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 |