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CONTENTS UNIT I INTRODUCTION TO UNIT VI NEUROLOGIC AND PHARMACOLOGY NEUROMUSCULAR AGENTS 1 Drug Action: Pharmaceutic, Pharmacokinetic, and Pharmacodynamic Phases, 2 20 Central Nervous System Stimulants, 284 2 The Drug Approval Process, 14 21 Central Nervous System Depressants, 291 3 Cultural and Pharmacogenetic 22 Anticonvulsants, 304 Considerations, 21 23 Drugs for Neurologic Disorders: Parkinsonism 4 Drug Interactions and Over-the-Counter and Alzheimer’s Disease, 314 Drugs, 29 24 Drugs for Neuromuscular Disorders: Myasthenia 5 Drugs of Abuse, 41 Gravis, Multiple Sclerosis, and Muscle 6 Herbal Therapies, 61 Spasms, 326 7 Pediatric Pharmacology, 79 8 Geriatric Pharmacology, 88 9 Collaboration in Community Settings, 98 UNIT VII PAIN AND 10 The Role of the Nurse in Drug Research, 105 INFLAMMATION MANAGEMENT AGENTS UNIT II A NURSE’S 25 Antiinflammatory Drugs, 336 PERSPECTIVE OF 26 Nonopioid and Opioid Analgesics, 352 PHARMACOLOGY 11 The Nursing Process in Patient-Centered UNIT VIII PSYCHIATRIC AGENTS Pharmacotherapy, 113 27 Antipsychotics and Anxiolytics, 370 12 Safety and Quality in Pharmacotherapy, 120 28 Antidepressants and Mood Stabilizers, 386 13 Medication Administration, 133 UNIT IX ANTIBACTERIAL AND UNIT III DRUG CALCULATIONS ANTIINFECTIVE AGENTS 14 Medications and Calculations, 148 29 Penicillins and Cephalosporins, 400 30 Macrolides, Tetracyclines, Aminoglycosides, and UNIT IV NUTRITION AND Fluoroquinolones, 414 ELECTROLYTES 31 Sulfonamides, 429 15 Vitamin and Mineral Replacement, 211 16 Fluid and Electrolyte Replacement, 223 UNIT X ADDITIONAL 17 Nutritional Support, 243 ANTIINFECTIVE AGENTS 32 Antituberculars, Antifungals, Peptides, and UNIT V AUTONOMIC NERVOUS Metronidazole, 436 SYSTEM AGENTS 33 Antivirals, Antimalarials, and Anthelmintics, 448 34 Drugs for Urinary Tract Disorders, 460 18 Adrenergic Agonists and Adrenergic Blockers, 255 19 Cholinergic Agonists and Anticholinergics, 268 UNIT XI IMMUNOLOGIC AGENTS UNIT XVII ENDOCRINE AGENTS 35 HIV- and AIDS-Related Drugs, 469 51 Endocrine Drugs: Pituitary, Thyroid, 36 Vaccines, 489 Parathyroid, and Adrenal Disorders, 742 52 Antidiabetics, 758 UNIT XII ANTINEOPLASTIC AGENTS UNIT XVIII REPRODUCTIVE AND GENDER-RELATED 37 Anticancer Drugs, 502 AGENTS 38 Targeted Therapies to Treat Cancer, 530 39 Biologic Response Modifiers, 554 53 Female Reproductive Cycle I: Pregnancy and Preterm Labor Drugs, 777 54 Female Reproductive Cycle II: Labor, Delivery, UNIT XIII RESPIRATORY AGENTS and Preterm Neonatal Drugs, 800 55 Postpartum and Newborn Drugs, 826 40 Drugs for Upper Respiratory Disorders, 573 56 Drugs for Women’s Reproductive Health and 41 Drugs for Lower Respiratory Disorders, 583 Menopause, 845 57 Drugs for Men’s Health and Reproductive UNIT XIV CARDIOVASCULAR Disorders, 873 AGENTS 58 Drugs for Disorders in Women’s Health, Infertility, and Sexually Transmitted 42 Cardiac Glycosides, Antianginals, and Infections, 885 Antidysrhythmics, 601 43 Diuretics, 620 UNIT XIX EMERGENCY AGENTS 44 Antihypertensives, 633 45 Anticoagulants, Antiplatelets, and 59 Adult and Pediatric Emergency Drugs, 909 Thrombolytics, 650 46 Antihyperlipidemics and Peripheral Vasodilators, 664 APPENDIX A Therapeutic Drug Monitoring, 927 UNIT XV GASTROINTESTINAL APPENDIX B AGENTS Selected Potential Weapons of Bioterrorism, 932 47 Drugs for Gastrointestinal Tract Disorders, 676 REFERENCES, 934 48 Antiulcer Drugs, 693 INDEX, 939 UNIT XVI EYE, EAR, AND SKIN AGENTS 49 Drugs for Eye and Ear Disorders, 709 50 Drugs for Dermatologic Disorders, 727 PHARMACOLOGY A Patient-Centered Nursing Process Approach 8e Joyce LeFever Kee, MS, RN Associate Professor Emerita School of Nursing College of Health Sciences University of Delaware Newark, Delaware Evelyn R. Hayes, PhD, MPH, FNP-BC Professor School of Nursing College of Health Sciences University of Delaware Newark, Delaware Linda E. McCuistion, PhD, RN, CNS Professor South University Richmond Campus Richmond, Virginia 3251 Riverport Lane St. Louis, Missouri 63043 PHARMACOLOGY: A PATIENT-CENTERED ISBN: 978-1-4557-5148-8 NURSING PROCESS APPROACH Copyright © 2015, 2012, 2009, 2006, 2003, 2000, 1997, 1993 by Saunders, an imprint of Elsevier Inc. All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or any information storage and retrieval system, without permission in writing from the publisher. Details on how to seek permission, further information about the Publisher’s permissions policies and our arrangements with organizations such as the Copyright Clearance Center and the Copyright Licensing Agency, can be found at our website: www.elsevier. com/permissions. This book and the individual contributions contained in it are protected under copyright by the Publisher (other than as may be noted herein). Notices Knowledge and best practice in this field are constantly changing. As new research and experience broaden our understanding, changes in research methods, professional practices, or medical treatment may become necessary. Practitioners and researchers must always rely on their own experience and knowledge in evaluating and using any information, methods, compounds, or experiments described herein. In using such information or methods they should be mindful of their own safety and the safety of others, including parties for whom they have a professional responsibility. With respect to any drug or pharmaceutical products identified, readers are advised to check the most current information provided (i) on procedures featured or (ii) by the manufacturer of each product to be administered, to verify the recommended dose or formula, the method and duration of administration, and contraindications. It is the responsibility of practitioners, relying on their own experience and knowledge of their patients, to make diagnoses, to determine dosages and the best treatment for each individual patient, and to take all appropriate safety precautions. To the fullest extent of the law, neither the Publisher nor the authors, contributors, or editors, assume any liability for any injury and/or damage to persons or property as a matter of products liability, negligence or otherwise, or from any use or operation of any methods, products, instructions, or ideas contained in the material herein. Library of Congress Cataloging-in-Publication Data Kee, Joyce LeFever, author. Pharmacology : a patient-centered nursing process approach / Joyce LeFever Kee, Evelyn R. Hayes, Linda E. McCuistion ; section editor, Marilyn Herbert-Ashton.—8th edition. p. ; cm. Previous edition has subtitle: “a nursing process approach.” Includes bibliographical references and index. ISBN 978-1-4557-5148-8 (pbk. : alk. paper) I. Hayes, Evelyn R., author. II. McCuistion, Linda E., author. III. Title. [DNLM: 1. Pharmacological Phenomena—Nurses’ Instruction. 2. Drug Therapy—Nurses’ Instruction. 3. Patient-Centered Care—Nurses’ Instruction. 4. Pharmaceutical Preparations—Nurses’ Instruction. QV 4] RM301 615.5′8—dc23 2013038375 Executive Content Strategist: Lee Henderson Content Manager: Jennifer Ehlers Publishing Services Manager: Jeff Patterson Project Manager: Clay S. Broeker Design Direction: Amy Buxton Printed in Canada Last digit is the print number: 9 8 7 6 5 4 3 In loving memory of my parents, Esther B. and Samuel H. LeFever Joyce LeFever Kee In loving memory of my parents, Margaret and Justin Hayes, and in gratitude for the support of my family Evelyn R. Hayes To Dr. Gerald DeLuca for expert guidance, and in memory of my parents, Otto and Pauline Schmidt Linda E. McCuistion MEET THE AUTHORS JOYCE LEFEVER KEE EVELYN R. HAYES Joyce LeFever Kee received her Bach- Evelyn (Lyn) R. Hayes received her elor of Science and Master of Science Bachelor of Science in Nursing from degrees in Nursing from the University Cornell University—New York Hospi- of Maryland and earned 36 postgradu- tal School of Nursing; an MPH in ate credits from the University of Dela- Public Health Nursing from the Uni- ware. She was a distinguished faculty versity of North Carolina, School of educator at the University of Mary- Public Health, in Chapel Hill, North land for 4 years and at the University Carolina; and a PhD in Higher Educa- of Delaware for 27 years. tion from Boston College. In addition, Joyce is a member of the Sigma Theta Tau Nursing Honor she completed a Post Master’s Certificate as Family Nurse Society and Phi Kappa Phi Honor Society. She received the Practitioner at the University of Massachusetts at Amherst Excellence in Teaching Award from and was inducted into the and is a certified family nurse practitioner. Her professional Mentor’s Circle at the University of Delaware. practice experience includes both acute care institutions and Joyce gave numerous lectures and presentations through- the community setting. Currently she is a Professor in the out the United States from 1970 to 1990. She has written School of Nursing, College of Health Sciences, at the Univer- various articles, particularly on fluids and electrolytes, labo- sity of Delaware. In this role, she has vast experience with a ratory and diagnostic tests, and research projects, in the variety of teaching modalities at both the undergraduate and American Journal of Nursing, Nursing Clinics of North America, graduate levels and experience with distance learning. Reflec- Nursing Journal, and Critical Care Quarterly. She has partici- tive of a global focus, Lyn has provided consultation to uni- pated in several research studies on “Identification of Hyper- versity faculty in Taiwan and Panama. tensive Young Adults.” A strong advocate of health promotion, Lyn served as Joyce has authored and coauthored several text and refer- Project Director and co-investigator of a U.S. Public Health ence books, including Fluids and Electrolytes with Clinical Service grant promoting healthy lifestyles in Delaware. She Applications, eighth edition; Handbook of Fluid, Electrolyte, was a finalist for the Excellence in Community Based Nursing and Acid-Base Imbalances, third edition; Clinical Calculations Practice Award sponsored by the Delaware Nurses Associa- in General and Specialty Areas, seventh edition; Laboratory tion and Delaware Organization of Nurse Executives. and Diagnostic Tests with Nursing Implications, ninth edition; As author, coauthor, and collaborative team member, she and Handbook of Laboratory and Diagnostic Tests with Nursing has published in multiple journals. Research interests include Implications, seventh edition. smoking cessation in teens and young adults, online caregiver Joyce and her husband enjoy traveling all over the world. support groups, and the meaning of storytelling of military experience by veterans at end of life. In addition, Lyn has made multiple presentations at regional, national, and inter- national professional meetings. Throughout her career, Lyn has assumed member and leadership positions at various levels within the University of Delaware as well as professional and community organiza- tions. She ably provides long-term service and leadership to Sigma Theta Tau International, the American Nurses Associa- tion, the National League for Nursing Accrediting Commis- sion (NLNAC), and the Delaware Nurses Association. Now a retired colonel in the United States Army Reserve, Lyn’s last assignment was as Principal Reservist to Deputy Commander for Nursing, Walter Reed Army Medical Center, Washington, DC. When at her home base, she enjoys being creative with crafts and spending time with family and friends. vi LINDA E. MCCUISTION in the state of Louisiana. She has served as a legal nurse con- sultant; a member of a medical review panel; advisory board Dr. Linda E. McCuistion received a member, consultant, and reviewer of a software preparation Diploma of Nursing from the Lutheran company focused on the state licensure examination; advi- Hospital School of Nursing in Fort sory board member for a school for surgical technicians; Wayne, Indiana; Bachelor of Science in and consultant to a local hospital to improve the quality of Nursing from William Carey College nursing care and assist acute care facilities in preparation for in Hattiesburg, Mississippi; Masters accreditation. in Nursing from Louisiana State Uni- Linda was chosen as a “Great One Hundred Nurse” by the versity Medical Center; and PhD in New Orleans District Nurses’ Association in 1993. She is also Curriculum and Instruction from the listed in the 2005/2006 edition of the Empire Who’s Who University of New Orleans. She was licensed as an Advanced Executive and Professional Registry. Practice Nurse in Louisiana and has many years of nursing Linda has given numerous lectures and presentations experience, including acute care and home health nursing. regionally and nationally on a variety of nursing topics. She For 20 years, Linda was a Nursing Professor at Our Lady of has published articles in nursing journals and authored many Holy Cross College in New Orleans, Louisiana. She received chapters in several nursing textbooks, including Pharmaco- an Endowed Professorship Award in 2000 and 2003. Linda is therapeutics: Clinical Decision-Making in Nursing (1999), currently a Nursing Professor at South University, Richmond, Saunders Manual of Medical-Surgical Nursing: A Guide for Virginia. Clinical Decision-Making (2002), and the Saunders Nursing Linda has served as a past president, vice president, and Survival Guide: Pathophysiology (2007). She is author and faculty advisor of the Sigma Theta Tau International Honor coauthor of many chapters and co-editor of the Saunders Society in Nursing, Xi Psi chapter-at-large. She is a past asso- Nursing Survival Guide: Pharmacology (2007). ciate editor of the NODNA Times, a New Orleans District Linda enjoys cruises and other travel. When at home, she Nurses’ Association newsletter. She has been a member of Phi enjoys family, friends, crafts, golf, and writing. Delta Kappa and The American Society of Hypertension. Linda was coordinator for the Graduate Plus Internship Program, a preceptorship program for new nursing graduates vii This page intentionally left blank