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Pharmacology - E-Book

Pharmacology - E-Book

Linda E. McCuistion | Joyce LeFever Kee | Evelyn R. Hayes

(2014)

Additional Information

Book Details

Abstract

Prepare to administer drugs safely by mastering key pharmacology concepts and drug calculation skills! Pharmacology: A Patient-Centered Nursing Process Approach, 8th Edition covers nursing pharmacology within a real-world nursing context. Using a clear, streamlined approach, this text makes it easier to understand pharmacology with a detailed unit on dosage calculations, a nursing process framework for drug therapy, and summaries of prototype drugs. Written by nursing educators Joyce Kee, Evelyn Hayes, and Linda McCuistion, this edition includes a strong QSEN focus, enhanced coverage of prioritization, and more NCLEX® Examination–style questions on the subject of pharmacology.

  • NEW QSEN focus emphasizes patient-centered care, safety, quality, and collaboration and teamwork.
  • NEW content covers the most commonly used drugs, including updated Prototype Drug Charts and drug tables.
  • Enhanced coverage of prioritization includes nursing interventions in the Nursing Process sections listed in order of priority.
  • Updated illustrations include new drug labels in the Drug Calculations chapter.

Table of Contents

Section Title Page Action Price
Front cover cover
Inside front cover ifc1
Table of Contents i
Pharmacology, 8/e iii
Copyright page iv
Dedication v
Meet the Authors vi
Joyce LeFever Kee vi
Evelyn R. Hayes vi
Linda E. McCuistion vii
Contributors ix
Reviewers xi
Preface xiii
Organization xiii
Additional Features xiii
Teaching And Learning Resources xiv
For Students xiv
For Faculty Members xiv
Acknowledgments xv
Unit I Introduction to Pharmacology 1
1 Drug Action: 2
Outline 2
Objectives 2
Key Terms 2
Pharmaceutic Phase 3
Pharmacokinetic Phase 3
Absorption 3
Distribution 4
Protein Binding 4
Metabolism, or Biotransformation 6
Excretion, or Elimination 7
Pharmacodynamic Phase 7
Dose Response and Maximal Efficacy 7
Onset, Peak, and Duration of Action 7
Receptor Theory 8
Agonists and Antagonists 8
Nonspecific and Nonselective Drug Effects 8
Categories of Drug Action 8
Therapeutic Index and Therapeutic Range (Therapeutic Window) 9
Peak and Trough Drug Levels 9
Loading Dose 10
Side Effects, Adverse Reactions, and Toxic Effects 10
Pharmacogenetics 11
Tolerance and Tachyphylaxis 11
Placebo Effect 11
Key Websites 12
Critical Thinking Case Study 12
NCLEX Study Questions 13
Answers: 13
2 The Drug Approval Process 14
Outline 14
Objectives 14
Key Terms 14
Drug Standards and Legislation 14
Drug Standards 14
Federal Legislation 15
1938: Food, Drug, and Cosmetic Act 15
1952: Durham-Humphrey Amendment to the 1938 Act 15
1962: Kefauver-Harris Amendment to the 1938 Act 15
1970: The Controlled Substances Act 16
1978: Drug Regulation Reform Act 16
1983: The Drug Enforcement Administration and the Orphan Drug Act 16
1997: The Food and Drug Administration Modernization Act 16
2002: Best Pharmaceuticals for Children Act 17
2003: Health Insurance Portability and Accountability Act 17
2003: Pediatric Research Equity Act 17
2007: Food and Drug Administration Amendments Act 17
2009: Family Smoking Prevention and Tobacco Control Act 17
2010: Patient Protection and Affordable Care Act 17
Nurse Practice Acts 17
Canadian Drug Regulation 17
Initiatives to Combat Drug Counterfeiting 18
Drug Names 18
Drug Resources 18
U.S. Food and Drug Administration Pregnancy Categories 19
Key Websites 19
NCLEX Study Questions 19
Answers: 20
3 Cultural and Pharmacogenetic Considerations 21
Outline 21
Objectives 21
Key Terms 21
Ethnopharmacology 21
Transcultural Nursing 22
The Giger and Davidhizar Transcultural Assessment Model 22
Communication 22
Language 22
Vernacular English 23
Greetings and Communication Styles 23
Space 23
Social Organization 23
Time 24
Environmental Control 24
Biologic Variations 24
Key Websites 27
Critical Thinking Case Study 27
NCLEX Study Questions 27
Answers: 28
4 Drug Interactions and Over-the-Counter Drugs 29
Outline 29
Objectives 29
Key Terms 29
Drug Interactions 29
Pharmacokinetic Interactions 30
Absorption 30
Distribution 30
Metabolism or Biotransformation 31
Excretion 31
Pharmacodynamic Interactions 32
Additive Drug Effect 32
Synergistic Drug Effect or Potentiation 33
Antagonistic Drug Effect 33
Drug-Food Interactions 34
Drug-Laboratory Interactions 34
Drug-Induced Photosensitivity 34
Over-the-Counter Drugs 36
Cough and Cold Remedies 38
Sleep Aids 38
Weight-Control Drugs 38
Key Websites 39
Critical Thinking Case Study 39
NCLEX Study Questions 40
Answers: 40
5 Drugs of Abuse 41
Outline 41
Objectives 41
Key Terms 42
Context of Drug Abuse 42
Cultural Considerations 42
Definitions 42
Neurobiology of Addictive Drugs 42
Overview of Addictive States 43
Intoxication 43
Detoxification 43
Withdrawal Syndrome 43
Cessation and Maintenance of Abstinence 43
Stimulants 44
Nicotine 44
Pharmacokinetics 44
Pharmacodynamics 44
Side Effects and Adverse Reactions 44
Treatment 44
Cocaine 46
Pharmacokinetics 46
Pharmacodynamics 47
Side Effects and Adverse Reactions 47
Treatment 49
Amphetamines 50
Pharmacokinetics 50
Pharmacodynamics 50
Side Effects and Adverse Reactions 50
Unit II A Nurse's Perspective of Pharmacology 112
11 The Nursing Process in Patient-Centered Pharmacotherapy 113
Outline 113
Objectives 113
Key Terms 113
Nursing Process: Patient-Centered Collaborative Care 114
Assessment 114
Subjective Data 114
Objective Data 115
Nursing Diagnosis 115
Planning 115
Implementation and Nursing Interventions 116
Patient Teaching 116
Evaluation 118
Key Websites 118
Critical Thinking Case Study 118
NCLEX Study Questions 119
Answers: 119
12 Safety and Quality in Pharmacotherapy 120
Outline 120
Objectives 120
Key Terms 120
“Five-Plus-Five” Rights of Medication Administration 121
Nurses’ Rights When Administering Medications 124
Culture of Safety 125
Joint Commission 2013 National Patient Safety Goals 126
Medication Reconciliation 126
Tips for Medication Reconciliation 127
Disposal of Medications 127
Sharps Safety 127
Safety Risks for Medication Administration 128
Counterfeit Drugs 128
Dosage Forms: To Crush or Not to Crush 128
High-Alert Medications 128
Look-Alike and Sound-Alike Drug Names 129
Other Factors in Prevention of Medication Errors 129
Resources for Preventing Errors in Medication Administration 130
Pregnancy Categories 130
Factors That Modify Drug Response 130
Guidelines for Medication Administration 130
Key Websites 131
NCLEX Study Questions 132
Answers: 132
13 Medication Administration 133
Outline 133
Objectives 133
Key Terms 133
Self-Administration of Medication 133
Forms and Routes for Drug Administration 134
Tablets and Capsules 134
Liquids 134
Transdermal 135
Topical 135
Instillations 135
Inhalations 136
Nasogastric and Gastrostomy Tubes 137
Suppositories 137
Rectal Suppositories 137
Vaginal Suppositories 138
Parenteral 138
Intradermal 138
Action 138
Sites 139
Equipment 139
Technique 139
Subcutaneous 139
Action 139
Sites 140
Unit III Drug Calculations 147
14 Medications and Calculations 148
Overview 148
Section 14A: Systems of Measurement with Conversion 148
Outline 148
Objectives 148
Key Terms 148
Metric System 149
Conversion within the Metric System 149
Metric Conversion 149
Household System 149
Household Conversion 150
Metric, Apothecary, and Household Equivalents 150
Answers to Practice Problems 150
Section 14B: Methods for Calculation 152
Objectives 152
Outline 152
Key Terms 152
Interpreting Oral and Injectable Drug Labels 152
Answers to Practice Problems 163
Section 14C: Calculations of Oral Dosages 165
Objectives 165
Outline 165
Key Terms 165
Tablets, Capsules, and Liquids 165
Interpreting Oral Drug Labels 165
Drug Differentiation 165
Preventing Medication Errors 165
Calculation for Tablet, Capsule, and Liquid Doses 167
Body Weight and Body Surface Area 172
Example 172
Answers to Practice Problems 172
Drugs Administered via Nasogastric Tube 173
Section 14D: Calculations of Injectable Dosages 174
Objectives 174
Outline 174
Key Terms 174
Injectable Preparations 174
Vials and Ampules 174
Syringes 175
Prefilled Drug Cartridges and Syringes 176
Needles 176
Angles for Injections 176
Interpreting Injectable Drug Labels 177
Intradermal Injections 177
Subcutaneous Injections 177
Calculations: Subcutaneous Injections 178
Insulin Injections 179
Types of Insulins 179
Mixing Insulins 180
Intramuscular Injections 180
Drug Solutions for Injection 181
Powdered Drug Reconstitution 181
Mixing Injectable Drugs 183
Method 1: Mixing Two Drugs in the Same Syringe from Two Vials 183
Method 2: Mixing Two Drugs in the Same Syringe from One Vial and One Ampule 184
Method 3: Mixing Two Drugs in a Prefilled Cartridge from a Vial 184
Mixing Drugs in the Same Syringe 184
Procedure 184
Answers to Practice Problems 187
Section 14E: Calculations of Intravenous Fluids 190
Objectives 190
Outline 190
Key Terms 190
Continuous Intravenous Administration 190
Intravenous Sets 190
Calculating Intravenous Flow Rate 191
Method I: Three-Step 191
Method II: Two-Step 191
Method III: One-Step 191
Mixing Drugs for Continuous Intravenous Administration 191
Intermittent Intravenous Administration 191
Secondary Intravenous Sets without IV Pumps 192
Intermittent Infusion Adapters/Devices 193
Direct Intravenous Injections 193
Electronic Intravenous Regulators 194
Safety Considerations for IV Use 195
Infusion Pumps 195
Patient-Controlled Analgesia 195
Patient Teaching 196
Calculating Flow Rates for Intravenous Drugs 196
Answers to Practice Problems 199
Section 14F: Pediatric Drug Calculations 202
Objectives 202
Outline 202
Key Terms 202
Oral 202
Intramuscular 202
Pediatric Dosage Per Body Weight 203
Pediatric Dosage Per Body Surface Area 203
Pediatric Calculations for Injectables 207
Answers to Practice Problems 208
Unit IV Nutrition and Electrolytes 210
15 Vitamin and Mineral Replacement 211
Outline 211
Objectives 211
Key Terms 211
Vitamins 211
Fat-Soluble Vitamins 212
Vitamin A 214
Pharmacokinetics 214
Pharmacodynamics 214
Vitamin D 214
Vitamin E 215
Vitamin K 215
Water-Soluble Vitamins 215
Vitamin B Complex 215
Vitamin C 216
Pharmacokinetics 216
Pharmacodynamics 216
Folic Acid (Folate) 216
Vitamin B12 217
Minerals 218
Iron 218
Pharmacokinetics 218
Pharmacodynamics 220
Copper 220
Zinc 220
Chromium 220
Selenium 220
Key Websites 221
Critical Thinking Case Study 222
NCLEX Study Questions 222
Answers: 222
16 Fluid and Electrolyte Replacement 223
Outline 223
Objectives 223
Key Terms 223
Homeostasis 224
Osmolality 225
Osmolality and Tonicity 225
Fluid Replacement 225
General Considerations 225
Intravenous Solutions 225
Types of Intravenous Solutions 225
Crystalloids 225
Colloids 227
Blood and Blood Products 227
Electrolytes 230
Potassium 230
Functions 230
Hypokalemia 230
Pharmacodynamics 230
Hyperkalemia 231
Effect of Drugs on Potassium Balance 233
Sodium 234
Functions 235
Hyponatremia 235
Hypernatremia 235
Calcium 236
Functions 236
Hypocalcemia 236
Pharmacokinetics 237
Hypercalcemia 237
Effect of Drugs on Calcium Balance 237
Clinical Management of Calcium Imbalance 237
Magnesium 239
Functions 239
Effect of Drugs on Magnesium Balance 239
Chloride 241
Phosphorus 241
Key Websites 241
Critical Thinking Case Study 241
NCLEX Study Questions 242
Answers: 242
17 Nutritional Support 243
Outline 243
Objectives 243
Key Terms 243
Enteral Nutrition 244
Routes for Enteral Feedings 244
Enteral Solutions 244
Methods for Delivery 245
Complications 246
Enteral Safety 246
Enteral Medications 246
Parenteral Nutrition 248
Total Parenteral Nutrition 248
Complications 248
Transitional Feeding: Parenteral to Enteral 250
Key Websites 250
Critical Thinking Case Study 250
Nclex Study Questions 251
Answers: 251
Unit V Autonomic Nervous System Agents 252
Sympathetic Nervous System 252
Parasympathetic Nervous System 252
18 Adrenergic Agonists and Adrenergic Blockers 255
Outline 255
Objectives 255
Key Terms 255
Adrenergic Agonists 255
Inactivation of Neurotransmitters 257
Classification of Sympathomimetics 258
Epinephrine 258
Pharmacokinetics 258
Pharmacodynamics 258
Albuterol 258
Pharmacokinetics 259
Pharmacodynamics 259
Central-Acting Alpha Agonists 259
Clonidine and Methyldopa 259
Side Effects and Adverse Reactions 260
Adrenergic Blockers (Antagonists) 262
Alpha-Adrenergic Blockers 262
Beta-Adrenergic Blockers 263
Pharmacokinetics 263
Pharmacodynamics 263
Drug Interactions 263
Side Effects and Adverse Reactions 263
Adrenergic Neuron Blockers 263
Key Websites 266
Critical Thinking Case Study 267
NCLEX Study Questions 267
Answers: 267
19 Cholinergic Agonists and Anticholinergics 268
Outline 268
Objectives 268
Key Terms 268
Cholinergic Agonists 268
Direct-Acting Cholinergic Agonists 269
Pharmacokinetics 270
Pharmacodynamics 270
Side Effects and Adverse Reactions 270
Direct-Acting Cholinergics: Eye 270
Indirect-Acting Cholinergic Agonists 270
Reversible Cholinesterase Inhibitors 272
Side Effects 272
Irreversible Cholinesterase Inhibitors 272
Anticholinergics 272
Atropine 274
Pharmacokinetics 274
Pharmacodynamics 274
Side Effects and Adverse Reactions 274
Antiparkinson-Anticholinergic Drugs 274
Pharmacokinetics 275
Pharmacodynamics 275
Anticholinergics for Treating Motion Sickness 279
Side Effects and Adverse Reactions 279
Key Websites 279
Critical Thinking Case Study 279
NCLEX Study Questions 279
Answers: 280
Unit VI Neurologic and Neuromuscular Agents 281
20 Central Nervous System Stimulants 284
Outline 284
Objectives 284
Key Terms 284
Pathophysiology 285
Amphetamines 285
Side Effects and Adverse Reactions 285
Amphetamine-Like Drugs for ADHD and Narcolepsy 285
Pharmacokinetics 285
Pharmacodynamics 285
Anorexiants, Lipase Inhibitors, Analeptics, and Respiratory Stimulants 288
Anorexiants 288
Unit VII Pain and Inflammation Management Agents 335
25 Antiinflammatory Drugs 336
Outline 336
Objectives 336
Key Terms 336
Pathophysiology 337
Antiinflammatory Agents 337
Nonsteroidal Antiinflammatory Drugs 337
Salicylates 338
Pharmacokinetics 340
Pharmacodynamics 340
Hypersensitivity to Salicylate Products 340
Para-Chlorobenzoic Acid 342
Phenylacetic Acid Derivatives 342
Propionic Acid Derivatives 342
Pharmacokinetics 342
Pharmacodynamics 342
Fenamates 342
Oxicams 342
General Side Effects and Adverse Reactions for First-Generation NSAIDs 343
Selective COX-2 Inhibitors (Second-Generation NSAIDs) 344
Use of NSAIDs in Older Adults 344
Corticosteroids 344
Disease-Modifying Antirheumatic Drugs 345
Immunosuppressive Agents 345
Immunomodulators 345
Antimalarials 347
Antigout Drugs 348
Antiinflammatory Gout Drug: Colchicine 348
Uric Acid Inhibitor 348
Pharmacokinetics 348
Pharmacodynamics 348
Uricosurics 348
Side Effects and Adverse Reactions 348
Key Websites 350
Critical Thinking Case Study 350
NCLEX Study Questions 351
Answers: 351
26 Nonopioid and Opioid Analgesics 352
Outline 352
Objectives 352
Key Terms 352
Pathophysiology 353
Undertreatment of Pain 353
Nonopioid Analgesics 354
Nonsteroidal Antiinflammatory Drugs 354
Side Effects and Adverse Reactions 355
Acetaminophen 355
Pharmacokinetics 355
Pharmacodynamics 356
Side Effects and Adverse Reactions 356
Opioid Analgesics 356
Morphine 358
Pharmacokinetics 358
Pharmacodynamics 358
Meperidine 360
Hydromorphone 360
Side Effects and Adverse Reactions 360
Contraindications 360
Combination Drugs 362
Patient-Controlled Analgesia 362
Transdermal Opioid Analgesics 362
Analgesic Titration 362
Opioid Use in Special Populations 362
Children 362
Older Adults 363
Cognitively Impaired Individuals 363
Oncology Patients 363
Individuals with a History of Substance Abuse 363
Adjuvant Therapy 363
Treatment for Opioid-Addicted Individuals 363
Opioid Agonist-Antagonists 363
Pharmacokinetics 365
Pharmacodynamics 365
Opioid Antagonists 365
Headaches: Migraine and Cluster 365
Pathophysiology 366
Treatment of Migraine Headaches 366
Key Websites 368
Critical Thinking Case Study 368
NCLEX Study Questions 368
Answers: 368
Unit VIII Psychiatric Agents 369
27 Antipsychotics and Anxiolytics 370
Outline 370
Objectives 370
Key Terms 370
Psychosis 371
Antipsychotic Agents 371
Pharmacophysiologic Mechanisms of Action 371
Adverse Reactions 371
Extrapyramidal Syndrome 371
Neuroleptic Malignant Syndrome 372
Phenothiazines 372
Pharmacokinetics 373
Pharmacodynamics 373
Nonphenothiazines 373
Pharmacokinetics 374
Pharmacodynamics 374
Side Effects and Adverse Reactions 374
Drug Interactions 375
Antipsychotic Dosage for Older Adults 377
Atypical (Serotonin/Dopamine Antagonists) Antipsychotics 377
Anxiolytics 380
Nonpharmacologic Measures 380
Benzodiazepines 381
Pharmacokinetics 381
Pharmacodynamics 381
Miscellaneous Anxiolytics 381
Side Effects and Adverse Reactions 383
Key Websites 384
Critical Thinking Case Study 384
NCLEX Study Questions 384
Answers: 385
28 Antidepressants and Mood Stabilizers 386
Outline 386
Objectives 386
Key Terms 386
Depression 386
Pathophysiology 387
Herbal Supplements for Depression 387
Antidepressant Agents 387
Tricyclic Antidepressants 387
Pharmacokinetics 387
Unit IX Antibacterial and Antiinfective Agents 399
29 Penicillins and Cephalosporins 400
Outline 400
Objectives 400
Key Terms 400
Pathophysiology 400
Antibacterial Drugs 401
Antibacterials/Antibiotics 401
Mechanisms of Antibacterial Action 401
Pharmacokinetics 401
Pharmacodynamics 401
Body Defenses 401
Resistance to Antibacterials 402
Use of Antibiotic Combinations 403
General Adverse Reactions to Antibacterials 403
Narrow-Spectrum and Broad-Spectrum Antibiotics 403
Penicillins and Cephalosporins 404
Penicillins 404
Broad-Spectrum Penicillins (Aminopenicillins) 404
Penicillinase-Resistant Penicillins (Antistaphylococcal Penicillins) 404
Extended-Spectrum Penicillins (Antipseudomonal Penicillins) 405
Beta-Lactamase Inhibitors 407
Pharmacokinetics 407
Pharmacodynamics 407
Geriatrics 407
Side Effects and Adverse Reactions 407
Drug Interactions 407
Cephalosporins 407
First-, Second-, Third-, and Fourth-Generation Cephalosporins 407
Pharmacokinetics 408
Pharmacodynamics 409
Side Effects and Adverse Reactions 409
Drug Interactions 409
Key Websites 412
Critical Thinking Case Study 412
NCLEX Study Questions 413
Answers: 413
30 Macrolides, Tetracyclines, Aminoglycosides, and Fluoroquinolones 414
Outline 414
Objectives 414
Key Terms 414
Macrolides, Lincosamides, Glycopeptides, and Ketolides 415
Macrolides 415
Pharmacokinetics 415
Pharmacodynamics 415
Side Effects and Adverse Reactions 415
Drug Interactions 415
Extended Macrolide Group 415
Lincosamides 418
Unit X Additional Antiinfective Agents 435
32 Antituberculars, Antifungals, Peptides, and Metronidazole 436
Outline 436
Objectives 436
Key Terms 436
Tuberculosis 437
Pathophysiology 437
Antitubercular Drugs 437
Pharmacokinetics 437
Pharmacodynamics 437
Side Effects and Adverse Reactions 438
Antifungal Drugs 441
Polyenes 441
Amphotericin B 441
Unit XI Immunologic Agents 467
Immune System Structure 467
Immune System Function 467
Antibody-Mediated Immunity 467
Antigen-Antibody Interactions 467
Acquiring Antibody-Mediated Immunity 467
Cell-Mediated Immunity 468
Protection Provided by Cell-Mediated Immunity 468
35 HIV- and AIDS-Related Drugs 469
Outline 469
Objectives 469
Key Terms 469
HIV Infection: Pathophysiology 470
HIV Life Cycle 472
HIV Transmission 472
Laboratory Testing 472
HIV Resistance Testing 473
Additional Laboratory Evaluation 473
Classification 473
Treatment Goals 473
Indications for Antiretroviral Therapy 473
Classes of Antiretroviral Medications 473
Antiretroviral Agents 474
Nucleoside/Nucleotide Reverse Transcriptase Inhibitors 474
Non-Nucleoside Reverse Transcriptase Inhibitors 474
Protease Inhibitors 476
Entry Inhibitors 476
CCR5 Co-Receptor Antagonists 477
Integrase Inhibitors 478
Immune Reconstitution Inflammatory Syndrome 478
Nurse’s Role in Antiretroviral Therapy 483
Opportunistic Infections 485
Antiretroviral Therapy in Pregnancy 486
Occupational Exposure to HIV and Postexposure Prophylaxis 486
HIV Prevention Breakthroughs 487
Key Websites 487
Critical Thinking Case Study 487
NCLEX Study Questions 488
Answers: 488
36 Vaccines 489
Outline 489
Objectives 489
Key Terms 489
Active Immunity 490
Passive Immunity 490
Vaccine-Preventable Diseases 490
Childhood Immunizations 493
Adult Immunizations 493
Immunization before International Travel 493
Reporting of Diseases and Adverse Reactions 493
Varicella Vaccine 494
Pharmacokinetics 494
Pharmacodynamics 494
Contraindications 494
Drug Interactions 495
Newer Developments and the Future of Vaccines 495
Key Websites 497
Critical Thinking Case Study 497
NCLEX Study Questions 498
Answers: 499
Unit XII Antineoplastic Agents 500
Cell Cycle 500
Growth Rate 500
Anticancer Therapy 500
37 Anticancer Drugs 502
Outline 502
Objectives 502
Key Terms 502
Genetic, Infective, Environmental, and Dietary Influences 503
Cell Cycle–Nonspecific and Cell Cycle–Specific Anticancer Drugs 504
Cancer Chemotherapy 505
Combination Chemotherapy 505
General Side Effects and Adverse Reactions 505
Anticancer Therapy in Outpatient Settings and in the Home 505
Alkylating Drugs 507
Cyclophosphamide 510
Pharmacokinetics 510
Pharmacodynamics 510
Side Effects and Adverse Reactions 510
Antimetabolites 513
Fluorouracil 513
Pharmacokinetics 513
Pharmacodynamics 515
Side Effects and Adverse Reactions 515
Antitumor Antibiotics 518
Doxorubicin 518
Pharmacokinetics 519
Pharmacodynamics 519
Side Effects and Adverse Reactions 519
Plant Alkaloids 521
Vincristine 521
Pharmacokinetics 521
Pharmacodynamics 523
Side Effects and Adverse Reactions 523
Targeted Therapies 524
Liposomal Chemotherapy 524
Hormonal Agents 524
Corticosteroids 524
Sex Hormones 525
Gonadotropin-Releasing Hormone Analogues 525
Antiandrogens 525
Aromatase Inhibitors 525
Miscellaneous Chemotherapy Agents 525
Vaccines 525
Key Websites 528
Critical Thinking Case Study 528
NCLEX Study Questions 528
Answers: 529
38 Targeted Therapies to Treat Cancer 530
Outline 530
Objectives 530
Key Terms 530
Pathophysiology 531
Normal Cell Growth Regulation 531
Genetic Control over Cell Division 531
Genetic Control over Cell Death 533
Growth Regulation and Cancer 534
Loss of Genetic Control of Cell Growth. 534
Loss of Apoptosis. 534
Targeted Therapy Drugs 534
Tyrosine Kinase Inhibitors 534
Dasatinib 538
Pharmacokinetics 538
Pharmacodynamics 538
Side Effects and Adverse Reactions. 538
Drug Interactions. 538
Multikinase Inhibitors 540
Sorafenib 540
Unit XIII Respiratory Agents 571
Lung Compliance 572
Control of Respiration 572
Bronchial Smooth Muscle 572
40 Drugs for Upper Respiratory Disorders 573
Outline 573
Objectives 573
Key Terms 573
Common Cold, Acute Rhinitis, and Allergic Rhinitis 573
Antihistamines 574
First-Generation Antihistamines 574
Pharmacokinetics 574
Pharmacodynamics 574
Side Effects of Most First-Generation Antihistamines. 574
Second-Generation Antihistamines 574
Nasal and Systemic Decongestants 574
Side Effects and Adverse Reactions 577
Drug Interactions 577
Intranasal Glucocorticoids 577
Antitussives 578
Pharmacokinetics 578
Pharmacodynamics 578
Expectorants 578
Sinusitis 581
Acute Pharyngitis 581
Key Websites 581
Critical Thinking Case Study 582
NCLEX Study Questions 582
Answers: 582
41 Drugs for Lower Respiratory Disorders 583
Outline 583
Objectives 583
Key Terms 583
Chronic Obstructive Pulmonary Disease 584
Bronchial Asthma 585
Pathophysiology 585
Sympathomimetics: Alpha- and Beta2-Adrenergic Agonists 586
Albuterol 586
Metaproterenol 586
Isoproterenol 586
Use of an Aerosol Inhaler 586
Side Effects and Adverse Reactions 586
Anticholinergics 588
Methylxanthine (Xanthine) Derivatives 589
Theophylline 589
Pharmacokinetics 589
Pharmacodynamics 590
Side Effects and Adverse Reactions 590
Drug Interactions 590
Leukotriene Receptor Antagonists and Synthesis Inhibitors 590
Glucocorticoids (Steroids) 595
Side Effects and Adverse Reactions 595
Cromolyn and Nedocromil 597
Drug Therapy for Asthma According to Severity 597
Drug Therapy for Asthma According to Age 597
Young Children 597
Older Adults 597
Mucolytics 597
Antimicrobials 597
Key Websites 597
Critical Thinking Case Study 598
NCLEX Study Questions 598
Answers: 598
Unit XIV Cardiovascular Agents 599
Heart 599
Conduction of Electrical Impulses 599
Regulation of Heart Rate and Blood Flow 600
Circulation 600
Blood 600
42 Cardiac Glycosides, Antianginals, and Antidysrhythmics 601
Outline 601
Objectives 601
Key Terms 601
Cardiac Glycosides 602
Nonpharmacologic Measures to Treat Heart Failure 603
Laboratory Tests 603
Atrial Natriuretic Hormone or Peptide. 603
Brain Natriuretic Peptide. 603
Digoxin 603
Pharmacokinetics 603
Pharmacodynamics 603
Digitalis (Digoxin) Toxicity 603
Antidote for Cardiac/Digitalis Glycosides 603
Drug Interactions 604
Phosphodiesterase Inhibitors 604
Other Agents Used to Treat Heart Failure 605
Antianginal Drugs 607
Types of Angina Pectoris 607
Nonpharmacologic Measures to Control Angina 607
Types of Antianginal Drugs 607
Nitrates 607
Pharmacokinetics 608
Pharmacodynamics 608
Side Effects and Adverse Reactions 608
Drug Interactions 608
Beta Blockers 608
Unit XV Gastrointestinal Agents 674
Oral Cavity 674
Esophagus 674
Stomach 674
Small Intestine 674
Large Intestine 674
Drugs For Gastrointestinal Disorders 675
47 Drugs for Gastrointestinal Tract Disorders 676
Outline 676
Objectives 676
Key Terms 676
Vomiting 676
Nonpharmacologic Measures 677
Nonprescription Antiemetics 677
Prescription Antiemetics 678
Antihistamines and Anticholinergics 678
Side Effects and Adverse Reactions. 680
Dopamine Antagonists 680
Phenothiazine Antiemetics 680
Pharmacokinetics 680
Pharmacodynamics 680
Drug and Laboratory Interactions. 681
Unit XVI Eye, Ear, and Skin Agents 707
Overview of the Eye 707
Overview of the Ear 707
Overview of the Skin 707
49 Drugs for Eye and Ear Disorders 709
Outline 709
Objectives 709
Key Terms 709
Drugs for Disorders of the Eye 710
Diagnostic Stains 710
Topical Anesthetics 710
Antiinfectives 710
Antiinflammatories 710
Decongestants 710
Lubricants 714
Immunosuppressants 714
Antiglaucoma Agents 714
Prostaglandin Analogues 715
Side Effects and Adverse Reactions. 715
Cholinergic Agents 715
Beta-Adrenergic Blockers 716
Side Effects and Adverse Effects 716
Alpha-Adrenergic Agonists 718
Side Effects and Adverse Effects 718
Carbonic Anhydrase Inhibitors 718
Unit XVII Endocrine Agents 739
Pituitary Gland 739
Anterior Pituitary Gland 740
Thyroid-Stimulating Hormone 740
Adrenocorticotropic Hormone 740
Gonadotropic Hormones 740
Growth Hormone 740
Posterior Pituitary Gland 740
Thyroid Gland 740
Parathyroid Glands 740
Adrenal Glands 741
Pancreas 741
Drugs for Endocrine Disorders 741
51 Endocrine Drugs: 742
Outline 742
Objectives 742
Key Terms 742
Pituitary Gland 743
Anterior Lobe 743
Growth Hormone 743
Drug Therapy: Growth Hormone Deficiency 743
Drug Therapy: Growth Hormone Excess 743
Thyroid-Stimulating Hormone 743
Adrenocorticotropic Hormone 743
Pharmacokinetics 744
Pharmacodynamics 745
Drug Interactions. 745
Posterior Lobe 745
Thyroid Gland 746
Hypothyroidism 747
Drug Therapy: Hypothyroidism 747
Pharmacokinetics 748
Pharmacodynamics 748
Drug Interactions. 748
Hyperthyroidism 748
Drug Therapy: Hyperthyroidism 749
Drug Interactions. 749
Parathyroid Glands 749
Hypoparathyroidism 749
Calcitriol 749
Pharmacokinetics 750
Pharmacodynamics 750
Hyperparathyroidism 751
Adrenal Glands 751
Glucocorticoids 752
Pharmacokinetics 753
Pharmacodynamics 753
Side Effects and Adverse Reactions. 753
Drug Interactions. 753
Mineralocorticoids 755
Key Websites 756
Critical Thinking Case Study 756
NCLEX Study Questions 757
Answers: 757
52 Antidiabetics 758
Outline 758
Objectives 758
Key Terms 758
Diabetes Mellitus 759
Insulin 759
Beta Cell Secretion of Insulin 759
Commercially Prepared Insulin 759
Administration of Insulin 760
Types of Insulin 760
Insulin Resistance 761
Storage of Insulin 761
Pharmacokinetics 761
Pharmacodynamics 761
Sliding-Scale Insulin Coverage 761
Drug Interactions. 761
Side Effects and Adverse Reactions: Hypoglycemic Reactions and Ketoacidosis. 762
Insulin Pen Injectors 763
Insulin Pumps 764
Insulin Jet Injectors 764
Oral Antidiabetic Drugs (Oral Hypoglycemic Drugs) 765
First- and Second-Generation Sulfonylureas 765
Pharmacokinetics 766
Pharmacodynamics 766
Side Effects, Adverse Reactions, and Contraindications. 768
Drug Interactions. 768
Nonsulfonylureas 768
Biguanides: Metformin (Glucophage) 768
Alpha-Glucosidase Inhibitors: Acarbose (Precose) and Miglitol (Glyset) 769
Thiazolidinediones 769
Meglitinides 769
Incretin Modifier 770
Guidelines for Oral Antidiabetic (Hypoglycemic) Therapy for Type 2 Diabetes 770
Other Antidiabetic Agents 770
Hyperglycemic Drugs 771
Glucagon 771
Diazoxide 771
Key Websites 771
Critical Thinking Case Study 772
NCLEX Study Questions 772
Answers: 772
Unit XVIII Reproductive and Gender-Related Agents 773
Female Reproductive Processes 773
The Menstrual Cycle 773
Male Reproductive Processes 774
Male Reproductive Anatomy and Physiology 774
Hormonal Regulation of Male Reproductive Functioning and Spermatogenesis 774
Sexual Function 775
Process of Fertilization 775
53 Female Reproductive Cycle I: 777
Outline 777
Objectives 777
Key Terms 777
Physiology of Pregnancy 778
Therapeutic Drug and Herbal Use in Pregnancy 780
Iron 780
Unit XIX Emergency Agents 908
59 Adult and Pediatric Emergency Drugs 909
Outline 909
Objectives 909
Key Terms 909
Oxygen as an Emergency Drug 910
Emergency Drugs for Cardiac Disorders 910
Aspirin 911
Nitroglycerin 911
Morphine Sulfate 911
Atropine Sulfate 912
Pediatric Implications 912
Adenosine 912
Diltiazem 913
Amiodarone 913
Appendices 927
Appendix A Therapeutic Drug Monitoring* 927
Appendix B Selected Potential Weapons of Bioterrorism 932
References 934
Index 939
A 939
B 942
C 943
D 946
E 948
F 949
G 950
H 951
I 953
J 954
K 954
L 954
M 955
N 957
O 959
P 960
Q 966
R 966
S 967
T 969
U 970
V 970
W 971
X 971
Y 971
Z 971
List of Features 976
Prototype Drug Charts 976
Nursing Process 976
Herbal Alerts IBC1
Safety: Preventing Medication Errors IBC1