headaches	932
	Introduction	933
	Overview of Migraine Headaches	933
	Nonsteroidal Anti-Inflammatory Agents	935
	Acetaminophen, Aspirin, and Caffeine	936
	Ergot Alkaloids	938
	Triptans	940
	Estrogen	943
	Preventive Therapy for Migraine Headaches	943
	Adjuvant Medications for Migraine Headaches	945
	The Nursing Process	946
52	Drug Therapy for Seizure Disorders and Spasticity	949
	Introduction	950
	Overview of Epilepsy	950
	Drugs Used to Treat Seizure Disorders	952
	Other Antiepileptic Drugs	964
	The Nursing Process	972
	Overview of Spinal Cord Injury	973
	Drugs Used to Treat Muscle Spasms and Spasticity	974
	The Nursing Process	980
53	Drug Therapy to Reduce Anxiety and Produce Hypnosis	983
	Introduction	984
	Overview of Anxiety	984
	Overview of Sleep and Insomnia	986
	Benzodiazepines	988
	Nonbenzodiazepine Sedative-Hypnotic Agents	993
	The Nursing Process	996
54	Drug Therapy for Depression and Mood Stabilization	1000
	Introduction	1001
	Overview of Depression	1001
	Overview of Bipolar Disorder	1004
	Tricyclic Antidepressants	1004
	Selective Serotonin Reuptake inhibitors	1008
	Serotonin-Norepinephrine Reuptake Inhibitors	1011
	Monoamine Oxidase Inhibitors	1012
	Atypical Antidepressants	1014
	Mood-Stabilizing Agents: Drugs Used to Treat Bipolar Disorder	1015
	Other Medications Used to Treat Bipolar Disorder	1018
	The Nursing Process	1018
55	Drug Therapy for Psychotic Disorders	1022
	Introduction	1023
	Overview of Psychosis	1023
	Phenothiazine Antipsychotics	1026
	Nonphenothiazines	1029
	The Nursing Process	1036
56	Drug Therapy to Stimulate the Central Nervous System	1040
	Introduction	1041
	Overview of Attention Deficit Hyperactivity Disorder	1041
	Overview of Narcolepsy	1042
	Stimulants	1042
	Other Medications Used to Treat Attention Deficit Hyperactivity Disorder and Narcolepsy	1051
	Herbal and Dietary Supplements	1051
	The Nursing Process	1052
57	Drug Therapy for Substance Abuse Disorders	1055
	Introduction	1056
	Overview of Substance Abuse and Dependence	1056
	Central Nervous System Depressant Abuse and Dependence: Drug Therapy	1059
	Central Nervous System Stimulant Abuse and Dependence: Drug Therapy	1064
	Psychoactive Substance Abuse and Dependence: Drug Therapy	1065
	The Nursing Process	1067
SECTION 11	DRUGS AFFECTING THE EYE, EAR, AND SKIN
58	Drug Therapy for Disorders of the Eye	1073
	Introduction	1074
	Basic Structure and Function of the Eye	1074
	Overview of Disorders of the Eye	1074
	Drug Therapy for the Diagnosis and Treatment of Ocular Disorders	1076
	Drug Therapy for the Treatment of Glaucoma	1080
	Drug Therapy for Ocular Infections and Inflammation	1088
	The Nursing Process	1095
59	Drug Therapy for Disorders of the Ear	1098
	Introduction	1099
	Overview of Disorders of the Ear	1099
	Anti-Infective, Antiseptic, Clucocorticoid, and Acidifying Agents	1100
	Fluoroquinolone: Ciprofloxacin	1102
	Penicillin: Amoxicillin	1104
	Adjuvant Medications to Treat Pain and Fever Related to Infections of the Ear	1105
	The Nursing Process	1105
60	Drug Therapy for Disorders of the Skin	1108
	Introduction	1109
	Disorders of the Skin	1109
	Drug Therapy	1111
	Retinoids	1116
	The Nursing Process	1118
	Index
	AVAILABLE ON thePoint
Appendix A	Answers for NCLEX Success
Appendix B	Answers for the Clinical Application Case Studies
Appendix C	Answers for the Critical Thinking Questions
Appendix D	The International System of Units
Appendix E	Serum Drug Concentrations