Lehne’s Pharmacotherapeutics for Advanced Practice Nurses and Physician Assistants, 2nd Edition
By Laura D. Rosenthal and Jacqueline Rosenjack Burchum
Table of Contents:
Cover image
Title Page
Copyright
Dedication
Acknowledgments
About the Authors
Contributor and Reviewers
Preface
Laying Foundations in Basic Principles
Reviewing Physiology and Pathophysiology
Teaching Through Prototypes
Using Clinical Reality to Prioritize Content
Special Features
Teaching Supplements for Instructors
Student Resources
Ways to Use This Textbook
Unit I Introduction
1 Prescriptive Authority
Abstract
What Is Prescriptive Authority?
Prescriptive Authority Regulations
The Case for Full Prescriptive Authority
Prescriptive Authority and Responsibility
2 Rational Drug Selection and Prescription Writing
Abstract
Responsibility of Prescribing
Drug Selection
Prescriptions
Assistance
3 Promoting Positive Outcomes of Drug Therapy
Abstract
Medication Education
Monitoring
Adherence
Managing Medication Therapy
Summary
Unit II Basic Principles of Pharmacology
4 Pharmacokinetics, Pharmacodynamics, and Drug Interactions
Abstract
Pharmacokinetics
Pharmacodynamics
Drug Interactions
5 Adverse Drug Reactions and Medication Errors
Abstract
Adverse Drug Reactions
Medication Errors
6 Individual Variation in Drug Responses
Abstract
Body Weight and Composition
Age
Pathophysiology
Tolerance
Placebo Effect
Variability in Absorption
Genetics and Pharmacogenomics
Gender- and Race-Related Variations
Comorbidities and Drug Interactions
7 Genetic and Genomic Considerations in Pharmacotherapeutics
Abstract
Pharmacogenomics
Application of Pharmacogenomics
Barriers to Pharmacogenomic Application in Practice
Implications and Ethics
Guidelines
Unit III Drug Therapy Across the Life Span
8 Drug Therapy During Pregnancy and Breastfeeding
Abstract
Drug Therapy During Pregnancy: Basic Considerations
Drug Therapy During Pregnancy: Teratogenesis and Other Risks
Drug Therapy During Breastfeeding
9 Drug Therapy in Pediatric Patients
Abstract
Pharmacokinetics: Neonates and Infants
Pharmacokinetics: Children 1 Year and Older
Adverse Drug Reactions
Dosage Determination
Promoting Adherence
10 Drug Therapy in Geriatric Patients
Abstract
Pharmacokinetic Changes in Older Adults
Pharmacodynamic Changes in Older Adults
Adverse Drug Reactions and Drug Interactions
Promoting Adherence
Considerations for End-of-Life Care
Unit IV Peripheral Nervous System Drugs
11 Basic Principles of Neuropharmacology
Abstract
How Neurons Regulate Physiologic Processes
Basic Mechanisms by Which Neuropharmacologic Agents Act
Multiple Receptor Types and Selectivity of Drug Action
An Approach to Learning About Peripheral Nervous System Drugs
12 Physiology of the Peripheral Nervous System
Abstract
Divisions of the Nervous System
Overview of Autonomic Nervous System Functions
Autonomic Nervous System Regulation of Physiologic Processes
Anatomic Considerations
Transmitters of the Peripheral Nervous System
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
13 Muscarinic Agonists and Cholinesterase Inhibitors
Abstract
Introduction to Cholinergic Drugs
Muscarinic Agonists
Cholinesterase Inhibitors
14 Muscarinic Antagonists
Abstract
Introduction to Anticholinergic Drugs
Muscarinic Antagonists (Anticholinergic Drugs)
Abstract
Mechanisms of Adrenergic Receptor Activation
Overview of the Adrenergic Agonists
Therapeutic Applications and Adverse Effects of Adrenergic
Receptor Activation
Properties of Representative Adrenergic Agonists
16 Adrenergic Antagonists
Abstract
α-Adrenergic Antagonists
β-Adrenergic Antagonists
17 Indirect-Acting Antiadrenergic Agents
Abstract
Centrally Acting α2 Agonists
Unit V Central Nervous System Drugs
18 Introduction to Central Nervous System Pharmacology
Abstract
Transmitters of the Central Nervous System
The Blood–Brain Barrier
How Central Nervous System Drugs Produce Therapeutic Effects
Adaptation of the Central Nervous System to Prolonged Drug
Exposure
Development of New Psychotherapeutic Drugs
Approaching the Study of Central Nervous System Drugs
19 Drugs for Parkinson Disease
Abstract
The Pathophysiology Underlying Motor Symptoms
Overview of Motor Symptom Management
Pharmacology of the Drugs Used for Motor Symptoms
Nonmotor Symptoms and Their Management
20 Drugs for Alzheimer Disease
Abstract
Pathophysiology of Alzheimer Disease
Risk Factors and Symptoms
Drugs for Cognitive Impairment
21 Drugs for Seizure Disorders
Abstract
Generation of Seizures
Types of Seizures
How Antiseizure Drugs Work
Basic Therapeutic Considerations
Classification of Antiseizure Drugs
Traditional Antiseizure Drugs
Newer Antiseizure Drugs
Management of Generalized Convulsive Status Epilepticus
22 Drugs for Muscle Spasm and Spasticity
Abstract
Drugs for Spasticity
Drugs for Localized Muscle Spasm
Cyclobenzaprine
Unit VI Drugs for Pain
23 Local Anesthetics
Abstract
Basic Pharmacology of the Local Anesthetics
Properties of Individual Local Anesthetics
Clinical Use of Local Anesthetics
24 Opioid Analgesics, Opioid Antagonists, and Nonopioid Centrally Acting
Analgesics
Abstract
Opioid Analgesics
Basic Pharmacology of the Opioids
Opioid Antagonists
Nonopioid Centrally Acting Analgesic—Tramadol
Prescribing Opioids for Chronic, Noncancer Pain During a National
Opioid Crisis
25 Drugs for Headache
Abstract
Migraine Headache
Cluster Headaches
Medication Overuse Headache
Unit VII Psychotherapeutic Drugs
26 Antipsychotic Agents and Their Use in Schizophrenia
Abstract
Schizophrenia: Clinical Presentation and Etiology
First-Generation (Conventional) Antipsychotics
Second-Generation (Atypical) Antipsychotics
Depot Antipsychotic Preparations
Management of Schizophrenia
27 Antidepressants
Abstract
Major Depression: Clinical Features, Pathogenesis, and Treatment
Overview
Drugs Used for Depression
Peripartum Depression
28 Drugs for Bipolar Disorder
Abstract
Characteristics of Bipolar Disorder
Treatment of Bipolar Disorder
Mood-Stabilizing Drugs
Antipsychotic Drugs
29 Sedative-Hypnotic Drugs
Abstract
Benzodiazepines
Benzodiazepine-Like Drugs
Ramelteon: a Melatonin Agonist
Suvorexant: an Orexin Antagonist
Barbiturates
Management of Insomnia
Other Hypnotics
30 Management of Anxiety Disorders
Abstract
Generalized Anxiety Disorder
Panic Disorder
Obsessive-Compulsive Disorder
Social Anxiety Disorder
Posttraumatic Stress Disorder
31 Central Nervous System Stimulants and Attention-Deficit/Hyperactivity
Disorder
Abstract
Central Nervous System Stimulants
Attention-Deficit/Hyperactivity Disorder
Unit VIII Substance Use Disorders
32 Substance Use Disorders I
Abstract
Definitions
Diagnostic Criteria for Substance Use Disorder
Factors That Contribute to Substance Use Disorder
Neurobiology of Substance Use Disorders
Principles of Substance Use Disorder Treatment
Controlled Substances Act
33 Substance Use Disorders II
Abstract
Basic Pharmacology of Alcohol
Alcohol Use Disorder
Drugs for Alcohol Use Disorder
34 Substance Use Disorders III
Abstract
Basic Pharmacology of Nicotine
Pharmacologic Aids to Smoking Cessation
35 Substance Use Disorders IV
Abstract
Heroin, Oxycodone, and Other Opioids
Kratom
General Central Nervous System Depressants
Psychostimulants
Marijuana and Related Preparations
Psychedelics
Dextromethorphan
3,4-Methylenedioxymethamphetamine (MDMA, Ecstasy)
Inhalants
Anabolic Steroids
Unit IX Drugs That Affect the Heart, Blood Vessels, Blood, and
Blood Volume
36 Review of Hemodynamics
Abstract
Overview of the Circulatory System
Regulation of Cardiac Output
Regulation of Arterial Pressure
37 Diuretics
Abstract
Review of Renal Anatomy and Physiology
Introduction to Diuretics
Loop Diuretics
Thiazides and Related Diuretics
Potassium-Sparing Diuretics
38 Drugs Acting on the Renin-Angiotensin-Aldosterone System
Abstract
Physiology of the Renin-Angiotensin-Aldosterone System
Angiotensin-Converting Enzyme Inhibitors
Angiotensin II Receptor Blockers
Aliskiren, a Direct Renin Inhibitor
Aldosterone Antagonists
39 Calcium Channel Blockers
Abstract
Calcium Channels: Physiologic Functions and Consequences of
Blockade
Calcium Channel Blockers: Classification and Sites of Action
Nondihydropyridines—Verapamil and Diltiazem: Agents That Act on
Vascular Smooth Muscle and the Heart
Dihydropyridines: Agents That Act Mainly on Vascular Smooth
Muscle
40 Vasodilators
Abstract
Basic Concepts in Vasodilator Pharmacology
Pharmacology of Individual Vasodilators
41 Drugs for Hypertension
Abstract
Basic Considerations in Hypertension
Management of Chronic Hypertension
Drugs for Hypertensive Disorders of Pregnancy
42 Drugs for Heart Failure
Abstract
Pathophysiology of Heart Failure
Overview of Drugs Used to Treat Heart Failure
Digoxin, a Cardiac Glycoside
Management of Heart Failure
43 Antidysrhythmic Drugs
Abstract
Introduction to Cardiac Electrophysiology, Dysrhythmias, and the
Antidysrhythmic Drugs
Pharmacology of the Antidysrhythmic Drugs
44 Prophylaxis of Atherosclerotic Cardiovascular Disease
Abstract
Cholesterol
Plasma Lipoproteins
Role of Low-Density Lipoprotein Cholesterol in Atherosclerosis
2018 American College of Cardiology/American Heart Association
Guideline on The Management of Blood Cholesterol
Drugs and Other Products Used to Improve Plasma Lipid Levels
Monoclonal Antibodies (Proprotein Convertase Subtilisin/Kexin Type
9 [PCSK9] Inhibitors)
45 Drugs for Angina Pectoris
Abstract
Angina Pectoris: Pathophysiology and Treatment Strategy
Organic Nitrates
β Blockers
Calcium Channel Blockers
Ranolazine
Treatment Measures
46 Anticoagulant and Antiplatelet Drugs
Abstract
Coagulation: Physiology and Pathophysiology
Overview of Drugs for Thromboembolic Disorders
Anticoagulants
Direct Oral Anticoagulants
Antiplatelet Drugs
47 Drugs for Deficiency Anemias
Abstract
Red Blood Cell Development
Iron Deficiency
Vitamin B12 Deficiency
Folic Acid Deficiency
Unit X Drugs for Endocrine Disorders
48 Drugs for Diabetes Mellitus
Abstract
Diabetes Mellitus: Basic Considerations
Insulin
Noninsulin Medications for the Treatment of Diabetes
49 Drugs for Thyroid Disorders
Abstract
Thyroid Physiology
Thyroid Function Tests
Thyroid Pathophysiology
Thyroid Hormone Preparations for Hypothyroidism
Drugs for Hyperthyroidism
Unit XI Women’s Health
50 Estrogens and Progestins
Abstract
The Menstrual Cycle
Estrogens
Phytoestrogens
Selective Estrogen Receptor Modulators
Progestins
Menopausal Hormone Therapy
Drug Therapy for Transgender Women
Management of Female Sexual Interest-Arousal Disorder
51 Birth Control
Abstract
Effectiveness of Birth Control Methods
Selecting a Birth Control Method
Oral Contraceptives
Combination Contraceptives With Novel Delivery Systems
Long-Acting Contraceptives
Spermicides
Emergency Contraception
Drugs for Medical Abortion
Unit XII Men’s Health
52 Androgens
Abstract
Testosterone
Clinical Pharmacology of the Androgens
Androgen (Anabolic Steroid) Abuse
53 Male Sexual Dysfunction and Benign Prostatic Hyperplasia
Abstract
Male Sexual Dysfunction
Erectile Dysfunction
Premature Ejaculation
Benign Prostatic Hyperplasia
Unit XIII Antiinflammatory, Antiallergic, and Immunologic
Drugs
54 Review of the Immune System
Abstract
Introduction to the Immune System
Antibody-Mediated (Humoral) Immunity
Cell-Mediated Immunity
55 Childhood Immunization
Abstract
General Considerations
Target Diseases
Specific Vaccines and Toxoids
56 Antihistamines
Abstract
Histamine
The Two Types of Antihistamines: Histamine-1 Antagonists and
Histamine-2 Antagonists
57 Cyclooxygenase Inhibitors
Abstract
Mechanism of Action
Classification of Cyclooxygenase Inhibitors
First-Generation Nonsteroidal Antiinflammatory Drugs
Second-Generation Nonsteroidal Antiinflammatory Drugs
(Cyclooxygenase-2 Inhibitors, Coxibs)
Acetaminophen
American Heart Association Statement on Cyclooxygenase Inhibitors
in Chronic Pain
58 Glucocorticoids in Nonendocrine Disorders
Abstract
Review of Glucocorticoid Physiology
Pharmacology of Glucocorticoids
Unit XIV Drugs for Bone and Joint Disorders
59 Drug Therapy of Rheumatoid Arthritis
Abstract
Pathophysiology of Rheumatoid Arthritis
Overview of Therapy
Nonsteroidal Antiinflammatory Drugs
Glucocorticoids
Conventional Disease-Modifying Antirheumatic Drugs
Biologic Disease-Modifying Antirheumatic Drugs
Targeted Disease-Modifying Antirheumatic Drug: Janus Kinase
Inhibitors
60 Drug Therapy for Gout
Abstract
Pathophysiology of Gout
Overview of Drug Therapy
Drugs for Acute Gouty Arthritis
Drugs for Hyperuricemia (Urate-Lowering Therapy)
Pharmacologic Management of Gout
61 Drugs Affecting Calcium Levels and Bone Mineralization
Abstract
Calcium Physiology
Calcium-Related Pathophysiology
Drugs for Disorders Involving Calcium and Bone Mineralization
Osteoporosis
Unit XV Respiratory Tract Drugs
62 Drugs for Asthma and Chronic Obstructive Pulmonary Disease
Abstract
Basic Considerations
Antiinflammatory Drugs
Bronchodilators
Combination Drugs
Management of Asthma
Management of Chronic Obstructive Pulmonary Disease
63 Drugs for Allergic Rhinitis, Cough, and Colds
Abstract
Drugs for Allergic Rhinitis
Drugs for Cough
Cold Remedies: Combination Preparations
Unit XVI Gastrointestinal Drugs
64 Drugs for Peptic Ulcer Disease
Abstract
Pathogenesis of Peptic Ulcers
Overview of Treatment
Antibacterial Drugs
Histamine-2 Receptor Antagonists
Proton Pump Inhibitors
Other Antiulcer Drugs
65 Laxatives
Abstract
General Considerations
Basic Pharmacology of Laxatives
Laxative Abuse
66 Other Gastrointestinal Drugs
Abstract
Antiemetics
Drugs for Motion Sickness
Antidiarrheal Agents
Drugs for Irritable Bowel Syndrome
Drugs for Inflammatory Bowel Disease
Prokinetic Agents
Pancreatic Enzymes
Anorectal Preparations
Unit XVII Nutrition and Complementary Therapies
67 Vitamins
Abstract
Basic Considerations
Fat-Soluble Vitamins
Water-Soluble Vitamins
68 Drugs for Weight Loss
Abstract
Assessment of Weight-Related Health Risk
Pathophysiology
Overview of Obesity Treatment
Weight-Loss Drugs
A Note Regarding Drugs for Weight Loss
69 Complementary and Alternative Therapy
Abstract
Regulation of Dietary Supplements
Private Quality Certification Programs
Standardization of Herbal Products
Adverse Interactions With Conventional Drugs
Some Commonly Used Dietary Supplements
Harmful Supplements to Avoid
Unit XVIII Therapy of Infectious and Parasitic Diseases
70 Basic Principles of Antimicrobial Therapy
Abstract
Selective Toxicity
Classification of Antimicrobial Drugs
Acquired Resistance to Antimicrobial Drugs
Selection of Antibiotics
Host Factors That Modify Drug Choice, Route of Administration, or
Dosage
Dosage and Duration of Treatment
Therapy With Antibiotic Combinations
Prophylactic Use of Antimicrobial Drugs
Misuses of Antimicrobial Drugs
Monitoring Antimicrobial Therapy
71 Drugs That Weaken the Bacterial Cell Wall I
Abstract
Introduction to the Penicillins
Properties of Individual Penicillins
72 Drugs That Weaken the Bacterial Cell Wall II
Abstract
Cephalosporins
Carbapenems
Other Inhibitors of Cell Wall Synthesis
73 Bacteriostatic Inhibitors of Protein Synthesis
Abstract
Tetracyclines
Macrolides
Other Bacteriostatic Inhibitors of Protein Synthesis
74 Aminoglycosides
Abstract
Basic Pharmacology of the Aminoglycosides
Properties of Individual Aminoglycosides
75 Sulfonamide Antibiotics and Trimethoprim
Abstract
Sulfonamides
Trimethoprim
Trimethoprim/Sulfamethoxazole
76 Drug Therapy of Urinary Tract Infections
Abstract
Organisms That Cause Urinary Tract Infections
Specific Urinary Tract Infections and Their Treatment
Urinary Tract Antiseptics
77 Drug Therapy for Tuberculosis
Abstract
Pathogenesis of Tuberculosis
Overview of Treatment
Treatment of Latent Tuberculosis
Vaccination Against Tuberculosis
Pharmacology of Individual Antituberculosis Drugs
Ethambutol
Second-Line Antituberculosis Drugs
78 Miscellaneous Antibacterial Drugs
Abstract
Fluoroquinolones
Additional Antibacterial Drugs
79 Antifungal Agents
Abstract
Drugs for Systemic Mycoses
Drugs for Superficial Mycoses
80 Antiviral Agents I
Abstract
Drugs for Infection With Herpes Simplex Viruses and Varicella Zoster
Virus
Drugs for Cytomegalovirus Infection
Drugs for Hepatitis C
Drugs for Hepatitis B
Drugs for Influenza
81 Antiviral Agents II
Abstract
82 Drug Therapy for Sexually Transmitted Diseases
Abstract
Chlamydia Trachomatis Infections
Gonococcal Infections
Nongonococcal Urethritis
Pelvic Inflammatory Disease
Acute Epididymitis
Syphilis
Bacterial Vaginosis
Trichomoniasis
Chancroid
Herpes Simplex Virus Infections
Proctitis
Anogenital Warts
83 Anthelmintics
Abstract
Classification of Parasitic Worms
Helminthic Infestations
Drugs of Choice for Helminthiasis
Unit XIX Cancer Therapy
84 Introduction to Immunomodulators
Abstract
Monoclonal Antibodies “Mabs”
Monoclonal Antibodies for Asthma
Monoclonal Antibodies for Infectious Disease—Clostridium Difficile
Monoclonal Antibodies for Migraine Prevention
Common Adverse Reactions to Monoclonal Antibodies
Tyrosine Kinase Inhibitors “Nibs”
Proteasome Inhibitors “Mibs”
Immunotherapy of the Future
85 Anticancer Drugs for the Nonspecialist
Abstract
The Role of the Nonspecialist
What Is Cancer?
Treatment of Cancer
Introduction to the Cytotoxic Anticancer Drugs
Cytotoxic Agents
Hormonal Agents, Targeted Drugs, and Other Noncytotoxic
Anticancer Drugs
Chemoprevention and Cancer Immunotherapy
86 Pain Management in Patients With Cancer
Abstract
Pain in Cancer Patients
Management Strategy
Assessment and Ongoing Evaluation
Drug Therapy
Nondrug Therapy
Patient Education
Unit XX Drugs for Eyes, Ears, and Skin
87 Drugs for the Eye
Abstract
Glaucoma
Allergic Conjunctivitis
Additional Ophthalmic Drugs
88 Drugs for the Skin
Abstract
Anatomy of the Skin
Topical Drug Formulations
Acne
Sunscreens
Drugs for Atopic Dermatitis (Eczema)
Agents for Wart Removal
Drugs for Miscellaneous Skin Conditions
89 Drugs for the Ear
Abstract
Otitis Media and Its Management
Otitis Media With Effusion
Acute Otitis Externa
Unit XXI Drug Therapy in Acute Care
90 Agents Affecting the Volume and Ion Content of Body Fluids
Abstract
Disorders of Fluid Volume and Osmolality
Acid–Base Disturbances
Magnesium Imbalances
91 Management of ST-Segment Elevation Myocardial Infarction
Abstract
Pathophysiology of STEMI
Management of ST-Segment Elevation Myocardial Infarction
Complications of STEMI
Secondary Prevention of STEMI
92 Drugs for Acute Care
Abstract
Anesthesia, Neuromuscular Blockers, and Analgesia
Cardiology
Hematology
Nephrology
Appendix A Canadian Drug Information
Canadian Drug Legislation
Drug Advertising
International System of Units
Drug Serum Concentrations
References
Index