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Integrated Cardiopulmonary Pharmacology,9780130305183
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Integrated Cardiopulmonary Pharmacology

by ;
Edition:
1st
ISBN13:

9780130305183

ISBN10:
0130305189
Format:
Paperback
Pub. Date:
1/1/2002
Publisher(s):
Prentice Hall
List Price: $69.60
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Summary

Marked by its readability and complete coverage, Integrated Cardiopulm onary Pharmacology is a truly introductory and interactive textbook, i ntegrated with a unique self-study website that allows for continual u pdates of new drugs on the market as well as illuminating videos and a nimations. This text is indeed an integrated project, with an interdis ciplinary perspective of both respiratory therapists and pharmacists; pharmacology integrated and linked to physiology/pathology to give tot al understanding and enhance relevant learning.

Table of Contents

Preface xxiii
General Pharmacological Principles
1(26)
Objectives
1(1)
Abbreviations
2(1)
Introduction
2(1)
Basic Terms
2(1)
Drug Development
3(1)
Herbals
4(1)
Drug Information Sources
4(1)
Interpreting Drug Information
5(5)
Drug Names
5(1)
Clinical Pharmacology
5(2)
Indications and Usage
7(1)
Contraindications
7(1)
Drug Interactions
7(1)
Adverse Drug Reactions (ADRs)
8(2)
Dosage and Administration
10(1)
Routes of Administration
10(3)
Enteral Routes
11(1)
Parenteral Routes
11(1)
Other Routes
12(1)
Pharmacokinetics
13(4)
Absorption
13(2)
Distribution
15(1)
Metabolism
16(1)
Elimination
16(1)
Pharmacodynamics
17(5)
Selectivity
18(1)
Lock-and-Key Receptor Theory
18(1)
Racemic Mixtures
19(1)
Agonists Versus Antagonists
19(1)
Potency
19(1)
Tolerance
20(1)
Half-Life
21(1)
Poisonings/Toxicity
21(1)
Prescription Orders
22(1)
Common Sense Rules
23(1)
Summary
24(1)
Review Questions
24(1)
Glossary
25(2)
The Metric System and Drug Dosage Calculations
27(16)
Objectives
27(1)
Abbreviations
27(1)
Introduction
28(1)
Exponential Powers of Ten
28(2)
Exponents
28(2)
Systems of Measurement
30(4)
United States Customary System (USCS)
30(1)
The Metric System
30(1)
Example Calculation 1
31(1)
Example Calculation 2
31(1)
Conversion of Units
32(1)
Example Calculation 3
33(1)
Example Calculation 4
33(1)
Factor-Label Method for Conversion Between Systems
33(1)
Example Calculation 5
34(1)
Example Calculation 6
34(1)
Drug Dosage Calculations
34(7)
Solutions
34(1)
Percentage Solutions
35(1)
Setting Up Proportions
36(1)
Example Calculation 7
36(1)
Example Calculation 8
37(1)
Example Calculation 9
37(1)
Ratio Solutions
38(1)
Example Calculation 10
38(1)
Example Calculation 11
38(1)
Drug Orders in Drops
39(1)
Example Calculation 12
39(2)
Summary
41(1)
Review Questions
41(1)
Glossary
41(2)
Pharmacology of the Autonomic Nervous System
43(18)
Objectives
43(1)
Abbreviations
44(1)
Introduction
44(1)
Nervous System Divisions
44(3)
PNS Divisions
45(2)
Nervous System Conduction
47(5)
Types and Location of Neurotransmitters
48(2)
Receptors
50(1)
Receptor Classification
50(2)
ANS Drug Terminology
52(5)
Direct- and Indirect-Acting Agents
54(1)
Parasympathomimetic
54(1)
Parasympatholytics
54(1)
Sympathomimetic
55(1)
Sympatholytics
56(1)
Review Questions
57(1)
Glossary
58(3)
Medicated Aerosol Treatments
61(16)
Objectives
61(1)
Abbreviations
61(1)
Introduction
62(1)
Basic Concepts of Medicated Aerosols
62(5)
What Is Aerosol Therapy?
62(1)
Advantages and Disadvantages
63(1)
Technical Background
63(1)
Aerosol Size Matters
64(1)
Breathing Pattern
64(2)
Types of Aerosolized Drugs
66(1)
Aerosol Delivery Devices
67(6)
Metered Dose Inhalers (MDIs)
67(1)
Spacers and Special Considerations
68(1)
Administering a MDI Treatment
69(1)
MDI Instructions
69(1)
Small Volume Nebulizer
70(1)
Continuous Nebulization
71(1)
Dry Powder Inhaler
71(1)
Choosing the Proper Treatment
72(1)
The Future
73(1)
Summary
73(1)
Review Questions
73(1)
Case Study
74(1)
Glossary
74(3)
Bronchodilators
77(24)
Objectives
77(1)
Abbreviations
78(1)
Introduction
78(1)
Airway Anatomy and Physiology
78(2)
Bronchoconstriction versus Bronchospasm
78(2)
Neurological Control of Bronchial Smooth Muscle
80(4)
Sympathetic Nervous System
80(1)
Parasympathetic Nervous System
81(1)
Chemical Mediators of Neural Transmission
81(1)
Sympathetic Nervous System Receptors
82(1)
The Sympathetic Nervous System in the Lung
83(1)
Bronchodilators
84(2)
Sympathomimetic (Adrenergic) Bronchodilators
85(1)
Mechanism of Action
85(1)
Development of the β Agonists
86(6)
Catecholamines
87(1)
Resorcinols
88(1)
Saligenins
89(1)
Side Effects of β-Agonists
90(1)
Classification by Duration of Action
91(1)
Anticholinergic (Parasympatholytic) Bronchodilators
92(3)
Mechanism of Action
93(1)
Atropine sulfate
94(1)
ipratropium bromide (Atrovent)
95(1)
Monitoring Outcomes of Inhaled Bronchodilatory Therapy
95(1)
Xanthines
96(1)
Mechanism of Action
96(1)
Nonbronchodilating Effects of Theophylline
96(1)
Summary
97(1)
Review Questions
97(1)
Case Study 1
98(1)
Case Study 2
98(1)
Glossary
99(2)
Mucokinetics and Surfactants
101(22)
Objectives
101(1)
Abbreviations
101(1)
Introduction
102(1)
The Mucociliary System
102(4)
Anatomy and Physiology
102(1)
Structure and Composition of Mucus
103(3)
Bland Aerosols
106(3)
Definitions
106(1)
Delivery Methods
106(2)
Bland Solutions
108(1)
Mucolytics
109(4)
Definition
109(2)
Other Mucolytic Agents
111(1)
Expectorants
112(1)
Antitussives/Cough Suppressants
112(1)
Ethanol (Ethyl Alcohol)
112(1)
Conclusions
113(1)
Surface-Active Agents
113(7)
Alveolar Physiology and Surfactant Synthesis
113(2)
Surfactant Function
115(2)
Indications for Surfactant Replacement Therapy
117(1)
General Techniques of Surfactant Administration
117(1)
Types of Exogenous Surfactants
117(2)
Surfactant Replacement Therapy Indications
119(1)
Surfactant Administration in Adult Patients
119(1)
Review Questions
120(1)
Case Study 1
120(1)
Case Study 2
121(1)
Glossary
121(2)
Anti-Inflammatory and Antiasthmatic Agents
123(20)
Objectives
123(1)
Abbreviations
124(1)
Introduction
124(1)
The Inflammatory Process
124(5)
The Immune Response
124(1)
Mast Cell Chemical Mediator Release
125(2)
Types of Asthma
127(1)
Phases of the Inflammatory Response
127(2)
Corticosteroids
129(7)
Corticosteroid Physiology
129(1)
Hypothalamic Pituitary Adrenal Axis
130(1)
Corticosteroid Mechanism of Action
131(1)
Corticosteroid Use in Airway Remodeling
132(1)
Adverse Effects of Corticosteroids
132(1)
Oral and Parenteral Corticosteroid Administration
133(1)
Inhaled Corticosteroids
134(1)
Benefits of Daily Corticosteroid Use
135(1)
Steroid Dependency
135(1)
Antiasthmatics
136(1)
cromolyn and nedocromil sodium
136(1)
Dosage Forms
136(1)
Side Effects
136(1)
Prostaglandins
136(1)
Physiology
136(1)
Leukotriene Modifiers
137(1)
Physiology
137(1)
Treating Upper Airway Congestion
138(3)
Allergic Rhinitis
138(1)
Intranasal Medications
138(1)
Antihistamine
138(2)
Decongestants
140(1)
Summary
141(1)
Review Questions
141(1)
Glossary
142(1)
Anti-Infective Agents
143(18)
Objectives
143(1)
Abbreviations
143(1)
Introduction
144(1)
General Principles of Anti-infective Therapy
144(6)
Terminology
144(1)
The Infectious Process
144(1)
Empiric Therapy
145(1)
Bacteria Classification
146(1)
Identification of Pathogenic Organisms
146(3)
Mechanisms of Resistance
149(1)
Monitoring Anti-infective Therapy
149(1)
Classification of Antibacterial Agents
150(7)
Bacteriostatic versus Bactericidal
150(1)
Broad versus Narrow
150(1)
Based on Mechanism of Action
150(1)
Antibacterial Agents
150(1)
Beta Lactams
150(3)
Quinolones
153(1)
Aminoglycosides
153(1)
Vancomycin
153(1)
Teicoplanin
154(1)
Protein Synthesis Inhibitors
154(1)
Tetracyclines
154(1)
Folate Inhibitors
154(1)
Oxazolidinones
154(1)
Dalfopristin/quinupristine
155(1)
Metronidazole
155(1)
Antitubercular Agents
155(1)
Antivirals
155(2)
Antifungals
157(1)
Aerosol Anti-infective Therapy
157(1)
Rationale
157(1)
Summary
158(1)
Review Questions
158(1)
Case Study
159(1)
Glossary
159(2)
Cardiac and Renal Agents
161(22)
Objectives
161(1)
Abbreviations
161(1)
Introduction
162(1)
Cardiovascular Overview
162(5)
Basic Terminology
162(1)
Cardiac Circulation
163(1)
Cardiac Conduction
163(1)
Ion Influence
164(1)
The ECG Tracing
165(1)
Arrhythmias
166(1)
Sites of Arrhythmias
167(1)
Antiarrhythmic Agents
167(4)
Therapeutic Goals
167(1)
Mechanism of Action
168(1)
Antiarrhythmic Drug Classification
168(2)
Digoxin
170(1)
Adenosine
170(1)
Proarrhythmia
171(1)
Congestive Heart Failure
171(4)
Definition
171(1)
Drugs to Treat CHF
171(1)
Digoxin as an Inotrope
172(1)
ACE Inhibitors for CHF
173(1)
Dobutamine for CHF
173(1)
Dopamine for CHF
173(1)
Nitroprusside for CHF
173(1)
Beta Antagonists for CHF
173(1)
Vasodilators for CHF
174(1)
Phosphodiesterase Inhibitors for CHF
174(1)
Diuretics for CHF
174(1)
Renal Pharmacology
175(2)
Renal Physiology
175(1)
Specific Diuretics
175(2)
Other Renal Medications
177(1)
Shock Management
177(1)
Angina
177(2)
Angina Pathophysiology
177(1)
Pharmacologic Treatment of Angina
177(1)
Beta Blockers as Antianginals
178(1)
Calcium-Channel Blockers as Antianginals
178(1)
Nitroglycerin as an Antianginal
179(1)
Myocardial Infarction
179(1)
ACE Inhibitors After MI
179(1)
Summary
180(1)
Review Questions
180(1)
Case Study
180(1)
Glossary
181(2)
Blood Pressure and Antithrombotic Agents
183(18)
Objectives
183(1)
Abbreviations
183(1)
Introduction
184(1)
Blood Pressure
184(4)
The Basics
184(1)
The Blood Vessels
184(1)
Blood Pressure Regulation
185(1)
Hypertension
186(2)
Drug Categories to Treat Hypertension
188(5)
Direct-Acting, α2-Agonists, or Central-Acting Sympatholytics
188(1)
α-Blockers or Peripheral-Acting Sympatholytics
188(1)
Beta Blockers
189(1)
Diuretics
189(1)
Angiotensin-Converting Enzyme (ACE) Inhibitors
190(1)
Angiotensin II Receptors Blockers
191(1)
Calcium-Channel Blockers (CCBs)
191(1)
Vasodilators
192(1)
Agents for Hypertensive Emergencies/Urgencies
192(1)
Treating Hypotension
193(1)
The Hemostatic System
193(6)
The Clotting Process
193(1)
Anticoagulants
194(2)
Warfarin Interactions and Side Effects
196(1)
Antiplatelet Drugs
197(1)
Thrombolytics
198(1)
Summary
199(1)
Review Questions
199(1)
Glossary
200(1)
Neuromuscular, Anesthetic, Sedative, and Analgesic Agents
201(22)
Objectives
201(1)
Abbreviations
202(1)
Introduction
202(1)
Nerve Transmission
202(6)
Physiology of Muscle Contraction
202(2)
Acetylcholinesterase (AChE)
204(1)
Neuromuscular Blocking Drugs
204(1)
Nondepolarizing Agents
204(1)
Depolarizing Agents
205(1)
NMBD Selection Factors
206(2)
Skeletal Muscle Relaxants
208(1)
Sedative/Hypnotics/Anxiolytics
208(2)
Terminology
208(1)
Benzodiazepines
209(1)
Barbiturates
209(1)
Cocktails
209(1)
Anesthetics
210(3)
General versus Local
210(1)
General Anesthesia
210(1)
Stages of Anesthesia
210(1)
Specific General Anesthetics
211(1)
Local Anesthetics
212(1)
Ventilatory Stimulants
213(1)
Analgesia
214(7)
Principles of Analgesia
214(1)
The Pain Response
215(1)
Analgesics
215(1)
Outcomes Assessment Analgesic Therapy
216(1)
Specific Analgesics
216(1)
Opioids
216(2)
Opioid Antagonists
218(1)
Steroid Anti-inflammatory Agents
218(1)
Nonsteroidal Anti-inflammatory Agents
219(1)
Analgesic Synergy
219(1)
Adjuncts to Analgesics
220(1)
Summary
221(1)
Review Questions
221(1)
Glossary
222(1)
Therapeutic Medical Gases
223(18)
Objectives
223(1)
Abbreviations
223(1)
Introduction
224(1)
Oxygen Therapy
224(10)
Physiologic Background
224(1)
Hypoxemia
225(1)
Clinical Manifestations of Hypoxemia
226(1)
Hypoxia
227(1)
Goals of Oxygen Therapy
228(1)
Oxygen Administration Devices
228(1)
Low-Flow Oxygen Devices
229(2)
High-Flow Oxygen Systems
231(1)
Monitoring Oxygen Therapy
232(1)
Hazards of Oxygen Therapy
232(2)
Carbon Dioxide
234(1)
Introduction
234(1)
Physiologic Effects
234(1)
Indications for Carbon Dioxide Therapy
235(1)
Carbon Dioxide Administration
235(1)
Helium Therapy
235(1)
Introduction
235(1)
Indications for Helium Therapy
235(1)
Administration of Helium/Oxygen
236(1)
Hazard of Helium/Oxygen Therapy
236(1)
Nitric Oxide Therapy
236(2)
Introduction
236(1)
Physiology of Nitric Oxide
237(1)
INO Administration and Dosage
237(1)
Therapeutic Indications for Inhalation of Nitric Oxide
237(1)
Monitoring of Nitric Oxide Therapy
237(1)
Summary
238(1)
Review Questions
238(1)
Case Study
239(1)
Glossary
239(2)
COPD: The Pharmacological Treatment of Asthma, Chronic Bronchitis, and Emphysema
241(24)
Objectives
241(1)
Abbreviations
241(1)
Introduction
242(1)
Asthma
243(10)
Background
243(1)
Differential Diagnosis
243(1)
Asthma Symptoms
243(2)
Asthma Treatment Goals
245(1)
Levels of Asthma
246(1)
Asthma Medications
247(1)
Asthma Management
248(1)
Management of Acute Asthma Exacerbations
248(5)
COPD
253(2)
Background
253(1)
Etiology
253(2)
Prevention: The Key to Treatment of COPD
255(4)
Smoking Cessation
255(1)
Smoking Cessation Therapies
256(2)
Vaccinations
258(1)
COPD Treatment Goals
259(3)
Drugs Used to Treat COPD
259(1)
Step-by-Step Approach
260(2)
Summary
262(1)
Review Questions
262(1)
Case Study
263(1)
Glossary
263(2)
Pharmacologic Treatment of Respiratory Infectious Disease
265(24)
Objectives
265(1)
Abbreviations
266(1)
Introduction
266(1)
Developing a Therapeutic Plan for Respiratory Infectious Diseases
267(3)
Empiric Treatment
267(1)
Local Resistance Patterns (the Antibiogram)
267(1)
Individualizing Therapy
268(2)
Upper Airway Infections Diseases
270(6)
Otitis Media
270(2)
Sinusitis
272(2)
Pharyngitis
274(2)
Other Upper Airway Infections
276(1)
Epiglottitis
276(1)
Croup
276(1)
Lower Respiratory Tract Infections
277(10)
Acute Bronchitis and Bronchiolitis
277(2)
Pneumonia
279(7)
Tuberculosis
286(1)
Summary
287(1)
Review Questions
287(1)
Glossary
288(1)
Pharmacology for Advanced Cardiac Life Support
289(20)
Objectives
289(1)
Abbreviations
289(1)
Introduction
290(1)
Normal Conduction and Arrhythmias
290(7)
Electrophysiology
290(1)
Normal Conduction
290(1)
Myocardial Infarction
291(1)
Bradycardia
292(1)
Tachycardia
293(2)
Ventricular Fibrillation
295(1)
Asystole
296(1)
Pulseless Electrical Activity (PEA)
296(1)
Pharmacologic Agents for Advanced Life Support
297(2)
Categories of ACLS Drugs
297(2)
Pharmacology I Agents
299(4)
Oxygen
299(1)
Epinephrine
300(1)
Atropine
300(1)
Lidocaine (Xylocaine)
301(1)
Amiodarone
301(1)
Procainamide (Pronestyl)
302(1)
Magnesium Sulfate
302(1)
Sodium Bicarbonate
303(1)
Calcium-Channel Blockers
303(2)
Verapamil (Calan, Isoptin)
304(1)
Diltiazem (Cardizem)
304(1)
Adenosine
304(1)
β-Adrenergic Blockers
305(1)
Positive Inotropic Drugs
306(1)
Digoxin
306(1)
Amrinone
306(1)
Epinephrine
306(1)
Isoproterenol
306(1)
Dopamine
306(1)
Dobutamine (Dobutrex)
307(1)
Review Questions
307(1)
Case Study
308(1)
Glossary
308(1)
References 309(10)
Drug list 319(12)
Index 331

Excerpts

Pharmacology is often perceived as one of the more difficult subjects in a medical curriculum. There are several possible explanations. First, there are difficult concepts and terms that are inherent to this subject. Second, there is a massive amount of information, often presented in a dry and highly technical manner. Finally, once a text is printed, it is practically out of date because of all the recent breakthroughs, new drugs, and new delivery devices that have been developed before it even hits the bookstores. We took all these factors into account as we developed and pilot-tested this innovative project. So what makes this book unique and able to address these concerns? First and foremost, this truly is anintegrated projectat several levels and not just a "buzz word" thrown into the title. The authors and publisher took very seriously the integrated aspect of this project and first sought the interdisciplinary perspective offered by both pharmacists and respiratory therapists. In addition, pharmacology was integrated and linked to physiology and pathology to give a total understanding and enhance connectional and relevant learning. The authors also took very seriously the concept of writing in a style that did not distance the student from the material and encouraged "learning and relating" the material versus massive memorization. Finally, there are some things we did not take so seriously. While we were serious about the contents, relevancy, and accuracy of the material, we had fun writing, researching, and collaborating on this project. We utilized splashes of humor within this textbook, with the underlying idea that what is learned with humor is not readily forgotten. While humor will make the learning easier, never take lightly your responsibilities as a health care professional. SPECIAL TEXTBOOK FEATURES Our goal is to produce a truly introductory and interactive pharmacology text that students can connect with and learn pharmacology. Several features will be incorporated into the textbook to help accomplish that goal; they include the following: Get Connected to the Web Site:This special text feature will connect the student to a managed companion Web page with current updates, new drugs, animations, videos, audio glossary and drug pronunciation, sample tests, and references. Learning Hints and Controversies:These special features will be contained in each chapter to ensure understanding of difficult concepts and to stimulate further thought. Clinical Pearls:Instances of this special feature will also be interspersed throughout the chapters to connect the knowledge and show the relevancy of learning the material. In addition, numerous clinical applications will be demonstrated to give a "real world" connection. Key Terms:Key terms will be boldfaced and included in a glossary. In addition, an audio glossary and drug name pronunciation will be provided on the Web site. Symbols, units, and abbreviation or medical terms will be defined in the chapter opener for easy reference. Chapter Questions:Periodic "Stop and Review" problems within each chapter will help to ensure concept understanding before a student can move on and get really lost. Comprehensive questions will also be included at the end of the chapter; they will build from multiple choice and matching questions to higher-level critical thinking and case-study questions. An interactive chapter exam will also be provided on the Web site. THE INTEGRATED WEB SITE Further proof of the commitment to integration lies in a unique and interactive web site that fully supports the text. While the textbook can certainly stand on its own, the web site is a powerful adjunct that can greatly facilitate learning and keep both faculty and students up on the "latest and greatest" in pharmacology. One of the difficult aspects of


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