Polypharmacy
FOURTH EDITION
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T
ORGANIZATION
The Foundation
PREFACE
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Pharmacotherapeutics With Single Drugs
Pharmacotherapeutics With Multiple Drugs
Special Drug Treatment Considerations
FEATURES
Unit I chapters
Unit II chapters
Unit III chapters
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Unit IV chapters
SUMMARY ACKNOWLEDGMENTS
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MARYLOU V. ROBINSON, PHD, FNP-CTERI MOSER WOO, RN, PHD, CPNP-PC, FAANP
ABOUT THE AUTHORS
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Lorena C. Guerrero, PhD, MN, ARNP, FNP-BC
Anne Hedger, DNP, ACNP-CS, ANP-CS, CPNP-AC, ENP-BC, CCRN
Leila N. Jones, MSN, BA, RN
Jennifer Jordan, RPh, PharmD, BCPS
Tracy Klein, PhD, FNP, ARNP, FAANP, FRE, FAAN
Ashim Malhotra, BPharm, PhD
Theresa Mallick-Searle, MS, RN-BC, ANP-BC
Erin Anderson, MSN, CPNP
Cally Bartley, MSN, FNP-C
Jane M. Carrington, PhD, RN
Diana L. Dewell, ARNP, ANP
Gina Dobbs, MSN, CRNP
Krista Estes, DNP, FNP-C
Teral Gerlt, MS, RN, WHCNP-E
Theresa Granger, PhD, ARNP, FNP
CONTRIBUTORS
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Fujio McPherson, RN, DAOM, MSN, FNP, LAC
Benjamin J. Miller, PhD, MN, ARNP, FNP, ACNP
Anne E. Morgan, PharmD
Joan Nelson, DNP, RN
Patricia Nodine PhD, CNM
Kristen Lambert Osborn, MSN, CPNP–AC/PC
James L. Raper, DSN, CRNP, JD, FAANP, FAAN
Peter J. Rice, PharmD, PhD, BCPS
Laura Rosenthal, DNP, ACNP
Ruth Schaffler, PhD, FNP
Tracy Scott, DNP, FNP
Kathy Shaw, DNP, RN, CDE
R. Brigg Turner, PharmD, BCPS
Connie Valdez, PharmD, MSEd, BCPS
Mary Weber, PhD, PMHNP-BC, FAANP
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Joan Parker Frizzell, PhD, CRNP, ANP-BC
Tammy Gilliam, DNP, APRN-BC, FNP
Cathy R. Kessenich, DSN, ARNP, FAANP
Pamela King, PhD, APRN, FNP, PNP
Angela I. Kulesza, DNP, NP-C
Christine Nelson-Tuttle, DNS, RN, PNP-BC
David G. O’Dell, DNP, ARPN, FNP-BC
JoAnne Pearce, MS, PhDc, RN, APRN
Marianne Adam, PhD, RN, CRNP
Nancy Beckham, PhD, FNP-C
Christopher W. Blackwell, PhD, ARNP, ANP-BC, AGACNP-BC, CNE
Sharon Chalmers, PhD, CNE, APRN-BC
Patsy E. Crihfield, DNP, APRN, FNP-BC, PMHNP-BC, PMHS
Linda Dayer-Berenson, PhD, MSN, CRNP, CNE, FAANP
Carolynn A. DeSandre, PhD, CNM, FNP-BC
Abimbola Farinde, PharmD, MS
REVIEWERS
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Julie Ponto, PhD, RN, ACNS-BC, AOCNS
Susan Quisenberry, DNP, APRN, CNP, FNP-C
Sandra Restaino, DNP, NP-C, FAANP, CSC
Maria Rosen, PhD, RN, PNP-BC
Kathleen R. Sheikh, MSN, FNP-BC
Jennifer Sipe, RN, MSN, APRN-BC
Angela Thompson, PhD, PharmD
Diane Yorke, MSN, MBA, PhD, RN, CPNP
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Chapter 16 Drugs Affecting the Cardiovascular and Renal Systems 295 Marylou V. Robinson, PhD, FNP-C
Chapter 17 Drugs Affecting the Respiratory System 361 Teri Moser Woo, PhD, CPNP
Chapter 18 Drugs Affecting the Hematopoietic System 415 Teri Moser Woo, PhD, CPNP and Kristen Lambert Osborne MSN, CPNP AC/PC
Chapter 19 Drugs Affecting the Immune System 447 Teri Moser Woo, PhD, CPNP
Chapter 20 Drugs Affecting the Gastrointestinal System 497 Teri Moser Woo, PhD, CPNP
Chapter 21 Drugs Affecting the Endocrine System 541 Marylou Robinson, PhD, FNP and Kathy Shaw, DNP, RN, CDE
Chapter 22 Drugs Affecting the Reproductive System 615 Diana L. Dewel, ARNP, ANP
Chapter 23 Drugs Affecting the Integumentary System 647 Cally Bartley, MSN, FNP-C
Chapter 24 Drugs Used in Treating Infectious Diseases 691 Jennifer Jordan, RPh, PharmD, BCPS; R. Brigg Turner, PharmD, BCPS; and Teri Moser Woo, PhD, CPNP
Chapter 25 Drugs Used in Treating Inflammatory Processes 801 Teri Moser Woo, PhD, CPNP
Chapter 26 Drugs Used in Treating Eye and Ear Disorders 837 Teri Moser Woo, PhD, CPNP
UNIT III. PHARMACOTHERAPEUTICS WITH MULTIPLE DRUGS 863
Chapter 27 Anemia 865 Teri Moser Woo, PhD, CPNP and Kristen Osborn MSN, CPNP AC/PC
Chapter 28 Chronic Stable Angina and Low-Risk Unstable Angina 881 Laura D. Rosenthal, DNP, ACNP
Chapter 29 Anxiety and Depression 897 Mary Weber, PhD, PMHNP-BC, FAANP and Krista Estes, DNP, FNP-C
UNIT I. THE FOUNDATION 1 Chapter 1 The Role of the Nurse Practitioner
as Prescriber 3 Teri Moser Woo, PhD, CPNP and Marylou V. Robinson, PhD, FNP-C
Chapter 2 Review of Basic Principles of Pharmacology 11 Peter J. Rice, PharmD, PhD, BCPS
Chapter 3 Rational Drug Selection 29 Teri Moser Woo, PhD, CPNP
Chapter 4 Legal and Professional Issues in Prescribing 37 Tracy Klein, PhD, FNP
Chapter 5 Adverse Drug Reactions 51 Connie A. Valdez, PharmD, MSEd, BCPS; Anne E. Morgan, PharmD; and Peter J. Rice, PharmD, PhD, BCPS
Chapter 6 Factors That Foster Positive Outcomes 61 Marylou V. Robinson, PhD, FNP-C and Teri Moser Woo, PhD, CPNP
Chapter 7 Cultural and Ethnic Influences in Pharmacotherapeutics 75 Lorena C. Guerrero, PhD, MS, ARNP, FNP-BC and Leila M. Jones, RN, MSN
Chapter 8 An Introduction to Pharmacogenomics 103 Ashim Malhotra, BPharm, PhD
Chapter 9 Nutrition and Neutraceuticals 115 Teri Moser Woo, PhD, CPNP
Chapter 10 Herbal Therapy and Nutritional Supplements 129 Fujio McPherson, RN, DAOM, MSN, FNP, LAC
Chapter 11 Information Technology and Pharmacotherapeutics 151 Jane M. Carrington, PhD, RN
Chapter 12 Pharmacoeconomics 159 Teri Moser Woo, PhD, CPNP
Chapter 13 Over-the-Counter Medications 165 Teri Moser Woo, PhD, CPNP
UNIT II. PHARMACOTHERAPEUTICS WITH SINGLE DRUGS 171
Chapter 14 Drugs Affecting the Autonomic Nervous System 173 Tracy Scott, DNP, FNP
Chapter 15 Drugs Affecting the Central Nervous System 225 Teri Moser Woo, PhD, CPNP
CONTENTS
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Chapter 30 Asthma and Chronic Obstructive Pulmonary Disease 913 Benjamin J. Miller, PhD, MN, ARNP, FNP, ACNP
Chapter 31 Contraception 943 Teri Gerlt, MS, RN, WCHNP
Chapter 32 Dermatological Conditions 957 Teri Moser Woo, PhD, CPNP
Chapter 33 Diabetes Mellitus 991 Kathy Shaw, DNP, RN, CDE and Marylou Robinson, PhD, FNP-C
Chapter 34 Gastroesophageal Reflux and Peptic Ulcer Disease 1021 Teri Moser Woo, PhD, CPNP
Chapter 35 Headaches 1035 Theresa Mallick-Searle, MS, RN-BC, ANP-BC
Chapter 36 Heart Failure 1063 Laura Rosenthal, DNP, ACNP
Chapter 37 Human Immunodeficiency Virus Disease and Acquired Immunodeficiency Syndrome 1081 James Raper, DSN, CRNP, JD, FAANP, FAAN and Gina Dobbs, MS, CRNP
Chapter 38 Hormone Replacement Therapy and Osteoporosis 1103 Marylou V. Robinson, PhD, FNP-C
Chapter 39 Hyperlipidemia 1129 Marylou V. Robinson, PhD, FNP-C
Chapter 40 Hypertension 1155 Marylou V. Robinson, PhD, FNP-C
Chapter 41 Hyperthyroidism and Hypothyroidism 1179 Marylou V. Robinson, PhD, FNP
Chapter 42 Pneumonia 1195 Anne Hedger, DNP, ACNP-CS, ANP-CS, CPNP-AC, ENP-BC, CCRN
Chapter 43 Smoking Cessation 1205 Benjamin J. Miller, PhD, MN, ARNP, FNP, ACNP
Chapter 44 Sexually Transmitted Diseases and Vaginitis 1217 Theresa Granger, PhD, ARNP, FNP
Chapter 45 Tuberculosis 1237 Teri Moser Woo, PhD, CPNP
Chapter 46 Upper Respiratory Infections, Otitis Media, and Otitis Externa 1253 Teri Moser Woo, PhD, CPNP
Chapter 47 Urinary Tract Infections 1267 Erin Anderson, MSN, CPNP
UNIT IV. SPECIAL DRUG TREATMENT CONSIDERATIONS 1281
Chapter 48 Women as Patients 1283 Priscilla M. Nodine, PhD, CNM
Chapter 49 Men as Patients 1303 James Raper, DNS, CRNP, JD, FAANP, FAAN
Chapter 50 Pediatric Patients 1321 Teri Moser Woo, PhD, CPNP
Chapter 51 Geriatric Patients 1337 Joan M. Nelson, DNP, RN
Chapter 52 Pain Management: Acute and Chronic Pain 1351 Ruth L. Schaffler, PhD, FNP
INDEX 1373
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UNIT I
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CHAPTER 1
Teri Moser Woo • Marylou Robinson
Other APRNs
Physician Assistants
Nurses Not in Advanced Practice Roles
CANADIAN NURSE PRACTITIONER PRACTICE, 8
CURRENT ISSUES AND TRENDS IN HEALTH CARE AND THEIR EFFECT ON PRESCRIPTIVE AUTHORITY, 8 Autonomy and Prescriptive Authority
Interdisciplinary Teams
Level of Education of Team Members
Reimbursement
N ROLES OF REGISTERED NURSES IN MEDICATION MANAGEMENT
Registered Nurses
ROLES OF REGISTERED NURSES IN MEDICATION MANAGEMENT, 3 Registered Nurses
Advanced Practice Registered Nurses
ROLES AND RESPONSIBILITIES OF APRN PRESCRIBERS, 4
ADVANCED KNOWLEDGE, 4
BENEFITS OF AN APRN AS PRESCRIBER, 5
CLINICAL JUDGMENT IN PRESCRIBING, 5
COLLABORATION WITH OTHER PROVIDERS, 7 Physicians
Pharmacists
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Advanced Practice Registered Nurses
ROLES AND RESPONSIBILITIES OF APRN PRESCRIBERS
ADVANCED KNOWLEDGE
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BENEFITS OF AN APRN AS PRESCRIBER
CLINICAL JUDGMENT IN PRESCRIBING
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Is There a Clear Indication for Drug Therapy?
What Drugs Are Effective in Treating This Disorder?
What Is the Goal of Therapy With This Drug?
Under What Conditions Is It Determined That a Drug Is Not Meeting the Goal and a Different Therapy or Drug Should Be Tried?
Are There Unnecessary Duplications With Other Drugs That the Patient Is Already Taking?
Would an Over-the-Counter Drug Be Just as Useful as a Prescription Drug?
What About Cost?
Where Is the Information to Answer These Questions?
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