Name: Test Bank for Pharmacology and the Nursing Process, 5th Edition: Linda L. Lilley
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ISBN-10 ‏ : ‎ 0323044867
ISBN-13 ‏ : ‎ 978-0323044868
Author: Linda Lilley, Julie S. Snyder

This market-leading text is known for presenting challenging content in a clear and consistent format that engages students. With an eye-catching design, full-color illustrations, and helpful, practical boxed features that highlight need-to-know information, the new edition of this bestseller continues its tradition of making pharmacology easy to learn and understand.

A companion CD includes resources such as 450 NCLEX examination-style review questions, 26 state-of-the-art animations, and 9 IV therapy and 5 medication errors checklists.
Study Skills Tips include practical advice on time management, note taking, study techniques, and test taking.
Drug profiles highlight the pharmacokinetics and unique variations of individual drugs.
Case studies and critical thinking activities test students’ knowledge and understanding.
Medication Errors: Preventing and Responding chapter discusses specific nursing measures to prevent medication errors, possible consequences of medication errors to nurses, responses to errors, reporting and learning from mistakes, and other ethical issues.
Patient teaching tips include key points to convey to patients, their families, and caregivers.
Points to Remember boxes summarize major concepts in a bulleted format.
NCLEX exam-style review questions provide a pharmacology review and add a new emphasis on prioritization.
e-Learning activities boxes list related content and exercises on the companion CD and Evolve website.
Key drugs are highlighted with an icon for quick identification.
Photo Atlas of Medication Administration depicts steps in drug administration for various routes.
Tear-out IV incompatibility chart provides a convenient portable reference.
Life Span Considerations boxes highlight important age-related implications for pediatric and elderly patients.

A new focus on prioritization identifies key nursing information and helps in preparation for the NCLEX® examination.
Preventing Medication Errors boxes reinforce concepts introduced in the medication errors chapter and relate them to specific common errors that occur in clinical practice.
Evidence-Based Practice boxes summarize current research relevant to safe and effective drug therapy.
Laboratory Values Related to Drug Therapy boxes highlight the therapeutic levels of various drugs.
Expanded bioterrorism content now includes chemical agents such as ricin.
Increased focus on drug class provides a “big picture” knowledge of how various drugs work in the body.
Expanded cultural content covers today’s increasingly diverse patient population.
Pharmacokinetic Bridge to the Nursing Process sections apply key pharmacokinetics information to nursing practice.

Table of Content:

PART 1 Pharmacology Basics
Pharmacology Basics
STUDY SKILLS TIPS
INTRODUCTION TO STUDY SKILLS CONCEPTS
PURR
Prepare
On-the-Run Action.
Understand
Rehearse
How to Rehearse.
When to Rehearse.
Review
How to Review.
Frequency of Review.
Techniques for Rehearsal and Review.
PHARMACOLOGY BASICS
Prepare
Chapter 1 Objectives
Vocabulary Development
CHAPTER 1 The Nursing Process and Drug Therapy
Objectives
e-Learning Activities
Companion CD
evolve Website (http://evolve.elsevier.com/Lilley/)
Glossary
OVERVIEW OF THE NURSING PROCESS
Box 1-1 Sample Nursing Care Plan Related to Drug Therapy and the Nursing Process
Assessment
Objective Data
Subjective Data
Nursing Diagnoses
Planning: Goals and Outcome Criteria
Implementation
Evaluation
ASSESSMENT
Analysis of Data
NURSING DIAGNOSES
Box 1-2 A Brief Look at NANDA and the Nursing Process
PLANNING
Box 1-3 Selected NANDA-Approved Nursing Diagnoses
Goals and Outcome Criteria
IMPLEMENTATION
Right Drug
Right Dose
Right Time
Preventing Medication Errors
Right Dose?
Table 1-1 Conversion of Standard Time to Military Time
Right Route
Right Patient
System Analysis
Medication Errors
EVALUATION
Legal and Ethical Principles
Charting Don’ts
Points to Remember
NCLEX Examination Review Questions
Critical Thinking Activities
CHAPTER 2 Pharmacologic Principles
Objectives
e-Learning Activities
Companion CD
evolve Website (http://evolve.elsevier.com/Lilley)
Glossary
OVERVIEW
FIGURE 2-1 Chemical structure of the common analgesic ibuprofen and the chemical, generic, and trade names for the drug.
FIGURE 2-2 Phases of drug activity. (From McKenry LM, Tessier E, Hogan M: Mosby’s pharmacology in nursing, ed 22, St Louis, 2006, Mosby.)
PHARMACEUTICS
Table 2-1 Drug Absorption of Various Oral Preparations
Table 2-2 Dosage Forms
PHARMACOKINETICS
Pharmacokinetic Profiles
Absorption
Overview of Pharmacokinetics: Oral Administration
Drug Movement Through the Body
Preventing Medication Errors
Does IV = PO?
Enteral
FIGURE 2-3 First-pass effect is the metabolism of a drug by the liver before its systemic availability.
Impact of Surface Area
Sublingual and Buccal
Table 2-3 Routes of Administration and Related Nursing Considerations
Box 2-1 Drugs to Be Taken on an Empty Stomach and Drugs to Be Taken with Food
Parenteral
Subcutaneous, Intradermal, and Intramuscular
Topical
Box 2-2 Drug Routes and First-Pass Effects
First-Pass Routes
Non–First-Pass Routes
Transdermal
Inhaled
Distribution
FIGURE 2-4 Drug transport in the body. GI, Gastrointestinal. (From McKenry LM, Salerno E: Mosby’s pharmacology in nursing, ed 19, St Louis, 1995, Mosby.)
Distribution of Fat-Soluble vs. Water-Soluble Drugs
Metabolism
Table 2-4 Mechanisms of Biotransformation
Table 2-5 Common Liver Cytochrome P-450 Enzymes and Corresponding Drug Substrates
Cytochrome P-450 Drug Metabolism
Table 2-6 Examples of Conditions and Drugs That Affect Drug Metabolism
Excretion
FIGURE 2-5 Renal drug excretion. The primary processes involved in drug excretion and the approximate location where these processes take place in the kidney are illustrated. GFR, Glomerular filtration rate.
Half-Life
Time to Steady State
Time to Steady State: Starting and Stopping Drug
Table 2-7 Example of Drug Half-Life Viewed from Different Perspectives
FIGURE 2-6 Characteristics of drug effect and relationship to the therapeutic window. (From McKenry LM, Tessier E, Hogan M: Mosby’s pharmacology in nursing, ed 22, St Louis, 2006, Mosby.)
Onset, Peak, and Duration
PHARMACODYNAMICS
FIGURE 2-7 A, Drugs act by forming a chemical bond with specific receptor sites, similar to a key and lock. B, The better the “fit,” the better the response. Drugs with complete attachment and response are called agonists. C, Drugs that attach but do not elicit a response are called antagonists. D, Drugs that attach, elicit some response, and also block other responses are called partial agonists or agonist-antagonists. (From Clayton BD, Stock YN: Basic pharmacology for nurses, ed 13, St Louis, 2004, Mosby.)
Table 2-8 Drug-Receptor Interactions
Agonists/Antagonists
Mechanism of Action
Receptor Interactions
Receptor Interaction
Enzyme Interactions
Nonselective Interactions
PHARMACOTHERAPEUTICS
Acute Therapy
Maintenance Therapy
Supplemental Therapy
Palliative Therapy
Supportive Therapy
Prophylactic Therapy and Empiric Therapy
Monitoring
Therapeutic Index
Drug Concentration
Patient’s Condition
Tolerance and Dependence
Interactions
Table 2-9 Examples of Drug Interactions and Their Effects on Pharmacokinetics
Adverse Drug Events
Other Drug Effects
Box 2-3 Drugs to Avoid in Patients with Glucose-6-Phosphate Dehydrogenase Deficiency
Cultural Implications
Glucose-6-Phosphate Dehydrogenase Deficiency
Box 2-4 Exogenous Causes of Cancer
PHARMACOGNOSY
TOXICOLOGY
CASE STUDY
Pharmacokinetics
Table 2-10 Common Causes of Poisoning and Antidotes
CONCLUSION
Nursing, Medical, and Pharmacology Domains
Points to Remember
NCLEX Examination Review Questions
Critical Thinking Activities
CHAPTER 3 Life Span Considerations
Objectives
e-Learning Activities
Companion CD
evolve Website (http://evolve.elsevier.com/Lilley)
Glossary
DRUG THERAPY DURING PREGNANCY
Table 3-1 Pregnancy Safety Categories
Passive Diffusion
DRUG THERAPY DURING BREAST-FEEDING
CONSIDERATIONS FOR NEONATAL AND PEDIATRIC PATIENTS
Physiology and Pharmacokinetics
Pharmacodynamics
Dosage Calculations for Pediatric Patients
Table 3-2 Classification of Young Patients
Life Span Considerations: The Pediatric Patient
Pharmacokinetic Changes in the Neonate and Pediatric Patient
Absorption
Distribution
Metabolism
Excretion
FIGURE 3-1 West nomogram for infants and children. S.A., Surface area. (Modified from data by E. Boyd and C. D. West. In Behrman RE, Kliegman RM, Jensen HB: Nelson textbook of pediatrics, ed 17, Philadelphia, 2004, Saunders.)
CONSIDERATIONS FOR ELDERLY PATIENTS
Lifespan Considerations: The Elderly Patient
Percentage of Population over 65 Years of Age
Polypharmacy and Drug Use
Life Span Considerations: The Elderly Patient
Alzheimer’s Disease
Physiologic Changes
Table 3-3 Physiologic Changes in the Elderly Patient
Pharmacokinetics
Absorption
Life Span Considerations: The Elderly Patient
Pharmacokinetic Changes
Absorption
Distribution
Metabolism
Excretion
Distribution
Metabolism
Excretion
Problematic Medications for the Elderly
Table 3-4 Problematic Medications and Conditions to Consider for the Elderly Patient
♦ NURSING PROCESS
♦ ASSESSMENT
EVIDENCE-BASED PRACTICE
The Beers Criteria for Drug Use in the Elderly
Review
Type of Evidence
Results of Study
Link of Evidence to Nursing Practice
♦ NURSING DIAGNOSES
♦ PLANNING
Goals
Outcome Criteria
♦ IMPLEMENTATION
♦ EVALUATION
Life Span Considerations: The Pediatric Patient
Age-Related Considerations for Medication Administration from Infancy to Adolescence
General Interventions
Infants
Toddlers
Preschoolers
School-Aged Children
Adolescents
Points to Remember
NCLEX Examination Review Questions
Critical Thinking Activities
CHAPTER 4 Cultural, Legal, and Ethical Considerations
Objectives
e-Learning Activities
Companion CD
evolve Website (http://evolve.elsevier.com/Lilley)
Glossary
Table 4-1 Summary of Major U.S. Drug Legislation
Table 4-2 Controlled Substances: Schedule Categories
U.S. DRUG LEGISLATION
Table 4-3 Controlled Substances: Categories, Dispensing Restrictions, and Examples
NEW DRUG DEVELOPMENT
Investigational New Drug Application
Informed Consent
U.S. Food and Drug Administration Drug Approval Process
Preclinical Investigational Drug Studies
Four Clinical Phases of Investigational Drug Studies
Phase I
Phase II
Phase III
Phase IV
LEGAL AND ETHICAL PRINCIPLES
Use of Placebos
Expedited Drug Approval
LEGAL ISSUES AND NURSING IMPLICATIONS
LEGAL AND ETHICAL PRINCIPLES
Ethical Terms Related to Nursing Practice
Box 4-1 American Nurses Association Code of Ethics for Nurses
Provisions of the Code
Ethical Practice
Box 4-2 Legal-Ethical Considerations in Nursing Practice: The ICN Code of Ethics for Nurses
CULTURAL CONSIDERATIONS
Influence of Ethnicity and Genetics
CULTURAL IMPLICATIONS
Cultural Terms Related to Nursing Practice
CULTURAL IMPLICATIONS
Common Practices of Selected Cultural Groups
Table 4-4 Examples of Varying Drug Responses in Different Racial or Ethnic Groups
♦ NURSING PROCESS
♦ ASSESSMENT
Maintaining Health
Protecting Health
Restoring Health
♦ NURSING DIAGNOSES
♦ PLANNING
Goals
Outcome Criteria
♦ IMPLEMENTATION
♦ EVALUATION
Points to Remember
NCLEX Examination Review Questions
Critical Thinking Activities
CHAPTER 5 Medication Errors: Preventing and Responding
Objectives
e-Learning Activities
Companion CD
evolve Website (http://evolve.elsevier.com/Lilley)
Glossary
INTRODUCTION
General Impact of Errors on Patients
Medication Errors
FIGURE 5-1 Diagram illustrating the various classes and subclasses of adverse drug events. ADRs, Adverse drug reactions; ARs, allergic reactions; IRs, idiosyncratic reactions; SEs, side effects.
Box 5-1 Common Classes of Medications Involved in Serious Errors
PSYCHOSOCIAL ISSUES THAT CONTRIBUTE TO ERRORS
Organizational Issues
PREVENTING MEDICATION ERRORS
Selected Examples of Commonly Confused Drug Names
Educational System Issues and Their Potential Impact on Medication Errors
Medication Errors and Related Sociologic Factors
PREVENTING AND RESPONDING TO ERRORS
Reporting and Responding to Medication Errors
Medication Reconciliation
OTHER ETHICAL ISSUES
Notification of Patients Regarding Errors
Whistle-Blowing
NURSING MEASURES TO PREVENT MEDICATION ERRORS
LEGAL AND ETHICAL PRINCIPLES
Use of Abbreviations
Possible Consequences of Medication Errors for Nurses
Life Span Considerations: The Elderly Patient
Medication Errors
Life Span Considerations: The Pediatric Patient
Medication Errors
POLITICAL ACTION
An Ounce of Prevention: Nurse Advocacy for Safer Health Care Organizations
CASE STUDY
Medication Errors
SUMMARY
Points to Remember
NCLEX Examination Review Questions
Critical Thinking Activities
CHAPTER 6 Patient Education and Drug Therapy
Objectives
e-Learning Activities
Companion CD
evolve Website (http://evolve.elsevier.com/Lilley)
ASSESSMENT OF LEARNING NEEDS RELATED TO DRUG THERAPY
Box 6-1 Erikson’s Stages of Development
CULTURAL IMPLICATIONS
Patient Education
NURSING DIAGNOSES RELATED TO LEARNING NEEDS AND DRUG THERAPY
Patient Noncompliance
PLANNING RELATED TO LEARNING NEEDS AND DRUG THERAPY
Table 6-1 Educational Strategies to Address Common Changes Related to Aging That May Influence Learning
IMPLEMENTATION RELATED TO PATIENT EDUCATION AND DRUG THERAPY
EVIDENCE-BASED PRACTICE
The Impact of Better Education of Nurses on Patient Outcomes
Type of Evidence
Results of Study
Link of Evidence to Nursing Practice
Box 6-2 General Teaching and Learning Principles
LEGAL AND ETHICAL PRINCIPLES
Discharge Teaching
EVALUATION OF PATIENT LEARNING RELATED TO DRUG THERAPY
SUMMARY
Patient Teaching Tips
Points to Remember
NCLEX Examination Review Questions
Critical Thinking Activities
CHAPTER 7 Over-the-Counter Drugs and Herbal and Dietary Supplements
Objectives
e-Learning Activities
Companion CD
evolve Website (http://evolve.elsevier.com/Lilley)
Glossary
OVER-THE-COUNTER DRUGS
Box 7-1 Timetable of Major Legal Events Affecting U.S. Drug Use
Box 7-2 Criteria for Over-the-Counter Status
Indication for Use
Safety Profile
Practicality for Over-the-Counter Use
Box 7-3 Reclassified Over-the-Counter Products
Analgesics
Histamine Blockers
H1 Receptors
H2 Receptors
Mast Cell Stabilizers
Smoking Deterrents
Topical Medications
FIGURE 7-1 Example of an over-the-counter drug label.
Table 7-1 Common Over-the-Counter (OTC) Drugs
HERBALS AND DIETARY SUPPLEMENTS
History
Table 7-2 Conventional Medicines Derived from Plants
Consumer Use of Dietary Supplements
Safety
HERBAL THERAPIES AND DIETARY SUPPLEMENTS
Selected Herbs and Dietary Supplements and Their Possible Drug Interactions
Epidemiology
♦ NURSING PROCESS
♦ ASSESSMENT
Over-the-Counter Drugs
Herbal Products and Dietary Supplements
♦ NURSING DIAGNOSES
♦ PLANNING
Goals
Outcome Criteria
♦ IMPLEMENTATION
CULTURAL IMPLICATIONS
Drug Responses and Cultural Factors
♦ EVALUATION
Patient Teaching Tips
Points to Remember
NCLEX Examination Review Questions
Critical Thinking Activities
CHAPTER 8 Substance Abuse
Objectives
e-Learning Activities
Companion CD
evolve Website (http://evolve.elsevier.com/Lilley)
Glossary
Box 8-1 Categories of Abused Substances
Major Categories
Individual Drugs
OPIOIDS
Mechanism of Action and Drug Effects
Indications
Contraindications
Adverse Effects
Management of Withdrawal, Toxicity, and Overdose
Box 8-2 Signs and Symptoms of Opioid Withdrawal
Peak Period
Duration
Signs
Symptoms
Box 8-3 Medications for Treatment of Opioid Withdrawal
Clonidine (Catapres) Substitution
Methadone Substitution
STIMULANTS
Table 8-1 Various Forms of Amphetamine and Cocaine with Street Names
Life Span Considerations: The Pediatric Patient
Substance Abuse
Mechanism of Action and Drug Effects
Indications
Contraindications
Adverse Effects
Management of Withdrawal, Toxicity, and Overdose
Box 8-4 Signs and Symptoms of Stimulant Withdrawal
Peak Period
Duration
Signs
Symptoms
DEPRESSANTS
Mechanism of Action and Drug Effects
Indications
Contraindications
Adverse Effects
Management of Withdrawal, Toxicity, and Overdose
Box 8-5 Signs, Symptoms, and Treatment of Depressant Withdrawal
Peak Period
Duration
Signs
Symptoms
Treatment of Benzodiazepine Withdrawal
Treatment of Barbiturate Withdrawal
Table 8-2 Barbiturate Equivalencies
ALCOHOL
Mechanism of Action and Drug Effects
Indications
Adverse Effects
Management of Withdrawal, Toxicity, and Overdose
Box 8-6 Signs, Symptoms, and Treatment of Ethanol Withdrawal
Mild Withdrawal
Signs and Symptoms
Treatment
Moderate Withdrawal
Signs and Symptoms
Treatment
Severe Withdrawal (Delirium Tremens)*
Signs and Symptoms
Treatment
Table 8-3 Acetaldehyde Syndrome
NICOTINE
Mechanism of Action and Drug Effects
Indications
Adverse Effects
Management of Withdrawal, Toxicity, and Overdose
♦ NURSING PROCESS
♦ ASSESSMENT
Table 8-4 Nicotine Withdrawal Therapies
♦ NURSING DIAGNOSES
♦ PLANNING
Goals
Outcome Criteria
♦ IMPLEMENTATION
♦ EVALUATION
Life Span Considerations: The Elderly Patient
Substance Abuse
Patient Teaching Tips
Points to Remember
NCLEX Examination Review Questions
Critical Thinking Activities
CHAPTER 9 Photo Atlas of Drug Administration
PREPARING FOR DRUG ADMINISTRATION
ENTERAL DRUGS
Administering Oral Drugs
Oral Medications
FIGURE 9-1 Using a computer-dispensing system to remove unit-dose medication.
FIGURE 9-2 Checking the medication against the order on the medication administration record.
FIGURE 9-3 Always check the patient’s identification and allergies before giving medications.
Box 9-1 Standard Precautions
Sublingual and Buccal Medications
FIGURE 9-4 Some medications require special assessment before giving, such as taking an apical pulse.
FIGURE 9-5 Crushing tablets with a mortar and pestle.
FIGURE 9-6 Enteric-coated tablets and long-acting medications should not be crushed.
FIGURE 9-7 Giving oral medications.
FIGURE 9-8 Proper placement of a sublingual tablet.
FIGURE 9-9 Example of a medication administration record (MAR).
Liquid Medications
FIGURE 9-10 Liquid medication in a unit-dose package. B, Liquid measured into a medicine cup from a multidose container. C, Liquid medicine in an oral-dosing syringe.
Oral Medications and Infants
FIGURE 9-11 Measuring liquid medication.
FIGURE 9-12 Administering oral liquid medication to an infant.
Administering Drugs Through a Nasogastric or Gastrostomy Tube
FIGURE 9-13 Elevate the head of the bed before administering medications through a nasogastric tube.
FIGURE 9-14 Medications given through gastric tubes should be administered separately. Dilute crushed pills in 15 to 30 mL of water before administration.
FIGURE 9-15 Pour liquid medication into the syringe, then unclamp the tubing and allow it to flow in by gravity.
Administering Rectal Drugs
FIGURE 9-16 Lubricate the suppository with a water-soluble lubricant.
FIGURE 9-17 Inserting a rectal suppository.
PARENTERAL DRUGS
Preparing for Parenteral Drug Administration
FIGURE 9-18 NEVER RECAP A USED NEEDLE! Always dispose of uncapped needles in the appropriate sharps container. Refer to Box 9-1 for Standard Precautions.
FIGURE 9-19 An UNUSED needle may need to be recapped before the medication is given to the patient. The “scoop method” is one way to recap an unused needle safely. Be sure not to touch the needle to the countertop or to the outside of the needle cap.
FIGURES 9-20 AND 9-21 There are several types of needlestick prevention syringes. This example (Figure 9-20) has a guard over the unused syringe. After the injection, the nurse pulls the guard up over the needle until it locks into place (Figure 9-20).
FIGURE 9-22 The parts of a syringe and hypodermic needle.
FIGURE 9-23 Close-up view of the bevel of a needle.
FIGURE 9-24 Be sure to choose the correct size and type of syringe for the drug ordered.
FIGURE 9-25 Needles come in various gauges and lengths. The larger the gauge, the smaller the needle. Be sure to choose the correct needle—gauge and length—for the type of injection ordered.
FIGURES 9-26 AND 9-27 Some medications come in a prefilled, sterile medication cartridge. Figures 9-26 and 9-27 show the Carpuject prefilled cartridge and syringe system. Follow the manufacturer’s instructions for assembling prefilled syringes. After use, the syringe is disposed of in a sharps container; the cartridge is reusable.
Inserting a Pre-Filled Cartridge with Needle into the Carpuject Syringe
FIGURE 9-28 Ampules containing medications come in various sizes. The ampules must be broken carefully to withdraw the medication.
FIGURE 9-29 A filter needle should be used when withdrawing medication from an ampule. Filter needles help to remove tiny glass particles that may result from the ampule breakage. DO NOT USE A FILTER NEEDLE for injection into a patient! Some facilities may require the use of a filter needle to withdraw medications from a vial.
Removing Medications from Ampules
Drawing up Medication from an Ampule
FIGURE 9-30 Tapping an ampule to move the fluid below the neck.
FIGURES 9-31 AND 9-32 Breaking an ampule.
FIGURE 9-33 Using a filter needle to withdraw medication from an ampule.
Removing Medications from Vials
Withdrawing Medication from a Vial
Mixing Two Medications in One Syringe from Two Vials
Mixing Two Medications in One Syringe from One Vial and One Ampule
Mixing Two Medications in One Pre-Filled Cartridge and a Vial
Mix-O-Vials
FIGURE 9-34 Insert air into a vial before withdrawing medication (needleless system shown).
FIGURE 9-35 Withdrawing medication from a vial (needleless system shown).
FIGURE 9-36 Using a needle and syringe to remove medication from a vial.
Injections Overview
Needle Insertion Angles for Intramuscular, Subcutaneous, and Intradermal Injections
FIGURE 9-37 Various needle angles.
Z-Track Method
FIGURES 9-38 AND 9-39 The Z-track method for intramuscular injections.
Air-Lock Technique
FIGURE 9-40 Air-lock technique for intramuscular injections.
Intradermal Injection
FIGURES 9-41 AND 9-42 Intradermal injection.
Subcutaneous Injections
FIGURE 9-43 Potential sites for subcutaneous injections.
Insulin Syringes
FIGURE 9-44 Before giving an injection, cleanse the skin with an alcohol or antiseptic swab.
FIGURE 9-45 Giving a subcutaneous injection at a 90-degree angle.
FIGURE 9-46 When giving a subcutaneous injection in the abdomen, be sure to choose a site at least 2 inches away from the umbilicus.
FIGURE 9-47 Insulin syringes are available in 100-unit and 50-unit calibrations.
FIGURE 9-48 A variety of devices are available for insulin injections.
FIGURE 9-49 Mixing two types of insulin in the same syringe.
Intramuscular Injections
FIGURE 9-50 Finding landmarks for a ventrogluteal injection.
Ventrogluteal Site
FIGURES 9-51 AND 9-52 Ventrogluteal intramuscular injection.
Vastus Lateralis Site
FIGURE 9-53 Vastus lateralis intramuscular injection in an infant.
FIGURES 9-54, 9-55, AND 9-56 Vastus lateralis intramuscular injection.
Dorsogluteal Site
FIGURES 9-57, 9-58, AND 9-59 Dorsogluteal intramuscular injection.
Deltoid Site
FIGURES 9-60, 9-61, AND 9-62 Deltoid intramuscular injection.
Preparing Intravenous Medications
FIGURE 9-63 Two types of intravenous piggyback (IVPB) medication delivery systems. These IVPB medications must be activated before administration to the patient.
FIGURE 9-64 Activating an intravenous piggyback infusion bag (step 1).
FIGURE 9-65 Activating an intravenous piggyback infusion bag (step 2).
FIGURE 9-66 Activating an intravenous piggyback infusion bag (step 3).
FIGURES 9-67, 9-68, AND 9-69 Adding a medication to an intravenous infusion bag with a needle and syringe.
FIGURE 9-70 Mix the medication thoroughly before infusing.
FIGURE 9-71 Label the intravenous infusion bag when medication has been added.
Infusions of Intravenous Piggyback Medications
FIGURE 9-72 Infusing an intravenous piggyback medication with a gravity primary intravenous infusion.
FIGURE 9-73 Infusing an intravenous piggyback medication with the primary intravenous infusion on an electronic infusion pump.
FIGURE 9-74 Adding a medication to a volume-controlled administration set.
FIGURE 9-75 Instructing the patient on the use of a patient-controlled analgesia pump.
Intravenous Push Medications
Intravenous Push Medications Through an Intravenous Lock
Intravenous Push Medications Through an Existing Infusion
After Injection of an Intravenous Push Medication
FIGURE 9-76 Cleanse the port before attaching the syringe.
FIGURE 9-77 Attaching the syringe to the intravenous lock.
FIGURE 9-78 Slowly inject the intravenous push medication through the intravenous lock; use a watch to time the injection.
FIGURE 9-79 When giving an intravenous push medication through an intravenous line, pinch the tubing just above the injection port.
TOPICAL DRUGS
Administering Eye Medications
Eyedrops
FIGURE 9-80 Cleanse the eye, washing from the inner to outer canthus, before giving eye medications.
Eye Ointment
After Instillation of Eye Medications
FIGURE 9-81 Insert the eyedrop into the lower conjunctival sac.
FIGURE 9-82 Applying eye ointment.
FIGURE 9-83 Applying gentle pressure against the nasolacrimal duct after giving eye medications.
Administering Eardrops
FIGURE 9-84 For adults, pull the pinna up and back.
FIGURE 9-85 For infants and children younger than 3 years of age, pull the pinna down and back.
Administering Nasal Medications
Nasal Drops
FIGURE 9-86 Nasal medications may come in various delivery forms.
FIGURE 9-87 Administering nose drops.
Nasal Spray
After Administration of Nasal Medicines
FIGURE 9-88 Before self-administering the nasal spray, the patient should occlude the other nostril.
Administering Inhaled Drugs
Metered-Dose Inhalers
FIGURE 9-89 A, Metered-dose inhaler (MDI). B, Automated, or breath-activated, MDI. C, Dry powder inhaler that delivers powdered medication.
FIGURE 9-90 Using a metered-dose inhaler without a spacer.
FIGURE 9-91 Instructing the patient on how to use a spacer device.
FIGURE 9-92 Using a spacer device with a metered-dose inhaler.
Small-Volume Nebulizers
FIGURE 9-93 Adding medication to the nebulizer cup.
FIGURE 9-94 Administering a small-volume nebulizer treatment.
Administering Medications to the Skin
Lotions, Creams, Ointments, and Powders
FIGURE 9-95 Use gloves to apply topical skin preparations.
Transdermal Patches
After Administration of Topical Skin Preparations
FIGURE 9-96 Spread the lotion on the skin with long, smooth, gentle strokes.
FIGURE 9-97 Measure nitroglycerin ointment carefully before application.
FIGURE 9-98 Opening a transdermal patch medication.
FIGURE 9-99 Ensure that the edges of the transdermal patch are secure after applying.
Administering Vaginal Medications
Creams, Foams, or Gels Applied with an Applicator
FIGURE 9-100 Vaginal suppositories (right) are larger and more oval than rectal suppositories (left).
FIGURE 9-101 Vaginal cream and suppository, with applicators.
Suppositories
FIGURE 9-102 Administering vaginal cream with an applicator.
FIGURE 9-103 Administering a vaginal suppository.
ILLUSTRATION CREDITS
PART 2 Drugs Affecting the Central Nervous System
Drugs Affecting the Central Nervous System
STUDY SKILLS TIPS
VOCABULARY
TEXT NOTATION
LANGUAGE CONVENTIONS
CHAPTER 10 Analgesic Drugs
Objectives
e-Learning Activities
Companion CD
evolve Website (http://evolve.elsevier.com/Lilley)
Drug Profiles
Glossary
PHYSIOLOGY AND PSYCHOLOGY OF PAIN
CULTURAL IMPLICATIONS
The Patient Experiencing Pain
Table 10-1 Conditions That Alter Pain Threshold
Table 10-2 Acute Versus Chronic Pain
Table 10-3 A and C Nerve Fibers
FIGURE 10-1 Gate theory of pain transmission. CNS, Central nervous system.
Treatment of Pain in Special Situations
Box 10-1 Potential Opioid Adverse Effects and Their Management
Constipation
Nausea and Vomiting
Sedation and Mental Clouding
Respiratory Depression
Subacute Overdose
Other Opioid Adverse Effects
OPIOID DRUGS
Chemical Structure
Mechanism of Action and Drug Effects
Indications
Table 10-4 Chemical Classification of Opioids
Table 10-5 Opioid Receptors and Their Characteristics
CASE STUDY
Opioid Administration
PREVENTING MEDICATION ERRORS
Fentanyl Transdermal Patches
Contraindications
Adverse Effects
Table 10-6 Opioid-Induced Adverse Effects by Body System
LEGAL AND ETHICAL PRINCIPLES
The Impact of Nursing Assessment on Medication Administration–Related Errors
Table 10-7 Opioid Antagonists (Reversal Drugs)
Toxicity and Management of Overdose
Interactions
Laboratory Test Interactions
Dosages
Drug Profiles
▸ morphine sulfate
DOSAGES
Selected Analgesic Drugs and Related Drugs
Pharmacokinetics
▸ codeine sulfate
Pharmacokinetics
▸ fentanyl
Table 10-8 Equianalgesic Opioid Potencies (Based on Morphine 10 mg Intramuscularly and 30 mg Orally)
Table 10-9 Transdermal Fentanyl Dosages
Pharmacokinetics
▸ meperidine hydrochloride
Pharmacokinetics
▸ methadone hydrochloride
Pharmacokinetics
▸ oxycodone hydrochloride
Pharmacokinetics (Immediate Release)
Opioids and Agonists-Antagonists
Partial Opioid Agonists
Opioid Antagonists
▸ naloxone hydrochloride
Pharmacokinetics
▸ naltrexone hydrochloride
Pharmacokinetics
NONOPIOID ANALGESICS
Mechanism of Action and Drug Effects
Indications
Contraindications
Adverse Effects
Toxicity and Management of Overdose
Interactions
Drug Profiles
Nonopioid Analgesics
▸ acetaminophen
Pharmacokinetics
tramadol hydrochloride
Pharmacokinetics
♦ NURSING PROCESS
♦ ASSESSMENT
Box 10-2 Assessment of Pain
EVIDENCE-BASED PRACTICE
Strategies of Pain Assessment Used by Nurses on Surgical Units
Review
Type of Evidence
Results of Study
Link of Evidence to Nursing Practice
Life Span Considerations: The Pediatric Patient
Opioid Use
Life Span Considerations: The Elderly Patient
Opioid Use
♦ NURSING DIAGNOSES
♦ PLANNING
Goals
Outcome Criteria
♦ IMPLEMENTATION
Box 10-3 Nonpharmacologic Treatment Options for Pain
HERBAL THERAPIES AND DIETARY SUPPLEMENTS
Feverfew (Chrysanthemum parthenium)
Overview
Common Uses
Adverse Effects
Potential Drug Interactions
Contraindications
Table 10-10 Opioid Administration Guidelines
Table 10-11 Drugs Not Recommended for Treatment of Cancer Pain
CASE STUDY
Pain Management in Terminal Illness
♦ EVALUATION
Patient Teaching Tips
Points to Remember
NCLEX Examination Review Questions
Critical Thinking Activities
CHAPTER 11 General and Local Anesthetics
Objectives
e-Learning Activities
Companion CD
evolve Website (http://evolve.elsevier.com/Lilley)
Drug Profiles
Glossary
GENERAL ANESTHETICS
Box 11-1 General Anesthesia: A Historical Perspective
Table 11-1 Inhaled General Anesthetics
Mechanism of Action and Drug Effects
Table 11-2 General Anesthetic Drugs
Table 11-3 Adjunctive Anesthetic Drugs
Life Span Considerations: The Elderly Patient
Anesthesia
Indications
Contraindications
Adverse Effects
Table 11-4 Effects of Inhaled and Intravenous General Anesthetics
Toxicity and Management of Overdose
Interactions
Dosages
Drug Profiles
enflurane
DOSAGES
Selected General Anesthetic Drugs
Life Span Considerations: The Pediatric Patient
Anesthesia
halothane
isoflurane
methoxyflurane
nitrous oxide
▸ propofol
sevoflurane
LOCAL ANESTHETICS
Table 11-5 Topical Anesthetics
Box 11-2 Types of Local Anesthesia
Central
Peripheral
Mechanism of Action and Drug Effects
Table 11-6 Selected Parenteral Anesthetic Drugs*
Indications
Contraindications
Adverse Effects
Box 11-3 Chemical Groups of Local Anesthetics
Ester Type
Amide Type
Toxicity and Management of Overdose
Interactions
Dosages
DOSAGES
Local Anesthetic Drug
Drug Profiles
▸ lidocaine
NEUROMUSCULAR BLOCKING DRUGS
Mechanism of Action and Drug Effects
Indications
Table 11-7 Effects of Ganglionic Blockade by Neuromuscular Blocking Drugs
Contraindications
Adverse Effects
Toxicity and Management of Overdose
PREVENTING MEDICATION ERRORS
Neuromuscular Blocking Drugs
Box 11-4 Conditions That Predispose Patients to Toxic Effects from Neuromuscular Blocking Drugs
Box 11-5 Conditions That Oppose the Effects of Neuromuscular Blocking Drugs
Box 11-6 Drugs That Interact with Neuromuscular Blocking Drugs
Additive Effects
Opposing Effects
Interactions
Dosages
Drug Profiles
Depolarizing Neuromuscular Blocking Drugs
▸ succinylcholine
Pharmacokinetics
Nondepolarizing Neuromuscular Blocking Drugs
pancuronium
DOSAGES
Selected Neuromuscular Blocking Drugs
Table 11-8 Classification of Neuromuscular Blocking Drugs
Pharmacokinetics
▸ vecuronium
Pharmacokinetics
MODERATE SEDATION
PHARMACOKINETIC BRIDGE to Nursing Practice
Life Span Considerations: The Pediatric Patient
Moderate or Conscious Anesthesia
♦ NURSING PROCESS
♦ ASSESSMENT
HERBAL THERAPIES AND DIETARY SUPPLEMENTS
Possible Effects of Popular Herbal Products When Combined with Anesthetics
♦ NURSING DIAGNOSES
♦ PLANNING
Goals
Outcome Criteria
♦ IMPLEMENTATION
Box 11-7 Moderate or Conscious Sedation: What to Expect
♦ EVALUATION
Patient Teaching Tips
General Anesthesia
Local Anesthesia
Miscellaneous
NCLEX Examination Review Questions
Critical Thinking Activities
CHAPTER 12 Central Nervous System Depressants and Muscle Relaxants
Objectives
e-Learning Activities
Companion CD
evolve Website (http://evolve.elsevier.com/Lilley)
Drug Profiles
Glossary
SLEEP
Table 12-1 Sedative-Hypnotic Drugs: Points of Interest
BARBITURATES
Mechanism of Action and Drug Effects
Table 12-2 Stages of Sleep
Table 12-3 Barbiturates: Onset and Duration
CULTURAL IMPLICATIONS
Sedatives-Hypnotics
Indications
Contraindications
Adverse Effects
Table 12-4 Barbiturates: Adverse Effects
Toxicity and Management of Overdose
Interactions
Laboratory Test Interactions
Dosages
Drug Profiles
DOSAGES
Selected Barbiturates
Table 12-5 Barbiturates: Controlled Substance Schedule
pentobarbital
Pharmacokinetics
phenobarbital
Pharmacokinetics
secobarbital
Pharmacokinetics
BENZODIAZEPINES
Mechanism of Action and Drug Effects
Table 12-6 Sedative-Hypnotic Benzodiazepines
Indications
Contraindications
Adverse Effects
Toxicity and Management of Overdose
Table 12-7 Flumazenil Treatment Regimen
Table 12-8 Benzodiazepines: Drug Interactions
Interactions
Laboratory Test Interactions
Dosages
Drug Profiles
estazolam
DOSAGES
Benzodiazepines: Selected Hypnotic Drugs
Pharmacokinetics
flurazepam
Pharmacokinetics
quazepam
Pharmacokinetics
▸ temazepam
Pharmacokinetics
triazolam
Pharmacokinetics
▸ zaleplon
Pharmacokinetics
▸ zolpidem
Pharmacokinetics
MUSCLE RELAXANTS
Mechanism of Action and Drug Effects
Indications
Contraindications
Adverse Effects
Toxicity and Management of Overdose
Interactions
Laboratory Test Interactions
Dosages
Drug Profiles
▸ baclofen
Pharmacokinetics
▸ cyclobenzaprine
Pharmacokinetics
dantrolene
DOSAGES
Selected Muscle Relaxants
Pharmacokinetics
MISCELLANEOUS DRUGS
♦ NURSING PROCESS
♦ ASSESSMENT
♦ NURSING DIAGNOSES
♦ PLANNING
Goals
Outcome Criteria
♦ IMPLEMENTATION
HERBAL THERAPIES AND DIETARY SUPPLEMENTS
Kava (Piper methysticum)
Overview
Common Uses
Adverse Effects
Potential Drug Interactions
Contraindications
HERBAL THERAPIES AND DIETARY SUPPLEMENTS
Valerian (Valeriana officinalis)
Overview
Common Uses
Adverse Effects
Potential Drug Interactions
Contraindications
♦ EVALUATION
Patient Teaching Tips
Box 12-1 Sleep Diaries and Non-Pharmacologic Treatment of Sleep Disorders
Information for a Sleep Diary
Nonpharmacologic Sleep Interventions
Points to Remember
NCLEX Examination Review Questions
Critical Thinking Activities
CHAPTER 13 Antiepileptic Drugs
Objectives
e-Learning Activities
Companion CD
Evolve Website (http://evolve.elsevier.com/Lilley)
Drug Profiles
Glossary
EPILEPSY
Box 13-1 International Classification of Seizures
Partial Seizures
Description
Simple Seizures
Complex Seizures
Generalized Seizures
Description
ANTIEPILEPTIC DRUGS
Mechanism of Action and Drug Effects
Indications
Table 13-1 Antiepileptic Drugs of Choice
Table 13-2 Antiepileptic Drugs Used for Treatment of Status Epilepticus
Contraindications
Adverse Effects
Interactions
Dosages
Drug Profiles
Table 13-3 Adverse Effects of Selected Antiepileptic Drugs
Barbiturates
▸ phenobarbital
Table 13-4 Drug Interactions of Selected Antiepileptic Drugs
Table 13-5 Therapeutic Plasma Levels of NTI Antiepileptic Drugs
Table 13-6 Antiepileptic Drugs: FDA Pregnancy Risk Classification
Pharmacokinetics
DOSAGES
Selected Antiepileptic Drugs
Life Span Considerations: The Pediatric Patient
AEDs
Hydantoins
▸ phenytoin
Table 13-7 Phenytoin Sodium Versus Fosphenytoin Sodium
Pharmacokinetics
▸ valproic acid
Pharmacokinetics
Iminostilbenes
▸ carbamazepine
Pharmacokinetics
oxcarbazepine
Pharmacokinetics
Miscellaneous Drugs
▸ gabapentin
Pharmacokinetics
lamotrigine
Pharmacokinetics
levetiracetam
Pharmacokinetics
tiagabine
Pharmacokinetics
topiramate
Pharmacokinetics
zonisamide
Pharmacokinetics
pregabalin
♦ NURSING PROCESS
♦ ASSESSMENT
♦ NURSING DIAGNOSES
♦ PLANNING
Goals
Outcome Criteria
Implementation
♦ EVALUATION
Patient Teaching Tips
Points to Remember
NCLEX Examination Review Questions
Critical Thinking Activities
CHAPTER 14 Antiparkinsonian Drugs
Objectives
e-Learning Activities
Companion CD
Evolve Website (http://evolve.elsevier.com/Lilley)
Drug Profiles
Glossary
PARKINSON’S DISEASE
FIGURE 14-1 The neurotransmitter abnormality of Parkinson’s disease.
Table 14-1 Classic Parkinsonian Symptom
Table 14-2 Antiparkinsonian Drugs
SELECTIVE MONOAMINE OXIDASE INHIBITOR THERAPY
Mechanism of Action and Drug Effects
Table 14-3 Selegiline: Adverse Effects
Indications
Contraindications
Adverse Effects
Interactions
PREVENTING MEDICATION ERRORS
Look-Alike Drugs: Selegiline and Salagen
Dosage
Drug Profiles
▸ selegiline
Pharmacokinetics
DOPAMINERGIC THERAPY
Mechanism of Action and Drug Effects
Indications
Contraindications
Adverse Effects
Interactions
Table 14-4 Dopaminergic Drugs: Adverse Effects
Dosages
Drug Profiles
levodopa
Pharmacokinetics
▸ levodopa-carbidopa
Pharmacokinetics
amantadine
Pharmacokinetics
Dopamine Agonists
Dosages
Selegiline and Selected Dopaminergic Drugs
bromocriptine and pergolide
Pharmacokinetics (bromocriptine)
Pharmacokinetics (pergolide)
▸ ropinirole
Pharmacokinetics
COMT Inhibitors
entacapone
Pharmacokinetics
ANTICHOLINERGIC THERAPY
Mechanism of Action and Drug Effects
Indications
Contraindications
Adverse Effects
Interactions
Table 14-5 Anticholinergic Drugs: Adverse Effects
Dosages
Drug Profiles
▸ benztropine mesylate
Pharmacokinetics
Dosages
Selected Anticholinergic Drugs
♦ NURSING PROCESS
♦ ASSESSMENT
Life Span Considerations: The Elderly Patient
Antiparkinsonian Drugs
♦ NURSING DIAGNOSES
♦ PLANNING
Goals
Outcome Criteria
♦ IMPLEMENTATION
♦ EVALUATION
Patient Teaching Tips
Points to Remember
NCLEX Examination Review Questions
Critical Thinking Activities
CHAPTER 15 Psychotherapeutic Drugs
Objectives
e-Learning Activities
Companion CD
evolve Website (http://evolve.elsevier.com/Lilley)
Drug Profiles
Glossary
CULTURAL IMPLICATIONS
Psychotherapeutic Drugs
OVERVIEW OF MENTAL ILLNESS
ANTIANXIETY DRUGS
Mechanism of Action and Drug Effects
Table 15-1 Various Anxiety Disorders: Drugs of Choice
Indications
Table 15-2 Benzodiazepines: Approved Indications
Contraindications
Adverse Effects
Table 15-3 Benzodiazepines: Common Adverse Effects
Toxicity and Management of Overdose
Box 15-1 Flumazenil Treatment Regimen
Recommended Regimen
Duration of Action
Interactions
Dosages
Drug Profiles
Benzodiazepines
▸ alprazolam
Pharmacokinetics
▸ chlordiazepoxide
Pharmacokinetics
▸ diazepam
Pharmacokinetics
▸ lorazepam
Pharmacokinetics
Miscellaneous Drugs
DOSAGES
Selected Antianxiety Drugs
hydroxyzine
Pharmacokinetics
buspirone
Pharmacokinetics
DRUGS USED TO TREAT AFFECTIVE DISORDERS
PREVENTING MEDICATION ERRORS
Look-Alike Drugs: Bupropion and Buspirone
ANTIMANIC DRUGS
Drug Profiles
▸ lithium
Pharmacokinetics
valproic acid
Pharmacokinetics
ANTIDEPRESSANT DRUGS
DOSAGES
Selected Antimanic Drugs
FIGURE 15-1 Biologic amine hypothesis. NE, Norepinephrine.
FIGURE 15-2 Permissive hypothesis. NE, Norepinephrine; 5-HT, serotonin.
SELECTIVE SEROTONIN REUPTAKE INHIBITORS AND SECOND- AND THIRD-GENERATION ANTIDEPRESSANTS
Mechanism of Action and Drug Effects
Indications
Contraindications
Adverse Effects
Interactions
Box 15-2 Common Symptoms of Serotonin Syndrome
Table 15-4 Newer Generation Antidepressants: Adverse Effects
Table 15-5 Newer Generation Antidepressants: Drug Interactions
DOSAGES
Selected NGAs
Drug Profiles
trazodone
Pharmacokinetics
▸ bupropion
Pharmacokinetics
▸ fluoxetine
Pharmacokinetics
venlafaxine
Pharmacokinetics
▸ mirtazapine
Pharmacokinetics
TRICYCLIC ANTIDEPRESSANTS
Mechanism of Action and Drug Effects
Table 15-6 Tricyclic Antidepressants: Therapeutic and Undesirable Drug Effects by Receptor Site
Indications
Contraindications
Adverse Effects
Table 15-7 Tricyclic Antidepressants: Adverse Effects
Toxicity and Management of Overdose
Interactions
Dosages
DOSAGES
Selected Tricyclic Antidepressants
Box 15-3 Cyclic Antidepressant Categories
Tertiary Amine TCAs
Secondary Amine TCAs
Tetracyclic Antidepressants
Drug Profiles
▸ amitriptyline
Pharmacokinetics
MONOAMINE OXIDASE INHIBITORS
HERBAL THERAPIES AND DIETARY SUPPLEMENTS
St. John’s Wort (Hypericum perforatum)
Overview
Common Uses
Adverse Effects
Potential Drug Interactions
Contraindications
Table 15-8 MAOIs: Adverse Effects
Toxicity and Management of Overdose
Table 15-9 Food and Drink to Avoid When Taking MAOIs
DOSAGES
Selected MAOIs
Interactions
Dosages
ANTIPSYCHOTIC DRUGS
Mechanism of Action and Drug Effects
Table 15-10 Major Dopamine Systems in the Brain
Indications
Contraindications
Adverse Effects
Table 15-11 Antipsychotics: Receptor-Related Adverse Effects
Table 15-12 Antipsychotics: Adverse Effects
Interactions
Dosages
Drug Profiles
Phenothiazines
fluphenazine
DOSAGES
Selected First-Generation Antipsychotic Drugs
Table 15-13 Compatibility of Selected Liquid Antipsychotic Dosage Forms with Beverages for Dosing Purposes*
Pharmacokinetics
Butyrophenones
haloperidol
Pharmacokinetics
Atypical Antipsychotics
DOSAGES
Selected Atypical Antipsychotic Drugs
clozapine
Pharmacokinetics
▸ risperidone
Pharmacokinetics
▸ olanzapine
Pharmacokinetics
quetiapine
Pharmacokinetics
ziprasidone
Pharmacokinetics
Antipsychotic Drugs Summary
♦ NURSING PROCESS
♦ ASSESSMENT
Antianxiety Drugs
Lifespan Considerations: The Pediatric Patient
Psychotherapeutic Drugs
Lifespan Considerations: The Elderly Patient
Psychotherapeutic Drugs
Antimanic Drugs
Antidepressants
HERBAL THERAPIES AND DIETARY SUPPLEMENTS
Ginseng
Overview
Common Uses
Adverse Effects
Potential Drug Interactions
Contraindications
Antipsychotics
♦ NURSING DIAGNOSES
♦ PLANNING
Goals
Outcome Criteria
♦ IMPLEMENTATION
Antianxiety Drugs
Antimanic Drugs
Antidepressants
Antipsychotics
♦ EVALUATION
Patient Teaching Tips
Antianxiety Drugs
Antimanic Drugs
Antidepressant Drugs
MAOIs and TCAs
Haloperidol
Points to Remember
NCLEX Examination Review Questions
Critical Thinking Activities
CHAPTER 16 Central Nervous System Stimulants and Related Drugs
Objectives
e-Learning Activities
Companion CD
evolve Website (http://evolve.elsevier.com/Lilley)
Drug Profiles
Glossary
CENTRAL NERVOUS SYSTEM STIMULANTS
Table 16-1 Structurally Related CNS Stimulants
Table 16-2 CNS Stimulants: Site of Action
Table 16-3 CNS Stimulants and Related Drugs: Therapeutic Categories
OVERVIEW OF PATHOPHYSIOLOGY
ATTENTION DEFICIT HYPERACTIVITY DISORDER
NARCOLEPSY
DRUGS FOR ATTENTION DEFICIT HYPERACTIVITY DISORDER AND NARCOLEPSY
Mechanism of Action and Drug Effects
Indications
Contraindications
Adverse Effects
Interactions
Drug Profiles
Amphetamines and Related Stimulants
▸ amphetamines
Table 16-4 CNS Stimulants: Common Drug Interactions
Pharmacokinetics (dextroamphetamine)
▸ methylphenidate
Pharmacokinetics (Immediate Release)
atomoxetine
Pharmacokinetics
modafinil
Pharmacokinetics
Miscellaneous Narcolepsy Drugs
sodium oxybate
Pharmacokinetics
OBESITY
DOSAGES
Selected CNS Stimulants and Related Drugs
LEGAL AND ETHICAL PRINCIPLES
Handling of Prescription Drugs
ANOREXIANTS
Mechanism of Action and Drug Effects
EVIDENCE-BASED PRACTICE
An Applied Evidence-Based Review of the Diagnosis and Treatment of Obesity in Adults
Review
Type of Evidence
Results of Study
Link of Evidence to Nursing Practice
Indications
Contraindications
Adverse Effects
Interactions
Drug Profiles
Anorexiants
▸ phentermine
▸ sibutramine
Pharmacokinetics
orlistat
Pharmacokinetics
MIGRAINE
ANTIMIGRAINE DRUGS (SEROTONIN AGONISTS)
Mechanism of Action and Drug Effects
Indications
Contraindications
Adverse Effects
Interactions
Drug Profiles
Serotonin Agonists
▸ sumatriptan
Pharmacokinetics
ANALEPTIC-RESPONSIVE RESPIRATORY DEPRESSION SYNDROMES
ANALEPTICS
Mechanism of Action and Drug Effects
Indications
Contraindications
Adverse Effects
Interactions
Drug Profiles
▸ caffeine
Pharmacokinetics
doxapram
Table 16-5 Caffeine-Containing Beverages and Drugs
Pharmacokinetics
♦ NURSING PROCESS
♦ ASSESSMENT
HERBAL THERAPIES AND DIETARY SUPPLEMENTS
Selected Herbal Compounds Used for Nervous System Stimulation*
♦ NURSING DIAGNOSES
♦ PLANNING
Goals
Outcome Criteria
♦ IMPLEMENTATION
♦ EVALUATION
Patient Teaching Tips
CNS Stimulants in General
Anorexiants
Drugs Used to Treat ADHD
Antimigraine Drugs
Points to Remember
NCLEX Examination Review Questions
Critical Thinking Activities
PART 3 Drugs Affecting the Autonomic Nervous System
Drugs Affecting the Autonomic Nervous System
STUDY SKILLS TIPS
PURR APPLICATION
Planning for the Part
Part Title
Part Chapters
Chapters 19 and 20
Active Questioning
Study Groups
CHAPTER 17 Adrenergic Drugs
Objectives
e-Learning Activities
Companion CD
evolve Website (http://evolve.elsevier.com/Lilley)
Drug Profiles
Glossary
SYMPATHETIC NERVOUS SYSTEM
FIGURE 17-1 The sympathetic nervous system in relation to the entire nervous system. ACh, Acetylcholine; NE, norepinephrine.
Table 17-1 Adrenergic Receptor Responses to Stimulation
FIGURE 17-2 The mechanism by which stimulation of a nerve fiber results in a physiologic process; adrenergic drugs mimic this same process. COMT, Catechol ortho-methyltransferase; MAO, monoamine oxidase; NE, norepinephrine.
ADRENERGIC DRUGS
FIGURE 17-3 Mechanism of physiologic response to direct-acting sympathomimetics. D, Drug; NE, norepinephrine.
Table 17-2 Catecholamines and Their Dose-Response Relationship
FIGURE 17-4 Mechanism of physiologic response to indirect-acting sympathomimetics. D, Drug; NE, norepinephrine.
FIGURE 17-5 Mechanism of physiologic response to mixed-acting sympathomimetics. D, Drug; NE, norepinephrine.
Mechanism of Action and Drug Effects
Indications
Respiratory Indications
Indications for Topical Nasal Decongestants
Ophthalmic Indications
Cardiovascular Indications
Epinephrine for Cardiac Arrest
Contraindications
Adverse Effects
Life Span Considerations: The Elderly Patient
Use of β-Adrenergic Agonists
Toxicity and Management of Overdose
Interactions
Laboratory Test Interactions
Dosages
Drug Profiles
Bronchodilators
DOSAGES
Selected Bronchodilators
▸ albuterol sulfate
Pharmacokinetics
▸ epinephrine
Pharmacokinetics
▸ salmeterol
Pharmacokinetics
Nasal Decongestants
▸ pseudoephedrine
Pharmacokinetics
Ophthalmic Decongestants
tetrahydrozoline
DOSAGES
Selected Nasal and Ophthalmic Decongestant Adrenergics
Pharmacokinetics
Vasoactive Adrenergics
▸ dobutamine
Pharmacokinetics
▸ dopamine
Pharmacokinetics
DOSAGES
Selected Vasoactive Adrenergics
▸ epinephrine
Pharmacokinetics
fenoldopam
Pharmacokinetics
midodrine
Pharmacokinetics
▸ norepinephrine
Pharmacokinetics
phenylephrine
Pharmacokinetics
♦ NURSING PROCESS
♦ ASSESSMENT
♦ NURSING DIAGNOSES
♦ PLANNING
Goals
Outcome Criteria
♦ IMPLEMENTATION
LEGAL AND ETHICAL PRINCIPLES
Infiltrating Intravenous (IV) Infusions
Situation
♦ EVALUATION
Patient Teaching Tips
Points to Remember
NCLEX Examination Review Questions
Critical Thinking Activities
CHAPTER 18 Adrenergic-Blocking Drugs
Objectives
e-Learning Activities
Companion CD
evolve Website (http://evolve.elsevier.com/Lilley)
Drug Profiles
Glossary
α-BLOCKERS
Mechanism of Action and Drug Effects
Indications
FIGURE 18-1 Mechanisms for αadrenergic competitive and noncompetitive blockade by α-blockers. A, α-blocker; NE, norepinephrine.
CASE STUDY
Alternative Therapies for Migraine Headaches
Contraindications
Adverse Effects
Toxicity and Management of Overdose
Table 18-1 α-Blockers: Adverse Effects
Table 18-2 α-Blockers: Common Drug Interactions
Interactions
Dosages
Drug Profiles
ergotamine tartrate
Pharmacokinetics
phenoxybenzamine hydrochloride
Pharmacokinetics
▸ phentolamine
Pharmacokinetics
DOSAGES
Selected α-Adrenergic-Blocking Drugs
▸ prazosin
Pharmacokinetics
tolazoline
Pharmacokinetics
β-BLOCKERS
Mechanism of Action and Drug Effects
Box 18-1 Currently Available β-blockers
Nonselective β-blockers
Cardioselective β-blockers
Indications
Contraindications
Adverse Effects
Toxicity and Management of Overdose
Interactions
Table 18-3 β-Blockers: Common Adverse Effects
Table 18-4 β-Blockers: Drug Interactions
Dosages
Drug Profiles
acebutolol
Pharmacokinetics
▸ atenolol
Pharmacokinetics
carvedilol
DOSAGES
Selected β-Adrenergic-Blocking Drugs
Pharmacokinetics
▸ esmolol
Pharmacokinetics
labetalol
Pharmacokinetics
▸ metoprolol
Pharmacokinetics
propranolol
Pharmacokinetics
sotalol
Pharmacokinetics
PREVENTING MEDICATION ERRORS
Look-Alike Drugs: Toprol-XL, Topamax, and Tegretol
♦ NURSING PROCESS
♦ ASSESSMENT
♦ NURSING DIAGNOSES
♦ PLANNING
Goals
Outcome Criteria
EVIDENCE-BASED PRACTICE
β-blockers
Review
Type of Evidence
Results of Study
Link of Evidence to Nursing Practice
♦ IMPLEMENTATION
♦ EVALUATION
Patient Teaching Tips
Points to Remember
NCLEX Examination Review Questions
Critical Thinking Activities
CHAPTER 19 Cholinergic Drugs
Objectives
e-Learning Activities
Companion CD
evolve Website (http://evolve.elsevier.com/Lilley)
Drug Profiles
Glossary
PARASYMPATHETIC NERVOUS SYSTEM
FIGURE 19-1 The parasympathetic and sympathetic nervous systems and their relationship to one another. ACh, Acetylcholine; NE, norepinephrine.
FIGURE 19-2 The sympathetic, parasympathetic, and somatic nervous systems. Note the location of the nicotinic and muscarinic receptors in the parasympathetic nervous system.
CHOLINERGIC DRUGS
Mechanism of Action and Drug Effects
Box 19-1 Cholinergic Drugs
Direct-Acting Drugs
Indirect-Acting Drugs
Indications
Table 19-1 Cholinergic Agonists: Drug Effects
Contraindications
Adverse Effects
Table 19-2 Cholinergic Drugs: Adverse Effects
Interactions
Toxicity and Management of Overdose
Dosages
Drug Profiles
▸ bethanechol
EVIDENCE-BASED PRACTICE
Alzheimer’s Disease and Razadyne ER
Review
Type of Evidence
Results of Study
Link of Evidence to Nursing Practice
Pharmacokinetics
cevimeline
Pharmacokinetics
▸ physostigmine
Pharmacokinetics
▸ pyridostigmine
DOSAGES
Selected Cholinergic Agonist Drugs
Pharmacokinetics
Cholinergic Agonists Used Specifically for Alzheimer’s Disease
▸ donepezil
Pharmacokinetics
galantamine
Pharmacokinetics
rivastigmine
Pharmacokinetics
Miscellaneous Alzheimer’s Disease Medications
memantine
♦ NURSING PROCESS
♦ ASSESSMENT
HERBAL THERAPIES AND DIETARY SUPPLEMENTS
Ginkgo (Ginkgo biloba)
Overview
Common Uses
Adverse Effects
Potential Drug Interactions
Contraindications
♦ NURSING DIAGNOSES
♦ PLANNING
Goals
Outcome Criteria
♦ IMPLEMENTATION
♦ EVALUATION
Patient Teaching Tips
Points to Remember
NCLEX Examination Review Questions
Critical Thinking Activities
CHAPTER 20 Cholinergic-Blocking Drugs
Objectives
e-Learning Activities
Companion CD
evolve Website (http://evolve.elsevier.com/Lilley)
Drug Profiles
Glossary
CHOLINERGIC-BLOCKING DRUGS
Mechanism of Action and Drug Effects
FIGURE 20-1 Site of action of cholinergic blockers in the parasympathetic nervous system. ACh, Acetylcholine.
Box 20-1 Cholinergic Blockers Grouped According to Chemical Class
Natural Drugs
Synthetic and Semisynthetic Drugs
Indications
Table 20-1 Cholinergic Blockers: Drug Effects
Contraindications
Adverse Effects
Interactions
Table 20-2 Cholinergic Blockers: Adverse Effects
Toxicity and Management of Overdose
Dosages
Drug Profiles
DOSAGES
Selected Cholinergic Antagonist (Anticholinergic) Drugs
▸ atropine
Atropine for Sinus Bradycardia
Pharmacokinetics
▸ benztropine mesylate
▸ dicyclomine
Pharmacokinetics
glycopyrrolate
Pharmacokinetics
scopolamine
Pharmacokinetics
▸ tolterodine
Pharmacokinetics
♦ NURSING PROCESS
♦ ASSESSMENT
♦ NURSING DIAGNOSES
♦ PLANNING
Goals
Outcome Criteria
♦ IMPLEMENTATION
Life Span Considerations: The Elderly Patient
Overactive Bladder
EVALUATION
Patient Teaching Tips
Points to Remember
NCLEX Examination Review Questions
Critical Thinking Activities
PART 4 Drugs Affecting the Cardiovascular and Renal Systems
Drugs Affecting the Cardiovascular and Renal Systems
STUDY SKILLS TIPS
LINKING LEARNING
Chapter Structure
Chapter Objectives
Example Based on Chapter 21 Objectives
Chapter Headings
Glossary
Glossary and Text Relationship
TEXT NOTATION
Text Notation Application
Chapter 26, Paragraphs One and Two
Discussion
Chapter 26, Paragraph Three
Discussion
CHAPTER 21 Positive Inotropic Drugs
Objectives
e-Learning Activities
Companion CD
evolve Website (http://evolve.elsevier.com/Lilley)
Drug Profiles
Glossary
HEART FAILURE AND CARDIAC DYSRHYTHMIAS
Box 21-1 Myocardial Deficiency and Increased Workload: Common Causes
Myocardial Deficiency
Inadequate Contractility
Inadequate Filling
Increased Workload
Pressure Overload
Volume Overload
FIGURE 21-1 Conduction system of the heart. AV, Atrioventricular; LA, left atrium; LV, left ventricle; RA, right atrium; RV, right ventricle; SA, sinoatrial. (Modified from Kinney M et al: Comprehensive cardiac care, ed 8, St Louis, 1996, Mosby; Lewis SM, Heitkemper MM, Dirksen SR: Medical-surgical nursing: assessment and management of clinical problems, ed 6, St Louis, 2004, Mosby.)
CARDIAC GLYCOSIDES
Mechanism of Action and Drug Effects
Indications
Contraindications
Adverse Effects
Toxicity and Management of Overdose
Table 21-1 Cardiac Glycosides: Common Adverse Effects
Table 21-2 Digoxin Toxicity: Step-by-Step Management
Life Span Considerations: The Pediatric Patient
Heart Failure and Cardiac Glycosides
Interactions
PREVENTING MEDICATION ERRORS
The Importance of Decimal Points
Dosages
Drug Profiles
▸ digoxin
Pharmacokinetics
Table 21-3 Cardiac Glycosides: Drug Interactions
DOSAGES
Selected Cholinergic Antagonist (Anticholinergic) Drugs
digoxin immune Fab
Pharmacokinetics
PHOSPHODIESTERASE INHIBITORS
Mechanism of Action and Drug Effects
Indications
Contraindications
Adverse Effects
Toxicity and Management of Overdose
Interactions
Dosages
Drug Profiles
milrinone
Pharmacokinetics
MISCELLANEOUS HEART FAILURE DRUGS
♦ NURSING PROCESS
♦ ASSESSMENT
Table 21-4 Conditions Predisposing to Digitalis Toxicity
♦ NURSING DIAGNOSES
♦ PLANNING
Goals
Outcome Criteria
♦ IMPLEMENTATION
♦ EVALUATION
Patient Teaching Tips
Points to Remember
NCLEX Examination Review Questions
Critical Thinking Activities
CHAPTER 22 Antidysrhythmic Drugs
Objectives
e-Learning Activities
Companion CD
evolve Website (http://evolve.elsevier.com/Lilley)
Drug Profiles
Glossary
DYSRHYTHMIAS AND NORMAL CARDIAC ELECTROPHYSIOLOGY
Normal Electrophysiology
FIGURE 22-1 Resting membrane potential of a cardiac cell. ATPase, Adenosine triphosphatase.
FIGURE 22-2 Action potentials. RMP, Resting membrane potential; SA, sinoatrial; TP, threshold potential.
FIGURE 22-3 Purkinje fiber action potential.
FIGURE 22-4 Aspects of an action potential. APD, Action potential duration; ERP, effective refractory period; RRP, relative refractory period.
Table 22-1 Comparison of Action Potentials in Different Cardiac Tissue
Electrocardiography
FIGURE 22-5 The waves and intervals of a normal electrocardiogram. (From Goldberger AL: Clinical electrocardiography: a simplified approach, ed 6, St Louis, 1999, Mosby.)
Common Dysrhythmias
Table 22-2 Common Dysrhythmias
Table 22-3 Vaughan Williams Classification of Antidysrhythmic Drugs
ANTIDYSRHYTHMIC DRUGS
Mechanism of Action and Drug Effects
Table 22-4 Antidysrhythmic Drugs: Mechanisms of Action
Box 22-1 Effects of Antidysrhythmic Drugs
Class I (moricizine)
Class Ia (disopyramide, procainamide, quinidine)
Class Ib (lidocaine, mexiletine, phenytoin)
Class Ic (flecainide, propafenone)
Class II (β-blockers [e.g., atenolol, esmolol, metoprolol])
Class III (amiodarone, sotalol*, ibutilide, dofetilide)
Class IV (diltiazem, verapamil)
Indications
Contraindications
Adverse Effects
Toxicity and Management of Overdose
Interactions
Table 22-5 Antidysrhythmic Drugs: Indication
Drug Profiles
Class Ia Drugs
Table 22-6 Common Adverse Effects of Various Antidysrhythmic Drugs
procainamide
Table 22-7 Common Electrocardiographic Effects of Various Antidysrhythmic Drugs
Table 22-8 Selected Antidysrhythmic Drugs: Management of Overdose
Pharmacokinetics
quinidine
Table 22-9 Common Drug Interactions for Selected Antidysrhythmic Drugs
Pharmacokinetics
Class Ib Drugs
▸ lidocaine
DOSAGES
Selected Antiepileptic Drugs
Pharmacokinetics
mexiletine
Pharmacokinetics
Class Ic Drugs
flecainide
Pharmacokinetics
propafenone
Pharmacokinetics
Class II Drugs
▸ atenolol
Pharmacokinetics
esmolol
Pharmacokinetics
▸ metoprolol
Pharmacokinetics
▸ propranolol
Pharmacokinetics
▸ sotalol
Pharmacokinetics
Class III Drugs
Amiodarone for Ventricular Tachycardia
Amiodarone for Ventricular Fibrillation
▸ amiodarone
Table 22-10 Recommendations for Oral Dosage after IV Infusion of Amiodarone
Pharmacokinetics
ibutilide
Pharmacokinetics
Class IV Drugs
▸ diltiazem
Cardiac Effects of Diltiazem Injection
Pharmacokinetics
▸ verapamil
Pharmacokinetics
Unclassified Antidysrhythmics
adenosine
Cardiac Effects of Adenosine
Pharmacokinetics
PHARMACOKINETIC BRIDGE to Nursing Practice
♦ NURSING PROCESS
♦ ASSESSMENT
♦ NURSING DIAGNOSES
♦ PLANNING
Goals
EVIDENCE-BASED PRACTICE
Antidysrhythmics and the Elderly Patient
Review
Type of Evidence
Results of Study
Link of Evidence to Nursing Practice
Outcome Criteria
♦ IMPLEMENTATION
♦ EVALUATION
Patient Teaching Tips
Points to Remember
NCLEX Examination Review Questions
Critical Thinking Activities
CHAPTER 23 Antianginal Drugs
Objectives
e-Learning Activities
Companion CD
evolve Website (http://evolve.elsevier.com/Lilley)
Drug Profiles
Glossary
ANGINA AND CORONARY ARTERY DISEASE
Acute Myocardial Infarction
Table 23-1 Antianginal Drugs: Therapeutic Effects
ANTIANGINAL DRUGS
FIGURE 23-1 Benefit of drug therapy for angina through increasing oxygen supply and decreasing oxygen demands.
NITRATES AND NITRITES
Mechanism of Action and Drug Effects
Indications
Contraindications
Adverse Effects
Interactions
Dosages
Drug Profiles
▸ isosorbide dinitrate
Pharmacokinetics
▸ isosorbide mononitrate
Pharmacokinetics
▸ nitroglycerin
DOSAGES
Selected Antianginal Nitrate Coronary Vasodilators
PREVENTING MEDICATION ERRORS
Rate vs. Dose
Pharmacokinetics
β-BLOCKERS
Mechanism of Action and Drug Effects
Indications
Contraindications
Table 23-2 β-Blockers: Adverse Effects
Table 23-3 β-Blockers: Common Drug Interactions
Adverse Effects
Interactions
Dosages
Drug Profiles
DOSAGES
Selected β-Adrenergic-Blocking Drugs
▸ atenolol
Pharmacokinetics
▸ metoprolol
Pharmacokinetics
CALCIUM CHANNEL BLOCKERS
Table 23-4 Classification of Calcium Channel Blockers
Mechanism of Action and Drug Effects
Indications
Contraindications
Adverse Effects
Interactions
Dosages
Table 23-5 Calcium Channel Blockers: Adverse Effects
Table 23-6 Calcium Channel Blockers: Common Drug Interactions
Drug Profiles
▸ diltiazem
Pharmacokinetics
amlodipine
Pharmacokinetics
MISCELLANEOUS ANTIANGINAL DRUGS
Drug Profiles
ranolazine
DOSAGES
Selected Calcium Channel-Blocking Drugs
SUMMARY OF ANTIANGINAL PHARMACOLOGY
PHARMACOKINETIC BRIDGE To Nursing Practice
♦ NURSING PROCESS
♦ ASSESSMENT
♦ NURSING DIAGNOSES
♦ PLANNING
Goals
Outcome Criteria
♦ IMPLEMENTATION
♦ EVALUATION
Patient Teaching Tips
Nitroglycerin
Isosorbide Dinitrate or Isosorbide Mononitrate
Points to Remember
NCLEX Examination Review Questions
Critical Thinking Activities
CHAPTER 24 Antihypertensive Drugs
Objectives
e-Learning Activities
Companion CD
evolve Website (http://evolve.elsevier.com/Lilley)
Drug Profiles
Glossary
Box 24-1 New Hypertension Guidelines—The Seventh Report
HYPERTENSION
Evidence-Based Practice
Effects of Exercise on Blood Pressure in Those 55 Years of Age and Older
Review
Type of Evidence
Results of Study
Link of Evidence to Nursing Practice
Table 24-1 Classification and Management of Blood Pressure
FIGURE 24-1 Normal regulation of blood pressure and corresponding medications. ACE, Angiotensin-converting enzyme; CNS, central nervous system.
ANTIHYPERTENSIVE DRUGS
Box 24-2 Categories and Subcategories of Antihypertensive Drugs
Adrenergic Drugs
Angiotensin-Converting Enzyme Inhibitors
Angiotensin II Receptor Blockers
Calcium Channel Blockers
Diuretics
Vasodilators
FIGURE 24-2 Location of the nicotinic receptors in the parasympathetic and sympathetic nervous systems. ACh, Acetylcholine; NE, norepinephrine.
REVIEW OF AUTONOMIC NEUROTRANSMISSION
CULTURAL IMPLICATIONS
Antihypertensive Drug Therapy
ADRENERGIC DRUGS
Mechanism of Action and Drug Effects
Renin-Angiotensin in Control of Blood Pressure
FIGURE 24-3 Site and mechanism of action of the various antihypertensive drugs. (From U.S. Department of Health and Human Services: The seventh report of the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure (JNC-7), Washington, DC, 2003, National Institutes of Health. In Lewis SM, Heitkemper MM, Dirksen SR: Medical-surgical nursing: assessment and management of clinical problems, ed 6, St Louis, 2003, Mosby.)
Indications
Contraindications
Adverse Effects
Table 24-2 Adrenergic Drugs: Drug Interactions
Interactions
Dosages
Drug Profiles
α2-Adrenergic Receptor Stimulators (Agonists)
▸ clonidine
DOSAGES
Selected Antihypertensive Drugs: Adrenergic Agonist and Antagonists
Pharmacokinetics
α1-Blockers
prazosin
Pharmacokinetics
Dual-Action α1 and β Receptor Blockers
carvedilol
Pharmacokinetics
ANGIOTENSIN-CONVERTING ENZYME INHIBITORS
Table 24-3 ACE Inhibitors: Distinguishing Characteristics
Mechanism of Action and Drug Effects
Indications
Contraindications
Table 24-4 ACE Inhibitors: Therapeutic Effects
DOSAGES
Selected Antihypertensive Drugs: ACE Inhibitors and Angiotensin II Receptor Blockers
Adverse Effects
Toxicity and Management of Overdose
Interactions
Dosages
Drug Profiles
▸ captopril
Pharmacokinetics
enalapril
Pharmacokinetics
ANGIOTENSIN II RECEPTOR BLOCKERS
Mechanism of Action and Drug Effects
Indications
Contraindications
Adverse Effects
Toxicity and Management of Overdose
Interactions
Table 24-5 Angiotensin II Receptor Blockers (ARBs): Drug Interactions
Dosages
Drug Profile
▸ losartan
Pharmacokinetics
CALCIUM CHANNEL BLOCKERS
DIURETICS
VASODILATORS
Mechanism of Action and Drug Effects
Indications
Contraindications
Adverse Effects
Toxicity and Management of Overdose
Interactions
Dosages
Table 24-6 Direct-Acting Vasodilators: Drug Interactions
Drug Profiles
▸ hydralazine hydrochloride
Pharmacokinetics
DOSAGES
Selected Antihypertensive Drugs: Vasodilators
sodium nitroprusside
Pharmacokinetics
MISCELLANEOUS ANTIHYPERTENSIVE DRUGS
Drug Profiles
eplerenone
bosentan
treprostinil
DOSAGES
Miscellaneous Antihypertensive Drugs
LABORATORY VALUES RELATED TO DRUG THERAPY
Sodium Nitroprusside
♦ NURSING PROCESS
♦ ASSESSMENT
♦ NURSING DIAGNOSES
♦ PLANNING
Goals
Outcome Criteria
CASE STUDY
Hypertension
♦ IMPLEMENTATION
♦ EVALUATION
Patient Teaching Tips
Antihypertensives in General
α-Adrenergic Agonists
β-Blockers
Points to Remember
NCLEX Examination Review Questions
Critical Thinking Activities
CHAPTER 25 Diuretic Drugs
Objectives
e-Learning Activities
Companion CD
evolve Website (http://evolve.elsevier.com/Lilley)
Drug Profiles
Glossary
OVERVIEW OF RENAL PHYSIOLOGY
DIURETIC DRUGS
FIGURE 25-1 The nephron and diuretic sites of action. ADH, Antidiuretic hormone.
Table 25-1 Classification of Diuretics
CARBONIC ANHYDRASE INHIBITORS
Mechanism of Action and Drug Effects
Indications
Contraindications
Adverse Effects
Interactions
Dosages
Drug Profiles
acetazolamide
Pharmacokinetics
LOOP DIURETICS
Mechanism of Action and Drug Effects
Summary of Major Drug Effects of Loop Diuretics
Indications
Contraindications
Table 25-2 Loop Diuretics: Common Adverse Effects
Table 25-3 Loop Diuretics: Common Drug Interactions
Adverse Effects
Toxicity and Management of Overdose
Interactions
Dosages
Drug Profiles
Pharmacokinetics
▸ furosemide
DOSAGES
Selected Loop Diuretics and Osmotic Diuretics
Pharmacokinetics
OSMOTIC DIURETICS
Mechanism of Action and Drug Effects
Indications
Contraindications
Adverse Effects
Interactions
Dosages
Drug Profiles
▸ mannitol
Pharmacokinetics
POTASSIUM-SPARING DIURETICS
Mechanism of Action and Drug Effects
Life Span Considerations: The Pediatric Patient
Diuretics
Indications
Contraindications
Adverse Effects
Interactions
Table 25-4 Potassium-Sparing Diuretics: Common Adverse Effects
Dosages
Drug Profiles
amiloride
Pharmacokinetics
▸ spironolactone
Pharmacokinetics
triamterene
Pharmacokinetics
DOSAGES
Selected Potassium-Sparing Diuretic Drugs
THIAZIDES AND THIAZIDE-LIKE DIURETICS
Mechanism of Action and Drug Effects
Indications
Table 25-5 Thiazide and Thiazide-Like Diuretics: Potential Adverse Effects
Contraindications
Adverse Effects
Table 25-6 Thiazide and Thiazide-Like Diuretics: Common Drug Interactions
DOSAGES
Thiazide and Selected Thiazide-Like Diuretic Drugs
Toxicity and Management of Overdose
Interactions
Dosages
Drug Profiles
▸ hydrochlorothiazide
Pharmacokinetics
metolazone
Pharmacokinetics
♦ NURSING PROCESS
♦ ASSESSMENT
♦ NURSING DIAGNOSES
♦ PLANNING
Goals
Outcome Criteria
♦ IMPLEMENTATION
CASE STUDY
Diuretic Therapy
Life Span Considerations: The Elderly Patient
Diuretic Therapy
♦ EVALUATION
Patient Teaching Tips
Points to Remember
NCLEX Examination Review Questions
Critical Thinking Activities
CHAPTER 26 Fluids and Electrolytes
Objectives
e-Learning Activities
Companion CD
evolve Website (http://evolve.elsevier.com/Lilley)
Drug Profiles
Glossary
PHYSIOLOGY OF FLUID BALANCE
FIGURE 26-1 Distribution of total body water (TBW). ECF, Extracellular fluid; ICF, intracellular fluid; ISF, interstitial fluid; PV, plasma volume.
Table 26-1 Fluid Location: Descriptive Terms and Actual Volumes
FIGURE 26-2 Colloid osmotic pressure (oncotic pressure). As shown, the colloids inside the blood vessel are too large to pass through the vessel wall. The resulting oncotic pressure exerted by the colloids draws fluid from the surrounding tissues and other extravascular spaces into the blood vessels and also keeps fluid inside the blood vessel.
Table 26-2 Types of Dehydration
Table 26-3 Conditions Leading to Fluid Loss or Dehydration and Associated Corresponding Symptoms*
CRYSTALLOIDS
Mechanism of Action and Drug Effects
Table 26-4 Crystalloids
Indications
Contraindications
Adverse Effects
Table 26-5 Crystalloids and Colloids: Dosing Guidelines
Interactions
Dosages
Drug Profiles
sodium chloride
Pharmacokinetics
COLLOIDS
Table 26-6 Commonly Used Colloids
Mechanism of Action and Drug Effects
Indications
Contraindications
Adverse Effects
Interactions
Dosages
Drug Profiles
albumin
Pharmacokinetics
dextran
Pharmacokinetics
BLOOD PRODUCTS
Mechanism of Action and Drug Effects
Table 26-7 Blood Products
Table 26-8 Blood Products: Indications
Indications
Contraindications
Adverse Effects
Table 26-9 Suggested Guidelines for Blood Products: Management of Bleeding
Interactions
Dosages
Drug Profiles
Packed Red Blood Cells
Fresh Frozen Plasma
PHYSIOLOGY OF ELECTROLYTE BALANCE
POTASSIUM
Box 26-1 Symptoms of Hypokalemia
Early
Late
Mechanism of Action and Drug Effects
Indications
Contraindications
Adverse Effects
Toxicity and Management of Overdose
Interactions
Dosages
Drug Profiles
Pharmacokinetics
Table 26-10 Potassium: Various Salt Forms
sodium polystyrene sulfonate (potassium exchange resin)
SODIUM
Mechanism of Action and Drug Effects
Indications
Contraindications
Adverse Effects
Toxicity and Management of Overdose
Interactions
Dosages
Drug Profiles
sodium chloride
Pharmacokinetics
♦ NURSING PROCESS
♦ ASSESSMENT
LABORATORY VALUES RELATED TO DRUG THERAPY
Calcium
♦ NURSING DIAGNOSES
♦ PLANNING
Goals
Outcome Criteria
♦ IMPLEMENTATION
♦ EVALUATION
Patient Teaching Tips
Points to Remember
NCLEX Examination Review Questions
Critical Thinking Activities
CHAPTER 27 Coagulation Modifier Drugs
Objectives
e-Learning Activities
Companion CD
evolve Website (http://evolve.elsevier.com/Lilley)
Drug Profiles
Glossary
FIGURE 27-1 Coagulation pathway and factors: extrinsic pathway. Plt, Platelets.
COAGULATION AND HEMOSTASIS
FIGURE 27-2 Coagulation pathway and factors: intrinsic pathway. HMW-K, High-molecular weight kininogen; Plt, platelets.
COAGULATION-MODIFYING DRUGS
FIGURE 27-3 The fibrinolytic system.
Table 27-1 Coagulation Modifiers: Comparison of Drug Subclasses
ANTICOAGULANTS
Case Study
Heparin Therapy
Mechanism of Action and Drug Effects
Heparin for Acute Coronary Syndrome
Indications
Heparin for Atrial Fibrillation
Contraindications
Adverse Effects
Interactions
Table 27-2 Anticoagulants: Common Adverse Effects
Toxicity and Management of Overdose
Table 27-3 Anticoagulants: Drug Interactions
Dosages
Drug Profiles
▸ warfarin
Pharmacokinetics
▸ enoxaparin
DOSAGES
Selected Anticoagulant Drugs
Pharmacokinetics
▸ heparin
Pharmacokinetics
lepirudin
Pharmacokinetics
argatroban
Pharmacokinetics
PLATELET PHYSIOLOGY
FIGURE 27-4 Relationship between platelets and clotting cascade. ADP, Adenosine diphosphate; 5-HT, serotonin; PF4, platelet factor 4; TXA2, thromboxane A2.
ANTIPLATELET DRUGS
Mechanism of Action and Drug Effects
FIGURE 27-5 Cyclooxygenase pathway. PG, Prostaglandin; TXA2, thromboxane A2.
Indications
Contraindications
Adverse Effects
Table 27-4 Selected Antiplatelet Drugs: Adverse Effects
Interactions
Drug Profiles
Dosages
▸ aspirin
DOSAGES
Selected Antiplatelet Drugs
Pharmacokinetics
▸ clopidogrel
Pharmacokinetics
▸ eptifibatide
Pharmacokinetics
ANTIFIBRINOLYTIC DRUGS
Mechanism of Action and Drug Effects
Indications
Contraindications
Adverse Effects
Table 27-5 Antifibrinolytics: Mechanisms of Action
Interactions
Dosages
Drug Profiles
aminocaproic acid
Pharmacokinetics
desmopressin
Table 27-6 Antifibrinolytics: Adverse Effects
DOSAGES
Selected Antifibrinolytic Drugs
Pharmacokinetics
THROMBOLYTIC DRUGS
Thrombolytic Drugs
Mechanism of Action and Drug Effects
Indications
Contraindications
Adverse Effects
Toxicity and Management of Overdose
Interactions
Dosages
Drug Profiles
▸ alteplase
Pharmacokinetics
▸ streptokinase
DOSAGES
Selected Thrombolytic Drugs
Pharmacokinetics
♦ NURSING PROCESS
♦ ASSESSMENT
LABORATORY VALUES RELATED TO DRUG THERAPY
Anticoagulants
♦ NURSING DIAGNOSES
♦ PLANNING
Goals
Outcome Criteria
♦ IMPLEMENTATION
Box 27-1 Anticoagulation Therapy and Related Nursing Considerations
Subcutaneous Heparin Injections
Intravenous Heparin Administration
Oral Anticoagulant Administration
♦ EVALUATION
Patient Teaching Tips
Points to Remember
NCLEX Examination Review Questions
Critical Thinking Activities
CHAPTER 28 Antilipemic Drugs
Objectives
e-Learning Activities
Companion CD
evolve Website (http://evolve.elsevier.com/Lilley)
Drug Profiles
Glossary
HERBAL THERAPIES AND DIETARY SUPPLEMENTS
Garlic (allium sativum)
Overview
Common Uses
Adverse Effects
Potential Drug Interactions
Contraindications
HERBAL THERAPIES AND DIETARY SUPPLEMENTS
Flax
Overview
Common Uses
Adverse Effects
Potential Drug Interactions
Contraindications
LIPIDS AND LIPID ABNORMALITIES
PRIMARY FORMS OF LIPIDS
Table 28-1 Lipoprotein Classification
CHOLESTEROL HOMEOSTASIS
FIGURE 28-1 Cholesterol homeostasis. CE, Cholesterol ester; HDL, high-density lipoprotein; HMG-CoA, hydroxymethylglutaryl-coenzyme A; IDL, intermediate-density lipoprotein; LCAT, lecithin cholesterol acetyltransferase; LDL, low-density lipoprotein; TG, triglyceride; VLDL, very-low-density lipoprotein.
ATHEROSCLEROTIC PLAQUE FORMATION
LINK BETWEEN CHOLESTEROL AND CORONARY HEART DISEASE
Evidence-Based Practice
Statins and Stroke Reduction in Patients With and Without Coronary Heart Disease
Review
Type of Evidence and Type of Research
Results of Study
Link of Evidence to Nursing Practice
HYPERLIPIDEMIAS AND TREATMENT GUIDELINES
Box 28-1 Coronary Heart Disease: Risk Factors
Positive Risk Factors
Negative Risk Factors
Table 28-2 Types of Hyperlipidemias
Table 28-3 Treatment Decisions Based on LDL Cholesterol Level
Box 28-2 Identifying Features of the Metabolic Syndrome
HMG–CoA Reductase Inhibitors
Mechanism of Action and Drug Effects
Indications
Contraindications
Adverse Effects
Table 28-4 HMG—CoA Reductase Inhibitors: Potential Adverse Effects
Toxicity and Management of Overdose
Interactions
Laboratory Test Interactions
Dosages
Drug Profiles
▸ atorvastatin
Pharmacokinetics
OTHER ANTILIPEMIC DRUGS
BILE ACID SEQUESTRANTS
Mechanism of Action and Drug Effects
Table 28-5 Bile Acid Sequestrants: Adverse Effects
Indications
Contraindications
Adverse Effects
Toxicity and Management of Overdose
Interactions
Dosages
Drug Profiles
▸ cholestyramine
NIACIN
Mechanism of Action and Drug Effects
Indications
DOSAGES
Selected Antilipemic Drugs
Table 28-6 Nicotinic Acid: Potential Adverse Effects
Contraindications
Adverse Effects
Interactions
Dosages
Drug Profiles
▸ niacin
Pharmacokinetics
FIBRIC ACID DERIVATIVES
Mechanism of Action and Drug Effects
Indications
Contraindications
Adverse Effects
Table 28-7 Fibric Acid Derivatives: Potential Adverse Effects
Toxicity and Management of Overdose
Interactions
Dosages
Drug Profiles
Fibric Acid Derivatives (Fibrates)
gemfibrozil
Pharmacokinetics
Cholesterol Absorption Inhibitors
ezetimibe
Pharmacokinetics
♦ NURSING PROCESS
♦ ASSESSMENT
♦ NURSING DIAGNOSES
♦ PLANNING
Goals
Outcome Criteria
♦ IMPLEMENTATION
LABORATORY VALUES RELATED TO DRUG THERAPY
Coronary Heart Disease
♦ EVALUATION
Patient Teaching Tips
Points To Remember
NCLEX Examination Review Questions
Critical Thinking Activities
PART 5 Drugs Affecting the Endocrine System
Drugs Affecting the Endocrine System
STUDY SKILLS TIPS
QUESTIONING STRATEGY
Part Title
Chapter Titles
Chapter Objectives
Chapter Headings
Type 1 Diabetes Mellitus
Mechanism of Action and Drug Effects
Print Conventions Within the Body of the Chapter
Chapter Tables
CHAPTER 29 Pituitary Drugs
Objectives
e-Learning Activities
Companion CD
evolve Website (http://evolve.elsevier.com/Lilley)
Drug Profiles
Glossary
ENDOCRINE SYSTEM
Box 29-1 Hormones of the Anterior and Posterior Pituitary
Anterior Pituitary Adenohypophysis
Posterior Pituitary (Neurohypophysis)
FIGURE 29-1 Pituitary hormones. (From McKenry LM, Tessier E, Hogan MA: Mosby’s pharmacology in nursing,ed 22, St Louis, 2006, Mosby.)
PITUITARY DRUGS
Mechanism of Action and Drug Effects
Table 29-1 Anterior and Posterior Pituitary Hormones and Drugs
Indications
Table 29-2 Corticotropin: Common Adverse Effects
Table 29-3 Desmopressin and Vasopressin: Common Adverse Effects
Table 29-4 Growth Hormone Analogs: Common Adverse Effects
Table 29-5 Selected Drug Interactions Involving Pituitary Drugs
Contraindications
Adverse Effects
Interactions
Dosages
Drug Profiles
▸ corticotropin
Pharmacokinetics
DOSAGES
Selected Pituitary Drugs
Selected Pituitary Drugs
♦ NURSING PROCESS
♦ ASSESSMENT
Box 29-2 Pituitary Drugs: Assessment Data
♦ NURSING DIAGNOSES
♦ PLANNING
Goals
Outcome Criteria
♦ IMPLEMENTATION
♦ EVALUATION
Patient Teaching Tips
Points to Remember
NCLEX Examination Review Questions
Critical Thinking Activities
CHAPTER 30 Thyroid and Antithyroid Drugs
Objectives
e-Learning Activities
Companion CD
evolve Website (http://evolve.elsevier.com/Lilley)
Drug Profiles
Glossary
THYROID FUNCTION
HYPOTHYROIDISM
THYROID AUGMENTATION DRUGS
Mechanism of Action and Drug Effects
Indications
Contraindications
Adverse Effects
Table 30-1 Thyroid Drugs: Clinically Equivalent Doses
Interactions
Dosages
Table 30-2 Thyroid Drugs: Common Adverse Effects
Drug Profiles
▸ levothyroxine
Pharmacokinetics
DOSAGES
Selected Thyroid Drugs
HYPERTHYROIDISM
ANTITHYROID DRUGS
Mechanism of Action and Drug Effects
Indications
Table 30-3 Antithyroid Drugs: Common Adverse Effects
Contraindications
Adverse Effects
Interactions
Dosages
Drug Profiles
▸ propylthiouracil
DOSAGES
Selected Antithyroid Drugs
Pharmacokinetics
PHARMACOKINETIC BRIDGE TO NURSING PRACTICE
♦ NURSING PROCESS
♦ ASSESSMENT
Life Span Considerations: The Elderly Patient
Thyroid Hormones
♦ NURSING DIAGNOSES
♦ PLANNING
Goals
Outcome Criteria
♦ IMPLEMENTATION
♦ EVALUATION
Patient Teaching Tips
Points to Remember
NCLEX Examination Review Questions
Critical Thinking Activities
CHAPTER 31 Antidiabetic Drugs
Objectives
e-Learning Activities
Companion CD
evolve Website (http://evolve.elsevier.com/Lilley)
Drug Profiles
Glossary
PANCREAS
DIABETES MELLITUS
Box 31-1 Criteria for Diagnosis of Diabetes
Box 31-2 Major Long-Term Consequences of Diabetes (Type 1 and Type 2)
Table 31-1 Type 1 and Type 2 Diabetes: Characteristics
Type 1 Diabetes Mellitus
Acute Diabetic Complications: Diabetic Ketoacidosis and Hyperosmolar Nonketotic Syndrome
Type 2 Diabetes Mellitus
FIGURE 31-1 Islet of Langerhans. (From Boron WF, Boulapaep EL:Medical physiology, Philadelphia, 2003, Saunders.)
Table 31-2 Comparison of Some Salient Features of Diabetic Ketoacidosis and Hyperosmolar Nonketotic Syndrome
Gestational Diabetes
Prevention and Screening
Nonpharmacologic Treatment Interventions
ANTIDIABETIC DRUGS
INSULINS
Table 31-3 Human Insulins and Analogues: Comparison of Pharmacokinetic Properties
Table 31-4 Insulin Mixing Compatibilities
Mechanism of Action and Drug Effects
Indications
Contraindications
Adverse Effects
Box 31-3 Intensive Insulin Therapy and Tight Glucose Control
Table 31-5 Insulin: Common Adverse Effects
Interactions
Dosages
Drug Profiles
Insulins
DOSAGES
Human-Based Insulin Products
Rapid-Acting Insulins
▸ insulin lispro and insulin aspart
Table 31-6 Sources of Available Insulin Products
Table 31-7 Considerations for the Use of Antidiabetic Drugs and Insulin
Short-Acting Insulin
▸ regular insulin
Intermediate-Acting Insulins
▸ insulin zinc suspension (Lente) and insulin isophane suspension (NPH)
Long-Acting Insulins
▸ extended insulin zinc suspension (Ultralente) and glargine
Fixed-Combination Insulins
Sliding-Scale Insulin Dosing
ORAL ANTIDIABETIC DRUGS
Mechanism of Action and Drug Effects
Sulfonylureas
Meglitinides
Biguanide
Table 31-8 Sulfonylurea Drugs: Qualitative Comparison of Pharmacokinetic Properties
Thiazolidinediones
α-Glucosidase Inhibitors
Indications
Contraindications
Adverse Effects
Sulfonylureas
Meglitinides
Biguanide
Thiazolidinediones
α-Glucosidase Inhibitors
Interactions
Sulfonylureas
Meglitinides
Biguanide
Thiazolidinediones
α-Glucosidase Inhibitors
Dosages
Drug Profiles
acarbose
DOSAGES
Selected Oral Antidiabetic Drugs
Pharmacokinetics
▸ glipizide
Pharmacokinetics
▸ glyburide
Pharmacokinetics
glimepiride
Pharmacokinetics
▸ metformin
Pharmacokinetics
repaglinide
Pharmacokinetics
▸ rosiglitazone
Pharmacokinetics
MISCELLANEOUS ANTIDIABETIC DRUGS
Amylin Mimetic
Incretin Mimetic
HYPOGLYCEMIA
GLUCOSE-ELEVATING DRUGS
PHARMACOKINETIC BRIDGE to Nursing Practice
♦ NURSING PROCESS
♦ ASSESSMENT
CASE STUDY
Diabetes Mellitus
♦ NURSING DIAGNOSES
♦ PLANNING
Goals
Outcome Criteria
♦ IMPLEMENTATION
Box 31-4 Administration, Handling, and Storage of Insulin
Dosages, Storage, Handling, and Mixing
Administration
♦ EVALUATION
EVIDENCE-BASED PRACTICE
Tight Insulin Control
Review
Type of Evidence
Results of Study
Link of Evidence to Nursing Practice
Patient Teaching Tips
Insulin Therapy
Table 31-9 Diabetes Care: Correlation of Glycosylated Hemoglobin Levels with Mean Serum Glucose Levels
Points to Remember
NCLEX Examination Review Questions
Critical Thinking Activities
CHAPTER 32 Adrenal Drugs
Objectives
e-Learning Activities
Companion CD
evolve Website (http://evolve.elsevier.com/Lilley)
Drug Profiles
Glossary
ADRENAL SYSTEM
Table 32-1 Adrenal Gland: Characteristics
Box 32-1 Adrenal Cortex Hormones: Biologic Functions
Glucocorticoids
Mineralocorticoids
ADRENAL DRUGS
Mechanism of Action and Drug Effects
Table 32-2 Available Synthetic Corticosteroids
Indications
Table 32-3 Systemic Glucocorticoids: A Comparison
Contraindications
Adverse Effects
Interactions
Table 32-4 Corticosteroids: Common Adverse Effects
Dosages
Drug Profiles
Corticosteroids
DOSAGES
Selected Antiadrenal and Corticosteroid Drugs
▸ fludrocortisone
Pharmacokinetics
▸ prednisone
Pharmacokinetics
Antiadrenals
▸ aminoglutethimide
Pharmacokinetics
♦ NURSING PROCESS
♦ ASSESSMENT
♦ NURSING DIAGNOSES
♦ PLANNING
Goals
Outcome Criteria
♦ IMPLEMENTATION
♦ EVALUATION
Patient Teaching Tips
Points to Remember
NCLEX Examination Review Questions
Critical Thinking Activities
CHAPTER 33 Women’s Health Drugs
Objectives
e-Learning Activities
Companion CD
evolve Website (http://evolve.elsevier.com/Lilley)
Drug Profiles
Glossary
OVERVIEW OF FEMALE REPRODUCTIVE FUNCTIONS
Table 33-1 Phases of the Menstrual Cycle
FIGURE 33-1 Hormonal activity during the monthly menstrual cycle. Gonadotropin-releasing hormone (Gn-RH) from the hypothalamus stimulates the pituitary gland, causing it to secrete follicle-stimulating hormone (FSH) early in the cycle (coinciding with the menses) and later luteinizing hormone (LH). FSH stimulates the ovaries to produce estrogen (primarily estradiol). Later in the cycle the combined surges in the levels of estrogen, Gn-RH, FSH, and LH stimulate ovulation. The corpus luteum then secretes estrogen and progesterone, providing negative feedback to the hypothalamus and pituitary gland to reduce Gn-RH, FSH, and LH secretions. If the ovum (egg) is not fertilized by a spermatozoon, levels of estrogen and progesterone then fall to their monthly lows, Gn-RH and FSH rise again, and the onset of menses begins a new cycle.
FEMALE SEX HORMONES
ESTROGENS
FIGURE 33-2 Chemical structures for steroid nucleus. A, Detailed structure. B, Abbreviated structure.
Mechanism of Action and Drug Effects
Box 33-1 Diethylstilbestrol
Indications
Contraindications
Box 33-2 Indications for Estrogen Therapy
Table 33-2 Estrogens: Common Adverse Effects
Adverse Effects
Interactions
Dosages
Drug Profiles
▸ estrogen
DOSAGES
Selected Estrogenic Drugs
CULTURAL IMPLICATIONS
Racial Disparities in Survival of Women with Endometrial Cancers
PROGESTINS
Mechanism of Action and Drug Effects
Indications
Contraindications
Adverse Effects
Interactions
Table 33-3 Progestins: Common Adverse Effects
Dosages
Drug Profiles
▸ medroxyprogesterone
Pharmacokinetics
megestrol
Pharmacokinetics
CONTRACEPTIVE DRUGS
DOSAGES
Selected Progestational Drugs
Mechanism of Action and Drug Effects
Indications
Contraindications
Adverse Effects
Interactions
Table 33-4 Oral Contraceptives: Common Adverse Effects
Dosages
Drug Profiles
Contraceptive Drugs
DOSAGES
Selected Contraceptive Drugs
CURRENT DRUG THERAPY FOR OSTEOPOROSIS
CASE STUDY
Osteoporosis
Mechanism of Action and Drug Effects
Bisphosphonates
Selective Estrogen Receptor Modulators
Calcitonin
Teriparatide
Indications
Contraindications
Bisphosphonates
Selective Estrogen Receptor Modulators
Calcitonin
Teriparatide
Adverse Effects
Interactions
Dosages
Drug Profiles
▸ alendronate
Pharmacokinetics
raloxifene
DOSAGES
Selected Drugs Used Specifically for Osteoporosis
Pharmacokinetics
calcitonin
Pharmacokinetics (Nasal Spray)
DRUG THERAPY RELATED TO PREGNANCY, LABOR, DELIVERY, AND THE POSTPARTUM PERIOD
FERTILITY DRUGS
Mechanism Of Action And Drug Effects
Indications
Contraindications
Adverse Effects
Table 33-5 Fertility Drugs: Most Common Adverse Effects
DOSAGES
Selected Fertility Drugs
Interactions
Dosages
Drug Profiles
choriogonadotropin alfa
Pharmacokinetics
clomiphene
Pharmacokinetics
▸ menotropins
Pharmacokinetics
LABOR, DELIVERY, AND POSTPARTUM DRUGS: UTERINE-ACTIVE MEDICATIONS
Uterine Stimulants
Mechanism of Action and Drug Effects
Indications
Contraindications
Adverse Effects
Interactions
Table 33-6 Oxytocic Drugs: Most Common Adverse Effects
Dosages
Drug Profiles
▸ dinoprostone
Pharmacokinetics
▸ methylergonovine
Pharmacokinetics
mifepristone
Pharmacokinetics
▸ oxytocin
DOSAGES
Selected Uterine Stimulants
Pharmacokinetics
Uterine Relaxants
Mechanism of Action and Drug Effects
Indications
Contraindications
Adverse Effects
Toxicity and Management of Overdose
Interactions
Table 33-7 Tocolytic Drugs: Most Common Adverse Effects
Dosages
Drug Profiles
ritodrine
Pharmacokinetics
terbutaline
Pharmacokinetics
♦ NURSING PROCESS
♦ ASSESSMENT
DOSAGES
Selected Uterine Relaxants
♦ NURSING DIAGNOSES
♦ PLANNING
Goals
Outcome Criteria
♦ IMPLEMENTATION
♦ EVALUATION
Patient Teaching Tips
Points to Remember
NCLEX Examination Review Questions
Critical Thinking Activities
CHAPTER 34 Men’s Health Drugs
Objectives
e-Learning Activities
Companion CD
evolve Website (http://evolve.elsevier.com/Lilley)
Drug Profiles
Glossary
MALE REPRODUCTIVE SYSTEM
ANDROGENS AND OTHER DRUGS PERTAINING TO MEN’S HEALTH
Mechanism of Action and Drug Effects
CULTURAL IMPLICATIONS
Men’s Health Concerns and Screening
Indications
Box 34-1 Currently Available Men’s Health Drugs
a1-Adrenergic Blockers
Anabolic Steroids
Other Androgens
Antiandrogens
5α-Reductase Inhibitors
Gonadotropin-Releasing Hormone Analogues
Peripheral Vasodilator
Drugs for Erectile Dysfunction
Table 34-1 Men’s Health Drugs: Indications
Contraindications
Adverse Effects
Table 34-2 Mens’ Health Drugs: Selected Adverse Effects
Interactions
Dosages
Drug Profiles
finasteride
DOSAGES
Selected Men’s Health Drugs
Pharmacokinetics
▸ sildenafil
Pharmacokinetics
▸ testosterone
Pharmacokinetics
PHARMACOKINETIC BRIDGE to Nursing Practice
♦ NURSING PROCESS
♦ ASSESSMENT
Life Span Considerations: The Elderly Patient
Sildenafil: Use and Concerns
♦ NURSING DIAGNOSES
♦ PLANNING
Goals
Outcome Criteria
♦ IMPLEMENTATION
HERBAL THERAPIES AND DIETARY SUPPLEMENTS
Saw Palmetto (Serenoa repens, Sabal serrulata)
Overview
Common Uses
Adverse Effects
Potential Drug Interactions
Contraindications
♦ EVALUATION
Patient Teaching Tips
Points to Remember
NCLEX Examination Review Questions
Critical Thinking Activities
PART 6 Drugs Affecting the Respiratory System
Drugs Affecting the Respiratory System
STUDY SKILLS TIPS
STUDY ON THE RUN, PURR
Where Is the Time?
SOTR and Plan
SOTR and Vocabulary
Creating Vocabulary Cards with SOTR
SOTR and Vocabulary Review
SOTR and Chapter Review
CHAPTER 35 Antihistamines, Decongestants, Antitussives, and Expectorants
Objectives
e-Learning Activities
Companion CD
evolve Website (http://evolve.elsevier.com/Lilley)
Drug Profiles
Glossary
COLD MEDICATIONS
HERBAL THERAPIES AND DIETARY SUPPLEMENTS
Echinacea (Echinacea)
Overview
Common Uses
Adverse Effects
Potential Drug Interactions
Contraindications
ANTIHISTAMINES
Mechanism of Action and Drug Effects
FIGURE 35-1 Comparison of efficacy and adverse effects of selected antihistamines.
Indications
Contraindications
Table 35-1 Effects of Various Antihistamines
Table 35-2 Antihistamines: Drug Effects
Adverse Effects
Table 35-3 Antihistamines: Reported Adverse Effects
Interactions
Dosages
Drug Profiles
Nonsedating Antihistamines
▸ loratadine
Pharmacokinetics
Traditional Antihistamines
▸ diphenhydramine
DOSAGES
Selected Antihistamines
Pharmacokinetics
DECONGESTANTS
HERBAL THERAPIES AND DIETARY SUPPLEMENTS
Goldenseal (Hydrastis canadensis)
Overview
Common Uses
Adverse Effects
Potential Drug Interactions
Contraindications
Mechanism of Action and Drug Effects
Indications
Contraindications
Adverse Effects
Interactions
Dosages
Drug Profiles
naphazoline
DOSAGES
Selected Decongestant, Expectorant, and Antitussive Drugs
Pharmacokinetics
ANTITUSSIVES
Mechanism of Action and Drug Effects
Indications
Contraindications
Adverse Effects
Interactions
Dosages
Drug Profiles
benzonatate
Pharmacokinetics
codeine
Pharmacokinetics
▸ dextromethorphan
Pharmacokinetics
EXPECTORANTS
Mechanism of Action and Drug Effects
Indications
Contraindications
Adverse Effects
Interactions
Dosages
Table 35-4 Expectorants: Reported Adverse Effects
Drug Profiles
▸ guaifenesin
♦ NURSING PROCESS
♦ ASSESSMENT
♦ NURSING DIAGNOSES
CASE STUDY
Decongestants
♦ PLANNING
Goals
Outcome Criteria
♦ IMPLEMENTATION
♦ EVALUATION
Patient Teaching Tips
Points to Remember
NCLEX Examination Review Questions
Critical Thinking Activities
CHAPTER 36 Bronchodilators and Other Respiratory Drugs
Objectives
e-Learning Activities
Companion CD
evolve Website (http://evolve.elsevier.com/Lilley)
Drug Profiles
Glossary
DISEASES OF THE RESPIRATORY SYSTEM
ASTHMA
Box 36-1 Steps Involved in an Attack of Allergic Asthma
Box 36-2 Classifications of Drugs Used to Treat Asthma
Long-Term Control
Quick Relief
Table 36-1 Stepwise Therapy for the Management of Asthma
CHRONIC BRONCHITIS
EMPHYSEMA
TREATMENT OF DISEASES OF THE LOWER RESPIRATORY TRACT
BRONCHODILATORS
β-ADRENERGIC AGONISTS
Mechanism of Action and Drug Effects
Table 36-2 Mechanisms of Antiasthmatic Drug Action
Table 36-3 β-Agonist Bronchodilators
PREVENTING MEDICATION ERRORS
Oral Ingestion of Capsules for Inhalation Devices
Indications
Contraindications
Adverse Effects
Interactions
Dosages
Drug Profiles
▸ albuterol
Pharmacokinetics
ANTICHOLINERGICS
Mechanism of Action and Drug Effects
DOSAGES
Bronchodilators
Indications
Contraindications
Adverse Effects
Drug Interactions
Dosages
Drug Profiles
ipratropium
Pharmacokinetics
XANTHINE DERIVATIVES
Mechanism of Action and Drug Effects
Indications
Contraindications
Adverse Effects
Interactions
Dosages
Drug Profiles
▸ theophylline
DOSAGES
Theophylline Salts
Table 36-4 Available Theophylline Preparations
Pharmacokinetics
NONBRONCHODILATING RESPIRATORY DRUGS
ANTILEUKOTRIENE DRUGS
Mechanism of Action and Drug Effects
Indications
Contraindications
Adverse Effects
Table 36-5 Drug Interactions: Antileukotriene Drugs
Interactions
Dosages
Drug Profiles
▸ montelukast
DOSAGES
Selected Antileukotriene Drugs
Pharmacokinetics
CORTICOSTEROIDS
Mechanism of Action and Drug Effects
Indications
Table 36-6 White Blood Cells (Leukocytes)
Contraindications
Adverse Effects
Interactions
Dosages
Drug Profiles
fluticasone
DOSAGES
Selected Corticosteroids
Pharmacokinetics
CASE STUDY
Chronic Obstructive Pulmonary Disease
methylprednisolone
Pharmacokinetics
♦ NURSING PROCESS
♦ ASSESSMENT
Life Span Considerations: The Elderly Patient
Xanthine Derivatives
♦ NURSING DIAGNOSES
♦ PLANNING
Goals
Outcome Criteria
♦ IMPLEMENTATION
LEGAL AND ETHICAL PRINCIPLES
Chlorofluorocarbons and the Environment
♦ EVALUATION
Patient Teaching Tips
β-Agonists
Xanthines
Anticholinergics
Corticosteroids/Glucocorticoids
Leukotriene Antagonists
Points to Remember
NCLEX Examination Review Questions
Critical Thinking Activities
PART 7 Antiinfective and Antiinflammatory Drugs
Antiinfective and Antiinflammatory Drugs
STUDY SKILLS TIPS
NURSING PROCESS
ASSESSMENT
NURSING DIAGNOSES
EVALUATION
CHAPTER 37 Antibiotics Part 1
Objectives
e-Learning Activities
Companion CD
evolve Website (http://evolve.elsevier.com/Lilley)
Drug Profiles
Glossary
MICROBIAL INFECTION
FIGURE 37-1 General morphology of bacteria. (From Murray PR et al: Medical microbiology, St Louis, 2002, Mosby.)
FIGURE 37-2 A dividing bacterial cell with a single flagellum, four sex pili, numerous common fibrae, a cell wall, a cytoplasmic membrane, two nuclear bodies, three mesosomes, and numerous ribosomes. (From Greenwood D et al: Medical microbiology, ed 16, Edinburgh, 2002, Elsevier Science.)
FIGURE 37-3 Gram-stain differentiation of bacteria. The crystal violet of Gram stain is precipitated by Gram iodine and is trapped in the thick peptidoglycan layer in gram-positive bacteria. The decolorizer disperses the gram-negative outer membrane and washes the crystal violet from the thin layer of peptidoglycan. Gram-negative bacteria are visualized by the red counterstain. (From Murray PR et al: Medical microbiology, St Louis, 2002, Mosby.)
FIGURE 37-4 Gram-positive and gram-negative bacteria. A gram-positive bacterium has a thick layer of peptidoglycan (left). A gram-negative bacterium has a thin peptidoglycan layer and an outer membrane (right). Structures in parentheses are not found in all bacteria. (From Murray PR et al: Medical microbiology, St Louis, 2002, Mosby.)
FIGURE 37-5 Molecules on the surface of gram-negative and gram-positive bacteria involved in pathogenesis. Not shown is the type 3 secretory apparatus of gram-negative bacteria. (From Cotran RS, Kumar V, Collins T: Robbins pathologic basis of disease, ed 6, Philadelphia, 1999, Saunders.)
GENERAL PRINCIPLES OF ANTIBIOTIC THERAPY
ANTIBIOTICS
FIGURE 37-6 Basic sites of antibiotic activity. DNA, Deoxyribonucleic acid; mRNA, messenger ribonucleic acid; RNA, ribonucleic acid. (From Murray PR et al: Medical microbiology, St Louis, 2002, Mosby.)
SULFONAMIDES
Mechanism of Action and Drug Effects
Indications
Contraindications
Adverse Effects
Interactions
Table 37-1 Sulfonamides: Reported Adverse Effects
Dosages
Drug Profiles
sulfamethoxazole-trimethoprim (co-trimoxazole)
Pharmacokinetics
β-LACTAM ANTIBIOTICS
DOSAGES
Selected Sulfonamides and Combination Drug Products
FIGURE 37-7 Chemical structure of penicillins showing the β-lactam ring. R, Variable portion of drug chemical structure.
PENICILLINS
Mechanism of Action and Drug Effects
Table 37-2 Classification of Penicillins
Indications
Contraindications
Adverse Effects
Table 37-3 Penicillins: Reported Adverse Effects
Interactions
Table 37-4 Penicillins: Drug Interactions
Dosages
Drug Profiles
Natural Penicillins
▸ penicillin G and penicillin V potassium
Pharmacokinetics
Penicillinase-Resistant Penicillins
nafcillin
Pharmacokinetics
Aminopenicillins
▸ amoxicillin
Pharmacokinetics
ampicillin
DOSAGES
Selected Penicillins
Pharmacokinetics
Extended-Spectrum Penicillins
Pharmacokinetics
Half-Life of Intravenously Administered Ampicillin
CEPHALOSPORINS
Table 37-5 Cephalosporins: Parenteral and Oral Preparations
Table 37-6 Cephalosporins: Drug Interactions
Dosages
DOSAGES
Selected Cephalosporins
Drug Profiles
First-Generation Cephalosporins
▸ cefazolin
Pharmacokinetics
▸ cephalexin
Pharmacokinetics
Second-Generation Cephalosporins
▸ cefoxitin
Pharmacokinetics
cefuroxime
Pharmacokinetics
Third-Generation Cephalosporins
▸ ceftriaxone
Pharmacokinetics
ceftazidime
Pharmacokinetics
Fourth-Generation Cephalosporins
cefepime
Pharmacokinetics
CARBAPENEMS
Drug Profiles
▸ imipenem-cilastatin
DOSAGES
Carbapenems and Monobactams
Pharmacokinetics
MONOBACTAMS
Drug Profiles
aztreonam
Pharmacokinetics
MACROLIDES AND KETOLIDES
Mechanism of Action and Drug Effects
Table 37-7 Erythromycin Formulations
Indications
Table 37-8 Macrolides: Reported Adverse Effects
Contraindications
Adverse Effects
Interactions
Dosages
Drug Profiles
▸ erythromycin
▸ azithromycin and clarithromycin
DOSAGES
Selected Macrolides and Ketolides
Table 37-9 Erythromycin Dosage Forms and Product Names
Pharmacokinetics
telithromycin
Pharmacokinetics
TETRACYCLINES
Table 37-10 Available Tetracycline Antibiotics
Mechanism of Action and Drug Effects
Indications
Contraindications
Adverse Effects
Interactions
Dosages
Drug Profiles
DOSAGES
Selected Tetracyclines
demeclocycline
Pharmacokinetics
▸ doxycycline
Pharmacokinetics
♦ NURSING PROCESS
♦ ASSESSMENT
♦ NURSING DIAGNOSES
♦ PLANNING
Goals
Outcome Criteria
♦ IMPLEMENTATION
CASE STUDY
Antibiotic Therapy
♦ EVALUATION
Patient Teaching Tips
Points to Remember
NCLEX Examination Review Questions
Critical Thinking Activities
CHAPTER 38 Antibiotics Part 2
Objectives
e-Learning Activities
Companion CD
evolve Website (http://evolve.elsevier.com/Lilley)
Drug Profiles
Glossary
AMINOGLYCOSIDES
Table 38-1 Availability of Aminoglycoside Antibiotics
Mechanism of Action and Drug Effects
Indications
Contraindications
Adverse Effects
Table 38-2 Aminoglycosides: Comparative Spectra of Antimicrobial Activity
Interactions
Dosages
Drug Profiles
amikacin
Pharmacokinetics
▸ gentamicin
Pharmacokinetics
DOSAGES
Selected Aminoglycosides
tobramycin
Pharmacokinetics
neomycin
Pharmacokinetics
FLUOROQUINOLONES
Mechanism of Action and Drug Effects
Indications
Box 38-1 Overview of Quinolone-Susceptible Microbial Spectra
Table 38-3 Quinolones: Common Indications for Specific Drugs
Contraindications
Adverse Effects
Interactions
Dosages
Table 38-4 Quinolones: Reported Adverse Effects
Drug Profiles
Quinolones
▸ ciprofloxacin
Pharmacokinetics
levofloxacin
Pharmacokinetics
Miscellaneous Antibiotics
▸ clindamycin
DOSAGES
Selected Fluoroquinolones (“Quinolones”)
DOSAGES
Selected Miscellaneous Antibiotics
Pharmacokinetics
dapsone
Pharmacokinetics
linezolid
Pharmacokinetics
▸ metronidazole
Pharmacokinetics
nitrofurantoin
Pharmacokinetics
quinupristin and dalfopristin
Pharmacokinetics
▸ vancomycin
Pharmacokinetics
daptomycin
Pharmacokinetics
♦ NURSING PROCESS
♦ ASSESSMENT
♦ NURSING DIAGNOSES
♦ PLANNING
Goals
Outcome Criteria
♦ IMPLEMENTATION
EVALUATION
Patient Teaching Tips
Aminoglycosides
Fluoroquinolones
Clindamycin
Vancomycin
Dapsone
Linezolid
Metronidazole Hydrochloride
Nitrofurantoin
Points to Remember
NCLEX Examination Review Questions
Critical Thinking Activities
CHAPTER 39 Antiviral Drugs
Objectives
e-Learning Activities
Companion CD
evolve Website (http://evolve.elsevier.com/Lilley)
Drug Profiles
Glossary
GENERAL PRINCIPLES OF VIROLOGY
FIGURE 39-1 Virus replication. Some viruses integrate into host chromosome with development of latency. (Modified from Brody TM, Larner J, Minneman KP: Human pharmacology: molecular to clinical, ed 3, St Louis, 1998, Mosby.)
OVERVIEW OF VIRAL ILLNESSES AND THEIR TREATMENT
Table 39-1 Examples of Nucleoside Analog Antiviral Drugs
Table 39-2 Examples of Non-Nucleoside Analog Antiviral Drugs
OVERVIEW OF HERPES SIMPLEX VIRUSES AND VARICELLA-ZOSTER VIRUS INFECTION
Herpes Simplex Viruses
Table 39-3 Antiviral Drugs: Viral Spectra, Indications, and Therapeutic Effects
Table 39-4 Selected Antiviral Drugs: Adverse Effects
Box 39-1 Selected Antiviral Drugs: Interactions
Acyclovir with the Following
Amantadine with the Following
Didanosine with the Following
Ganciclovir with the Following
Indinavir with the Following
Nevirapine with the Following
Zalcitabine with the Following
Zidovudine with the Following
Varicella Zoster Virus
ANTIVIRAL DRUGS (NONRETROVIRAL)
Mechanism of Action and Drug Effects
Indications
Contraindications
PPREVENTING MEDICATION ERRORS
Look-Alike Drugs: Zostrix and Zovirax
Adverse Effects
Interactions
Dosages
Drug Profiles
Nonretroviral Antiviral Drugs
amantadine and rimantadine
Pharmacokinetics
▸ acyclovir
Pharmacokinetics
▸ ganciclovir
DOSAGES
Antiviral Drugs (Nonretroviral)
Pharmacokinetics
oseltamivir and zanamivir
Pharmacokinetics (zanamivir)
Pharmacokinetics (oseltamivir)
ribavirin
Pharmacokinetics
OVERVIEW OF HIV INFECTION AND THE AIDS PANDEMIC
FIGURE 39-2 Human immunodeficiency virus (HIV). Within the core capsid, the diploid, single-stranded, positive-sense RNA is complexed to nucleoprotein. (From Dorland’s illustrated medical dictionary, ed 30, Philadelphia, 2003, Saunders.)
FIGURE 39-3 Life cycle of the HIV virus. The extracellular envelope protein gp120 binds to CD4 on the surface of T lymphocytes or mononuclear phagocytes, while the transmembrane protein gp41 mediates the fusion of the viral envelope with the cell membrane. gp, Glycoprotein. (From Dorland’s illustrated medical dictionary, ed 30, Philadelphia, 2003, Saunders.)
Box 39-2 Epidemiology of HIV Infection
Disease Viral Factors
Transmission
Who Is At Risk?
Geographic Factors
Modes of Control
Box 39-3 Indicator Diseases of AIDS
Opportunistic Infections
Protozoal
Fungal
Viral
Bacterial
Opportunistic Neoplasias
Others
FIGURE 39-4 Natural history of HIV infection in the absence of therapy in a hypothetical patient. (From Fauci AS, Pantaleo G, Stanley S, Weissman D: Immunopathogenic mechanisms of HIV infection. Ann Intern Med 1996; 124:654-663. In Mandell GL, Bennett JE, Dolin R: Principles and practice of infectious diseases, ed 6, Philadelphia, 2005, Churchill Livingstone.)
ANTIRETROVIRAL DRUGS
Mechanism of Action and Drug Effects
Table 39-5 Recommendations for Occupational HIV Exposure Chemoprophylaxis
Indications
Contraindications
Adverse Effects
Interactions
Dosages
Drug Profiles
enfuvirtide
Pharmacokinetics
▸ indinavir
Pharmacokinetics
▸ nevirapine
Pharmacokinetics
tenofovir
Pharmacokinetics
▸ zidovudine
Pharmacokinetics
DOSAGES
Antiretroviral Drugs
OTHER SIGNIFICANT VIRAL ILLNESSES OF RECENT CONCERN
NURSING PROCESS
♦ ASSESSMENT
♦ NURSING DIAGNOSES
♦ PLANNING
Goals
Outcome Criteria
♦ IMPLEMENTATION
♦ EVALUATION
CASE STUDY
Antiviral Therapy
Patient Teaching Tips
Points to Remember
NCLEX Examination Review Questions
Critical Thinking Activities
CHAPTER 40 Antitubercular Drugs
Objectives
e-Learning Activities
Companion CD
evolve Website (http://evolve.elsevier.com/Lilley)
Drug Profiles
Glossary
TUBERCULOSIS
ANTITUBERCULAR DRUGS
Box 40-1 First- and Second-Line Antitubercular Drugs
First-Line Drugs
Second-Line Drugs
Box 40-2 Miscellaneous TB-related Injections
Table 40-1 Antitubercular Drugs: Mechanisms of Action
Mechanism of Action and Drug Effects
Indications
Contraindications
Table 40-2 Antitubercular Drugs: Indications
Adverse Effects
Interactions
Table 40-3 Antitubercular Drugs: Common Adverse Effects
Table 40-4 Antitubercular Drugs: Drug Interactions
Dosages
Drug Profiles
ethambutol
Pharmacokinetics
▸ isoniazid
DOSAGES
Selected Antitubercular Drugs
Pharmacokinetics
pyrazinamide
Pharmacokinetics
rifabutin
Pharmacokinetics
rifampin
Pharmacokinetics
rifapentine
Pharmacokinetics
streptomycin
Pharmacokinetics
♦ NURSING PROCESS
♦ ASSESSMENT
♦ NURSING DIAGNOSES
♦ PLANNING
Goals
Outcome Criteria
♦ IMPLEMENTATION
♦ EVALUATION
CASE STUDY Tuberculosis
Patient Teaching Tips
Points to Remember
NCLEX Examination Review Questions
Critical Thinking Activities
CHAPTER 41 Antifungal Drugs
Objectives
e-Learning Activities
Companion CD
Evolve Website (http://evolve.elsevier.com/Lilley)
Drug Profiles
Glossary
FUNGAL INFECTIONS
Table 41-1 Mycotic Infections
ANTIFUNGAL DRUGS
Mechanism of Action and Drug Effects
Indications
Box 41-1 Fungal Species That Are Susceptible to Current Antifungal Drugs
Cutaneous and Subcutaneous Mycoses
Systemic Mycoses
Contraindications
Adverse Effects
Interactions
Dosages
Drug Profiles
▸ amphotericin B
Pharmacokinetics*
caspofungin
Pharmacokinetics
▸ fluconazole
Pharmacokinetics
nystatin
Pharmacokinetics
terbinafine
Table 41-2 Selected Antifungal Drugs: Common Adverse Effects and Cautions
Table 41-3 Antifungal Drugs: Drug Interactions
DOSAGES
Selected Antifungal Drugs
Pharmacokinetics
voriconazole
Pharmacokinetics
♦ NURSING PROCESS
♦ ASSESSMENT
♦ NURSING DIAGNOSES
♦ PLANNING
Goals
Outcome Criteria
♦ IMPLEMENTATION
♦ EVALUATION
Patient Teaching Tips
Points to Remember
NCLEX Examination Review Questions
Critical Thinking Activities
CHAPTER 42 Antimalarial, Antiprotozoal, and Anthelmintic Drugs
Objectives
e-Learning Activities
Companion CD
Evolve Website (http://evolve.elsevier.com/Lilley)
Drug Profiles
Glossary
MALARIA
FIGURE 42-1 Life cycle of the malarial parasite. (From McKenry LM, Salerno E: Mosby’s pharmacology in nursing—revised and updated, ed 21, St Louis, 2003, Mosby.)
ANTIMALARIAL DRUGS
Mechanism of Action and Drug Effects
Indications
Contraindications
Adverse Effects
Interactions
Dosages
Table 42-1 Antimalarial Drugs: Common Adverse Effects
Table 42-2 Antimalarial Drugs: Drug Interactions
Drug Profiles
▸ chloroquine and hydroxychloroquine
Pharmacokinetics
mefloquine
Pharmacokinetics
▸ primaquine
DOSAGES
Selected Antimalarial Drugs
Table 42-3 Types of Protozoal Infections and Common Drug Therapy
Pharmacokinetics
pyrimethamine
Pharmacokinetics
OTHER PROTOZOAL INFECTIONS
ANTIPROTOZOAL DRUGS
Mechanism of Action and Drug Effects
Table 42-4 Selected Antiprotozoal Drugs: Mechanisms of Action
Indications
Contraindications
Table 42-5 Indications for Selected Antiprotozoal Drugs
Adverse Effects
Interactions
Dosages
Drug Profiles
atovaquone
Pharmacokinetics
iodoquinol
Table 42-6 Adverse Effects for Selected Antiprotozoal Drugs
Table 42-7 Antiprotozoal Drugs: Drug and Laboratory Test Interactions
DOSAGES
Selected Antiprotozoal Drugs
Pharmacokinetics
▸ metronidazole
Pharmacokinetics
paromomycin
Pharmacokinetics
pentamidine
Pharmacokinetics
HELMINTHIC INFECTIONS
Table 42-8 Helminthic Infections
Table 42-9 Anthelmintics: Class of Worms Killed
ANTHELMINTIC DRUGS
Mechanism of Action and Drug Effects
Indications
Contraindications
Adverse Effects
Interactions
Dosages
Drug Profiles
diethylcarbamazine
Pharmacokinetics
Table 42-10 Anthelmintics: Mechanisms of Action
Table 42-11 Anthelmintics: Indications
Table 42-12 Anthelmintics: Common Adverse Effects
▸ mebendazole
Pharmacokinetics
praziquantel
Pharmacokinetics
pyrantel
Pharmacokinetics
DOSAGES
Selected Anthelmintic Drugs
♦ NURSING PROCESS
♦ ASSESSMENT
♦ NURSING DIAGNOSES
♦ PLANNING
Goals
Outcome Criteria
♦ IMPLEMENTATION
♦ EVALUATION
Patient Teaching Tips
Points to Remember
NCLEX Examination Review Questions
Critical Thinking Activities
CHAPTER 43 Antiseptic and Disinfectant Agents
Objectives
e-Learning Activities
Companion CD
Evolve Website (http://evolve.elsevier.com/Lilley)
Drug Profiles
Glossary
COMMUNITY-ACQUIRED AND NOSOCOMIAL INFECTIONS
Table 43-1 Changing Prevalence of Nosocomial Pathogens
TOPICAL ANTIMICROBIALS
Mechanism of Action and Effects of Antiseptics and Disinfectants
Table 43-2 Antiseptics Versus Disinfectants
Table 43-3 Disinfectants and Antiseptics: Chemical Categories
Table 43-4 Antiseptics and Disinfectants: Mechanisms of Action
Table 43-5 Antiseptics and Disinfectants: Therapeutic Effects
Indications
Table 43-6 Antiseptic and Disinfectant Agents: Adverse Effects
Contraindications
Adverse Effects
Interactions
Dosages
Drug Profiles
Acid Agents
Alcohol Agents
Aldehyde Agents
Biguanide Agents
Dyes
Chlorine Compounds
DOSAGES
Selected Antiseptic and Disinfectant Agents
Mercurial Agents
Iodine Compounds
Oxidizing Agents
Phenolic Compounds
Surface-Active Agents
Table 43-7 Iodine Formulations
♦ NURSING PROCESS
♦ ASSESSMENT
♦ NURSING DIAGNOSES
♦ PLANNING
Goals
Outcome Criteria
♦ IMPLEMENTATION
♦ EVALUATION
Patient Teaching Tips
Points to Remember
NCLEX Examination Review Questions
Critical Thinking Activities
CHAPTER 44 Antiinflammatory, Antirheumatic, and Related Drugs
Objectives
e-Learning Activities
Companion CD
Evolve Website (http://evolve.elsevier.com/Lilley)
Drug Profiles
Glossary
CASE STUDY
Postoperative Pain
ARACHIDONIC ACID PATHWAY
NONSTEROIDAL ANTIINFLAMMATORY DRUGS
Mechanism of Action and Drug Effects
FIGURE 44-1 Arachidonic acid pathway.
Box 44-1 Chemical Categories of NSAIDs
Acetic Acids
Carboxylic Acids
Acetylated
Nonacetylated
COX-2 Inhibitors
Fenamic Acids
Napthylalkanones (Nonacidic)
Oxicams
Propionic Acids
Box 44-2 NSAIDs: FDA-Approved Indications
Indications
Table 44-1 Suggested NSAIDs for Patients with Various Medical Conditions
Contraindications
Adverse Effects
Table 44-2 NSAIDs: Adverse Effects
Toxicity and Management of Overdose
Table 44-3 Acute or Chronic Salicylate Intoxication: Signs and Symptoms
Table 44-4 Acute Salicylate Intoxication: Treatment
Table 44-5 Acute Salicylate Intoxication: Treatment Goals
Table 44-6 Salicylates and Other NSAIDs: Drug Interactions
Interactions
DOSAGES
Most Commonly Used NSAIDs
Dosages
Drug Profiles
Nonsteroidal Antiinflammatory Drugs
Acetic Acids
▸ aspirin
Pharmacokinetics
▸ indomethacin
Pharmacokinetics
Propionic Acids
▸ ibuprofen
Pharmacokinetics
Pyrrolizine Carboxylic Acids
▸ ketorolac
Pharmacokinetics
COX-2 Inhibitors
▸ celecoxib
Pharmacokinetics
ENOLIC ACIDS, FENAMIC ACIDS, AND NONACIDIC COMPOUNDS
ANTIRHEUMATIC DRUGS
FIGURE 44-2 Uric acid production. XO, Xanthine oxidase.
Drug Profiles
Antigout Drugs
▸ allopurinol
colchicine
probenecid and sulfinpyrazone
Antirheumatoid Arthritis Drugs
auranofin
aurothioglucose and gold sodium thiomalate
leflunomide
♦ NURSING PROCESS
♦ ASSESSMENT
Herbal Therapies and Dietary Supplements
Glucosamine and Chondroitin
Overview
Common Uses
Adverse Effects
Potential Drug Interactions
Contraindications
♦ NURSING DIAGNOSES
♦ PLANNING
Goals
Outcome Criteria
♦ IMPLEMENTATION
Lifespan Considerations: The Pediatric Patient
Reye’s Syndrome
Signs and Symptoms
Medical Management
Nursing Management
♦ EVALUATION
Patient Teaching Tips
Points to Remember
NCLEX Examination Review Questions
Critical Thinking Activities
PART 8 Immune and Biologic Modifiers and Chemotherapeutic Drugs
Immune and Biologic Modifiers and Chemotherapeutic Drugs
STUDY SKILLS TIPS
TIME MANAGEMENT
EVALUATE PRIOR PERFORMANCE
What Type of Errors Did I Make?
Did I Have Trouble with Questions That Required Mastery of Terminology?
Did I Miss Concept Questions?
Did I Make Errors Because I Did not Know the Material?
ANTICIPATE THE TEST
PLAN FOR DISTRIBUTED STUDY
CHAPTER 45 Immunosuppressant Drugs
Objectives
e-Learning Activities
Companion CD
evolve Website (http://evolve.elsevier.com/Lilley)
Drug Profiles
Glossary
IMMUNOSUPPRESSANT DRUGS
Mechanism of Action and Drug Effects
Indications
Table 45-1 Classification, Mechanisms of Action, and Indications for Available Immunosuppressant Drugs
Contraindications
Adverse Effects
Table 45-2 Selected Immunosuppressant Drugs: Common Adverse Effects
Interactions
Dosages
DOSAGES
Selected Immunosuppressant Drugs
Drug Profiles
▸ azathioprine and mycophenolate mofetil
Pharmacokinetics (azathioprine)
Pharmacokinetics (mycophenolate mofetil)
basiliximab and daclizumab
Pharmacokinetics(basiliximab)
Pharmacokinetics(daclizumab)
▸ cyclosporine
Pharmacokinetics*
glatiramer acetate
▸ muromonab-CD3
Pharmacokinetics
sirolimus and tacrolimus
Pharmacokinetics(sirolimus)
Pharmacokinetics(sirolimus)
♦ NURSING PROCESS
♦ ASSESSMENT
♦ NURSING DIAGNOSES
♦ PLANNING
Goals
Outcome Criteria
♦ IMPLEMENTATION
♦ EVALUATION
Patient Teaching Tips
Points to Remember
NCLEX Examination Review Questions
Critical Thinking Activities
CHAPTER 46 Immunizing Drugs and Biochemical Terrorism
Objectives
e-Learning Activities
Companion CD
Evolve Website (http://evolve.elsevier.com/Lilley)
Drug Profiles
Glossary
IMMUNITY AND IMMUNIZATION
Table 46-1 Active Versus Passive Immunization
ACTIVE IMMUNIZATION
Toxoids
Vaccines
PASSIVE IMMUNIZATION
Box 46-1 Available Immunizing Drugs
Passively Immunizing Drugs
Actively Immunizing Drugs
FIGURE 46-1 Recommended childhood immunization schedule. ACIP, Advisory Committee on Immunization Practices; DTP, diphtheria, tetanus, and pertussis vaccine; HBsAG, hepatitis B surface antigen; Tdap, tetanus and diphtheria toxoids and acellular pertussis vaccine. (From Centers for Disease Control and Prevention, National Immunization Program: Recommended childhood and adolescent immunization schedule: United States: 2006. Available at www.cdc.gov/nip/recs/child-schedule-color-print.pdf.)
IMMUNIZING DRUGS
Mechanism of Action and Drug Effects
Indications
Contraindications
Adverse Effects
Table 46-2 Immunizing Drugs: Minor and Severe Adverse Effects
Interactions
Table 46-3 Vaccine Injury Table
Dosages
Drug Profiles
Active Immunizing Drugs
diphtheria and tetanus toxoids, and acellular pertussis vaccine (adsorbed)
Haemophilus Influenzae Type b conjugate vaccine
▸ hepatitis B virus vaccine (inactivated)
▸ influenza virus vaccine
DOSAGES
Selected Immunizing Drugs
▸ measles, mumps, and rubella virus vaccine (live)
▸ pneumococcal vaccine, polyvalent and seven-valent
▸ poliovirus vaccine (inactivated)
rabies virus vaccine
▸ varicella virus vaccine
Passive Immunizing Drugs
▸ hepatitis B immunoglobulin
▸ immunoglobulin
Box 46-2 Current FDA-Approved Uses of Immunoglobulins*
Rh0(D) immunoglobulin
rabies immunoglobulin
tetanus immunoglobulin
varicella-zoster immunoglobulin
BIOLOGIC AND CHEMICAL TERRORISM
ANTHRAX
Table 46-4 Illnesses Caused by CDC Category “A” Possible Bioterrorism Agents*
Table 46-5 Possible Chemical Terrorism Agents
♦ NURSING PROCESS
♦ ASSESSMENT
♦ NURSING DIAGNOSES
♦ PLANNING
Goals
Outcome Criteria
♦ IMPLEMENTATION
♦ EVALUATION
Patient Teaching Tips
Points to Remember
NCLEX Examination Review Questions
Critical Thinking Activities
CHAPTER 47 Antineoplastic Drugs Part 1: Cancer Overview and Cell Cycle–Specific Drugs
Objectives
e-Learning Activities
Companion CD
evolve Website (http://evolve.elsevier.com/Lilley)
Drug Profiles
Glossary
FIGURE 47-1 Schematic model of multistep carcinogenesis. Genetic change refers to events such as the activation of protooncogenes or drug-resistance genes or the inactivation of tumor suppressor genes, antimetastasis genes, or apoptosis (normal cell death). Genetic change may be relatively minimal, as with the translocations seen in various leukemias, or it may involve multiple sequential genetic alterations, as exemplified by the development of colon cancer. (From Haskell CM: Cancer treatment, ed 5, Philadelphia, 2001, Saunders.)
Table 47-1 Tumor Characteristics: Benign and Malignant
Table 47-2 Tumor Classification Based on Specific Tissue of Origin
Table 47-3 Paraneoplastic Syndromes Associated with Some Cancers
ETIOLOGY OF CANCER
AGE- AND SEX-RELATED DIFFERENCES
Table 47-4 Cancer: Proposed Etiologic Factors
GENETIC AND ETHNIC FACTORS
ONCOGENIC VIRUSES
OCCUPATIONAL AND ENVIRONMENTAL CARCINOGENS
RADIATION
IMMUNOLOGIC FACTORS
Table 47-5 Common Names for Selected Cell Cycle–Specific Antineoplastic Drugs
CANCER DRUG NOMENCLATURE
CELL GROWTH CYCLE
Table 47-6 Cell Cycle Phases
FIGURE 47-2 General phase of the cell cycle in which the various cell cycle–specific chemotherapeutic drugs have their greatest proportionate kill of cancer cells.
DRUG THERAPY
FIGURE 47-3 Gompertzian tumor growth curve showing the relationship between tumor size and clinical status. (From Lehne RA: Pharmacology for nursing care, ed 6, St Louis, 2007, Saunders.)
FIGURE 47-4 Relationship of tumor burden to treatment strategies and outcome with systemic chemotherapy. Human tumors grow in accordance with the Gompertz curve (dashed line), with a decreasing doubling time as tumor burden increases. Treatment interventions relate to tumor type and extent of disease. A, Surgery followed by pulse courses of adjuvant chemotherapy. Combined modality has curative potential with the addition of chemotherapy after surgery. B, Systemic chemotherapy for stage III Hodgkin’s disease. Cure is possible with prolonged administration of combination chemotherapy. C, Palliative chemotherapy for advanced non–small cell cancer. The patient’s tumor burden is too great, and the potency of the drugs for this specific form of cancer too inadequate because of the development of drug resistance, to allow cure. (Modified from Salmon SE, Sartorelli AC: Cancer chemotherapy. In Katzung BG, editor: Basic and clinical pharmacology, ed 4, Norwalk, Conn, 1989, Appleton & Lange, p. 685.)
Box 47-1 Relative Emetic Potential of Selected Antineoplastic Drugs*
Low (Less Than 10% to 30%)
Moderate (30% to 60%)
High (60% to More Than 90%)
CELL CYCLE–SPECIFIC ANTINEOPLASTIC DRUGS
ANTIMETABOLITES
Mechanism of Action and Drug Effects
Folic Acid Antagonism
Purine Antagonism
Pyrimidine Antagonism
Indications
Adverse Effects
Table 47-7 Common Manifestations of Antineoplastic Toxicity
Table 47-8 Selected Antimetabolites: Common Drug-Specific Adverse Effects
Table 47-9 Selected Antimetabolites: Common Drug Interactions
Interactions
Dosages
Drug Profiles
Folate Antagonists
▸ methotrexate
Purine Antagonists
cladribine
fludarabine
Pyrimidine Antagonists
capecitabine
DOSAGES
Selected Antimetabolites
▸ cytarabine
fluorouracil
gemcitabine
MITOTIC INHIBITORS
Mechanism of Action and Drug Effects
Indications
Adverse Effects
Table 47-10 Selected Mitotic Inhibitors: Adverse Effects
Toxicity: Management of Extravasation
Interactions
Dosages
Drug Profiles
▸ etoposide
▸ paclitaxel
Table 47-11 Mitotic Inhibitor Extravasation: Listed Specific Antidotes
Table 47-12 Selected Mitotic Inhibitors: Common Drug Interactions
DOSAGES
Selected Mitotic Inhibitors
▸ vincristine
TOPOISOMERASE I INHIBITORS
Mechanism of Action and Drug Effects
Indications
Adverse Effects
Table 47-13 Irinotecan: Common Drug Interactions
Interactions
Dosages
Drug Profiles
irinotecan
topotecan
ANTINEOPLASTIC ENZYMES
DOSAGES
Selected Topoisomerase I Inhibitors
Indications
Adverse Effects
Table 47-14 Selected Antineoplastic Enzymes: Common Drug Interactions
Interactions
Dosages
Drug Profiles
▸ asparaginase
pegaspargase
DOSAGES
Selected Antineoplastic Enzymes
♦ NURSING PROCESS
♦ ASSESSMENT
LABORATORY VALUES RELATED TO DRUG THERAPY
Antineoplastic Therapy: Rationales for Assessment and Monitoring of Blood Cell Counts
Box 47-2 Effects of Antineoplastic Drugs on Normal Cells and Related Adverse Effects
♦ NURSING DIAGNOSES
♦ PLANNING
Goals
Outcome Criteria
♦ IMPLEMENTATION
CASE STUDY
Facing Chemotherapy
♦ EVALUATION
Patient Teaching Tips
Points to Remember
NCLEX Examination Review Questions
Critical Thinking Activities
CHAPTER 48 Antineoplastic Drugs Part 2: Cell Cycle–Nonspecific and Miscellaneous Drugs
Objectives
e-Learning Activities
Companion CD
Evolve Website (http://evolve.elsevier.com/Lilley)
Drug Profiles
Glossary
Table 48-1 Common Names for Selected Antineoplastic Drugs
CELL CYCLE–NONSPECIFIC ANTINEOPLASTIC DRUGS
ALKYLATING DRUGS
Mechanism of Action and Drug Effects
Indications
Adverse Effects
Interactions
FIGURE 48-1 Deoxyribonucleic acid (DNA) double helix. A, Diagrammatic model of the helical structure, showing its dimensions, the major and minor grooves, the periodicity of the bases, and the antiparallel orientation of the backbone chains (represented by ribbons). The base pairs (represented by rods) are perpendicular to the axis and lie stacked one on another. B, The chemical structure of the backbone and bases of DNA, showing the sugar-phosphate linkages of the backbone and the hydrogen bonding between the base pairs. There are two hydrogen bonds between adenine and thymine, and three between cytosine and guanine. (From Dorland’s illustrated medical dictionary, ed 30, Philadelphia, 2003, Saunders.)
FIGURE 48-2 Organization of deoxyribonucleic acid (DNA) and site of action of alkylating drugs.
Table 48-2 Commonly Used Alkylating Drugs: Severe Adverse Effects
Box 48-1 Extravasation of Antineoplastics
Table 48-3 Alkylating Drug Extravasation: Specific Antidotes
Dosages
Drug Profiles
▸ cisplatin
▸ cyclophosphamide
DOSAGES
Selected Alkylating Drugs
▸ mechlorethamine
CYTOTOXIC ANTIBIOTICS
Preventing Medication Errors
Sound-Alike Drugs: “Rubicins”
Mechanism of Action and Drug Effects
Table 48-4 Cytotoxic Antibiotics: Severe Adverse Effects
Box 48-2 Treatment of Doxorubicin Extravasation
Indications
Adverse Effects
Toxicity and Management of Overdose
Interactions
Dosages
DOSAGES
Selected Cytotoxic Antibiotics
Drug Profiles
▸ doxorubicin
mitoxantrone
MISCELLANEOUS ANTINEOPLASTICS
Drug Profiles
bevacizumab
hydroxyurea
imatinib
mitotane
octreotide
HORMONAL ANTINEOPLASTICS
RADIOPHARMACEUTICALS AND RELATED ANTINEOPLASTICS
CYTOPROTECTIVE DRUGS AND MISCELLANEOUS TOXICITY INHIBITORS
Box 48-3 Concerns in the Handling and Administration of Vesicant Antineoplastic Drugs
♦ NURSING PROCESS
♦ ASSESSMENT
LABORATORY VALUES RELATED TO DRUG THERAPY
Antineoplastics
♦ NURSING DIAGNOSES
♦ PLANNING
Goals
Outcome Criteria
♦ IMPLEMENTATION
♦ EVALUATION
Box 48-4 Indications of an Oncologic Emergency
Patient Teaching Tips
Points to Remember
NCLEX Examination Review Questions
Critical Thinking Activities
CHAPTER 49 Biologic Response–Modifying Drugs
Objectives
e-Learning Activities
Companion CD
evolve Website (http://evolve.elsevier.com/Lilley)
Drug Profiles
Glossary
OVERVIEW OF IMMUNOMODULATORS
IMMUNE SYSTEM
Humoral Immune System
Cell-Mediated Immune System
FIGURE 49-1 Cells of the humoral (antibody-mediated) immune system. Ab, Antibody; Ag, antigen; Ig, immunoglobulin.
FIGURE 49-2 Cells of the cellular immune system.
Box 49-1 Biologic Response Modifiers
Hematopoietic Drugs
Colony-Stimulating Factors
Other
Immunomodulating Drugs
Interferons
Monoclonal Antibodies
Interleukin Receptor Agonists and Antagonists
Miscellaneous Immunomodulators
HEMATOPOIETIC DRUGS
Mechanism of Action and Drug Effects
Indications
Contraindications
Table 49-1 Hematopoietic Drugs: Common Adverse Effects
Adverse Effects
Interactions
Dosages
Drug Profiles
▸ epoetin alfa
DOSAGES
Hematopoietic Drugs
Pharmacokinetics
▸ filgrastim
Pharmacokinetics
▸ sargramostim
Pharmacokinetics
▸ oprelvekin
Pharmacokinetics
INTERFERONS
Mechanism of Action and Drug Effects
Indications
Contraindications
Adverse Effects
Interactions
Table 49-2 Interferons: Adverse Effects
Dosages
Drug Profiles
Interferon Alfa Products
▸ interferon alfa-2a, interferon alfa-2b, interferon alfa-n3, interferon alfacon-1, peginterferon alfa-2a, peginterferon alfa-2b
DOSAGES
Interferons
Interferon Beta Products
▸ interferon beta-1a
Interferon Gamma Products
interferon gamma-1b
MONOCLONAL ANTIBODIES
Mechanism of Action, Drug Effects, and Indications
Contraindications
Table 49-3 Common Adverse Effects Associated with Specific Immunomodulating Drugs
Adverse Effects
Interactions
Dosages
Drug Profiles
adalimumab
DOSAGES
Monoclonal Antibodies
alemtuzumab
bevacizumab
cetuximab
gemtuzumab ozogamicin
ibritumomab tiuxetan
infliximab
natalizumab
▸ rituximab
tositumomab and iodine I 131 tositumomab
trastuzumab
INTERLEUKINS AND RELATED DRUGS
Mechanism of Action and Drug Effects
Box 49-2 Interleukin-2: Drug Effects
Modulating Effects
Enhancing Effects
Indications
Contraindications
Adverse Effects
Interactions
DOSAGES
Interleukins and Related Drugs
Dosages
Drug Profiles
▸ aldesleukin
denileukin diftitox
anakinra
MISCELLANEOUS IMMUNOMODULATING DRUGS
♦ NURSING PROCESS
♦ ASSESSMENT
Table 49-4 Miscellaneous Immunomodulating Drugs
♦ NURSING DIAGNOSES
PLANNING
Goals
LEGAL AND ETHICAL PRINCIPLES
The Nurse and Patient Care
Outcome Criteria
♦ IMPLEMENTATION
♦ EVALUATION
Patient Teaching Tips
Points to Remember
NCLEX Examination Review Questions
Critical Thinking Activities
CHAPTER 50 Gene Therapy and Pharmacogenomics
Objectives
e-Learning Activities
Companion CD
evolve Website (http://evolve.elsevier.com/Lilley)
Glossary
INTRODUCTION
BASIC PRINCIPLES OF GENETIC INHERITANCE
DISCOVERY, STRUCTURE, AND FUNCTION OF DNA
Protein Synthesis
The Human Genome Project
GENE THERAPY
Regulatory and Ethical Issues Regarding Gene Therapy
FIGURE 50-1 Gene therapy for adenosine deaminase (ADA) deficiency attempts to correct this immunodeficiency state. The viral vector containing the therapeutic gene is inserted into the patient’s lymphocytes. These cells can then make the ADA enzyme. (From Lewis SM, Heitkemper MM, Dirksen SR: Medical-surgical nursing: assessment and management of clinical problems, ed 6, St Louis, 2004, Mosby.)
PHARMACOGENOMICS
Table 50-1 Clinical Applications of Pharmacogenomics
SUMMARY
Box 50-1 Application of Genetics, Genomics, and Pharmacogenomics in Nursing and Health Care
Points to Remember
NCLEX Examination Review Questions
Critical Thinking Activities
PART 9 Drugs Affecting the Gastrointestinal System and Nutrition
Drugs Affecting the Gastrointestinal System and Nutrition
STUDY SKILLS TIPS
ACTIVE QUESTIONING
WHAT ARE THE RIGHT QUESTIONS?
KINDS OF QUESTIONS
Literal Questions
Interpretive Questions
QUESTIONING APPLICATION
CHAPTER 51 Acid-Controlling Drugs
Objectives
e-Learning Activities
Companion CD
evolve Website (http://evolve.elsevier.com/Lilley)
Drug Profiles
Glossary
ACID-RELATED PATHOPHYSIOLOGY
FIGURE 51-1 The three zones of the stomach and the associated glands.
FIGURE 51-2 Parietal cell stimulation and secretion. ADP, Adenosine diphosphate; ATP, adenosine triphosphate; ATPase, adenosine triphosphatase; cAMP, cyclic adenosine monophosphate.
Table 51-1 Current FDA-Approved Regimens for Eradication of Helicobacter pylori
ANTACIDS
Mechanism of Action and Drug Effects
Indications
Contraindications
Adverse Effects
Interactions
Box 51-1 Nursing Concerns for Patients Taking Antacids
Dosages
Drug Profiles
Antacids, general
DOSAGES
Selected Antacid Drugs*
Box 51-2 Antacids
Antacids: Salt Content
Commonly Available Antacid Products
Magnesium-Containing Antacids
Aluminum-Containing Antacids
Calcium-Containing Antacids
Sodium-Containing Antacids
H2 ANTAGONISTS
Mechanism of Action and Drug Effects
Indications
Contraindications
Adverse Effects
Interactions
Table 51-2 H2 Antagonists: Adverse Effects
Dosages
Drug Profiles
▸ cimetidine
DOSAGES
Selected H2 Antagonists
Pharmacokinetics
PROTON PUMP INHIBITORS
Mechanism of Action and Drug Effects
Indications
Contraindications
Adverse Effects
Interactions
Dosages
DOSAGES
Selected Proton Pump Inhibitors
Drug Profiles
▸ omeprazole
Pharmacokinetics
MISCELLANEOUS ACID-CONTROLLING DRUGS
Drug Profiles
▸ sucralfate
Pharmacokinetics
misoprostol
Pharmacokinetics
simethicone
♦ NURSING PROCESS
♦ ASSESSMENT
♦ NURSING DIAGNOSES
♦ PLANNING
Goals
Outcome Criteria
♦ IMPLEMENTATION
CASE STUDY
Gastroesophageal Reflux Disease
♦ EVALUATION
Patient Teaching Tips
Points to Remember
NCLEX Examination Review Questions
Critical Thinking Activities
CHAPTER 52 Antidiarrheals and Laxatives
Objectives
e-Learning Activities
Companion CD
evolve Website (http://evolve.elsevier.com/Lilley)
Drug Profiles
Glossary
ANTIDIARRHEALS
Mechanism of Action and Drug Effects
Table 52-1 Antidiarrheals: Drug Categories and Selected Drugs
Indications
Contraindications
Adverse Effects
Interactions
Table 52-2 Selected Antidiarrheals: Adverse Effects
Life Span Considerations: The Pediatric Patient
Antidiarrheal Preparations
Dosages
Drug Profiles
Adsorbents
bismuth subsalicylate
Pharmacokinetics
Anticholinergics
belladonna alkaloid combinations
DOSAGES
Selected Antidiarrheal Drugs
Pharmacokinetics
Opiates
▸ diphenoxylate with atropine
Pharmacokinetics*
▸ loperamide
Pharmacokinetics
Intestinal Flora Modifiers
Lactobacillus acidophilus
LAXATIVES
Table 52-3 Causes of Constipation
Mechanism of Action and Drug Effects
Table 52-4 Laxatives: Drug Categories and Selected Drugs
Table 52-5 Laxatives: Drug Effects
Indications
Table 52-6 Laxatives: Indications
Contraindications
Adverse Effects
Interactions
Table 52-7 Laxatives: Adverse Effects
Dosages
Drug Profiles
Bulk-Forming Laxatives
methylcellulose
Pharmacokinetics
▸ psyllium
Pharmacokinetics
Emollient Laxatives
▸ docusate salts
Pharmacokinetics
mineral oil
Pharmacokinetics
Hyperosmotic Laxatives
▸ glycerin
Pharmacokinetics
DOSAGES
Selected Laxatives
▸ lactulose
Pharmacokinetics
polyethylene glycol 3350
Pharmacokinetics
Box 52-1 Saline Laxatives
Magnesium Laxatives
Sulfate
Hydroxide
Citrate
Sodium Laxatives
Saline Laxatives
magnesium salts
Pharmacokinetics
Stimulant Laxatives
▸ senna
Pharmacokinetics
Drugs for Irritable Bowel Syndrome
DOSAGES
Drugs for Irritable Bowel Syndrome
♦ NURSING PROCESS
♦ ASSESSMENT
CASE STUDY
Constipation
♦ NURSING DIAGNOSES
♦ PLANNING
Goals
Outcome Criteria
♦ IMPLEMENTATION
♦ EVALUATION
Patient Teaching Tips
Points to Remember
NCLEX Examination Review Questions
Critical Thinking Activities
CHAPTER 53 Antiemetic and Antinausea Drugs
Objectives
e-Learning Activities
Companion CD
evolve Website (http://evolve.elsevier.com/Lilley)
Drug Profiles
Glossary
NAUSEA AND VOMITING
ANTIEMETIC DRUGS
Life Span Considerations: The Pediatric Patient
Syrup of Ipecac
Mechanism of Action and Drug Effects
Table 53-1 Neurotransmitters Involved in Nausea and Vomiting
FIGURE 53-1 The various pathways and areas in the body sending signals to the vomiting center.
Table 53-2 Antiemetic Drugs: Common Drug Categories
Indications
Contraindications
Adverse Effects
Interactions
Dosages
Drug Profiles
FIGURE 53-2 Sites of action of selected antinausea drugs. THC, Tetrahydrocannabinol.
Table 53-3 Antiemetic Drugs: Mechanisms of Action
Anticholinergics
scopolamine
Table 53-4 Antiemetic Drugs: Indications
Pharmacokinetics
Table 53-5 Antinausea Drugs: Adverse Effects
Antihistamines
▸ meclizine
Pharmacokinetics
Neuroleptics
▸ prochlorperazine
Pharmacokinetics
Prokinetics
▸ metoclopramide
Pharmacokinetics
Serotonin Blockers
▸ ondansetron
Pharmacokinetics
Tetrahydrocannabinoids
dronabinol
DOSAGES
Selected Antitubercular Drugs
Pharmacokinetics
Miscellaneous Antinausea Drugs
phosphorated carbohydrate solution
aprepitant
CASE STUDY
Nausea and Chemotherapy
♦ NURSING PROCESS
♦ ASSESSMENT
HERBAL THERAPIES AND DIETARY SUPPLEMENTS
Ginger (Zingiber officinale)
Overview
Common Uses
Adverse Effects
Potential Drug Interactions
Contraindications
♦ NURSING DIAGNOSES
♦ PLANNING
Goals
Outcome Criteria
♦ IMPLEMENTATION
EVALUATION
Patient Teaching Tips
Points to Remember
NCLEX Examination Review Questions
Critical Thinking Activities
CHAPTER 54 Vitamins and Minerals
Objectives
e-Learning Activities
Companion CD
evolve Website (http://evolve.elsevier.com/Lilley)
Drug Profiles
Glossary
VITAMINS
Table 54-1 Fat- and Water-Soluble Vitamins
FAT-SOLUBLE VITAMINS
VITAMIN A
Mechanism of Action and Drug Effects
Table 54-2 Food Sources for Selected Nutrients
Table 54-3 Vitamin A: Adverse Effects
Indications
Contraindications
Adverse Effects
Toxicity and Management of Overdose
Interactions
Dosages
Drug Profiles
vitamin A
Pharmacokinetics
VITAMIN D
Mechanism of Action and Drug Effects
Indications
Contraindications
Adverse Effects
DOSAGES
Selected Vitamins
Table 54-4 Vitamin D: Adverse Effects
Toxicity and Management of Overdose
Interactions
Dosages
Drug Profiles
calcifediol
Pharmacokinetics
calcitriol
Pharmacokinetics
dihydrotachysterol
Pharmacokinetics
ergocalciferol
Pharmacokinetics
VITAMIN E
Mechanism of Action and Drug Effects
Indications
Table 54-5 Vitamin E: Adverse Effects
Contraindications
Adverse Effects
Dosages
Drug Profiles
vitamin E
Pharmacokinetics
VITAMIN K
Mechanism of Action and Drug Effects
Indications
Contraindications
Adverse Effects
Toxicity and Management of Overdose
Table 54-6 Vitamin K: Adverse Effects
Dosages
Drug Profiles
vitamin K1
Pharmacokinetics
WATER-SOLUBLE VITAMINS
Box 54-1 Water-Soluble Vitamins: Alternate Names
VITAMIN B1
Mechanism of Action and Drug Effects
Indications
Contraindications
Adverse Effects
Interactions
Dosages
Drug Profiles
thiamine
Pharmacokinetics
VITAMIN B2
Mechanism of Action and Drug Effects
Indications
Contraindications
Adverse Effects
Dosages
Drug Profiles
riboflavin
Pharmacokinetics
VITAMIN B3
Mechanism of Action and Drug Effects
FIGURE 54-1 Niacin, once in the body, is converted to nicotinamide adenosine dinucleotide (NAD) and nicotinamide adenosine dinucleotide (NADP), which are coenzymes needed for many metabolic processes.
Indications
Contraindications
Adverse Effects
Dosages
Table 54-7 Niacin: Adverse Effects
Drug Profiles
niacin
Pharmacokinetics
VITAMIN B6
Mechanism of Action and Drug Effects
Indications
Contraindications
Table 54-8 Pyridoxine: Adverse Effects
Adverse Effects
Interactions
Dosages
Drug Profiles
pyridoxine
Pharmacokinetics
VITAMIN B12
FIGURE 54-2 Cyanocobalamin is a required coenzyme for many body processes.
FIGURE 54-3 The oral absorption of cyanocobalamin requires the presence of the intrinsic factor secreted by gastric parietal cells.
Mechanism of Action and Drug Effects
Indications
Table 54-9 Cyanocobalamin: Adverse Effects
Contraindications
Adverse Effects
Interactions
Dosages
Drug Profiles
cyanocobalamin
Pharmacokinetics
VITAMIN C
Mechanism of Action and Drug Effects
Indications
Contraindications
Adverse Effects
Interactions
Dosages
Drug Profiles
ascorbic acid
Pharmacokinetics
MINERALS
FIGURE 54-4 When mineral compounds are dissolved in water, they separate into positively charged metabolic cations or negatively charged nonmetallic anions and electrolytes.
Table 54-10 Mineral Elements
CALCIUM
Table 54-11 Calcium Deficiency: Causes and Disorders
Mechanism of Action and Drug Effects
Indications
Table 54-12 Calcium Salts: Calcium Content
Table 54-13 Calcium Salts: Adverse Effects
Contraindications
Adverse Effects
Toxicity and Management of Overdose
Interactions
Drug Profiles
calcium
MAGNESIUM
Mechanism of Action and Drug Effects
Indications
Contraindications
Adverse Effects
Toxicity and Management of Overdose
Interactions
Drug Profiles
magnesium
PHOSPHORUS
Mechanism of Action and Drug Effects
Indications
Contraindications
Adverse Effects
Toxicity and Management of Overdose
Interactions
Drug Profiles
phosphorus
ZINC
♦ NURSING PROCESS
♦ ASSESSMENT
♦ NURSING DIAGNOSES
♦ PLANNING
Goals
Outcome Criteria
♦ IMPLEMENTATION
CASE STUDY
Magnesium Sulfate Therapy
♦ EVALUATION
Patient Teaching Tips
Points to Remember
NCLEX Examination Review Questions
Critical Thinking Activities
CHAPTER 55 Nutrition Supplements
Objectives
e-Learning Activities
Companion CD
evolve Website (http://evolve.elsevier.com/Lilley)
Drug Profiles
Glossary
ENTERAL NUTRITION
Mechanism of Action and Drug Effects
Indications
Contraindications
FIGURE 55-1 Tube feeding routes. (From Beare PG, Myers JL: Adult health nursing, ed 3, St Louis, 1998, Mosby.)
Table 55-1 Routes of Enteral Nutrition Delivery
Adverse Effects
Interactions
Box 55-1 Enteral Formulations
Box 55-2 Enteral Nutrition Supplements: Indications
Complete Nutrition Formulations (i.e., for General Nutrition Deficiencies)
Incomplete Nutrition Formulations (i.e., for Specific Nutrition Deficiencies)
Infant Nutrition Formulations
Dosages
Drug Profiles
Elemental Formulations
Polymeric Formulations
Modular Formulations
carbohydrate formulation
fat formulation
protein formulation
Altered Amino Acid Formulations
PARENTERAL NUTRITION
Table 55-2 Peripheral and Central Parenteral Nutrition: Characteristics
PERIPHERAL TOTAL PARENTERAL NUTRITION
Mechanism of Action and Drug Effects
Indications
Contraindications
Table 55-3 Amino Acids: Recommended Daily Dosage Guidelines
Adverse Effects
Dosages
Drug Profiles
Amino Acids
amino acids
Box 55-3 Enteral Formulations
Essential
Nonessential
Semiessential
FIGURE 55-2 One gram of dextrose, fat, or protein will provide varying amounts of energy as calories.
carbohydrates
fat
FIGURE 55-3 Lipid emulsions supply essential fatty acids and energy.
lipid emulsions
TRACE ELEMENTS
CENTRAL TOTAL PARENTERAL NUTRITION
Mechanism of Action and Drug Effects
Indications
Contraindications
Adverse Effects
Dosages
Drug Profiles
NURSING PROCESS
♦ ASSESSMENT
♦ NURSING DIAGNOSES
♦ PLANNING
Goals
Outcome Criteria
♦ IMPLEMENTATION
♦ EVALUATION
Patient Teaching Tips
Points to Remember
NCLEX Examination Review Questions
Critical Thinking Activities
PART 10 Miscellaneous Therapeutics: Hematologic, Dermatologic, Ophthalmic, and Otic Drugs
Miscellaneous Therapeutics: Hematologic, Dermatologic, Ophthalmic, and Otic Drugs
STUDY SKILLS TIPS
TIME MANAGEMENT
Goal Statements
Action Planning
Action Steps Example
PURR
Prepare Example
Outline Example
REPEAT THE STEPS
CHAPTER 56 Blood-Forming Drugs
Objectives
e-Learning Activities
Companion CD
evolve Website (http://evolve.elsevier.com/Lilley)
Drug Profiles
Glossary
ERYTHROPOIESIS
FIGURE 56-1 Schematic structure of a hemoglobin molecule.
FIGURE 56-2 Underlying causes of anemia are RBC maturation defects and factors secondary to excessive RBC destruction. RBC, Red blood cell.
FIGURE 56-3 Schematic showing common causes and results of RBC cytoplasmic maturation defects.
TYPES OF ANEMIA
FIGURE 56-4 Schematic showing common causes and results of RBC nuclear maturation defects.
FIGURE 56-5 Increased red blood cell destruction occurs as a result of intrinsic and extrinsic factors. DIC, Disseminated intravascular coagulation; G6PD, glucose-6-phosphate dehydrogenase; RBC, red blood cell.
IRON
Mechanism of Action and Drug Effects
Table 56-1 Ferrous Salts: Iron Content
Indications
Contraindications
Adverse Effects
Toxicity and Management of Overdose
Table 56-2 Iron Preparations: Adverse Effects
Interactions
Dosages
Drug Profiles
▸ ferrous fumarate
Pharmacokinetics
Pharmacokinetics
FOLIC ACID
Mechanism of Action and Drug Effects
DOSAGES
Selected Iron Preparations and Folic Acid
Indications
Contraindications
Adverse Effects
Interactions
Dosages
Drug Profiles
▸ folic acid
Pharmacokinetics
OTHER BLOOD-FORMING DRUGS
♦ NURSING PROCESS
♦ ASSESSMENT
♦ NURSING DIAGNOSES
♦ PLANNING
Goals
Outcome Criteria
♦ IMPLEMENTATION
Life Span Considerations: The Elderly Patient
Iron Products
♦ EVALUATION
Patient Teaching Tips
Points to Remember
NCLEX Examination Review Questions
Critical Thinking Activities
CHAPTER 57 Dermatologic Drugs
Objectives
e-Learning Activities
Companion CD
evolve Website (http://evolve.elsevier.com/Lilley)
Drug Profiles
Glossary
FIGURE 57-1 A microscopic view of the skin. The epidermis, shown in longitudinal section, is raised at one corner to reveal the ridges in the dermis. (Modified from Thibodeau GA, Patton KT: Anatomy and physiology, ed 5, St. Louis, 2003, Mosby.)
SKIN ANATOMY AND PHYSIOLOGY
Table 57-1 Epidermal Layers
Table 57-2 Exocrine Glands of the Skin
TOPICAL DERMATOLOGIC DRUGS
ANTIMICROBIALS
Drug Profiles
General Antibacterial Drugs
Table 57-3 Dermatologic Formulations: Characteristics and Examples
▸ bacitracin
neomycin and polymyxin B
mupirocin
▸ silver sulfadiazine
EVIDENCE-BASED PRACTICE
Antiseptics and Wound Care
Review
Type of Evidence and Research
Results of Study
Link of Evidence to Nursing Practice
Anti-Acne Drugs
▸ benzoyl peroxide
clindamycin
▸ isotretinoin
tretinoin
Antifungal Drugs
▸ clotrimazole
miconazole
Table 57-4 Topical Antifungal Drugs
Antiviral Drugs
ANESTHETIC, ANTIPRURITIC, AND ANTIINFLAMMATORY DRUGS
TOPICAL ANESTHETICS
TOPICAL ANTIPRURITICS
Table 57-5 Commonly Used Topical Corticosteroids (in Order of Decreasing Potency)
ANTIPSORIATIC DRUGS
Drug Profiles
tazarotene
tar-containing products
anthralin
calcipotriene
MISCELLANEOUS DERMATOLOGIC DRUGS
Drug Profiles
Ectoparasiticidal Drugs
Herbal Therapies and Dietary Supplements
Aloe (Aloe vera L.)
Overview
Common Uses
Adverse Effects
Potential Drug Interactions
Contraindications
▸ lindane
Hair Growth Drugs
minoxidil
Sunscreens
Antineoplastic Drugs
fluorouracil
Immunomodulators
▸ pimecrolimus
imiquimod
WOUND CARE DRUGS
♦ NURSING PROCESS
♦ ASSESSMENT
Table 57-6 Selected Wound-Care Products
♦ NURSING DIAGNOSES
♦ PLANNING
Goals
Outcome Criteria
♦ IMPLEMENTATION
♦ EVALUATION
Patient Teaching Tips
Points to Remember
NCLEX Examination Review Questions
Critical Thinking Activities
CHAPTER 58 Ophthalmic Drugs
Objectives
e-Learning Activities
Companion CD
evolve Website (http://evolve.elsevier.com/Lilley)
Drug Profiles
Glossary
OCULAR ANATOMY AND PHYSIOLOGY
FIGURE 58-1 A horizontal section through the left eyeball, looking from the top down. (Modified from Thibodeau GA, Patton KT: Anatomy and physiology, ed 5, St Louis, 2003, Mosby.)
FIGURE 58-2 Extrinsic muscles of the right eye. Lateral view. (Modified from Thibodeau GA, Patton KT: Anatomy and physiology, ed 5, St Louis, 2003, Mosby.)
LACRIMAL GLANDS
LAYERS OF THE EYE
FIGURE 58-3 Different nervous systems control pupil size.
FIGURE 58-4 Drug classes and their effects on pupil size.
FIGURE 58-5 Function of rods and cones in relation to color vision.
FIGURE 58-6 Main structures of the eye and an enlargement of the canal of Schlemm showing an aqueous flow. A, Normal eye. B, In angle-closure glaucoma, the closure of the anterior angle prevents aqueous humor from exiting through the canal of Schlemm, leading to increased intraocular pressure. C, In open-angle glaucoma, the anterior angle remains open, but the canal of Schlemm is obstructed by tissue abnormalities. (Modified from McKenry LM, Salerno E: Mosby’s pharmacology in nursing—revised and updated, ed 21, St Louis, 2003, Mosby.)
OCULAR DRUGS
ANTIGLAUCOMA DRUGS
Table 58-1 Glaucoma: Types and Characteristics
FIGURE 58-7 How increased aqueous humor can result in impaired vision. IOP, Intraocular pressure.
Table 58-2 Antiglaucoma Drug Effects on Aqueous Humor
CHOLINERGIC DRUGS
Mechanism of Action and Drug Effects
FIGURE 58-8 The therapeutic effects of direct- and indirect-acting parasympathomimetics on glaucoma. IOP, Intraocular pressure.
FIGURE 58-9 Cholinergic response of miosis to parasympathomimetics. ACh, Acetylcholine; AChE, acetylcholinesterase; PSNS, parasympathetic nervous system.
FIGURE 58-10 Metabolism of acetylcholine by endogenous enzymes.
Indications
Contraindications
Adverse Effects
Table 58-3 Miotics: Indications
Toxicity and Management of Overdose
Interactions
Dosages
Table 58-4 Miotics: Adverse Effects
Drug Profiles
Direct-Acting Miotics
acetylcholine
Pharmacokinetics
▸ pilocarpine
Pharmacokinetics (Immediate-Release Formulation)
Indirect-Acting Miotics
▸ echothiophate and demecarium
Pharmacokinetics
DOSAGES
Selected Miotics
SYMPATHOMIMETICS
Mechanism of Action and Drug Effects
Indications
Contraindications
FIGURE 58-11 Mechanism of mydriasis.
FIGURE 58-12 Ocular effects of alpha (a) and beta (b) stimulation. IOP, Intraocular pressure.
Adverse Effects
Toxicity and Management of Overdose
Interactions
Dosages
Drug Profiles
apraclonidine
DOSAGES
Selected Ocular Sympathomimetics
Pharmacokinetics
▸ dipivefrin
Pharmacokinetics
β-ADRENERGIC BLOCKERS
Mechanism of Action and Drug Effects
Indications
Contraindications
Adverse Effects
Toxicity and Management of Overdose
Interactions
Dosages
Drug Profiles
▸ betaxolol
DOSAGES
Selected Ocular β-Blockers
Pharmacokinetics
▸ timolol
Pharmacokinetics
CARBONIC ANHYDRASE INHIBITORS
Mechanism of Action and Drug Effects
Indications
Contraindications
Table 58-5 Carbonic Anhydrase Inhibitors: Adverse Effects
Adverse Effects
Toxicity and Management of Overdose
Interactions
Dosages
DOSAGES
Ocular Carbonic Anhydrase Inhibitors
Drug Profiles
▸ dorzolamide
Pharmacokinetics
OSMOTIC DIURETICS
Mechanism of Action and Drug Effects
Indications
Contraindications
Adverse Effects
Interactions
Toxicity and Management of Overdose
Dosages
Drug Profiles
glycerin
Pharmacokinetics
mannitol
FIGURE 58-13 Mechanism and ocular effects of osmotic diuretics. IOP, Intraocular pressure.
Table 58-6 Osmotic Diuretics: Adverse Effects
DOSAGES
Osmotic Diuretics
Pharmacokinetics
PROSTAGLANDIN AGONISTS
Mechanism of Action and Drug Effects
Indications
Contraindications
Adverse Effects
Interactions
Dosages
Drug Profiles
▸ latanoprost
DOSAGES
Prostaglandin Agonists
Pharmacokinetics
ANTIMICROBIAL DRUGS
Mechanism of Action and Drug Effects
Indications
Contraindications
Table 58-7 Common Ocular Infections
Adverse Effects
Interactions
Dosages
DOSAGES
Selected Ocular Antimicrobials
Drug Profiles
ANTIBACTERIAL DRUGS
Aminoglycosides
▸ gentamicin
Pharmacokinetics
Macrolides
▸ erythromycin
Pharmacokinetics
Polypeptides
▸ bacitracin
Pharmacokinetics
Quinolones
▸ ciprofloxacin
Pharmacokinetics
Sulfonamides
▸ sulfacetamide
Pharmacokinetics
Antifungal Drugs
natamycin
Pharmacokinetics
ANTIVIRALS
ganciclovir and fomivirsen
trifluridine
ANTIINFLAMMATORY DRUGS
Box 58-1 Ophthalmic Antiinflammatory Drugs
NSAIDs
Corticosteroids
Mechanism of Action and Drug Effects
FIGURE 58-14 Antiinflammatory action of corticosteroids and nonsteroidal antiinflammatory drugs (NSAIDs).
Indications
Contraindications
Adverse Effects
Drug Profiles
Corticosteroids
▸ dexamethasone
Pharmacokinetics
Nonsteroidal Antiinflammatory Drugs (NSAIDs)
flurbiprofen
Pharmacokinetics
ketorolac
Pharmacokinetics
TOPICAL ANESTHETICS
Mechanism of Action and Drug Effects
Indications
Contraindications
Adverse Effects
Interactions
Drug Profiles
tetracaine
Pharmacokinetics
DIAGNOSTIC DRUGS
Drug Profiles
Cycloplegic Mydriatics
▸ atropine sulfate
cyclopentolate
Mydriatic-Reversal Drug
dapiprazole
Ophthalmic Dye
fluorescein
ANTIALLERGIC DRUGS
Antihistamines
azelastine
Mast Cell Stabilizers
cromolyn
Decongestants
tetrahydrozoline
Lubricants and Moisturizers
▸ artificial tears
♦ NURSING PROCESS
♦ ASSESSMENT
DOSAGES
Ocular Antiallergics
♦ NURSING DIAGNOSES
♦ PLANNING
Goals
Outcome Criteria
♦ IMPLEMENTATION
Case Study
Eye Trauma
♦ EVALUATION
Patient Teaching Tips
Points to Remember
NCLEX Examination Review Questions
Critical Thinking Activities
CHAPTER 59 Otic Drugs
Objectives
e-Learning Activities
Companion CD
evolve Website (http://evolve.elsevier.com/Lilley)
Drug Profiles
Glossary
OVERVIEW OF EAR ANATOMY AND PATHOLOGY
FIGURE 59-1 Structure of the ear.
TREATMENT OF EAR DISORDERS
ANTIBACTERIAL AND ANTIFUNGAL OTIC DRUGS
Drug Profiles
Antibacterial Products
Cortisporin Otic, Ciprodex, Cipro HC Otic, Floxin Otic
Table 59-1 Common Antibacterial Otic Products
Table 59-2 Common Antifungal Otic Products
Antifungal Products
Cortic, Acetasol HC
Earwax Emsulfiers
▸ carbamide peroxide
♦ NURSING PROCESS
♦ ASSESSMENT
♦ NURSING DIAGNOSES
PLANNING
Goals
Outcome Criteria
♦ IMPLEMENTATION
♦ EVALUATION
Patient Teaching Tips
Points to Remember
NCLEX Examination Review Questions
Critical Thinking Activities
Appendix
APPENDIX Pharmaceutical Abbreviations
Bibliography
General
Chapter 1
Chapter 3
Chapter 4
Chapter 5
Chapter 6
Chapter 7
Chapter 8
Chapter 9
Chapter 10
Chapter 11
Chapter 12
Chapter 13
Chapter 14
Chapter 15
Chapter 16
Chapter 18
Chapter 20
Chapter 21
Chapter 22
Chapter 23
Chapter 24
Chapter 25
Chapter 27
Chapter 28
Chapter 29
Chapter 30
Chapter 31
Chapter 33
Chapter 34
Chapter 35
Chapter 36
Chapter 37
Chapter 38
Chapter 39
Chapter 40
Chapter 41
Chapter 42
Chapter 44
Chapter 46
Chapters 47 and 48
Chapter 49
Chapter 50
Chapter 51
Chapter 53
Chapter 54
Chapter 57
Chapter 58

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