Lehne's Pharmacology for Nursing Care - E-Book , livre ebook

Lehne's Pharmacology
for Nursing Care
9TH EDITION
Jacqueline Rosenjack Burchum, DNSc, FNP-BC,
CNE
Associate Professor, College of Nursing
Department of Advanced Practice and Doctoral Studies
University of Tennessee Health Science Center
Memphis, Tennessee
Laura D. Rosenthal, RN, DNP, ACNP-BC
Assistant Professor, College of Nursing
Assistant Professor, School of Medicine
University of Colorado, Anschutz Medical Campus
Denver, Colorado
In consultation with
Beth Outland Jones, PharmD
Clinical Pharmacist
Missouri Baptist Medical Center
St. Louis, Missouri
Joshua J. Neumiller, PharmD, CDE, FASCP
Assistant Professor of Pharmacotherapy
Washington State University
Spokane, WashingtonTable of Contents
Cover image
Title Page
Copyright
Dedication
About the Authors
Contributors and Reviewers
Preface
Laying Foundations in Basic Principles
Reviewing Physiology and Pathophysiology
Teaching Through Prototypes
Using Clinical Reality to Prioritize Content
Nursing Implications: Demonstrating the Application of Pharmacology in Nursing
Practice
What's New in the Book?
Learning Supplements for Students
Teaching Supplements for Instructors
Ways to Use This Textbook
Acknowledgments
Unit I Introduction
Chapter 1 Orientation to Pharmacology
Four Basic TermsProperties of an Ideal Drug
The Therapeutic Objective
Factors That Determine the Intensity of Drug Responses
Key Points
Chapter 2 Application of Pharmacology in Nursing Practice
Evolution of Nursing Responsibilities Regarding Drugs
Application of Pharmacology in Patient Care
Application of Pharmacology in Patient Education
Application of the Nursing Process in Drug Therapy
Key Points
Chapter 3 Drug Regulation, Development, Names, and Information
Landmark Drug Legislation
New Drug Development
Drug Names
Over-the-Counter Drugs
Sources of Drug Information
Key Points
Unit II Basic Principles of Pharmacology
Chapter 4 Pharmacokinetics
Application of Pharmacokinetics in Therapeutics
A Note to Chemophobes
Passage of Drugs Across Membranes
Absorption
Distribution
Metabolism
Excretion
Time Course of Drug Responses
Key PointsChapter 5 Pharmacodynamics
Dose-Response Relationships
Drug-Receptor Interactions
Drug Responses That Do Not Involve Receptors
Interpatient Variability in Drug Responses
The Therapeutic Index
Key Points
Chapter 6 Drug Interactions
Drug-Drug Interactions
Drug-Food Interactions
Drug-Supplement Interactions
Key Points
Chapter 7 Adverse Drug Reactions and Medication Errors
Adverse Drug Reactions
Medication Errors
Key Points
Chapter 8 Individual Variation in Drug Responses
Body Weight and Composition
Age
Pathophysiology
Tolerance
Placebo Effect
Variability in Absorption
Genetics and Pharmacogenomics
Gender- and Race-Related Variations
Comorbidities and Drug Interactions
Diet
Failure to Take Medicine as PrescribedKey Points
Unit III Drug Therapy Across the Life Span
Chapter 9 Drug Therapy During Pregnancy and Breast-Feeding
Drug Therapy during Pregnancy: Basic Considerations
Drug Therapy during Pregnancy: Teratogenesis
Drug Therapy during Breast-Feeding
Key Points
Chapter 10 Drug Therapy in Pediatric Patients
Pharmacokinetics: Neonates and Infants
Pharmacokinetics: Children 1 Year and Older
Adverse Drug Reactions
Dosage Determination
Promoting Adherence
Key Points
Chapter 11 Drug Therapy in Geriatric Patients
Pharmacokinetic Changes in Older Adults
Pharmacodynamic Changes in Older Adults
Adverse Drug Reactions and Drug Interactions
Promoting Adherence
Key Points
Unit IV Peripheral Nervous System Drugs
Introduction
Chapter 12 Basic Principles of Neuropharmacology
How Neurons Regulate Physiologic Processes
Basic Mechanisms by Which Neuropharmacologic Agents Act
Multiple Receptor Types and Selectivity of Drug ActionAn Approach to Learning About Peripheral Nervous System Drugs
Key Points
Chapter 13 Physiology of the Peripheral Nervous System
Divisions of the Nervous System
Overview of Autonomic Nervous System Functions
Basic Mechanisms by Which the Autonomic Nervous System Regulates
Physiologic Processes
Anatomic Considerations
Introduction to Transmitters of the Peripheral Nervous System
Introduction to Receptors of the Peripheral Nervous System
Exploring the Concept of Receptor Subtypes
Locations of Receptor Subtypes
Functions of Cholinergic and Adrenergic Receptor Subtypes
Receptor Specificity of the Adrenergic Transmitters
Transmitter Life Cycles
Key Points
Cholinergic Drugs
Chapter 14 Muscarinic Agonists and Antagonists
Introduction to Cholinergic Drugs
Muscarinic Agonists and Antagonists
Chapter 15 Cholinesterase Inhibitors and Their Use in Myasthenia Gravis
Reversible Cholinesterase Inhibitors
Irreversible Cholinesterase Inhibitors
Myasthenia Gravis
Key Points
Summary of Major Nursing Implications*
Chapter 16 Drugs That Block Nicotinic Cholinergic TransmissionControl of Muscle Contraction
Competitive (Nondepolarizing) Neuromuscular Blockers
Depolarizing Neuromuscular Blockers: Succinylcholine
Therapeutic Uses of Neuromuscular Blockers
Key Points
Summary of Major Nursing Implications*
Adrenergic Drugs
Chapter 17 Adrenergic Agonists
Mechanisms of Adrenergic Receptor Activation
Overview of the Adrenergic Agonists
Therapeutic Applications and Adverse Effects of Adrenergic Receptor Activation
Properties of Representative Adrenergic Agonists
Key Points
Summary of Major Nursing Implications
Chapter 18 Adrenergic Antagonists
Alpha-Adrenergic Antagonists
Beta-Adrenergic Antagonists
Chapter 19 Indirect-Acting Antiadrenergic Agents
Centrally Acting Alpha Agonists2
Adrenergic Neuron-Blocking Agents
Key Points
Summary of Major Nursing Implications*
Unit V Central Nervous System Drugs
Introduction
Chapter 20 Introduction to Central Nervous System Pharmacology
Transmitters of the CNSThe Blood-Brain Barrier
How Do CNS Drugs Produce Therapeutic Effects?
Adaptation of the CNS to Prolonged Drug Exposure
Development of New Psychotherapeutic Drugs
Approaching the Study of CNS Drugs
Key Points
Drugs for Neurodegenerative Disorders
Chapter 21 Drugs for Parkinson's Disease
Pathophysiology That Underlies Motor Symptoms
Overview of Motor Symptom Management
Pharmacology of the Drugs Used for Motor Symptoms
Nonmotor Symptoms and Their Management
Key Points
Summary of Major Nursing Implications*
Chapter 22 Drugs for Alzheimer's Disease
Pathophysiology
Risk Factors and Symptoms
Drugs for Cognitive Impairment
Drugs for Neuropsychiatric Symptoms
Can We Prevent Alzheimer's Disease or Delay Cognitive Decline?
Key Points
Chapter 23 Drugs for Multiple Sclerosis
Overview of MS and Its Treatment
Disease-Modifying Drugs I: Immunomodulators
Disease-Modifying Drugs II: Immunosuppressants
Drugs Used to Manage MS Symptoms
Key PointsSummary of Major Nursing Implications*
Neurologic Drugs
Chapter 24 Drugs for Epilepsy
Seizure Generation
Types of Seizures
How Antiepileptic Drugs Work
Basic Therapeutic Considerations
Classification of Antiepileptic Drugs
Traditional Antiepileptic Drugs
Newer Antiepileptic Drugs
Management of Generalized Convulsive Status Epilepticus
Key Points
Summary of Major Nursing Implications*
Chapter 25 Drugs for Muscle Spasm and Spasticity
Drug Therapy of Muscle Spasm: Centrally Acting Muscle Relaxants
Drugs for Spasticity
Key Points
Summary of Major Nursing Implications*
Drugs for Pain
Chapter 26 Local Anesthetics
Basic Pharmacology of the Local Anesthetics
Properties of Individual Local Anesthetics
Clinical Use of Local Anesthetics
Key Points
Summary of Major Nursing Implications*
Chapter 27 General AnestheticsInhalation Anesthetics
Intravenous Anesthetics
Chapter 28 Opioid Analgesics, Opioid Antagonists, and Nonopioid Centrally Acting
Analgesics
Opioid Analgesics
Opioid Antagonists
Nonopioid Centrally Acting Analgesics
Chapter 29 Pain Management in Patients with Cancer
Pathophysiology of Pain
Management Strategy
Assessment and Ongoing Evaluation
Drug Therapy
Nondrug Therapy
Pain Management in Special Populations
Patient Education
The Joint Commission Pain Management Standards
Key Points
Chapter 30 Drugs for Headache
Migraine Headache
Cluster Headaches
Tension-Type Headache
Psychotherapeutic Drugs
Chapter 31 Antipsychotic Agents and Their Use in Schizophrenia
Schizophrenia: Clinical Presentation and Etiology
First-Generation (Conventional) Antipsychotics
Second-Generation (Atypical) Antipsychotics
Depot Antipsychotic PreparationsManagement of Schizophrenia
Chapter 32 Antidepressants
Major Depression: Clinical Features, Pathogenesis, and Treatment Overview
Drugs Used for Depression
Somatic (Nondrug) Therapies for Depression
Chapter 33 Drugs for Bipolar Disorder
Characteristics of Bipolar Disorder
Treatment of Bipolar Disorder
Mood-Stabilizing Drugs
Antipsychotic Drugs
Key Points
Summary of Major Nursing Implications*
Chapter 34 Sedative-Hypnotic Drugs
Benzodiazepines
Benzodiazepine-Like Drugs
Ramelteon: A Melatonin Agonist
Barbiturates
Management of Insomnia
Key Points
Summary of Major Nursing Implications*
Chapter 35 Management of Anxiety Disorders
Generalized Anxiety Disorder
Panic Disorder
Obsessive-Compulsive Disorder
Social Anxiety Disorder (Social Phobia)
Post-Traumatic Stress Disorder
Key PointsChapter 36 Central Nervous System Stimulants and Attention-Deficit/Hyperactivity
Disorder
Central Nervous System Stimulants
Attention-Deficit/Hyperactivity Disorder
Drug Abuse
Chapter 37 Drug Abuse I
Definitions
Diagnostic Criteria Regarding Drugs of Abuse
Factors That Contribute to Drug Abuse
Neurobiology of Addiction
Principles of Addiction Treatment
The Controlled Substances Act
Key Points
Chapter 38 Drug Abuse II
Basic Pharmacology of Alcohol
Alcohol Use Disorder
Drugs for Alcohol Use Disorder
Key Points
Summary of Major Nursing Implications*
Chapter 39 Drug Abuse III
Basic Pharmacology of Nicotine
Pharmacologic Aids to Smoking Cessation
Key Points
Chapter 40 Drug Abuse IV
Heroin, Oxycodone, and Other Opioids
General CNS Depressants
PsychostimulantsMarijuana and Related Preparations
Psychedelics
Dissociative Drugs
Dextromethorphan
3,4-Methylenedioxymethamphetamine (MDMA, Ecstasy)
Inhalants
Anabo