course materials

1. NCSNSMT Latex Allergies Discussion
NCSNSMT Latex Allergies DiscussionNCSNSMT Latex Allergies DiscussionLisa Marie has
worked as a CNA in the local hospital for the last 7 years. Last year, she began to complain of
watery, nasal congestion and wheezing whenever she went to work. She suspected she was
allergic to something at the hospital because her symptoms abated when she was at home
over the weekends. One day?she arrived at work for the morning shift and put on
her?gloves. Within minutes,?she went into severe respiratory distress requiring treatment
in the emergency ward. It was determined at that time her?allergic response was due to
latex exposure.Lisa Marie experienced a type I,?IgE-mediated hypersensitivity
response.?How can this be determined by her signs and symptoms?Discuss the relationship
between food allergies and latex allergies?Which pages in the textbook were utilized for this
response?Use attached book only as resource for the questions.ORDER NOW FOR
CUSTOMIZED, PLAGIARISM-FREE PAPERSLehne’s PHARMACOLOGY for NURSING CARE
This page intentionally left blank 10 TH EDITION Lehne’s PHARMACOLOGY for NURSING
CARE 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, FAANP
Associate Professor, College of Nursing University of Colorado, Anschutz Medical Campus
Denver, Colorado 3251 Riverport Lane St. Louis, Missouri 63043 LEHNE’S PHARMACOLOGY
FOR NURSING CARE, TENTH EDITION ISBN 978-0-323-51227-5 Copyright © 2019, Elsevier
Inc. All Rights Reserved. No part of this publication may be reproduced or transmitted in
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are protected under copyright by the Publisher (other than as may be noted herein). Notices
Practitioners and researchers must always rely on their own experience and knowledge in
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2. otherwise, or from any use or operation of any methods, products, instructions, or ideas
contained in the material herein. Previous editions copyrighted 2016, 2013, 2010, 2007,
2004, 2001, 1998, 1994, 1990. International Standard Book Number: 978-0-323-51227-5
Executive Content Strategist: Sonya Seigafuse Senior Content Development Manager: Luke
Held Content Development Specialist: Jennifer Wade Publishing Services Manager: Jeff
Patterson Senior Project Manager: Jodi M. Willard Design Direction: Paula Catalano Printed
in Canada Last digit is the print number: 9 8 7 6 5 4 3 2 1 Contents UNIT I INTRODUCTION 1
Orientation to Pharmacology 1 2 Application of Pharmacology in Nursing Practice 5 3 Drug
Regulation, Development, Names, and Information 14 UNIT II BASIC PRINCIPLES OF
PHARMACOLOGY 4 5 6 7 8 Pharmacokinetics 24 Pharmacodynamics 44 NCSNSMT Latex
Allergies DiscussionDrug Interactions 55 Adverse Drug Reactions and Medication Errors 63
Individual Variation in Drug Responses 74 UNIT III DRUG THERAPY ACROSS THE LIFE
SPAN 9 Drug Therapy During Pregnancy and Breast-Feeding 82 10 Drug Therapy in
Pediatric Patients 90 11 Drug Therapy in Older Adults 94 UNIT IV PERIPHERAL NERVOUS
SYSTEM DRUGS SECTION 1 Introduction 12 Basic Principles of Neuropharmacology 100 13
Physiology of the Peripheral Nervous System 105 SECTION 2 Cholinergic Drugs 14
Muscarinic Agonists and Antagonists 118 15 Cholinesterase Inhibitors and Their Use in
Myasthenia Gravis 131 16 Drugs That Block Nicotinic Cholinergic Transmission:
Neuromuscular Blocking Agents 139 SECTION 3 Adrenergic Drugs 17 Adrenergic Agonists
147 18 Adrenergic Antagonists 159 19 Indirect-Acting Antiadrenergic Agents 174 UNIT V
CENTRAL NERVOUS SYSTEM DRUGS SECTION 4 Introduction 20 Introduction to Central
Nervous System Pharmacology 179 SECTION 5 Drugs for Neurodegenerative Disorders 21
Drugs for Parkinson Disease 182 22 Drugs for Alzheimer’s Disease 199 23 Drugs for
Multiple Sclerosis 206 SECTION 6 Neurologic Drugs 24 Drugs for Seizure Disorders 223 25
Drugs for Muscle Spasm and Spasticity 250 SECTION 7 Drugs for Pain 26 Local Anesthetics
259 27 General Anesthetics 265 28 Opioid Analgesics, Opioid Antagonists, and Nonopioid
Centrally Acting Analgesics 274 29 Pain Management in Patients With Cancer 300 30 Drugs
for Headache 318 SECTION 8 Psychotherapeutic Drugs 31 Antipsychotic Agents and Their
Use in Schizophrenia 330 32 Antidepressants 352 33 Drugs for Bipolar Disorder 376 34
Sedative-Hypnotic Drugs 384 35 Management of Anxiety Disorders 399 36 Central Nervous
System Stimulants and Attention-Deficit/Hyperactivity Disorder 406 SECTION 9 Drug
Abuse 37 Substance Use Disorders I: Basic Considerations 417 38 Substance Use Disorders
II: Alcohol 424 39 Substance Use Disorders III: Nicotine and Smoking 435 40 Substance Use
Disorders IV: Major Drugs of Abuse Other Than Alcohol and Nicotine 443 UNIT VI DRUGS
THAT AFFECT FLUID AND ELECTROLYTE BALANCE 41 Diuretics 459 42 Agents Affecting
the Volume and Ion Content of Body Fluids 471 UNIT VII DRUGS THAT AFFECT THE
HEART, BLOOD VESSELS, AND BLOOD 43 Review of Hemodynamics 476 44 Drugs Acting on
the Renin-Angiotensin-Aldosterone 45 46 47 48 49 50 51 52 53 54 55 56 System 482
Calcium Channel Blockers 497 Vasodilators 505 Drugs for Hypertension 510 Drugs for
Heart Failure 529 Antidysrhythmic Drugs 546 Prophylaxis of Atherosclerotic
Cardiovascular Disease: Drugs That Help Normalize Cholesterol and Triglyceride Levels 568
Drugs for Angina Pectoris 591 Anticoagulant, Antiplatelet, and Thrombolytic Drugs 604
Management of ST-Elevation Myocardial Infarction 633 Drugs for Hemophilia 640 Drugs for

3. Deficiency Anemias 648 Hematopoietic Agents 663 UNIT VIII DRUGS FOR ENDOCRINE
DISORDERS 57 Drugs for Diabetes Mellitus 674 58 Drugs for Thyroid Disorders 711 59
Drugs Related to Hypothalamic and Pituitary Function 723 60 Drugs for Disorders of the
Adrenal Cortex 732 UNIT IX WOMEN’S HEALTH 61 Estrogens and Progestins: Basic
Pharmacology and Noncontraceptive Applications 739 62 Birth Control 753 63 Drug
Therapy for Infertility 770 64 Drugs That Affect Uterine Function 778 UNIT X MEN’S
HEALTH 65 Androgens 789 66NCSNSMT Latex Allergies DiscussionDrugs for Erectile
Dysfunction and Benign Prostatic Hyperplasia 797 86 Bacteriostatic Inhibitors of Protein
Synthesis: Tetracyclines, Macrolides, and Others 1050 87 Aminoglycosides: Bactericidal
Inhibitors of Protein Synthesis 1061 88 Sulfonamides and Trimethoprim 1068 89 Drug
Therapy for Urinary Tract Infections 1076 90 Antimycobacterial Agents: Drugs for
Tuberculosis, 91 92 93 UNIT XI 94 ANTI-INFLAMMATORY, ANTIALLERGIC, AND
IMMUNOLOGIC DRUGS 95 Review of the Immune System 809 Childhood Immunization 820
Immunosuppressants 836 Antihistamines 844 Cyclooxygenase Inhibitors: Nonsteroidal
Anti-Inflammatory Drugs and Acetaminophen 852 72 Glucocorticoids in Nonendocrine
Disorders 871 67 68 69 70 71 UNIT XII DRUGS FOR BONE AND JOINT DISORDERS 73 Drug
Therapy for Rheumatoid Arthritis 881 74 Drug Therapy for Gout 894 75 Drugs Affecting
Calcium Levels and Bone Mineralization 900 UNIT XIII 96 UNIT XVII CHEMOTHERAPY OF
PARASITIC DISEASES 97 98 99 100 Disease 925 77 Drugs for Allergic Rhinitis, Cough, and
Colds 948 UNIT XIV GASTROINTESTINAL DRUGS 78 Drugs for Peptic Ulcer Disease 956 79
Laxatives 972 80 Other Gastrointestinal Drugs 981 UNIT XV NUTRITION 81 Vitamins 996
82 Drugs for Weight Loss 1007 Anthelmintics 1183 Antiprotozoal Drugs I: Antimalarial
Agents 1189 Antiprotozoal Drugs II: Miscellaneous Agents 1199 Ectoparasiticides 1206
UNIT XVIII CANCER CHEMOTHERAPY 101 Basic Principles of Cancer Chemotherapy 1212
102 Anticancer Drugs I: Cytotoxic Agents 1226 103 Anticancer Drugs II: Hormonal Agents,
Targeted Drugs, and Other Noncytotoxic Anticancer Drugs 1245 RESPIRATORY TRACT
DRUGS 76 Drugs for Asthma and Chronic Obstructive Pulmonary Leprosy, and
Mycobacterium avium Complex Infection 1081 Miscellaneous Antibacterial Drugs:
Fluoroquinolones, Metronidazole, Daptomycin, Rifampin, Rifaximin, and Fidaxomicin 1097
Antifungal Agents 1102 Antiviral Agents I: Drugs for Non-HIV Viral Infections 1113
Antiviral Agents II: Drugs for HIV Infection and Related Opportunistic Infections 1133 Drug
Therapy for Sexually Transmitted Infections 1167 Antiseptics and Disinfectants 1176 UNIT
XIX MISCELLANEOUS DRUGS AND THERAPIES 104 105 106 107 108 Drugs for the Eye
1272 Drugs for the Skin 1284 Drugs for the Ear 1304 Additional Noteworthy Drugs 1311
Complementary and Alternative Therapy 1328 UNIT XX TOXICOLOGY 109 Management of
Poisoning 1343 110 Potential Weapons of Biologic, Radiologic, and Chemical Terrorism
1349 UNIT XVI APPENDIX A CHEMOTHERAPY OF INFECTIOUS DISEASES Canadian Drug
Information 1359 83 Basic Principles of Antimicrobial Therapy 1014 84 Drugs That Weaken
the Bacterial Cell Wall I: Penicillins 1029 85 Drugs That Weaken the Bacterial Cell Wall II:
Cephalosporins, Carbapenems, Vancomycin, Telavancin, Aztreonam, and Fosfomycin 1039
APPENDIX B Prototype Drugs and Their Major Uses 1363 To my son, Jade Charmagan, BSN,
RN.NCSNSMT Latex Allergies DiscussionCongratulations, and welcome to the world of
nursing! JRB For Ashley, Christine, Courtney, Erica, Laura B., Laura P., and Stacy—my official

4. support team in life. LDR This page intentionally left blank About the Authors Laura D.
Rosenthal, RN, DNP, ACNP-BC, FAANP, has been a registered nurse since graduating with
her Bachelor of Science in Nursing degree from the University of Michigan in 2000. She
completed her Master of Science in Nursing degree in 2006 at Case Western Reserve
University in Cleveland, Ohio. She finished her nursing education at the University of
Colorado, College of Nursing, graduating with her Doctor of Nursing Practice degree in
2011. Her background includes practice in acute care and inpatient medicine. While
working as a nurse practitioner at the University of Colorado Hospital, she assisted in
developing one of the first fellowships for advanced practice clinicians in hospital medicine.
Dr. Rosenthal serves as an associate professor at the University of Colorado, College of
Nursing, where she teaches within the undergraduate and graduate programs. She received
the Dean’s Award for Excellence in Teaching in 2013. She serves on the board of the
Colorado Nurses Association, remains a member of the NP/PA committee for the Society of
Hospital Medicine, and volunteers as a Health Services RN for the Red Cross. In her spare
time, Dr. Rosenthal enjoys running, skiing, and fostering retired greyhounds for Colorado
Greyhound Adoption. Jacqueline Rosenjack Burchum, DNSc, FNP-BC, CNE, has been a
registered nurse since 1981 and a family nurse practitioner since 1996. She completed her
Doctor of Nursing Science degree in 2002. Dr. Burchum currently serves as an associate
professor for the University of Tennessee Health Science Center (UTHSC) College of
Nursing. She is credentialed as a certified nurse educator (CNE) by the National League for
Nursing. She is a two-time recipient of the UTHSC Student Government Association’s
Excellence in Teaching Award and a recipient of the 2014 UT Alumni Association’s
Outstanding Teacher Award. Dr. Burchum was also the 2016–2017 Faculty Innovation
Scholar for the UTHSC Teaching and Learning Center. Dr. Burchum has a special interest in
online teaching and program quality. To this end, she serves as an on-site evaluator for the
Commission on Collegiate Nursing Education (CCNE), a national agency that accredits
nursing education programs. In addition, she is a peer reviewer for Quality Matters, a
program that certifies the quality of online courses. As a nurse practitioner, Dr. Burchum’s
primary interests have centered on addressing the needs of vulnerable populations. She is a
member of the National Organization for Nurse Practitioner Faculties, Sigma Theta Tau
International Honor Society, the American and Tennessee Nurses Associations, and the
National League for Nursing. ix This page intentionally left blank Contributors and
Reviewers CONTRIBUTOR Joshua J. Neumiller, PharmD, CDE, FASCP Assistant Professor of
Pharmacotherapy Washington State University Spokane, Washington Chapter 57 NCSNSMT
Latex Allergies DiscussionREVIEWERS Laura Brennan, MS, RN Assistant Professor Elmhurst
College Elmhurst, Illinois Lisa Miklush, PhD, RNC, CNS Adjunct Faculty Nursing Department
Gonzaga University Spokane, Washington Joan Parker Frizzell, PhD, CRNP, ANP-BC
Associate Professor School of Nursing and Health Sciences La Salle University; Nurse
Practitioner Roxborough Memorial Hospital Philadelphia, Pennsylvania Janet Czermak
Russell MA, MS, APN-BC Associate Professor of Nursing Nursing Department Essex County
College Newark, New Jersey James Graves, PharmD Clinical Pharmacist University of
Missouri Inpatient Pharmacy Columbia, Missouri Carin Tripodina, EdD, MS, RN, CPN, CNE
Assistant Professor of Nursing Nursing Department American International College

5. Springfield, Massachusetts Ellen Ketcherside, RN, MA Nursing Professor Allied Health
Department Mineral Area College Park Hills, Missouri Jennifer J. Yeager, PhD, RN Assistant
Professor Department of Nursing Tarleton State University Stephenville, Texas xi This page
intentionally left blank Preface Pharmacology pervades all phases of nursing practice and
relates directly to patient care and education. Yet despite its importance, many students—
and even some teachers—are often uncomfortable with the subject. Why? Because
traditional texts have stressed memorizing rather than understanding. In this text, the
guiding principle is to establish a basic understanding of drugs, after which secondary
details can be learned as needed. This text has two major objectives: (1) to help you, the
nursing student, establish a knowledge base in the basic science of drugs, and (2) to show
you how that knowledge can be applied in clinical practice. The methods by which these
goals are achieved are described in the following sections. LAYING FOUNDATIONS IN BASIC
PRINCIPLES To understand drugs, you need a solid foundation in basic pharmacologic
principles. To help you establish that foundation, this text has major chapters on the
following topics: basic principles that apply to all drugs (Chapters 4 through 8), basic
principles of drug therapy across the life span (Chapters 9 through 11), basic principles of
neuropharmacology (Chapter 12), basic principles of antimicrobial therapy (Chapter 83),
and basic principles of cancer chemotherapy (Chapter 101). REVIEWING PHYSIOLOGY AND
PATHOPHYSIOLOGY To understand the actions of a drug, it is useful to understand the
biologic systems influenced by the drug. Accordingly, for all major drug families, relevant
physiology and pathophysiology are reviewed. In almost all cases, these reviews are
presented at the beginning of each chapter rather than in a systems review at the beginning
of a unit. This juxtaposition of pharmacology, physiology, and pathophysiology is designed
to help you understand how these topics interrelate. TEACHING THROUGH PROTOTYPES
Within each drug family we can usually identify a prototype—a drug that embodies the
characteristics shared by all members of the group. Because other family members are
similar to the prototype, to know the prototype is to know the basic properties of all family
members. NCSNSMT Latex Allergies Discussion