CONTENTS SECTION 1 Foundations of Drug Therapy 1 CHAPTER 1 Introduction to Pharmacology 3 A Message to Students 3 Pharmacology and Drug Therapy 3 Understanding Grouping and Naming of Drugs 4 Prescription and Nonprescription Drugs 4 Sources of Drugs 6 Drug Development and Approval 6 Pharmacoeconomics 8 Sources of Drug Information 8 Strategies for Studying Pharmacology 8 CHAPTER 2 Basic Concepts and Processes 10 Introduction 10 Cellular Physiology 10 Drug Transport Through Cell Membranes 12 Pharmacokinetics 12 Pharmacodynamics 17 Variables That Affect Drug Actions 18 Adverse Effects of Drugs 25 Toxicology: Drug Overdose 26 CHAPTER 3 Administering Medications 31 Introduction 31 General Principles of Accurate Drug Administration 31 Legal Responsibilities 32 Medication Errors 32 Medication Systems 33 Medication Orders 33 Drug Preparations and Dosage Forms 34 Calculating Drug Dosages 36 Routes of Administration 38 CHAPTER 4 Nursing Process in Drug Therapy 50 Introduction 50 Nursing Process in Drug Therapy 51 Integrating Nursing Process, Critical Paths, and Drug Therapy 56 General Principles of Drug Therapy 62 SECTION 2 Drugs Affecting the Central Nervous System 73 CHAPTER 5 Physiology of the Central Nervous System 75 Introduction 75 Basic Unit of the Central Nervous System: The Neuron 75 Neurotransmission 75 Major Components of the Central Nervous System 78 Drugs That Affect the Central Nervous System 80 CHAPTER 6 Opioid Analgesics and Opioid Antagonists 82 Introduction 82 General Characteristics of Opioid Analgesics 83 Individual Drugs 85 Principles of Therapy 92 CHAPTER 7 Analgesic Antipyretic Anti-Inflammatory and Related Drugs 103 Introduction 103 General Characteristics of Analgesic Antipyretic Anti-Inflammatory and Related Drugs 104 Classifications and Individual Drugs 109 Principles of Therapy 119 CHAPTER 8 Antianxiety and Sedative-Hypnotic Drugs 132 Introduction 132 General Characteristics of Benzodiazepines 135 Individual Drugs 138 Principles of Therapy 142 CHAPTER 9 Antipsychotic Drugs 153 Introduction 153 General Characteristics of Antipsychotic Drugs 154 Individual Drugs 155 Principles of Therapy 163 xvii
xviii Contents CHAPTER 10 Antidepressants and Mood Stabilizers 174 Introduction 174 General Characteristics of Antidepressant Drugs 176 Types of Antidepressants and Individual Drugs 177 Principles of Therapy 182 CHAPTER 11 Antiseizure Drugs 193 Introduction 193 General Characteristics of Antiseizure Drugs 194 Individual Drugs 195 Principles of Therapy 203 CHAPTER 12 Antiparkinson Drugs 214 Introduction 214 General Characteristics of Antiparkinson Drugs 214 Individual Antiparkinson Drugs 216 Principles of Therapy 220 CHAPTER 13 Skeletal Muscle Relaxants 227 Introduction 227 General Characteristics of Skeletal Muscle Relaxants 228 Individual Drugs 228 Principles of Therapy 231 CHAPTER 14 Substance Abuse Disorders 235 Introduction 235 Central Nervous System Depressants 237 Central Nervous System Stimulants 242 Principles of Therapy 250 Introduction 265 Structure and Function of the Autonomic Nervous System 265 Characteristics of Autonomic Drugs 271 CHAPTER 17 Adrenergic Drugs 272 Introduction 272 General Characteristics of Adrenergic Drugs 272 Individual Drugs 275 Principles of Therapy 279 CHAPTER 18 Antiadrenergic Drugs 289 Introduction 289 General Characteristics of Antiadrenergic Drugs 289 Individual Drugs 291 Principles of Therapy 298 CHAPTER 19 Cholinergic Drugs 307 Introduction 307 General Characteristics of Cholinergic Drugs 308 Individual Drugs 309 Principles of Therapy 312 CHAPTER 20 Anticholinergic Drugs 319 Introduction 319 General Characteristics of Anticholinergic Drugs 319 Individual Drugs 321 Principles of Therapy 326 SECTION 4 Drugs Affecting the Endocrine System 333 CHAPTER 15 Central Nervous System Stimulants 253 Introduction 253 General Characteristics of Stimulants 254 Individual Drugs 254 Principles of Therapy 258 SECTION 3 Drugs Affecting the Autonomic Nervous System 263 CHAPTER 16 Physiology of the Autonomic Nervous System 265 CHAPTER 21 Physiology of the Endocrine System 335 Introduction 335 Endocrine System Nervous System Interactions 336 General Characteristics of Hormones 336 Use of Hormonal Drugs 338 CHAPTER 22 Hypothalamic and Pituitary Hormones 339 Introduction 339 Types of Hormones 339 Individual Drugs 341 Principles of Therapy 347
Contents xix CHAPTER 23 Corticosteroids 352 Introduction 352 General Characteristics of Exogenous Corticosteroids 355 Principles of Therapy 363 CHAPTER 24 Thyroid and Antithyroid Drugs 373 Introduction 373 General Characteristics of Thyroid and Antithyroid Drugs 374 Individual Drugs 376 Principles of Therapy 379 CHAPTER 25 Hormones That Regulate Calcium and Bone Metabolism 387 Introduction 387 Individual Drugs 390 Principles of Therapy 396 CHAPTER 26 Antidiabetic Drugs 404 Introduction 404 Hypoglycemic Drugs 407 Principles of Therapy 419 CHAPTER 27 Estrogens, Progestins, and Hormonal Contraceptives 436 Introduction 436 General Characteristics of Estrogens, Progestins, and Hormonal Contraceptives 438 Individual Drugs 440 Principles of Therapy 447 CHAPTER 28 Androgens and Anabolic Steroids 455 Introduction 455 General Characteristics of Androgens and Anabolic Steroids Used As Drugs 457 Individual Drugs 458 Principles of Therapy 460 SECTION 5 Drugs Used to Treat Infections 465 CHAPTER 29 General Characteristics of Antimicrobial Drugs 467 Introduction 467 Microorganisms and Infections 467 Characteristics of Antimicrobial Drugs 474 Principles of Therapy 476 CHAPTER 30 Beta-Lactam Antibacterials: Penicillins, Cephalosporins, and Other Drugs 485 Introduction 485 Penicillins 485 Cephalosporins 489 Carbapenems 491 Monobactam 494 Principles of Therapy 495 CHAPTER 31 Aminoglycosides and Fluoroquinolones 504 Introduction 504 Aminoglycosides 504 Fluoroquinolones 507 Principles of Therapy 509 CHAPTER 32 Tetracyclines, Sulfonamides, and Urinary Agents 515 Introduction 515 Principles of Therapy 522 CHAPTER 33 Macrolides, Ketolides, and Miscellaneous Antibacterials 528 Introduction 528 Macrolides and Ketolides 528 Miscellaneous Antibacterial Drugs 530 Principles of Therapy 533 CHAPTER 34 Drugs for Tuberculosis and Mycobacterium avium Complex (MAC) Disease 542 Introduction 542 Antitubercular Drugs 544 Treatment of Active Tuberculosis 550 Mycobacterium avium Complex Disease 550 Principles of Therapy 552 CHAPTER 35 Antiviral Drugs 560 Introduction 560 Antiviral Drugs 562 Principles of Therapy 571
xx Contents CHAPTER 36 Antifungal Drugs 582 Introduction 582 Antifungal Drugs 583 Principles of Therapy 595 CHAPTER 37 Antiparasitics 603 Introduction 603 Antiparasitic Drugs 606 Principles of Therapy 614 SECTION 6 Drugs Affecting Hematopoiesis and the Immune System 619 CHAPTER 38 Physiology of the Hematopoietic and Immune Systems 621 Introduction 621 Hematopoietic Cytokines 621 Overview of Body Defense Mechanisms 624 Immunity 624 Immune Cells 626 Immune System Cytokines 629 Client-Related Factors That Influence Immune Function 629 Immune Disorders 631 Drugs That Alter Hematopoietic and Immune Responses 632 CHAPTER 39 Immunizing Agents 633 Introduction 633 General Characteristics of Immunizing Agents 634 Individual Immunizing Agents 634 Principles of Therapy 644 CHAPTER 40 Hematopoietic and Immunostimulant Drugs 651 Introduction 651 General Characteristics of Hematopoietic and Immunostimulant Drugs 651 Classifications and Individual Drugs 655 Principles of Therapy 658 CHAPTER 41 Immunosuppressants 665 Introduction 665 Classifications and Individual Drugs 668 Principles of Therapy 676 CHAPTER 42 Drugs Used in Oncologic Disorders 691 Introduction 691 Traditional Cytotoxic Antineoplastic Drugs 694 Biologic Targeted Antineoplastic Drugs 699 Antineoplastic Hormone Inhibitor Drugs 702 Cytoprotectant Drugs 705 Principles of Therapy 709 SECTION 7 Drugs Affecting the Respiratory System 723 CHAPTER 43 Physiology of the Respiratory System 725 Overview of the Respiratory System 725 Disorders of the Respiratory System 727 Drug Therapy 727 CHAPTER 44 Drugs for Asthma and Other Bronchoconstrictive Disorders 729 Introduction 729 Bronchodilators 732 Anti-Inflammatory Agents 735 Principles of Therapy 739 CHAPTER 45 Antihistamines and Allergic Disorders 747 Introduction 747 General Characteristics of Antihistamines 750 Classifications and Individual Drugs 753 Principles of Therapy 755 CHAPTER 46 Nasal Decongestants, Antitussives, and Cold Remedies 760 Introduction 760 General Characteristics of Drugs Used in/for Respiratory Disorders 761 Individual Drugs 762 Principles of Therapy 766 SECTION 8 Drugs Affecting the Cardiovascular System 771 CHAPTER 47 Physiology of the Cardiovascular System 773
Contents xxi Introduction 773 Heart 773 Blood Vessels 774 Blood 775 Cardiovascular Disorders 776 Drug Therapy Used for Cardiovascular Disorders 776 CHAPTER 54 Drugs That Affect Blood Coagulation 876 Introduction 876 Drugs Used in Thrombotic and Thromboembolic Disorders: Classifications and Individual Drugs 879 Principles of Therapy 888 CHAPTER 48 Drug Therapy for Heart Failure 777 Introduction 777 Inotropes 778 Human B-Type Natriuretic Peptide (Nesiritide) 783 Endothelin Receptor Antagonists (Bosentan) 784 Principles of Therapy 785 CHAPTER 49 Antidysrhythmic Drugs 794 Introduction 794 General Characteristics of Antidysrhythmic Drugs 796 Classifications and Individual Drugs 796 Principles of Therapy 807 CHAPTER 50 Antianginal Drugs 814 Introduction 814 Antianginal Drugs: Classifications and Individual Drugs 817 Principles of Therapy 823 CHAPTER 51 Drugs Used in Hypotension and Shock 829 Introduction 829 General Characteristics of Antishock Drugs 830 Individual Drugs 830 Principles of Therapy 833 CHAPTER 52 Antihypertensive Drugs 838 Introduction 838 Antihypertensives: Classifications and Individual Drugs 842 Principles of Therapy 851 CHAPTER 55 Drugs for Dyslipidemia 897 Introduction 897 General Characteristics of Drugs Used for Management of Dyslipidemia 900 Dyslipidemic Drugs: Classifications and Individual Drugs 901 Principles of Therapy 905 SECTION 9 Drugs Affecting the Digestive System 911 CHAPTER 56 Physiology of the Digestive System 913 Introduction 913 Structures of the Digestive System 913 Secretions of the Digestive System 915 Effects of Drugs on the Digestive System 916 CHAPTER 57 Nutritional Support Products, Vitamins, and Mineral Electrolytes 917 Introduction 917 Nutritional Deficiency States 917 Nutritional Products 918 Agents Used in Mineral Electrolyte Imbalances 925 Principles of Therapy 935 CHAPTER 58 Drugs to Aid Weight Management 952 Introduction 952 General Characteristics of Drugs for Obesity 957 Individual Drugs 957 Principles of Therapy 960 CHAPTER 53 Diuretics 861 Introduction 861 General Characteristics of Diuretic Drugs 863 Types of Diuretics and Individual Drugs 865 Principles of Therapy 868 CHAPTER 59 Drugs Used for Peptic Ulcer and Acid Reflux Disorders 970 Introduction 970 Classifications and Individual Drugs 972 Principles of Therapy 980
xxii Contents CHAPTER 60 Laxatives and Cathartics 987 Introduction 987 General Characteristics of Laxatives and Cathartics 988 Classifications and Individual Drugs 988 Principles of Therapy 992 CHAPTER 64 Drugs Used in Dermatologic Conditions 1039 Introduction 1039 Dermatologic Drug Therapy 1042 Principles of Therapy 1049 CHAPTER 61 Antidiarrheals 997 Introduction 997 Characteristics, Classifications, and Individual Antidiarrheal Drugs 998 Principles of Therapy 1004 CHAPTER 62 Antiemetics 1010 Introduction 1010 General Characteristics of Antiemetic Drugs 1011 Classifications and Individual Drugs 1011 Principles of Therapy 1015 SECTION 10 Drugs Used in Special Conditions 1021 CHAPTER 63 Drugs Used in Ophthalmic Conditions 1023 Introduction 1023 Ophthalmic Drug Therapy 1024 Principles of Therapy 1032 CHAPTER 65 Drug Use During Pregnancy and Lactation 1057 Introduction 1057 Pregnancy 1057 Fetal Therapeutics 1059 Maternal Therapeutics 1059 Drugs That Alter Uterine Motility 1069 Drugs Used During Labor and Delivery at Term 1071 Neonatal Therapeutics 1072 Principles of Therapy 1073 APPENDIX A Recently Approved and Miscellaneous Drugs 1079 APPENDIX B The International System of Units 1082 APPENDIX C Serum Drug Concentrations 1083 APPENDIX D Canadian Drug Laws and Standards 1084 APPENDIX E Canadian Drug Names 1087 APPENDIX F INDEX 1101 Anesthetics, Adjunctive Drugs, and Nursing Considerations 1095