pharmacology for nursing practice - gbv · cns depressants, 117 cns stimulants, 118 hallucinogens,...
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Pharmacologyfor Nursing Practice
Kathleen Gutierrez, PhD, RN, ANP, CNSAdult Nurse Practitioner
Private Practice;Associate Professor
Regis University andUniversity of Colorado Health Sciences Center
Denver, Colorado
Sherry F. Queener, PhDProfessor of Pharmacology
Indiana University School of Medicine;Associate Dean
Indiana University Graduate School;and Director of the Graduate Office
Indiana University Purdue University Indianapolis (IUPUI)Indianapolis, Indiana
MosbyAn Affiliate of Elsevier Science
Table of Contents
PART |
BASIC CONCEPTS AND PRINCIPLES
1 Drugs in the Body: Pharmacodynamicsand Pharmacokinetics, l
SHERRY F. QUEENER
Mechanisms of Drug Action: Pharmacodynamics, 2How Drug Dosage Relates to Drug Action:
Pharmacokinetics, 6
2 Perinatal Pharmacotherapeutics, 21KATHLEEN GUTIERREZ
Maternal Pharmacokinetic Considerations, 21Fetal-Placenta! Pharmacokinetic Considerations, 23Pharmacodynamics, 26Drugs and Lactation, 27APPLICATION TO PRACTICE, 29Assessment, 29Goals of Therapy, 30Intervention, 30Evaluation, 32
3 Pediatric Pharmacotherapeutics, 33KATHLEEN GUTIERREZ
Anatomic and Physiologic Variables, 34Pharmacokinetic Considerations, 36Pharmacodynamic Considerations, 38APPLICATION TO PRACTICE, 39Assessment, 39Goals of Therapy, 39Intervention, 40Evaluation, 43
4 Older Adult Pharmacotherapeutics, 45KATHLEEN GUTIERREZ
Anatomic and Physiologic Variables, 46Pharmacokinetic Considerations, 48Pharmacodynamic Considerations, 50APPLICATION TO PRACTICE, 51Assessment, 51Goals of Therapy, 53Intervention, 54Evaluation, 55
PART 11IMPLICATIONS OF DRUG THERAPY
5 Role of the Nurse in Drug Therapy, 57KATHLEEN GUTIERREZ
Collaborative Nature of Drug Therapy, 58Sources of Drug Information, 58APPLICATION TO PRACTICE, 60Assessment, 60Goals of Therapy, 62Intervention, 62Evaluation, 69
6 Evidence-Based Practice andPharmacoeconomics, 73
KATHLEEN GUTIERREZ
Evidence-Based Practice, 75EBP's Link to Pharmacoeconomics, 77Future of Pharmacoeconomics, 83Summary, 83
XI
Table of Contents
Legal Implications of Drug Therapy, 85LYNN ROGER WILLIS
Establishment of Safety and Efficacy of Drugs, 85Drug Testing, 89Controlled Substances, 91Canadian Drug Legislation, 92
Over-the-Counter Drugs and HerbalRemedies, 95
LYNN ROGER WILLIS and KATHLEEN GUTIERREZ
Regulation of Over-the-Counter Drugs, 95Resurgence of Herbal Remedies, 97Regulation of Herbal Remedies, 97Herbal Remedies Go Beyond the Scope of OTC
Drugs, 98Pseudoscience and Herbal Remedies, 98Pharmacology of Widely Used Herbal
Remedies, 99Potentially Dangerous Herbal Remedies, 103Nonherbal Dietary Supplements, 104APPLICATION TO PRACTICE, 106Assessment, 106Goals of Therapy, 106Intervention, 106Evaluation, 107
3 Substance Abuse, inMICHAEL R. VASKO and KATHLEEN GUTIERREZ
General Characteristics of Dependence-Producing Drugs, 111
Diagnosis of Drug Dependence, 112Opioids, 115CNS Depressants, 117CNS Stimulants, 118Hallucinogens, 120Inhalants, 122APPLICATION TO PRACTICE, 123Assessment, 123Goals of Therapy, 126Intervention, 127Evaluation, 127
HIuTONOMic NERVOUS SYSTEM DRUGS) Introduction to Autonomic Nervous
System Pharmacology, 129JOSEPH A. DiMICCO and KATHLEEN GUTIERREZ
Overview of the Autonomic Nervous System, 130Confusing Terminology of Drugs Acting through
the Autonomic Nervous System, 137
11 Parasympathetic Nervous SystemDrugs, 139
JOSEPH A. DiMICCO and KATHLEEN GUTIERREZ
PHYSIOLOGY: Muscarinic CholinergicMechanisms, 140
Eye, 140Exocrine Glands, 140Smooth Muscle of Gastrointestinal Tract and
Bladder, 140Airways, 140Heart, 140Bloodvessels, 140DRUG CIASS: Muscarinic Receptor Agonists or
Cholinomimetics, 141DRUG CLASS: Muscarinic Receptor Antagonists
or Anticholinergics, 143PHYSIOLOGY: Nicotinic Cholinergic
Mechanisms, 145DRUG CLASS: Ganglionic Nicotinic Receptor
Antagonist (Ganglionic Blocker), 145PHYSIOLOGY: Acetylcholinesterase, 146DRUG CIASS: Acetylcholinesterase
Inhibitors, 146APPLICATION TO PRACTICE, 148Assessment, 148Goals of Therapy, 150Intervention, 150Evaluation, 151
12 Drugs Affecting AdrenergicMechanisms, 153
JOSEPH A. DiMICCO and KATHLEEN GUTIERREZ
PHYSIOLOGY: Alpha-Adrenergic Receptors, 154DRUG CLASS: Alpha-Adrenergic Receptor
Agonists, 156DRUG CLASS: Alpha-Adrenergic Receptor
Antagonists (Alpha Blockers), 158PHYSIOLOGY: Beta-Adrenergic Receptors, 160DRUG CLASS: Beta-Adrenergic Receptor
Agonists, 160DRUG CLASS: Beta-Adrenergic Receptor
Antagonists (Beta Blockers), 162Other Drugs Acting on Sympathetic
Mechanisms, 163APPLICATION TO PRACTICE, 164Assessment, 164Goals of Therapy, 165Intervention, 165Evaluation, 165
Table of Contents XIII
PART |VCENTRAL NERVOUS SYSTEM DRUGS
13 Opioid Analgesics, 167MICHAEL R. VASKO and KATHLEEN GUTIERREZ
History of Opioids, 168PHYSIOLOGY: Pain, 168Pain Pathways, 169Types of Pain, 170DRUG CLASS: Opioid Agonists, 171DRUG CLASS: Mixed Agonist-Antagonists and
Partial Agonists, 180DRUG CLASS: Opioid Antagonists, 182DRUG CIASS: Miscellaneous Drugs, 183APPLICATION TO PRACTICE, 183Assessment, 183Goals of Therapy, 185Intervention, 185Evaluation, 187
14 Nonsteroidal Antiinflammatory Drugs(NSAIDs) and Disease-ModifyingAntirheumatic Drugs (DMARDs), 191
MICHAEL R. VASKO and KATHLEEN GUTIERREZ
PATHOPHYSIOLOGY: Inflammation, 192PATHOPHYSIOLOGY: Pain, 193PATHOPHYSIOLOGY: Fever, 194Additional Actions of Prostaglandins, 194DRUG CIASS: Salicylates, 195DRUG CIASS: Other NSAIDs, 200DRUG CIASS: Cyclooxygenase-2 Inhibitors, 202ACETAMINOPHEN, 202DRUG CIASS: Disease-Modifying Antirheumatic
Drugs, 204DRUG CIASS: Gold Salts, 205DRUG CLASS: Miscellaneous Drugs for
Osteoarthritis, 206PATHOPHYSIOLOGY: Gout, 207DRUG CLASS: Antigout Drugs, 207DRUG CIASS: Uricosuric Drugs, 208APPLICATION TO PRACTICE, 209Assessment, 209Goals of Therapy, 211Intervention, 211Evaluation, 215
15 Drugs to Treat Headaches, 217MICHAEL R. VASKO and KATHLEEN GUTIERREZ
PATIIOPHYSIOLOGY: Headaches, 218DRUG CLASS: Triptans, 220DRUG CLASS: Ergot Derivatives, 221APPLICATION TO PRACTICE, 22.1Assessment, 223Goals of Therapy, 224
Intervention, 225Evaluation, 226
16 Anesthetics and Related Drugs, 229JOSEPH A. DiMICCO and KATHLEEN GUTIERREZ
Anesthesia Defined, 230PHYSIOLOGY: Local Anesthesia ,ind the
Transmission ot Painful Stimuli, 230DRUG CLASS: Local Anesthetics, 230PHYSIOLOGY: General Anesthesia, 234DRUG CLASS: Inhaled Anesthetics, 235DRUG CLASS: Intravenous Anesthetics, 237PI lYSIOI.OGY: Neuromuscular Transmission, 239DRUG CLASS: Neuromuscular Blockers, 240APPLICATION TO PRACTICE, 242Assessment, 242Goals of Therapy, 243Intervention, 244Evaluation, 245
17 Anxiolytic and Sedative-HypnoticDrugs, 247
JOSEPH A. DiMICCO and KATHLEEN GUTIERREZ
PATHOPHYSIOLOGY: Anxiety, Sleep, and TheirDisorders, 248
DRUG CLASS: Benzodiazepines and RelatedDrugs, 250
DRUG CIASS: Benzodiazepine Antagonists, 252DRUG CLASS: Barbiturates, 252DRUG CLASS: Atypical Anxiolytic, 254DRUG CIASS: Older Sedative-Hypnotics, 254APPLICATION TO PRACTICE, 255Assessment, 255Goals of Therapy, 258Intervention, 258Evaluation, 260
18 Antidepressant and Antimania Drugs, 263MICHAEL R. VASKO and KATHLEEN GUTIERREZ
PATHOPHYSIOLOGY: Depression, 264DRUG CLASS: Selective Serotonin Reuptake
Inhibitors (SSRIs), 268DRUG CLASS: Tricyclic Antidepressants
(I(As), 270DRUG CLASS: Atypical Antidepressants, 271DRUG CLASS: Monoamine Oxidase Inhibitors
(MAOIs), 273PAIIIOPI lYSIOI.OGY: Bipolar Disorders, 273DRUG CLASS: Antimania or Mood-Altering
Drugs, 27bAPPLICATION TO PRACTICE, 278Assessment, 278Goals of Therapy, 281Intervention, 281Evaluation, 282
XII Table of Contents
7 Legal Implications of Drug Therapy, 85LYNN ROGER WILLIS
Establishment of Safety and Efficacy of Drugs, 85Drug Testing, 89Controlled Substances, 91Canadian Drug Legislation, 92
8 Over-the-Counter Drugs and HerbalRemedies, 95
LYNN ROGER WILLIS and KATHLEEN GUTIERREZ
Regulation of Over-the-Counter Drugs, 95Resurgence of Herbal Remedies, 97Regulation of Herbal Remedies, 97Herbal Remedies Go Beyond the Scope of OTC
Drugs, 98Pseudoscience and Herbal Remedies, 98Pharmacology of Widely Used Herbal
Remedies, 99Potentially Dangerous Herbal Remedies, 103Nonherbal Dietary Supplements, 104APPLICATION TO PRACTICE, 106Assessment, 106Goals of Therapy, 106Intervention, 106Evaluation, 107
9 Substance Abuse, illMICHAEL R. VASKO and KATHLEEN GUTIERREZ
General Characteristics of Dependence-Producing Drugs, 111
Diagnosis of Drug Dependence, 112Opioids, 115CNS Depressants, 117CNS Stimulants, 118Hallucinogens, 120Inhalants, 122APPLICATION TO PRACTICE, 123Assessment, 123Goals of Therapy, 126Intervention, 127Evaluation, 127
PART HIAUTONOMIC NERVOUS SYSTEM DRUGS
10 Introduction to Autonomic NervousSystem Pharmacology, 129
JOSEPH A. DiMICCO and KATHLEEN GUTIERREZ
Overview of the Autonomic Nervous System, 130Confusing Terminology of Drugs Acting through
the Autonomic Nervous System, 137
11 Parasympathetic Nervous SystemDrugs, 139
JOSEPH A. DiMICCO and KATHLEEN GUTIERREZ
PHYSIOLOGY: Muscarinic CholinergicMechanisms, 140
Eye, 140Exocrine Glands, 140Smooth Muscle of Gastrointestinal Tract and
Bladder, 140Airways, 140Heart, 140Bloodvessels, 140DRUG CIASS: Muscarinic Receptor Agonists or
Cholinomimetics, 141DRUG CIASS: Muscarinic Receptor Antagonists
or Anticholinergics, 143PHYSIOLOGY: Nicotinic Cholinergic
Mechanisms, 145DRUG CIASS: Ganglionic Nicotinic Receptor
Antagonist (Ganglionic Blocker), 145PHYSIOLOGY: Acetylcholinesterase, 146DRUG CIASS: Acetylcholinesterase
Inhibitors, 146APPLICATION TO PRACTICE, 148Assessment, 148Goals of Therapy, 150Intervention, 150Evaluation, 151
12 Drugs Affecting AdrenergicMechanisms, 153
JOSEPH A. DiMICCO and KATHLEEN GUTIERREZ
PHYSIOLOGY: Alpha-Adrenergic Receptors, 154DRLIG CIASS: Alpha-Adrenergic Receptor
Agonists, 156DRUG CLASS: Alpha-Adrenergic Receptor
Antagonists (Alpha Blockers), 158PHYSIOLOGY: Beta-Adrenergic Receptors, 160DRLIG CIASS: Beta-Adrenergic Receptor
Agonists, 160DRLIG CLASS: Beta-Adrenergic Receptor
Antagonists (Beta Blockers), 162Other Drugs Acting on Sympathetic
Mechanisms, 163APPLICATION TO PRACTICE, 164Assessment, 164Goals of Therapy, 165Intervention, 165Evaluation, 165
Table of Contents XIII
PART |VCENTRAL NERVOUS SYSTEM DRUGS
13 Opioid Analgesics, 167MICHAEL R. VASKO and KATHLEEN GUTIERREZ
History of Opioids, 168PHYSIOLOGY: Pain, 168Pain Pathways, 169Types of Pain, 170DRUG CIASS: Opioid Agonists, 171DRUG CLASS: Mixed Agonist-Antagonists and
Partial Agonists, 180DRUG CIASS: Opioid Antagonists, 182DRUG CLASS: Miscellaneous Drugs, 183APPLICATION TO PRACTICE, 183Assessment, 183Goals of Therapy, 185Intervention, 185Evaluation, 187
14 Nonsteroidal Antiinflammatory Drugs(NSAIDs) and Disease-ModifyingAntirheumatic Drugs (DMARDs), 191
MICHAEL R. VASKO and KATHLEEN GUTIERREZ
PATHOPHYSIOLOGY: Inflammation, 192PATHOPHYSIOLOGY: Pain, 193PATHOPHYSIOLOGY: Fever, 194Additional Actions of Prostaglandins, 194DRUG CIASS: Salicylates, 195DRUG CIASS: Other NSAIDs, 200DRUG CIASS: Cyclooxygenase-2 Inhibitors, 202ACETAMINOPHEN, 202DRLIG CIASS: Disease-Modifying Antirheumatic
Drugs, 204DRUG CLASS: Gold Salts, 205DRUG CIASS: Miscellaneous Drugs for
Osteoarthritis, 206PATHOPHYSIOLOGY: Gout, 207DRUG CIASS: Antigout Drugs, 207DRUG CIASS: Uricosuric Drugs, 208APPLICATION TO PRACTICE, 209Assessment, 209Goals of Therapy, 211Intervention, 211Evaluation, 215
15 Drugs to Treat Headaches, 217MICHAEL R. VASKO and KATHLEEN GUTIERREZ
PATHOPIIYSIOLOGY: Headaches, 218DRUG CIASS: Triptans, 220DRUG CLASS: Ergot Derivatives, 221APPLICATION TO PRACTICE, 223Assessment, 223Goals of Therapy, 224
Intervention, 225Evaluation, 226
16 Anesthetics and Related Drugs, 229JOSEPH A. DiMICCO and KATHLEEN GUTIERREZ
Anesthesia Defined, 230PHYSIOLOGY: Local Anesthesia and the
Transmission of Painful Stimuli, 230DRUG CLASS: Local Anesthetics, 230PHYSIOLOGY: General Anesthesia, 234DRUG CLASS: Inhaled Anesthetics, 235DRUG CIASS: Intravenous Anesthetics, 237PI IYSIOLOGY: Neuromuscular Transmission, 239DRUG CIASS: Neuromuscular Blockers, 240APPLICATION TO PRACTICE, 242Assessment, 242Goals of Therapy, 243Intervention, 244Evaluation, 245
17 Anxiolytic and Sedative-HypnoticDrugs, 247
JOSEPH A. DiMICCO and KATHLEEN GUTIERREZ
PATHOPI lYSIOI.OGY: Anxiety, Sleep, and TheirDisorders, 248
DRUG CLASS: Benzodiazepines and RelatedDrugs, 250
DRUG CIASS: Benzodiazepine Antagonists, 252DRUG CLASS: Barbiturates, 252DRUG CLASS: Atypical Anxiolytic, 254DRUG CLASS: Older Sedative-I lypnotics, 254APPLICATION TO PRACTICE, 255Assessment, 255Goals of Therapy, 258Intervention, 258Evaluation, 260
18 Antidepressant and Antimania Drugs, 263MICHAEL R. VASKO and KATHLEEN GUTIERREZ
PATHOPHYSIOLOGY: Depression, 264DRUG CIASS: Selective Serotonin Reuptake
Inhibitors (SSRIs), 268DRUG CIASS: Iricyclic Antidepressants
(TCAs), 270DRUG CIASS: Atypical Antidepressants, 271DRUG CIASS: Monoamine Oxidase Inhibitors
(MAOIs), 273PATHOPHYSIOI.OCY: Bipolar Disorders, 275DRUG CIASS: Antimania or Mood-Altering
Drugs, 276APPLICATION TO PRACTICE, 278Assessment, 278Goals of Therapy, 281Intervention, 281Evaluation, 282
XIV Table of Contents
19 Antipsychotic Drugs, 285MICHAEL R. VASKO and KATHLEEN GUTIERREZ
PATHOPHYSIOLOGY, 286Psychoses, 286Schizophrenia, 286DRUG CIASS: Antipsychotics, 287APPLICATION TO PRACTICE, 295Assessment, 295Goals of Therapy, 297Intervention, 297Evaluation, 299
20 Central Nervous System Stimulants, 303MICHAEL R. VASKO and KATHLEEN GUTIERREZ
PATHOPHYSIOLOGY: Narcolepsy, 303PATHOPHYSIOLOGY: Attention-Deficit
Hyperactivity Disorder, 304DRUG CLASS: CNS Stimulants, 305PATHOPHYSIOLOGY: Obesity, 308DRUG CLASS: Antiobesity Drugs, 309DRUG CLASS: Analeptics, 311APPLICATION TO PRACTICE, 312Assessment, 312Goals of Therapy, 313Intervention, 314Evaluation, 315
PART VNERVOUS SYSTEM DRUGS21 Skeletal Muscle Relaxants, 317
MICHAEL R. VASKO and SUSAN SCIACCA
PATHOPHYSIOLOGY: Spasms and Spasticity, 318Spasms, 318Spasticity, 319DRUG CLASS: Drugs Used to Treat Spasticity, 320DRUG CLASS: Skeletal Muscle Relaxants, 323APPLICATION TO PRACTICE, 324Assessment, 324Goals of Therapy, 325Intervention, 325Evaluation, 327
22 Anticonvulsants, 329MICHAEL R. VASKO and SUSAN SCIACCA
PATHOPHYSIOLOGY: Epilepsy, 330Classification of Epilepsy, 330Mechanisms Underlying Epilepsy, 332DRUG CLASS: Hydantoins, 332DRUG CIASS: Iminostilbenes, 334DRUG CLASS: Barbiturates, 335DRUG CLASS: Succinimides, 336DRUG CLASS: Valproates, 336DRLIG CLASS: Benzodiazepines, 337DRUG CLASS: Oxazolidinediones, 338DRUG CLASS: Miscellaneous Anticonvulsants, 339APPLICATION TO PRACTICE, 342
Assessment, 342Goals of Therapy, 343Intervention, 344Evaluation, 346
23 Drugs to Treat Movement Disorders,Myasthenia Gravis, and Alzheimer'sDisease, 349
MICHAEL R. VASKO and SUSAN SCIACCA
PATHOPHYSIOLOGY: Parkinson's Disease, 350DRUG CLASS: Anticholinergic Drugs, 353DRUG CIASS: Dopaminergic Drugs, 354DRUG CIASS: Dopamine Receptor Agonists, 355DRLJC CLASS: Miscellaneous Drugs Used to Treat
Parkinson's Disease, 356APPLICATION TO PRACTICE, 357Assessment, 357Goals of Therapy, 359Intervention, 359Evaluation, 361PATHOPHYSIOLOGY: Myasthenia Gravis, 362DRUG CIASS: Acetylcholinesterase Inhibitors, 364DRLIG CIASS: Immunosuppressive Drugs, 365APPLICATION TO PRACTICE, 366Assessment, 366Goals of Therapy, 367Intervention, 367Evaluation, 369PATHOPHYSIOLOGY: Alzheimer's Disease, 369DRUG CIASS: Acetylcholinesterase Inhibitors
LIsed to Treat Alzheimer's Disease, 370APPLICATION TO PRACTICE, 371Assessment, 371Goals of Therapy, 372Intervention, 372Evaluation, 373
PART V IANTIMICROBIAL DRUGS
24 Introduction to the Use ofAntimicrobial Drugs, 377
SHERRY F. QUEENER and KATHLEEN GUTIERREZ
PATHOPHYSIOLOGY: Infectious Disease, 377Strategies for Controlling Infectious Disease, 379Measures of Antibiotic Effectiveness, 379Factors Affecting Outcomes of Antibiotic
Therapy, 381Problems in Antibiotic Therapy, 384Misuse of Antibiotics, 385APPLICATION TO PRACTICE, 386Assessment, 386Goals of Therapy, 387Intervention, 387Evaluation, 388
Table of Contents XV
25 Penicillins, Cephalosporins, andRelated Drugs, 389
SHERRY F. QUEENER and KATHLEEN GUTIERREZ
PATHOPHYSIOLOGY, 389DRUG CIASS: Beta-Lactam Antibiotics, 390DRUG CLASS: Narrow-Spectrum Antibiotics, 393DRUG CLASS: Penicillinase-Resistant
Penicillins, 395DRUG CLASS: Extended-Spectrum Penicillins, 395DRUG CLASS: Anti-Pseudomonas Penicillins, 396DRUG CLASS: Cephalosporins, 396DRUG CIASS: Miscellaneous Beta-Lactam
Antibiotic, 398DRUG CLASS: Carbapenems, 399DRUG CIASS: Carbacephems, 399APPLICATION TO PRACTICE, 400Assessment, 400Goals of Therapy, 401Intervention, 401Evaluation, 403
26 Macrolides: Erythromycin and RelatedDrugs, 405
SHERRY F. QUEENER and KATHLEEN GUTIERREZ
PATHOPHYSIOLOGY, 405DRUG CLASS: Macrolides, 406APPLICATION TO PRACTICE, 409Assessment, 409Goals of Therapy, 410Intervention, 410Evaluation, 411
27 Fluoroquinolones and RelatedDrugs, 413
SHERRY F. QUEENER and KATHLEEN GUTIERREZ
PATHOPHYSIOLOGY, 413DRUG CLASS: Fluoroquinolones, 414APPLICATION TO PRACTICE, 417Assessment, 417Goals of Therapy, 417Intervention, 418Evaluation, 418
28 Tetracydines and Chloramphenicol, 421SHERRY F. QUEENER and KATHLEEN GUTIERREZ
PATHOPHYSIOLOGY: Nonbacterial Infections, 421DRUG CIASS: Tetracydines, 422DRLIG CIASS: Acetamides, 425APPLICATION TO PRACTICE, 426Assessment, 426Goals of Therapy, 428Intervention, 428Evaluation, 428
29 Aminoglycosides, 431SHERRY F. QUEENER and KATHLEEN GUTIERREZ
PATIIOPHYSIOLOCY, 432DRUG CLASS: Aminoglycosides, 432APPLICATION TO PRACTICE, 434Assessment, 434Goals of Therapy, 435Intervention, 435Evaluation, 437
30 Antibacterial Drugs for SpecialPurposes, 439
SHERRY F. QUEENER and KATHLEEN GUTIERREZ
PATHOPHYSIOLOGY: Urinary Tract Infections, 440DRUG CIASS: Sulfonamides, 441DRUG CIASS: Dihydrofolate Reductase
Inhibitors, 444DRUG CLASS: Urinary Tract Antiseptics, 445PATHOPHYSIOLOGY: Anaerobic Infections, 447DRUG CLASS: Nitroimidazoles, 448DRUG CIASS: Lincosamine, 448PATHOPHYSIOLOGY: Nosocomial Infections, 449DRUG CLASS: Glycopeptides, 450DRUG CLASS: Streptogramins, 451DRUG CIASS: Oxazolidinone, 452APPLICATION TO PRACTICE, 452Assessment, 452Goals of Therapy, 455Intervention, 455Evaluation, 457
31 Antiviral Drugs, 459SHERRY F. QUEENER and KATHLEEN GUTIERREZ
PATHOPHYSIOLOGY: Viral Infections, 459DRUG CIASS: Nucleoside Reverse Transcriptase
Inhibitors (NRTls) for HIV, 462DRLIG CLASS: Nucleotide Reverse Transcriptase
Inhibitors (NtRTIs) for HIV, 464DRUG CIASS: Nonnucleoside Reverse
Transcriptase Inhibitors (NNRTIs) for HIV, 465DRLIG CIASS: HIV Protease Inhibitors, 466DRUG CLASS: Acyclic Nucleoside Analogs for
Systemic Viral Diseases Other than AIDS, 467DRUG CLASS: Neuraminidase Inhibitors of
Influenza, 468DRUG CLASS: Amantidines for Influenza, 469DRUG CIASS: Nucleoside Analog for Systemic
Viral Diseases, 470DRUG CIASS: Alfa Interierons for Systemic Viral
Diseases, 470APPLICATION TO PRACTICE, 471Assessment, 471Goals of Therapy, 473Intervention, 473Evaluation, 476
XVI Table of Contents
32 Antifungal Drugs, 479SHERRY F. QUEENER and KATHLEEN GUTIERREZ
PATHOPHYSIOLOGY: Systemic FungalInfections, 480
DRLIG CLASS: Polyenes, 481DRUG CLASS: Antimetabolites, 483DRUG CIASS: Azole Antifungal Drugs, 484DRUG CLASS: Echinocandin, 486APPLICATION TO PRACTICE, 486Assessment, 486Goals of Therapy, 488Intervention, 488Evaluation, 490
33 Antitubercular and Other MycobacterialDrugs, 493
SHERRY F. QUEENER and KATHLEEN GUTIERREZ
PATHOPHYSIOLOGY: Tuberculosis, 493DRUG CIASS: Primary Drugs Used to Treat
Tuberculosis, 496DRUG CIASS: Miscellaneous Drugs Used to Treat
Tuberculosis, 499APPLICATION TO PRACTICE: Tuberculosis, 500Assessment, 500Goals of Therapy, 502Intervention, 502Evaluation, 504PATHOPHYSIOLOGY: Leprosy, 504DRUG CLASS: Drugs Used to Treat
Leprosy, 505DRUG CIASS: Miscellaneous Drugs Used to Treat
Leprosy, 506PATHOPHYSIOLOGY: Mycobacterium avium
Complex, 507DRUG CIASS: Drugs Used to Treat Mycobacterium
avium Complex, 507APPLICATION TO PRACTICE: Leprosy, 508Assessment, 508Goals of Therapy, 509Intervention, 509Evaluation, 509
34 Antiprotozoal and AntihelminthicDrugs, 511
SHERRY F. QUEENER and KATHLEEN GUTIERREZ
PATHOPHYSIOLOGY: Malaria, 512DRUG CLASS: Antimalarial Drugs, 513DRUG CLASS: Drugs Used Primarily to Treat
Chloroquine-Resistant Malaria, 515PATHOPHYSIOLOGY: Amebic Disease, 516DRUG CIASS: Drugs Used to Treat Amebic
Disease, 516PATHOPHYSIOLOGY: Selected Parasitic
Diseases, 517
Cryptosporidiosis and Microsporidiosis, 517Giardiasis, 518Leishmaniasis, 518Pneumocystosis, 518Toxoplasmosis, 519Trichomoniasis, 519DRUG CLASS: Primary Drugs Used to Treat
Selected Parasitic and Opportunistic Diseases,519
DRLIG CLASS: Miscellaneous Drugs Used toTreat Selected Parasitic and OpportunisticDiseases, 520
PATHOPHYSIOLOGY: Diseases Caused byHelminths, 521
Ascariasis, 521Enterobiasis, 521Whipworm Infestation, 521Threadworm Infestation, 523Hookworm Infestation, 523Trichinosis, 523Tapeworm Infestation, 523DRUG CLASS: Drugs Used to Treat Diseases
Caused by Helminths, 523APPLICATION TO PRACTICE, 525Assessment, 525Goals of Therapy, 527Intervention, 527Evaluation, 528
PART VI IIMMUNE SYSTEM DRUGS35 Immunizing Drugs, 531
SUSAN SCIACCA
PHYSIOLOGY: Immunostimulation, 532Types of Immunity, 533DRUG CLASS: Vaccines and Toxoids, 534DRUG CLASS: Antisera and Antitoxins, 539APPLICATION TO PRACTICE, 542Assessment, 542Goals of Therapy, 543Intervention, 544Evaluation, 548
36 Biologic Response Modifiers, 551SHERRY F. QUEENER and KATHLEEN GUTIERREZ
PATHOPHYSIOLOGY: Immune SystemDysfunction, 552
DRUG CLASS: Colony-Stimulating Factors, 555DRUG CLASS: Growth Factors that Stimulate
Platelet or Erythrocyte Production, 556DRUG CLASS: Interleukins, 556DRUG CLASS: Interleukin Receptor Blockers and
Other Immunosuppressant Antibodies, 557
Table of Contents XVII
DRUG CLASS: Cytokine Release Inhibitors, 558DRUG CLASS: Interferons, 559DRUG CIASS: Antagonists of 'Tumor Necrosis
Factor (TNF-alpha), 560DRUG CLASS: Biologic Response Modifiers
Targeted to Oil-Specific Markers, 561DRUG CLASS: Miscellaneous Modulators of
I m m u n e Function, 563APPLICATION TO PRACTICE, 564Assessment, 564Goals of Therapy, 566Intervention, 566Evaluation, 567
37 Antineoplastic Drugs, 569SHERRY F. QUEENER and KATHLEEN GUTIERREZ
PATHOPHYSIOLOGY: Cancer, 570DRLIG CIASS: Cytotoxic Drugs that Directly
Attack DNA, 576DRUG CIASS: Drugs that Block DNA
Synthesis, 579DRUG CIASS: Drugs that Block RNA or Protein
Synthesis, 582DRLIG CLASS: Drugs that Prevent or Arrest
Mitosis, 584DRLIG CIASS: Androgens and Anabolic
Steroids, 586DRLIG CLASS: Antiandrogens, 588DRUG CIASS: LH-FH Analogs, 589DRUG CIASS: Estrogens, 589DRLJG CIASS: Antiestrogens, 590DRUG CIASS: Aromatase Inhibitors, 591DRUG CLASS: Progestins, 591DRUG CLASS: Retinoids, 592DRLIG CIASS: Tyrosine Kinase Inhibitor, 592DRUG CIASS: Lympholytic Drugs, 593DRUG CIASS: Tissue-Directed Drugs and
Isotopes, 593DRUG CLASS: Photosensitizing Drugs, 594APPLICATION TO PRACTICE, 594Assessment, 594Goals of Therapy, 595Intervention, 596Evaluation, 603
PART VI11CARDIOVASCULAR SYSTEM DRUGS
38 Drugs Used to Treat Heart Failure, 605JOSEPH A. DiMICCO and KATHLEEN GUTIERREZ
PATHOPHYSIOI.OGY: Heart Failure, 606DRUG CLASS: Angiotensin-Converting Enzyme
(ACE) Inhibitors, 608
DRUG CIASS: Cardiac Glycosides, 609DRUG CLASS: I'hosphodiesterase Inhibitors, 611DRUG CLASS: Diuretics, 611DRUG CIASS: Vasodilators, 611DRUG CLASS: Alpha Antagonists, 612DRUG CLASS: Beta Agonists, 612DRUG CLASS: Beta-Adrenergic Antagonists (Beta
Blockers), 612APPLICATION'TO PRACTICE, 612Assessment, 612Goals of Therapy, 614Intervention, 614Evaluation, 617
39 Antianginal and Other VasodilatingDrugs, 619
LYNN ROGER WILLIS and KATHLEEN GUTIERREZ
PATHOPHYSIOI.OGY: Angina Pectoris, 620Cardiac Ischemia and Angina Pectoris, 620DRUG CLASS: Organic Nitrovasodilators, 622DRUG CIASS: Beta Blockers, 626DRUG CLASS: Calcium Channel Blockers, 627DRUG CIASS: Other Vasodilating Drugs, 628APPLICATION TO PRACTICE, 630Assessment, 630Goals of Therapy, 632Intervention, 633Evaluation, 636
40 Antiarrhythmic Drugs, 639JOSEPH A. DiMICCO and ELIZABETH KISSELL
PHYSIOLOGY: Normal Cardiac Function, 640PATHOPHYSIOLOGY: Cardiac Rhythm
Disturbances, 643DRUG CLASS: Sodium Channel Blockers (Class I
Antiarrhythmics), 645DRUG CLASS: Beta Blockers (Class II
Antiarrhythmics), 648DRUG CLASS: Drugs Prolonging Action Potential
Duration (Class III Antiarrhythmics), 648DRUG CIASS: Calcium Channel Blockers (Class
IV Antiarrhythmics), 650DRUG CLASS: Adenosine Receptor
Agonists, 650DRUG CLASS: Cardiac Glycosides, 650APPLICATION TO PRACTICE, 651Assessment, 651Goals of Therapy, 652Intervention, 652Evaluation, 653
XViii Table of Contents
41 Antihypertensive Drugs, 657JOSEPH A. DiMICCO and ELIZABETH KISSELL
PATHOPHYSIOLOGY: Hypertension, 658Essential Hypertension, 659Secondary Hypertension, 659Isolated Systolic Hypertension, 660Malignant Hypertension, 660Preeclampsia, 660Effects of Hypertension, 660Summary of Drug Therapy for
Hypertension, 660DRUG CIASS: Diuretics, 661DRLIG CIASS: Beta Blockers, 662DRLIG CIASS: Angiotensin-Converting Enzyme
(ACE) Inhibitors, 662DRLIG CIASS: Angiotensin 11-Receptor
Blockers, 663DRLIG CLASS: Calcium Channel Blockers, 664DRUG CIASS: Alpha Blockers, 664DRLIG CLASS: Centrally Acting
Antihypertensives, 664DRUG CIASS: Adrenergic Neuron-Blocking
Drugs, 665DRUG CLASS: Direct-Acting Vasodilators, 667'TREATMENT OF HYPERTENSIVE
EMERGENCIES, 667APPLICATION TO PRACTICE, 668Assessment, 668Goals of Therapy, 671Intervention, 671Evaluation, 674
42 Antilipemic Drugs, 677LYNN ROGER WILLIS and KATHLEEN GUTIERREZ
PATHOPHYSIOLOGY: Hyperlipoproteinemia, 678Types of Hyperlipoproteinemia, 681ANTILIPEMIC DRUGS, 681DRUG CIASS: Bile Acid Resins, 682DRUG CIASS: Fibric Acid Derivatives, 684DRUG CIASS: HMG-CoA Reductase
Inhibitors, 685DRUG CIASS: Nicotinic Acid, 686APPLICATION TO PRACTICE, 687Assessment, 687Goals of Therapy, 688Intervention, 688Evaluation, 691
PART | XHEMATOLOGIC SYSTEM DRUGS
43 Anticoagulant and AntiplateletDrugs, 693
LYNN ROGER WILLIS and SUSAN SCIACCA
PATHOPHYSIOLOGY: Coagulation, 694DRLIG CIASS: Anticoagulant Drugs, 694DRLIG CLASS: Direct-Acting Anticoagulants, 694DRLIG CLASS: Oral Anticoagulants, 699DRUG CLASS: Antiplatelet Drugs, 701APPLICATION TO PRACTICE, 703Assessment, 703Goals of Therapy, 705Intervention, 705Evaluation, 708
44 Thrombolytic and Sclerosing Drugs, 711LYNN ROGER WILLIS and SUSAN SCIACCA
PATHOPHYSIOLOGY: ThromboembolyticDiseases, 712
DRUG CLASS: Thromboembolytic Drugs, 714APPLICATION TO PRACTICE, 716Assessment, 716Goals of Therapy, 718Intervention, 718Evaluation, 719PATHOPHYSIOLOGY: Varicosities, 720DRUG CLASS: Sclerosing Drugs, 720DRUG CIASS: Antihemorrhagic Drugs, 721APPLICATION TO PRACTICE, 721Assessment, 721Goals of Therapy, 722Intervention, 722Evaluation, 723
45 Blood and Blood Products, 725KATHLEEN GUTIERREZ
BASIC PRINCIPLES OFIMMUNOHEMATOLOGY, 726
BLOOD PRODUCT: Whole Blood, 727BLOOD PRODUCT: Packed Red Blood Cells, 731BLOOD PRODUCT: Plasma, 732BLOOD PRODUCT: Platelets, 733BLOOD PRODUCT: Granulocytes, 734BLOOD PRODUCT: Cryoprecipitate AHF, 735APPLICATION TO PRACTICE, 736Assessment, 736Goals of Therapy, 738Intervention, 738Evaluation, 739
Table of Contents xix
PARTXRENAL SYSTEM DRUGS
46 Diuretics, 741LYNN ROGER WILLIS and ELIZABETH KISSELL
PHYSIOLOGY: Renal Function, 741Maintenance of Extracellular Fluid Volume, 741DRUG CLASS: Loop Diuretics, 744DRUG CLASS: Thiazide Diuretics, 749DRUG CLASS: Potassium-Sparing Diuretics, 751DRUG CLASS: Carbonic Anhydrase Inhibitors, 752DRUG CLASS: Osmotic Diuretics, 753APPLICATION TO PRACTICE, 754Assessment, 754Goals of Therapy, 755Intervention, 756Evaluation, 758
47 Drugs to Treat Renal Dysfunction, 761LYNN ROGER WILLIS and KATHLEEN GUTIERREZ
PATHOPHYSIOLOGY: Renal Failure, 762Acute Renal Failure, 762Chronic Renal Failure, 763PHARMACOTHERAPEUTIC OFFIONS, 764DRUG CLASS: Angiotensin-Converting Enzyme
(ACE) Inhibitors, 764DRUG CLASS: Antianemia Drug, 766DRUG CLASS: Iron Supplements, 767DRUG CLASS: Heavy Metal Antagonist, 767DRUG CLASS: Antihemorrhagic Drug, 768DRUG CLASS: Phosphate-Binding Drugs, 769DRUG CLASS: Vitamin D Supplement, 769DRUG CLASS: Cation-Exchange Resin, 770DRUG CLASS: Systemic Antacids, 771DRUG CLASS: Diuretics, 771DRUG CLASS: Renal Vasodilator, 772APPLICATION TO PRACTICE, 772Assessment, 772Goals of Therapy, 774Intervention, 775Evaluation, 777
PART X IGASTROINTESTINAL SYSTEM DRUGS
48 Hyperacidity and Related Drugs, 779ALAN P. AGINS and KATHLEEN GUTIERREZ
PATHOPHYSIOLOGY: GERD and Ulcers, 779DRUG CLASS: Histamine (H2) Receptor
Antagonists, 783DRUG CIASS: Proton (Acid) Pump Inhibitors, 784
DRUG CIASS: Antacids, 785DRUG CLASS: Prokinetic Drugs, 787DRUG CIASS: Miscellaneous Drugs, 787APPLICATION TO PRACTICE, 788Assessment, 788Goals of Therapy, 790Intervention, 791Evaluation, 792
49 Laxatives and Antidiarrheal Drugs, 795LYNN ROGER WILLIS and KATHLEEN GUTIERREZ
PATHOPHYSIOLOGY: Constipation, 796DRLIG CIASS: Stimulant Laxatives, 796DRUG CIASS: Stool Softeners, 799DRUG CLASS: Bulk-Forming Laxatives, 799DRLIG CLASS: Hyperosmotic Laxatives, 800DRUG CLASS: Lubricant Laxatives, 802APPLICATION TO PRACTICE, 802Assessment, 802Goals of Therapy, 804Intervention, 804Evaluation, 806PATHOPHYSIOLOGY: Diarrhea, 806DRUG CIASS: Opioids, 807DRUG CIASS: Absorbents, 808DRUG CIASS: Miscellaneous Antidiarrheal
Drugs, 809APPLICATION TO PRACTICE, 810Assessment, 810Goals of Therapy, 811Intervention, 812Evaluation, 813
50 Antiemetic Drugs, 815MICHAEL R. VASKO and KATHLEEN GUTIERREZ
PATHOPHYSIOLOGY: Emesis, 816DRLIG CIASS: Serotonin Receptor Antagonists, 819DRUG CLASS: Dopamine Receptor Antagonists,
819DRUG CIASS: Cannabinoids, 820DRUG CIASS: Muscarinic Receptor Antagonist,
821DRLIG CLASS: Histamine Receptor Antagonists,
822DRLIG CIASS: Miscellaneous Drugs, 822APPLICATION TO PRACTICE, 823Assessment, 823Goals of Therapy, 825Intervention, 825Evaluation, 828
XX Table of Contents
51 Drugs to Treat Liver, Gallbladder, andPancreatic Diseases, 829
SHERRY F. QUEENER and KATHLEEN GUTIERREZ
PATHOPHYSIOLOGY: Gallbladder Disease, 830DRUG CLASS: Anticholelithic Drugs, 831APPLICATION TO PRACTICE, 832Assessment, 832Goals of Therapy, 833Intervention, 833Evaluation, 833PATHOPHYSIOLOGY: Pancreatic Diseases, 833DRUG CLASS: Pancreatic Enzymes, 834APPLICATION TO PRACTICE, 834Assessment, 834Goals of Therapy, 835Intervention, 835Evaluation, 836PATHOPHYSIOLOGY: Liver Disease, 836DRUG CLASS: Ammonia-Detoxifying Drugs, 838APPLICATION TO PRACTICE, 839Assessment, 839Goals of Therapy, 840Intervention, 840Evaluation, 841
PART XI IRESPIRATORY SYSTEM DRUGS52 Drugs to Treat Asthma and Other
Pulmonary Diseases, 843ALAN P. AG1NS, LYNN ROGER WILLIS, and
KATHLEEN GUTIERREZ
PATHOPHYSIOLOGY: Asthma, 844DRUG CLASS: Beta Agonist Bronchodilators, 848DRUG CLASS: Leukotriene Modifiers, 850DRUG CLASS: Inhaled Corticosteroids, 851DRUG CLASS: Inhaled Nonsteroidal Antiallergy
Drugs, 852DRUG CLASS: Xanthines, 853DRUG CLASS: Anticholinergic Drugs, 854PATHOPHYSIOLOGY: Other Airflow-Obstructive
Lung Diseases, 854DRUG CLASS: Drugs for Chronic Obstructive
Pulmonary Disease, 855APPLICATION TO PRACTICE, 856Assessment, 856Goals of Therapy, 858Intervention, 858Evaluation, 864
53 Antihistamines, 867SHERRY F. QUEENER and KATHLEEN GUTIERREZ
PATHOPHYSIOLOGY: Allergies, 868PHYSIOLOGY: Allergic Reactions, 869DRUG CLASS: Antihistamines (Histamine H,
Receptor Antagonists), 872APPLICATION TO PRACTICE, 875Assessment, 875Goals of Therapy, 877Intervention, 877Evaluation, 879
54 Expectorants, Antitussives,Decongestants, and Mucolytics, 883
LYNN ROGER WILLIS and KATHLEEN GUTIERREZ
PHYSIOLOGY: Origin of Secretions, 884PATHOPHYSIOLOGY, 884Common Cold, 884Rhinitis, 884Cough, 884DRUG CLASS: Expectorants, 885DRUG CLASS: Antitussives, 886DRUG CLASS: Decongestants, 888DRUG CLASS: Mucolytic Drugs, 889APPLICATION TO PRACTICE, 891Assessment, 891Goals of Therapy, 892Intervention, 892Evaluation, 895
PART XI11ENDOCRINE SYSTEM DRUGS55 Pituitary Drugs, 897
MICHAEL R. VASKO and KATHLEEN GUTIERREZ
PHYSIOLOGY: Endocrine System, 897Posterior Pituitary, 899Anterior Pituitary, 900PATHOPHYSIOLOGY: ADH Deficiency
or Excess, 903DRUG CLASS: Posterior Pituitary Replacement
Drug, 904DRUG CLASS: Miscellaneous Drugs Used to Treat
Diabetes Insipidus, 904PATHOPHYSIOLOGY: Growth Hormone
Deficiency or Excess, 905DRUG CLASS: Growth Hormones, 906DRUG CLASS: Somastatin, 906APPLICATION TO PRACTICE, 907Assessment, 907Goals of Therapy, 908Intervention, 908Evaluation, 910
Table of Contents XXI
56 Thyroid and Parathyroid Drugs, 911MICHAEL R. VASKO and KATHLEEN GUTIERREZ
PHYSIOLOGY: Thyroid Hormones, 912Regulation of Synthesis and Release of Thyroid
Hormones, 912PATHOPHYSIOLOGY: Hypothyroidism, 914DRUG CLASS: Thyroid Hormones, 916APPLICATION TO PRACTICE, 917Assessment, 917Goals of Therapy, 918Intervention, 918Evaluation, 920PATHOPHYSIOLOGY: Hyperthyroidism, 920DRLIG CLASS: Antithyroid Drugs, 921DRLIG CLASS: Iodine, 922APPLICATION TO PRACTICE, 923Assessment, 923Goals of Therapy, 924Intervention, 925PHYSIOLOGY: Parathyroid Hormones, 925PATHOPHYSIOLOGY: Hypoparathyroidism, 926APPLICATION TO PRACTICE, 927Assessment, 927Goals of Therapy, 928Intervention, 928Evaluation, 929PATHOPHYSIOLOGY: Hyperparathyroidism, 929DRUG CLASS: Drugs Used to Treat
Hypercalcemia, 929APPLICATION TO PRACTICE, 931Assessment, 931Goals of Therapy, 932Intervention, 932Evaluation, 933
57 Adrenalcortical Steroids and DrugsAffecting the Adrenal Cortex, 935
JOSEPH A. DiMICCO and KATHLEEN GUTIERREZ
DRUG CLASS: Adrenal Cortex, 936DRLIG CLASS: Glucocorticoids, 939DRLIG CLASS: Mineralocorticoids, 945DRUG CLASS: Adrenocortical Inhibitors, 945DRUG CLASS: Adrenocortical Stimulants, 946APPLICATION TO PRACTICE, 947Assessment, 947Goals of Therapy, 949Intervention, 949Evaluation, 952
58 Drugs to Treat Diabetes Mellitus, 955JOSEPH A. DiMICCO and KATHLEEN GUTIERREZ
PATHOPHYSIOLOGY: Diabetes Mellitus, 956Type 1 Diabetes Mellitus, 956
'Type 2 Diabetes Mellitus, 956Gestational Diabetes, 957Impaired Glucose Tolerance/Impaired lasting
Glucose, 957Metabolic Derangements, 957PHYSIOLOGY: Regulation of Glucose
Metabolism, 959Insulin and Glucose Metabolism, 959Role of Insulin in Fat and Protein Metabolism, 960Regulation of Insulin Secretion, 960DRUG CLASS: Insulin and Insulin Analogs, 960DRUG CLASS: Sulfonylureas and Related
Drugs, 963DRUG CLASS: Biguanides, 965DRLIG CLASS: Thiazolidinediones, 966DRLIG CLASS: Alpha-Glucosidase Inhibitors, 966DRLIG CIASS: Antihypoglycemic Drugs, 967APPLICATION TO PRACTICE, 968Assessment, 968Goals of Therapy, 972Intervention, 972Evaluation, 975
PART X I VREPRODUCTIVE SYSTEM DRUGS
59 Estrogens, Progestins, andContraceptives, 977
JOSEPH A. DiMICCO and KATHLEEN GUTIERREZ
PHYSIOLOGY: Menses and Menopause, 978Hormones Affecting Ovulation, 978Hormones Affecting Endometrial Function, 978Hormones in Pregnancy, 979Menopause, 979DRUG CIASS: Estrogens, 979DRUG CLASS: Estrogen Antagonists and Selective
Estrogen Receptor Modulators, 983DRUG CIASS: Progestins, 983DRUG CIASS: Progesterone Antagonists, 985DRUG CLASS: Oral Contraceptives, 985DRUG CIASS: Contraceptive Implants, Depot
Injections, and Intrauterine Devices, 988APPLICATION TO PRACTICE, 989Assessment, 989Goals of Therapy, 990Intervention, 991Evaluation, 993
XXii Table of Contents
60 Drugs Affecting Uterine Motility, 995JOSEPH A. DiMICCO and KATHLEEN GUTIERREZ
PHYSIOLOGY: Labor and Delivery, 995DRUG CLASS: Oxytocic Drugs, 996DRLIG CLASS: Ergot Alkaloids LIsed as
Oxytocics, 997DRUG CLASS: Prostaglandins, 998DRUG CLASS: LIterine Relaxants (Tocolytics), 999DRUG CLASS: Other Tocolytic Drugs, 1000APPLICATION TO PRACTICE, 1001Assessment, 1001Goals of Therapy, 1002Intervention, 1003Evaluation, 1004
61 Fertility Drugs, 1005SHERRY F. QUEENER and KATHLEEN GUTIERREZ
PATHOPHYSIOLOGY: Infertility, 1005Disorders of Female Fertility, 1005Disorders of Male Fertility, 1007DRUG CLASS: Gonadotropin-Releasing
Hormone and Analogs, 1008DRUG CLASS: Gonadotropins, 1009DRUG CLASS: Antiprolactin Drugs, 1010DRUG CLASS: Antiestrogen, 1011DRUG CLASS: Male or Female Steroid
Hormones, 1012APPLICATION TO PRACTICE, 1012Assessment, 1012Goals of Therapy, 1014Intervention, 1014Evaluation, 1016
62 Androgens, Anabolic Steroids, andRelated Drugs, 1017
JOSEPH A. DiMICCO and KATHLEEN GUTIERREZ
PHYSIOLOGY, 1017PATHOPHYSIOLOGY: Hypogonadism, 1019DRUG CLASS: Androgens and "Anabolic
Steroids," 1019DRLIG CLASS: Antiandrogens, 1021DRUG CLASS: 5-Alpha-Reductase Inhibitors, 1022APPLICATION TO PRACTICE, 1023Assessment, 1023Goals of Therapy, 1024Intervention, 1024Evaluation, 1025
PART X VNUTRITIONAL BALANCE DRUGS63 Vitamins and Minerals, 1027
SHERRY F. QUEENER and SUSAN SCIACCA
PHYSIOLOGY: Vitamins and Minerals, 1027PATHOPHYSIOLOGY: Calcium and Vitamin D
Metabolism, 1030DRUG CLASS: Calcium Supplements, 1030DRUG CLASS: Vitamin D, 1031DRLIG CLASS: Biphosphonates, 1032DRUG CLASS: Selective Estrogen Receptor
Modulator, 1032PATHOPHYSIOLOGY: Fat-Soluble Vitamins, 1033DRUG CLASS: Vitamin A Family, 1033DRLIG CLASS: Vitamin E, 1034DRUG CLASS: Vitamin K, 1035PATHOPHYSIOLOGY: Water-Soluble
Vitamins, 1036DRUG CLASS: Water-Soluble Vitamins, 1037PATHOPHYSIOLOGY: Macrominerals, 1039DRUG CLASS: Macrominerals (Selected), 1039PATHOPHYSIOLOGY: Microminerals, 1041DRUG CLASS: Micronutrients, 1041APPLICATION TO PRACTICE, 1042Assessment, 1042Goals of Therapy, 1044Intervention, 1044Evaluation, 1049
64 Fluids, Electrolytes, and Acid-BaseBalance, 1051
LYNN ROGER WILLIS, SHERRY F. QUEENER, and
KATHLEEN GUTIERREZ
PATHOPHYSIOLOGY: Fluid or ElectrolyteImbalances, 1052
Regulation of Salt and Water Balance, 1052Clinical Indications for Fluid Therapy, 1054DRUG CLASS: Hydrating Solutions, 1058DRUG CLASS: Alkalinizing Drugs, 1059DRUG CLASS: Acidifying Drugs, 1061DRUG CLASS: Parenteral Nutrition
Formulations, 1062DRUG CLASS: Solutions to Correct Specific
Electrolyte Imbalances, 1063APPLICATION TO PRACTICE, 1063Assessment, 1063Goals of Therapy, 1066Intervention, 1067Evaluation, 1073
Table of Contents XXlH
PART XV ISENSORY SYSTEM DRUGS
65 Ophthalmic Drugs, 1075SHERRY F. QUEENER and KATHLEEN GUTIERREZ
PHYSIOLOGY: Preparing the Eye forExamination, 1076
DRUG CLASS: Muscarinic Antagonists, 1077DRUG CLASS: Alpha-Adrenergic Drugs, 1078PATHOPHYSIOLOGY: Glaucoma, 1078DRLIG CLASS: Adrenergic Agonists Used to Treat
Glaucoma, 1079DRLIG CIASS: Beta-Adrenergic Blockers Used to
Treat Glaucoma, 1081DRLIG CLASS: Cholinomimetics Used to Treat
Glaucoma, 1081DRUG CLASS: Anticholinesterase Miotics, 1082DRLIG CLASS: Carbonic Anhydrase Inhibitors
Used to Treat Glaucoma, 1083DRUG CLASS: Prostaglandin Analogs, 1084DRLIG CLASS: Specific Osmotic Agents Used to
Treat Glaucoma, 1084PATHOPHYSIOLOGY: Inflammation and
Infection of the Eyes, 1085DRUG CIASS: Antibacterial Drugs LIsed to Treat
Ophthalmic Diseases, 1086DRLIG CLASS: Antifungal Drug LIsed to Treat
Ophthalmic Diseases, 1086DRLIG CIASS: Antiviral Drugs LIsed to Treat
Ophthalmic Diseases, 1087DRUG CLASS: Antiinflammatory Drugs, 1088DRUG CLASS: Ocular Antihistamines and
Decongestants, 1089APPLICATION TO PRACTICE, 1089Assessment, 1089Goals of Therapy, 1091Intervention, 1091Evaluation, 1094
66 Otic Drugs, 1095MICHAEL R. VASKO and KATHLEEN GUTIERREZ
PATHOPHYSIOLOGY: Ear Infections, 1095DRLIG CIASS: Antibiotics Used to Treat Ear
infections, 1097DRLIG CLASS: Antibacterial and Drying
Drugs, 1098
DRUG CLASS: Steroids and Steroid-AntibioticCombinations, 1098
DRUG CLASS: Otic Anesthetics, 1099PATHOPI lYSIOI.OGY: Cerumen Impaction, 1100DRUG CLASS: Certiminolytics, 1100PATIIOPIIYSIOI.OCY: Ototoxieity, 1100APPLICATION TO PRACTICE, 1101Assessment, 1101Goals of Therapy, 1102Intervention, 1102Evaluation, 1105
67 Dermatologic Drugs, 1107SHERRY F. QUEENER and ELIZABETH KISSELL
PHYSIOLOGY: Structure and Functionof Skin, 1108
PATHOPI IYSIOLOGY: Skin Disorders, 1110Infectious Inflammatory Dermatoses, 1111Skin Trauma, 1113Drug Reactions, 1113Stings, Bites, and Infestations, 1113Ulcerations, 1114DRUG CLASS: Antiseptics, 1115DRUG CLASS: Topical Antibacterial Drugs, 1116DRUG CLASS: Topical Antifungal Drugs, 1117DRUG CLASS: Systemic Antifungals for Fungal
Skin Infections, 1118DRUG CLASS: Topical Antiviral Drugs, 1118DRLIG CLASS: Scabicides and Pediculicides, 1119DRLIG CLASS: Proteolytic Enzymes, 1119DRLIG CLASS: Antiinflammatory Drugs, 1120DRUG CIASS: Melanizing and Demelanizing
Drugs, 1121DRUG CIASS: Sunscreens, 1121APPLICATION TO PRACTICE, 1122Assessment, 1122Goals of Therapy, 1124Intervention, 1125Evaluation, 1130
AppendicesA Dietary Considerations, 1131B Selected Daig-lnduced Adverse Reactions, 1139
Answer Guidelines for Critical ThinkingQuestions, 1141