Clinical Pharmacology and Nursing Management

by Eisenhauer, Laurel A.; Nichols, Lynn Wemett; Spencer, Roberta Todd; Bergan, Frances West

• ISBN13: 9780397553297
• ISBN10: 0397553293
• Edition: 5th
• Format: Hardcover
• Copyright: 1998-01-01
• Publisher: Lippincott Williams & Wilkins

Summary

Boston College School of Nursing, Chestnut Hill, MA. Textbook for nursing students. Incorporates pharmacology content and nursing concerns into a nursing process format. New to this edition: home and community care, client education, and alternative therapies. DNLM: Pharmacology, Clinical--nurses' instruction.

Table of Contents

Unit I Introduction to Pharmacology	1	(42)
1 Orientation to Pharmacology	2	(12)
Scope of Pharmacology	2	(1)
History of Pharmacology	3	(4)
Prehistoric Era	3	(1)
Ancient Civilizations	4	(1)
Medieval to Modern Times	4	(1)
The World of Today	5	(1)
Future Concerns	6	(1)
Developing a Personal Knowledge Base	7	(3)
Drug-Related Nursing Responsibilities	7	(1)
Required Drug Knowledge	7	(1)
Reliable Sources of Information	8	(2)
Approaches to Drug Therapy	10	(1)
Magical Approach	10	(1)
Empirical Approach	10	(1)
Rational Approach	10	(1)
Nursing Implications	11	(3)
Assuming Greater Responsibilities	11	(1)
Teaching and Health Promotion	12	(1)
Case Finding and Referral	12	(1)
Continuing Education	12	(1)
Learning from the Client	12	(2)
2 Drug Preparations, Controls, and Standards	14	(18)
Characteristics of Medicinal Preparations	14	(6)
Drug Sources	14	(1)
Drug Components	15	(1)
Types of Preparations	16	(2)
Drug Nomenclature	18	(2)
Drug Controls	20	(6)
International Controls	20	(1)
National Controls	20	(3)
State Controls	23	(2)
Local Regulations	25	(1)
Institutional Controls	25	(1)
Individual Controls	26	(1)
Drug Standards	26	(1)
Purity	26	(1)
Potency	26	(1)
Bioavailability	26	(1)
Efficacy	26	(1)
Safety Versus Toxicity	27	(1)
Testing Standards	27	(1)
Nursing Management	27	(5)
Independent Nursing Functions	27	(1)
Collaborative Nursing Functions	28	(4)
3 Nursing Process: Management of Clients With Drug-Related Problems	32	(11)
Assessment	32	(8)
Data Base	32	(2)
Analysis	34	(6)
Nursing Diagnosis	40	(1)
Planning	40	(1)
Intervention	40	(1)
Outcome Evaluation	40	(1)
Critical Pathways	40	(3)
Unit II Therapy With Drugs	43	(44)
4 Pharmacodynamics and Pharmacokinetics	44	(17)
Pharmacodynamics	44	(3)
Alteration of Cellular Environments	44	(1)
Provision of Substrate Material	45	(1)
Alteration of Cell Functions	45	(1)
Agonist-Antagonist Interaction	46	(1)
Alteration of Genetic Material	46	(1)
Pharmacokinetics	47	(12)
Drug Absorption	47	(6)
Drug Distribution	53	(2)
Drug Biotransformation	55	(2)
Drug Excretion	57	(1)
Interaction of Pharmacokinetic Processes	58	(1)
Nursing Management	59	(2)
5 Adverse Drug Reactions	61	(11)
Overview	61	(1)
Risk Factors	61	(1)
Predictability	62	(1)
Iatrogenic Effects	62	(1)
Side Effects	62	(3)
Desired Effects	62	(1)
Adverse Effects	63	(2)
Toxic Reactions	65	(1)
Hepatotoxicity	65	(1)
Nephrotoxicity	65	(1)
Neurotoxicity	65	(1)
Ototoxicity	65	(1)
Allergic and Immunologic Reactions	66	(1)
Carcinogenicity	67	(1)
Chain Reactions	67	(1)
Cumulative Reactions	67	(1)
Idiosyncratic Reactions	67	(1)
Teratogenicity	68	(1)
Tolerance and Dependence	68	(4)
6 Drug Interactions	72	(15)
Kinds of Drug Interactions	72	(1)
Pharmacodynamic Interactions	72	(1)
Pharmacogenetic Interactions	72	(1)
Pharmacokinetic Interactions	72	(1)
Clinically Desirable Interactions	72	(1)
Drug-Drug Interactions	73	(5)
Interactions and Absorption	73	(1)
Interactions and Distribution	73	(1)
Interactions and Biotransformation	74	(2)
Interactions and Excretion	76	(2)
Drug-Food Interactions	78	(7)
Food and Pharmacokinetic Interactions	80	(3)
Interactions Associated With Enteral Feeding	83	(2)
Drug-Laboratory Test Interactions	85	(2)
Exogenous Interferents	85	(1)
Metabolites	85	(1)
Additives and Test Materials	85	(2)
Unit III Administration of Medications	87	(56)
7 Principles of Medication	88	(26)
Role Functions Related to Drug Therapy	88	(6)
Pharmacist	89	(1)
Physician, Dentist, and Veterinarian	89	(1)
Paraprofessionals	89	(1)
Professional Nurses	90	(1)
Trends in Role Assignments	90	(4)
Delivery of Drug Doses	94	(3)
The Right Drug	94	(1)
The Right Dose	94	(1)
The Right Client	95	(1)
The Right Route	96	(1)
The Right Time	96	(1)
Drug Administration in Healthcare Institutions	97	(1)
Institutional Medication Procedures	98	(1)
Home Care Medication Procedures	98	(1)
Medication Errors	98	(4)
Causes	99	(3)
Reporting an Error	102	(1)
Special Skills for Drug Administration	102	(1)
Storing and Handling Drugs	102	(3)
Learning the Language	105	(1)
Orders for Medication	105	(1)
Computation of Drug Doses	106
Occupational Hazards Related to Drug Administration	102	(12)
Chemical Dependence	112	(1)
Adverse Reaction to Toxic Substances	112	(1)
Antibiotic-Resistant Infections	113	(1)
Blood-Borne Infections	113	(1)
Allergy	113	(1)
Nursing Considerations	113	(1)
8 Strategies to Promote Therapeutic Alliance	114	(7)
Developing a Therapeutic Alliance	114	(1)
Factors Affecting a Therapeutic Alliance	114	(1)
Behavioral Responses to Drugs	114	(3)
Attitudes	114	(1)
Motivation	115	(1)
Meaning Attached to Drugs	115	(1)
Power of Suggestion	116	(1)
Type of Illness	117	(1)
Strategies to Promote Compliance	117	(4)
The Nurse's Behavioral Response	117	(4)
9 Cultural Aspects of Drug Therapy	121	(22)
Ethnomedicine	121	(1)
Cultural Diversity and Pharmacotherapy	122	(1)
Racial Diversity and Pharmacotherapy	122	(1)
African Americans	122	(1)
Health and Illness Beliefs	122	(1)
Remedies	122	(1)
Hispanic Americans	123	(3)
Health and Illness Beliefs	123	(1)
Remedies	124	(2)
Asian Americans	126	(3)
Health and Illness Beliefs	126	(1)
Remedies	126	(3)
Native Americans	129	(2)
Health and Illness Beliefs	129	(1)
Remedies	130	(1)
European Americans	131	(1)
Health and Illness Beliefs	131	(1)
Remedies	131	(1)
Ethnopharmacology	131	(9)
Preparation and Use of Herbs	132	(8)
Nursing Management	140	(3)
Unit IV Developmental Considerations in Drug Therapy	143	(56)
10 Drug Therapy in Maternal Care	144	(33)
Drug Safety During Pregnancy	144	(2)
FDA Pregnancy Risk Ratings for Drugs	145	(1)
TERIS and Canadian Ratings	145	(1)
Drug-Related Factors Affecting Pregnancy	146	(3)
Maternal Nutrition	146	(1)
Ingested and Inhaled Contaminants	146	(3)
Therapeutic Drug Use During Pregnancy	149	(10)
Drug Intervention in Maternal Medical Problems	149	(8)
Drug Intervention in Fetal Medical Problems	157	(1)
Implications: Benefits and Risks	158	(1)
Drug Use During Labor	159	(7)
Premature Labor	159	(3)
Term Labor and Natural Oxytocin	162	(1)
Artificially Induced Labor and Oxytocic Drugs	162	(1)
Artifically Induced Labor After Fetal Demise	163	(1)
Hypertension Control During Labor	163	(1)
Pain Control During Labor	163	(3)
Drug Use During Delivery	166	(1)
Local Anesthetics	166	(1)
General Anesthetics	166	(1)
Drug Use in Postpartum Care	167	(1)
Drug Use During Lactation	168	(9)
Mechanisms of Drug Passage From Plasma to Milk	168	(1)
Effects of Maternal Medication on the Infant	169	(8)
11 Drug Therapy in Pediatric Nursing	177	(11)
Factors Influencing Drug Responses in Children	177	(2)
Uniqueness of the Client	177	(1)
Body System Maturity and Metabolism	177	(1)
Physical Growth and Development	178	(1)
Pharmacologic Toxicity	178	(1)
Genetic Endowment	178	(1)
Chronic Conditions	179	(1)
Circadian Rhythms	179	(1)
Psychologic Development	179	(1)
Factors in Administering Medications to Children	179	(9)
Determining the Appropriate Dosage	179	(2)
Managing Pain	181	(7)
12 Drug Therapy in Gerontologic Nursing	188	(11)
Physiologic Changes of Aging	189	(1)
Absorption	189	(1)
Distribution	189	(1)
Metabolism	189	(1)
Excretion	189	(1)
Pharmacodynamic Changes	189	(1)
Other Physiologic Changes	190	(1)
Patterns of Drug Toxicity	190	(1)
Chronic Disease	191	(1)
Polypharmacy	192	(1)
Social and Emotional Behaviors Affecting Drug Use	192	(1)
Changing Resources of Elderly Clients	193	(6)
Decreased Physical Capacity	193	(1)
Hearing Impairment	193	(1)
Vision Impairment	193	(1)
Dietary Alterations	193	(1)
Memory Changes	193	(1)
Financial Circumstances	193	(6)
Unit V Pharmacology in Community-Based Nursing	199	(48)
13 Drug Therapy in the Home and Community	200	(16)
Trends Toward Self-care and Home Care	200	(1)
Self-Medication and Over-the-Counter Drugs	200	(5)
Economic Issues	201	(1)
Legislative Controls	201	(1)
Characteristics of Over-the-Counter Drugs	202	(1)
Interest in Alternative Therapies	203	(2)
Drug Therapy in the Home	205	(9)
Assessment for Home Drug Therapy	205	(3)
Home Drug Administration and Management	208	(6)
The Community as Client	214	(2)
14 Substance Abuse	216	(21)
Nature of Dependence and Addiction	216	(2)
Cycles of Dependence	216	(1)
Relation of Potency and Dependence	217	(1)
Classifications	218	(1)
Central Nervous System Depressants	218	(11)
Opioid Analgesics	218	(2)
General Central Nervous System Depressants	220	(9)
Central Nervous System Stimulants	229	(4)
Amphetamines	229	(1)
Cocaine	230	(1)
Hallucinogens	230	(2)
Inhalant Vapors	232	(1)
Nicotine	233	(1)
Caffeine	233	(1)
Substance Control	233	(1)
Substance Abuse and Reproduction	234	(1)
Drug Abuse and AIDS	234	(3)
15 Toxicology	237	(10)
Access Routes of Toxic Substances	237	(1)
Percutaneous Route	237	(1)
Gastrointestinal Route	238	(1)
Parenteral Route	238	(1)
Inhalation Route	238	(1)
Scope of Poisoning	238	(1)
Causes of Poisoning	238	(1)
Poison Management	238	(1)
Poison Control Centers	238	(1)
Medical Management	239	(1)
Lead Poisoning	239	(2)
Pathophysiology	239	(1)
Signs and Symptoms	239	(1)
Treatment	240	(1)
Prevention	241	(1)
Other Environmental Toxins	241	(6)
Toxins in Healthcare Settings	241	(6)
Unit VI Drugs That Affect the Nervous System	247	(164)
16 Drugs That Affect the Autonomic Nervous System	248	(36)
The Automatic Nervous System	249	(3)
Physiology	250	(2)
Adrenergic Drugs	252	(8)
Catecholamines	253	(5)
Synthetic Catecholamines	258	(1)
Noncatecholamines	258	(2)
Antiadrenergic Drugs	260	(7)
Alpha-Adrenergic Blockers	260	(4)
Beta-Adrenergic Blockers	264	(3)
Cholinergic Drugs	267	(9)
Parasympathomimetic Agents	267	(3)
Anticholinesterase Agents	270	(6)
Anticholinergic Drugs	276	(7)
Atropine Scopolamine and Semisynthetic	277	(3)
Antimuscarinics	280	(3)
Ganglionic Stimulants	283	(1)
Ganglionic Blockers	283	(1)
17 Drugs That Stimulate the Central Nervous System	284	(26)
Physiology of the Central Nervous System	284	(2)
Amphetamines	286	(6)
Xanthines	292	(4)
Analeptics	296	(2)
Strychnine	296	(1)
Pentylenetetrazol	296	(1)
Ammonia	296	(2)
Antiparkinson Agents	298	(7)
Selegiline	298	(1)
Levodopa	299	(6)
Other CNS Stimulants for Parkinsonism	305	(2)
Dopamine Agonists	305	(1)
Anticholinergics and Amantadine	306	(1)
Alzheimer's Drugs	307	(3)
Tacrine	307	(1)
Other Alzheimer's Drugs	308	(2)
18 Drugs That Depress the Central Nervous System	310	(53)
Overview of CNS Depressants	310	(1)
Understanding Pain	311	(1)
Pain Threshold	311	(1)
Pain Response	311	(1)
Pain Syndromes	311	(1)
Pain Management	311	(5)
Nonpharmacologic Pain Management Measures	312	(1)
Pharmacologic Pain Management Measures	312	(4)
Impediments to Effective Pain Management	316	(3)
Inadequate Assessment of Pain	316	(1)
Substitution of Inappropriate Drugs for Analgesics	317	(1)
Invalid Assumptions	317	(1)
Insufficient Knowledge	317	(1)
Biased Attitudes	317	(1)
Misapprehension of Pain	317	(2)
Analgesics	319	(16)
Nonnarcotic Analgesics	319	(1)
Opioid Analgesics	319	(12)
Opioid Antagonists	331	(4)
Central Analgesics	335	(1)
Anesthetic Drugs and Anesthesia	335	(16)
General Anesthetics	336	(7)
Local Anesthetics	343	(7)
Alternative Anesthetic Regimens	350	(1)
Sedative-Hypnotic Drugs	351	(12)
Understanding Sleep	351	(12)
19 Drugs That Control Seizures	363	(25)
Pathophysiology of Seizures	363	(1)
Factors Affecting Seizure Occurrence	363	(1)
Treatment With Drugs	364	(24)
Hydantoins	365	(3)
Barbiturates	370	(3)
Oxazolidinediones	373	(3)
Succinimides	376	(1)
Carbamazepine	376	(1)
Valproate (Valproic Acid)	377	(1)
Benzodiazepines	378	(1)
Other Agents	378	(10)
20 Drugs That Affect Emotional and Psychological Functions	388	(23)
General Considerations	388	(1)
Pathophysiology of Psychiatric Illness	389	(1)
Psychoactive Drug Classes	390	(1)
Antipsychotic Agents	390	(7)
Phenothiazines	390	(2)
Thioxanthenes	392	(1)
Butyrophenones	392	(1)
Other Agents	392	(1)
Atypical and Novel Agents	392	(5)
Anxiolytic Agents	397	(3)
Benzodiazepines	398	(2)
Antidepressants and Mood Stabilizers	400	(11)
Selective Serotonin Reuptake Inhibitors	401	(1)
Tricyclic and Other Cyclic Antidepressants	402	(2)
Monoamine Oxidase Inhibitors	404	(1)
Lithium	405	(2)
Anticonvulsants and Calcium Channel Blockers	407	(4)
Unit VII Drugs Affecting the Cardiovascular and Renal Systems	411	(154)
21 Drugs That Manage Heart Failure	412	(16)
Physiology	412	(1)
Pathophysiology of Heart Failure	412	(2)
Cardiac Glycosides	414	(8)
Digitalis Antidote: Digoxin Immune Fab	422	(3)
Other Drugs for Managing Heart Failure	425	(3)
Drugs That Reduce Ventricular Wall Stress	425	(1)
Drugs That Reduce Neurohormonal Activity	426	(2)
22 Drugs That Regulate Cardiac Rhythm	428	(21)
Pathophysiology of Abnormal Cardiac Rhythms	428	(2)
Class I Drugs: Sodium Channel Blocking Agents	430	(8)
Class IA Drugs	430	(3)
Class IB Drugs	433	(3)
Class IC Drugs	436	(1)
Other Class I Drugs	437	(1)
Class II Drugs: Beta-Adrenergic Blocking Agents	438	(2)
Propranolol	438	(2)
Class III Drugs: Drugs That Prolong Repolarization	440	(3)
Amiodarone	440	(1)
Bretylium	441	(1)
Sotalol	442	(1)
Class IV Drugs: Calcium Channel Blockers	443	(1)
Verapamil	443	(1)
Other Antiarrhythmic Drugs	444	(5)
Adenosine	444	(5)
23 Drugs That Regulate Lipid Levels	449	(14)
Vascular Physiology	449	(1)
Vascular Pathophysiology	449	(3)
Pathophysiology of Atherosclerosis	449	(1)
Role of Lipids and Lipoproteins	450	(1)
Classification of Hyperlipoproteinemias	450	(2)
HMG-CoA Reductase Inhibitors	452	(3)
Fluvastatin	452	(1)
Lovastatin	453	(1)
Pravastatin	454	(1)
Simvastatin	454	(1)
Bile Acid-Sequestering Resins	455	(1)
Cholestyramine and Colestipol	455	(1)
Nicotinic Acid	456	(1)
Fibric Acid Derivatives	457	(1)
Gemfibrozil	457	(1)
Miscellaneous Drugs	457	(4)
Neomycin	457	(1)
Estrogens	457	(1)
Beta-Sitosterol	458	(1)
Omega-3 Fish Oils	458	(3)
Drugs Used to Dissolve Cholesterol-Containing Gallstones	461	(2)
Chenodiol	461	(2)
24 Drugs That Affect Circulation	463	(16)
Physiology of the Coronary Vascular System	463	(1)
Pathophysiology of Myocardial Ischemia	463	(11)
Vasodilators	464	(6)
Other Agents Used to Treat Ischemic Heart Disease	470	(3)
Vasoconstrictors	473	(1)
Pathophysiology of Peripheral Vascular Disease	474	(1)
Drugs Used With Peripheral Vascular Disease	475	(4)
Pentoxifylline	475	(1)
Sclerosing Agent	476	(3)
25 Drugs That Regulate Blood Pressure	479	(31)
Physiology of Blood Pressure	479	(1)
Pathophysiology of Hypertension	479	(1)
Hypertension in Special Populations	480	(1)
Older Adults	480	(1)
Children	480	(1)
Pregnant Women	481	(1)
Ethnicity	481	(1)
Antithypertensive Drug Therapy	481	(1)
Sympathetic Inhibitors	482	(13)
Adrenergic Blocking Agents	482	(9)
Agents With Central Antihypertensive Action	491	(3)
Agents Causing Blockade of Neuroeffector Transmission	494	(1)
Miscellaneous Agents	494	(1)
Direct-Acting Vasodilators	495	(1)
Angiotensin-Converting Enzyme Inhibitors	496	(3)
Angiotensin Receptor Antagonist	499	(1)
Calcium Channel Blocking Agents	499	(7)
Agents Used for Hypertensive Emergencies	506	(4)
26 Drugs That Affect Hemostasis	510	(33)
Hemostasis	510	(2)
Defects of Hemostasis	512	(1)
Disorders Affecting Hemostatis	512	(1)
Hemostatics	512	(9)
Systemic Hemostatics	513	(5)
Topical Hemostatics	518	(3)
Anticoagulants	521	(5)
Heparin	521	(2)
Enoxaparin	523	(1)
Antithrombin III-Independent Anticoagulants	523	(1)
Protamine Sulfate	524	(1)
Coumarin and Indandione Derivatives	524	(2)
Antiplatelet Drugs	526	(8)
Aspirin	526	(1)
Dipyridamole	526	(1)
Ticlopidine	527	(1)
Abciximab	527	(1)
Dextran	527	(1)
Sulfinpyrazone	528	(6)
Fibrinolysis	534	(1)
Fibrinolytic Agents	534	(9)
Streptokinase	535	(1)
Anisoylated Plasminogen Streptokinase Activator Complex	536	(1)
Urokinase	536	(1)
Tissue Plasminogen Activator	537	(6)
27 Drugs That Affect the Kidneys	543	(22)
Physiology of the Kidneys	543	(1)
Pathophysiology	544	(1)
Diuretics and Cardiovascular Disease	544	(1)
Diuretics and Liver or Renal Disease	545	(1)
Diuretics and Other Conditions	545	(1)
Drugs Used as Diuretics	545	(18)
Adaptation to Diuretics	546	(1)
Agents That Increase Glomerular Filtration	547	(1)
Diuretics That Act Directly on the Nephron	547	(4)
Diuretics That Act on the Early Distal Tubule	551	(6)
Diuretics That Modify Filtrate Content	557	(1)
Agents That Act on the Proximal Tubule	558	(5)
Resin Exchange Agents	563	(2)
Unit VIII Drugs Affecting the Gastrointestinal System	565	(52)
28 Drugs That Affect the Upper Gastrointestinal Tract	566	(30)
Pathophysiology of the Upper Gastrointestinal Tract	566	(1)
Plaque and Periodontitis	566	(1)
Halitosis	566	(1)
Agents Used to Treat the Mouth	567	(2)
Digestants	569	(3)
Normal Processes	569	(1)
Abnormal Functioning	569	(1)
Gastric Acidifiers	569	(1)
Pancreatic Enzymes	569	(1)
Bile Drugs	570	(2)
Drug Therapy in Gastric Acidity and Gastrointestinal Muscosal	572	(12)
Physiology	572	(1)
Pathophysiology	572	(2)
Drugs Used to Suppress Acid Production	574	(4)
Drugs Used to Prevent or Treat Mucosal Integrity Damage	578	(6)
Antiemetics	584	(9)
Pathophysiology	584	(2)
Classification of Antiemetics	586	(7)
Miscellaneous Drugs Affecting the Upper Gastrointestinal Tract	593	(3)
Antiflatulents	593	(1)
Prokinetics	593	(3)
29 Drugs That Affect the Lower Gastrointestinal Tract	596	(21)
Physiology of Flatulence	596	(1)
Antiflatulents	596	(2)
Carminatives	596	(1)
Simethicone	597	(1)
Charcoal	597	(1)
Physiology of Fecal Elimination	598	(1)
Disturbances of Fecal Elimination	598	(1)
Laxatives	599	(10)
Irritant (and Vegetable) Laxatives	599	(4)
Hyperosmotic Laxatives	603	(1)
Bulk-Forming Laxatives	604	(1)
Lubricant Laxatives	604	(1)
Stool Softeners	605	(4)
Physiology of Diarrhea	609	(1)
Causes of Diarrhea	609	(1)
Antidiarrheal Agents	610	(5)
Fluid and Electrolyte Solutions	610	(1)
Lactobacillus acidophilus	610	(1)
Bismuth Subsalicylate	610	(2)
Anticholinergics	612	(1)
Demulcents and Protectives	612	(1)
Adsorbents	612	(1)
Astringents	612	(1)
Opioids	612	(3)
Antiinflammatory Drugs for Gastrointestinal Disease	615	(2)
Unit IX Drugs Affecting the Endocrine System	617	(122)
30 Drugs That Regulate Steroidal Hormone Levels	618	(34)
Hormones	618	(1)
Steroid Hormones	618	(32)
Steroidal Functions	619	(1)
Steroidal Actions	619	(1)
Kinds of Steroids	619	(1)
Pathophysiology of Significant Hormone Deficiencies	619	(1)
Glucocorticoids	620	(11)
Mineralocorticoids	631	(3)
Male Sex Hormones	634	(7)
Female Sex Hormones	641	(9)
Steroid Hormone Antagonists	650	(2)
Spironolactone	650	(1)
Male Hormone Antagonists	650	(1)
Antiestrogens	650	(2)
31 Drugs That Affect Sexual Behavior and Reproduction	652	(28)
Reproductive Systems	652	(8)
Growth and Development	652	(1)
Adult Sexual Cycles	652	(3)
Delayed Maturation	655	(1)
Impaired Sexual Response	655	(1)
Hormone Deficiency in Older Adults	655	(3)
Premenstrual Syndrome	658	(2)
Dysmenorrhea and Drug Treatment	660	(1)
Drugs That Affect Sexuality	660	(5)
Aphrodisiacs	660	(5)
Anaphrodisiacs	665	(1)
Drugs That Treat Sexual Problems	665	(2)
Effects of Toxic Materials	665	(2)
Drugs That Prevent Conception	667	(9)
Male Contraceptive Measures	667	(1)
Female Contraceptive Measures	667	(9)
Infertility and Fertility Drugs	676	(4)
Male Infertility	676	(1)
Female Infertility	676	(4)
32 Drugs That Regulate Blood Glucose Levels	680	(25)
Protein Hormones	680	(14)
Insulin	680	(1)
Exogenous Insulin Preparations	681	(2)
Pharmacology of Insulin	683	(11)
Oral Hypoglycemics	694	(6)
Sulfonylureas	694	(6)
Biguanides	700	(1)
Hyperglycemics	700	(5)
Acarbose	700	(1)
Glucagon	701	(3)
Miscellaneous Hyperglycemic Agents	704	(1)
33 Drugs That Affect the Thyroid, Parathyroid, Pituitary and Hypothalamic Glands	705	(34)
Physiology	705	(1)
Pathophysiology	705	(1)
Thyroid Hormone and Drugs Affecting Thyroid Function	706	(16)
Iodinated Thyroid Hormones	706	(2)
Antithyroid Drugs	708	(2)
Iodine	710	(2)
Radioactive Iodine	712	(10)
Calcitonin	722	(3)
Parathyroid Hormone (Parathormone)	725	(1)
Physiology	725	(1)
Pathophysiology	725	(1)
Adrenohypophyseal Hormones and Related Substances	726	(9)
Corticotropin	727	(5)
Growth Hormone	732	(2)
Growth Hormone Antagonist	734	(1)
Thyrotropin	734	(1)
Hypothalamic Hormones	735	(4)
Antidiuretic Hormones	735	(3)
Oxytocin	738	(1)
Unit X Drugs Affecting the Immune System	739	(72)
34 Drugs That Control Allergies	740	(14)
Pathophysiology of Allergies	740	(3)
Components and Contributors to Allergic Reactions	740	(1)
Allergic Signs and Symptoms	741	(1)
Clinical Manifestations	742	(1)
Allergy Treatments	743	(11)
Drug Therapy	743	(1)
Antihistamines	744	(1)
Corticosteroids and Topical Preparations	745	(3)
Immunotherapy	748	(6)
35 Drugs That Moderate the Immune System	754	(25)
Physiology of the Immune System	754	(1)
Kinds of Immunity	754	(1)
Pathophysiology of the Immune System	755	(9)
Hypersensitivity	755	(1)
Autoimmunity	755	(1)
Deficiencies	755	(1)
Rejection Reactions	755	(1)
Cancer	755	(1)
Immunopotentiators	755	(1)
Vaccines and Toxoids for Children	755	(6)
Immunizations for Adults	761	(1)
Antitoxins and Antivenins	761	(1)
Immune Serums	762	(2)
Biologic Response Modifiers	764	(8)
Monoclonal Antibodies	764	(1)
Cytokines	765	(7)
Tumor Necrosis Factor	772	(1)
Immunosuppressants	772	(7)
Azathioprine	772	(1)
Cyclosporine	773	(2)
Tacrolimus	775	(1)
Monoclonal Antibodies	775	(1)
Antithymocyte Globulin	775	(1)
Cytotoxic Drugs	776	(1)
Glucocorticoids	776	(1)
Mycophenolate Mofetil	776	(3)
36 Drugs That Treat Inflammation	779	(32)
Physiology of Inflammation	779	(1)
Pathophysiology of Inflammation	779	(2)
Pathophysiology of Fever	780	(1)
Therapeutic Management of Fever	781	(1)
Drugs Used to Control Fever	781	(1)
Quinine	781	(1)
Dantrolene	781	(1)
Other Modalities for Fever and Related Pain	781	(1)
Drugs Used to Reduce Inflammation and Pain	781	(30)
Nonsteroidal Anti-inflammatory Drugs	781	(19)
Pyrazoles	800	(1)
Para-Aminophenol Derivatives	800	(1)
Gold Compounds	801	(1)
Drugs Used for Gout	802	(2)
Uricosurics	804	(7)
Unit XI Drugs Affecting Other Body Systems	811	(74)
37 Drugs That Affect the Respiratory System	812	(28)
Physiology	812	(1)
Purpose of Respiration	812	(1)
Respiratory Structures	812	(1)
Pathophysiology	813	(2)
Bronchoconstriction	813	(1)
Bronchodilation	814	(1)
Disorders of the Respiratory Tract	815	(3)
Respiratory Failure	815	(1)
Chronic Obstructive Pulmonary Disease	815	(3)
Drug Therapy for Respiratory Disorders	818	(9)
Bronchodilators	819	(1)
Sympathomimetics	819	(4)
Xanthines	823	(4)
Anticholinergics	827	(1)
Other Asthma Drugs	827	(2)
Corticosteroids	827	(1)
Leukotriene Modifiers	828	(1)
Preventive Agents	828	(1)
Drugs That Affect Mucus and Mucous Secretion	829	(2)
Expectorants	829	(1)
Mucolytics	829	(2)
Antitussive Drugs	831	(1)
Codeine	831	(1)
Dextromethorphan	831	(1)
Benzonate	831	(1)
Other Respiratory Drugs	831	(9)
Dornase Alpha	831	(1)
Alpha-1 Antiproteinase	831	(1)
Surfactants	832	(8)
38 Drugs That Affect the Musculoskeletal System	840	(12)
Physiology	840	(1)
Pathophysiology	841	(1)
Peripheral Muscle Spasms	841	(1)
Spasticity From Central Nervous System Damage	841	(1)
Drugs That Relax Skeletal Muscles and Treat Spasticity	841	(11)
Skeletal Muscle Relaxants	842	(2)
Antispasmodic Agents	844	(8)
39 Drugs That Affect the Eyes and Ears	852	(11)
Physiology of the Eye	852	(2)
Common Ophthalmic Medications	854	(6)
Mydriatics and Cycloplegics	854	(1)
Antiglaucoma Agents	855	(1)
Ophthalmic Anti-Infectives	855	(1)
Ophthalmic Anti-inflammatory Drugs	856	(1)
Ophthalmic Anesthetics	857	(1)
Other Ophthalmic Drugs	857	(3)
Topical Otic Medications	860	(1)
Pathophysiology	860	(3)
Otic Anti-Infectives	860	(1)
Otic Analgesics	860	(3)
40 Drugs That Affect the Integumentary System	863	(22)
Pathophysiology of Integumentary Disorders	863	(1)
Acne Vulgaris	863	(1)
Psoriasis	864	(1)
Atopic Dermatitis (Eczema)	864	(1)
Wounds	864	(1)
General Skin Treatment Principles	864	(1)
Preparations for Drying the Skin	864	(1)
Preparations for Moisturizing the Skin	865	(1)
Drugs to Manage Integumentary System Disorders	865	(20)
Topical Glucocorticoids	865	(1)
Systemic Corticosteroids	866	(1)
Retinoids	867	(2)
Cytotoxic and Immunosuppressive Drugs	869	(1)
Antimalarials	869	(1)
Antimicrobials	869	(2)
Antivirals	871	(1)
Antipruritic Agents	871	(3)
Antipsoriasis Drugs	874	(1)
Antiseptics and Germicides	875	(2)
Topical Wound Therapy Agents	877	(1)
Topical Therapy for Burns	877	(2)
Soaps and Shampoos	879	(1)
Sunscreens	880	(1)
Miscellaneous Agents	880	(5)
Unit XII Drugs Affecting Inflammation and Infection	885	(98)
41 Antimicrobial Drugs That Affect Bacterial Cell Wall Synthesis	886	(19)
Introduction to Antimicrobials	887	(1)
Characteristics of the Ideal Antimicrobial	887	(1)
The Use of Antimicrobials	887	(4)
Spectra of Activity	888	(1)
Bacterial Resistance	888	(1)
Adverse Effects	889	(1)
Treatment Failures	890	(1)
Agents Affecting Bacterial Cell Wall Synthesis	891	(14)
Beta-Lactam Antibiotics	892	(10)
Beta-Lactamase Inhibitors	902	(1)
Other Antibiotics Affecting Cell Wall Synthesis	902	(3)
42 Antimicrobial Drugs That Affect Protein Synthesis	905	(16)
Aminoglycosides	905	(6)
Tetracyclines	911	(4)
Macrolides	915	(2)
Chloramphenicol	917	(2)
Spectinomycin	919	(1)
Lincomycin	919	(2)
Clindamycin	920	(1)
43 Other Antimicrobial Drugs	921	(23)
Pathophysiology of Mycobacterial Infections	921	(1)
Antimycobacterial Agents	922	(10)
Isoniazid	922	(2)
Rifampin	924	(1)
Pyrazinamide	924	(1)
Ethambutol Hydrochloride	925	(1)
Streptomycin	925	(1)
Rifabutin	925	(1)
Kanamycin	926	(1)
Aminosalicylate Sodium	926	(1)
Capreomycin Sulfate	926	(1)
Cycloserine	927	(1)
Ethionamide	928	(1)
Dapsone	928	(1)
Clofazimine	929	(3)
Miscellaneous Antimicrobials	932	(2)
Colistin	932	(1)
Polymyxin B	933	(1)
Pathophysiology of Urinary Tract Infection	934	(1)
Urinary Tract Anti-Infectives	935	(9)
Quinolones	935	(1)
Fluoroquinolones	935	(1)
Methenamine	935	(3)
Nitrofurantoin	938	(1)
Phenazopyridine	939	(1)
Trimethroprim	939	(1)
Sulfonamides	939	(5)
44 Drugs That Treat Viral and Fungal Infections	944	(19)
Pathophysiology of Viral Infections	944	(1)
Antiviral Agents, Vaccines, and Interferons	944	(1)
Antiviral Anti-Infectives	945	(7)
Acyclovir	945	(3)
Ganciclovir	948	(1)
Amantadine	949	(1)
Zidovudine	949	(1)
Ribavirin	950	(2)
Pathophysiology of Fungal Infections	952	(1)
Antifungal Anti-Infectives	952	(11)
Clotrimazole	952	(1)
Ketoconazole	953	(2)
Miconazole	955	(1)
Fluconazole	955	(1)
Itraconazole	956	(1)
Griseofulvin	956	(1)
Nystatin	957	(1)
Amphotericin B	957	(1)
Flucytosine	958	(1)
Terbinafine	959	(4)
45 Drugs That Treat Parasitic and Helminthic Infections	963	(20)
Pathophysiology of Parasitic Infections	963	(1)
Lyme Disease	964	(1)
Protozoan Infections	964	(11)
Malaria	964	(5)
Amebiasis	969	(4)
Miscellaneous Protozoan Infections	973	(2)
Helminthic Infestations	975	(8)
Antihelminthic Drugs	975	(8)
Unit XIII Drugs Affecting Neoplastic Disease	983	(66)
46 Chemotherapeutic Drugs: Alkylating Agents and Antimetabolites	984	(36)
Pathophysiology of Cancer	984	(1)
Cancer Therapy	984	(1)
Chemotherapy and Factors Influencing Its Effectiveness	984	(3)
Cell Cycle Concepts	985	(1)
Cell Kinetics	986	(1)
Growth Rate Fraction	986	(1)
Resistance	986	(1)
Toxicity	987	(1)
Therapeutic Strategies With Chemotherapy	987	(5)
Types of Chemotherapy	987	(2)
Routes of Drug Administration	989	(3)
Specific Chemotherapeutic Agents	992	(28)
Alkylating Agents	992	(7)
Antimetabolites	999	(21)
47 Other Anticancer Drugs: Natural Products, Hormones and Antineoplastics	1020	(29)
Natural Products	1020	(15)
Topoisomerase Inhibitors	1020	(1)
Topoisomerase I Inhibitors	1020	(1)
Topoisomerase II Inhibitors	1020	(4)
Mitotic Inhibitors or Vinca Alkaloids	1024	(4)
Antitumor Antibiotics	1028	(5)
Enzymes	1033	(1)
Taxanes	1034	(1)
Hormones	1035	(7)
Adrenocorticosteroids	1035	(3)
Androgens and Estrogens	1038	(2)
Antihormonal and Antiadrenal Agents	1040	(1)
Antiandrogenic Compounds	1040	(1)
Antiestrogenic Compounds	1040	(2)
Gonadotropin-Releasing Hormone Analogs	1042	(1)
Biologic Response Modifiers	1042	(1)
Miscellaneous Agents	1043	(6)
Analog of Somatostatin	1043	(1)
Anastrozole	1044	(1)
Cladribine	1044	(1)
Hydroxyurea	1044	(1)
Levamisole	1044	(1)
Mitotane	1044	(1)
Porfimer Sodium	1045	(1)
Procarbazine	1045	(1)
Tretinoin	1045	(4)
Unit XIV Miscellaneous Drug Families	1049	(66)
48 Parenteral Supplements	1050	(18)
Parenteral Fluids	1050	(18)
Clear Solutions	1050	(8)
Total Parenteral Nutrition	1058	(4)
Blood	1062	(1)
Physiology	1063	(1)
Pathophysiology	1063	(5)
49 Oral Nutritional Supplements	1068	(27)
Nutritional Agents	1068	(1)
Vitamins	1068	(10)
Role of Vitamins	1068	(2)
Vitamin Deficiencies	1070	(1)
Kinds of Vitamins	1070	(2)
Therapeutic Uses	1072	(1)
Preparations	1072	(1)
Adverse Effects	1073	(1)
Drug-Vitamin Interactions	1074	(1)
Responsible Use	1074	(4)
Minerals	1078	(13)
Role of Minerals	1078	(1)
Mineral Deficiencies	1078	(1)
Mineral Actions	1078	(6)
Pharmacokinetic Parameters	1084	(1)
Therapeutic Uses	1085	(1)
Preparations	1085	(1)
Adverse Effects	1085	(1)
Responsible Use	1086	(1)
Health Food Products	1091	(4)
Amino Acids	1091	(2)
Lipids	1093	(1)
Unrefined Products	1093	(2)
50 Diagnostic Drugs	1095	(20)
Ionizing Radiation	1095	(1)
Radiopaque Contrast Media	1096	(5)
Barium Sulfate	1096	(2)
Iodinated Contrast Media	1098	(3)
Agents Used for Volumetric Testing	1101	(8)
Nonradioactive Compounds	1102	(3)
Radioactive Tracers	1105	(4)
Provocative Agents	1109	(3)
Dermal Reactivity Indicators	1112	(3)
APPENDIX A FDA Pregnancy Risk Categories	1115	(1)
APPENDIX B MedWatch	1116	(2)
APPENDIX C Enzymes and Drugs Affecting Enzymes	1118	(3)
Glossary	1121	(6)
Index	1127	(59)
Selected Internet Sites Related to Pharmacology and Drug Therapy	1186