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9

TH EDITION

PHARMACOTHERAPY
A PAT H O P H YS I O LO G I C A P P R O AC H

Dipi_FM_i-xxxviii.indd i 10/24/13 12:12 PM


Notice
Medicine is an ever-changing science. As new research and clinical experience broaden our knowledge,
changes in treatment and drug therapy are required. The authors and the publisher of this work have checked
with sources believed to be reliable in their efforts to provide information that is complete and generally
in accord with the standards accepted at the time of publication. However, in view of the possibility of human
error or changes in medical sciences, neither the authors nor the publisher nor any other party who has
been involved in the preparation or publication of this work warrants that the information contained herein
is in every respect accurate or complete, and they disclaim all responsibility for any errors or omissions
or for the results obtained from use of the information contained in this work. Readers are encouraged to
confirm the information contained herein with other sources. For example and in particular, readers are
advised to check the product information sheet included in the package of each drug they plan to administer
to be certain that the information contained in this work is accurate and that changes have not been made in
the recommended dose or in the contraindications for administration. This recommendation is of particular
importance in connection with new or infrequently used drugs.

Dipi_FM_i-xxxviii.indd ii 10/24/13 12:12 PM


9 TH EDITION

PHARMACOTHERAPY
A PAT H O P H YS I O LO G I C A P P R O AC H

Joseph T. DiPiro, PharmD, FCCP


Executive Dean and Professor, South Carolina College of Pharmacy, University of
South Carolina and Medical University of South Carolina, Charleston and Columbia,
South Carolina

Robert L. Talbert, PharmD, FCCP, BCPS, FAHA


Professor, Pharmacotherapy Division, College of Pharmacy, University of Texas at
Austin, Professor, Department of Medicine, School of Medicine, University of Texas
Health Science Center at San Antonio, San Antonio, Texas

Gary C. Yee, PharmD, FCCP, BCOP


Professor and Associate Dean, Department of Pharmacy Practice, College of Pharmacy,
University of Nebraska Medical Center, Omaha, Nebraska

Gary R. Matzke, PharmD, FCP, FCCP, FASN, FNAP


Professor and Director, Pharmacy Practice Transformation Initiatives and Founding
Director, ACCP/ASHP/VCU Congressional Health Care Policy Fellow Program,
Department of Pharmacotherapy and Outcome Sciences, School of Pharmacy,
Virginia Commonwealth University, Richmond, Virginia

Barbara G. Wells, PharmD, FCCP, FASHP


Dean Emeritus and Professor Emeritus, Department of Pharmacy Practice,
University of Mississippi, School of Pharmacy, Oxford, Mississippi

L. Michael Posey, BSPharm, MA


Associate Vice President, Periodicals Department, American Pharmacists Association,
Washington, District of Columbia

New York Chicago San Francisco Athens Lisbon Madrid


Mexico City Milan New Delhi Singapore Sydney Toronto

Dipi_FM_i-xxxviii.indd iii 10/24/13 12:12 PM


Pharmacotherapy: A Pathophysiologic Approach, Ninth Edition

Copyright 2014 by McGraw-Hill Education. All rights reserved. Printed in the


United States of America. Except as permitted under the United States Copyright
Act of 1976, no part of this publication may be reproduced or distributed in any
form or by any means, or stored in a data base or retrieval system, without the prior
written permission of the publisher.

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ISBN 978-0-07-180053-2
MHID 0-07-180053-0

This book was set in Times LT Std Roman by Thomson Digital.


The editors were Michael Weitz and Brian Kearns.
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This book is printed on acid-free paper.

Library of Congress Cataloging-in-Publication Data


Pharmacotherapy (New York)
Pharmacotherapy : a pathophysiologic approach / [edited] by Joseph T. DiPiro,
Robert L. Talbert, Gary C. Yee, Gary R. Matzke, Barbara G. Wells, L. Michael
Posey.9/E.
p. ; cm.
ISBN 978-0-07-180053-2 (hbk. : alk. paper)ISBN 0-07-180053-0 (hbk. : alk. paper)
I. DiPiro, Joseph T., editor of compilation. II. Talbert, Robert L., editor of
compilation. III. Yee, Gary C., editor of compilation. IV. Matzke, Gary R., editor
of compilation. V. Wells, Barbara G., editor of compilation. VI. Posey, L. Michael,
editor of compilation. VII. Title.
[DNLM: 1. Drug Therapy. WB 330]
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a representative, please visit the Contact Us pages at www.mhprofessional.com.

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Dedication
To our patients, who have challenged and inspired us
and given meaning to all our endeavors.

To practitioners who continue to improve patient health


outcomes and thereby serve as role models for their
colleagues and students while clinging tenaciously to
the highest standards of practice.

To our mentors, whose vision provided educational and


training programs that encouraged our professional growth
and challenged us to be innovators in our patient care,
research, and education.

To our faculty colleagues for their efforts and support for


our mission to provide a comprehensive and challenging
educational foundation for the pharmacists of the future.

And finally to our families for the time that they have
sacrificed so that this ninth edition would become a reality.

Dipi_FM_i-xxxviii.indd v 10/24/13 12:12 PM


No other text helps you achieve optimal patient outcomes
through evidence-based medication therapy like DiPiros

Pharmacotherapy:
A Pathophysiologic Approach,
Ninth Edition
KEY FEATURES
Goes beyond drug indications and doses to include drug selection, administration, and monitoring
Enriched by more than 300 expert contributors
Revised and updated to reect the latest evidence-based information and recommendations
Includes valuable learning aids such Key Concepts at the beginning of each chapter, Clinical
Presentation tables that summarize disease signs and symptoms, and Clinical Controversies boxes
that examine the complicated issues faced by students and clinicians in providing drug therapy

NEW TO THIS EDITION


SECTION
4 Renal Disorders
A section on personalized pharmacotherapy

28
appears in most sections
Acute Kidney Injury All diagnostic ow diagrams, treatment
William Dager and Jenana Halilovic

KEY CONCEPTS algorithms, dosing guideline recommendations,


and monitoring approaches have been
1 Three classication systems exist for staging severity of
acute kidney injury (AKI): (a) Risk, Injury, Failure, Loss of
INTRODUCTION
Kidney Function, and End-Stage Kidney Disease (RIFLE), Acute kidney injury (AKI) is a clinical syndrome generally defined
(b) Acute Kidney Injury Network (AKIN), and (c) Kidney by an abrupt reduction in kidney function as evidenced by changes

updated in full color to clearly distinguish


Disease: Improving Global Outcomes (KDIGO) clinical in laboratory values, serum creatinine (Scr), blood urea nitrogen
practice guidelines. All three classication systems are (BUN), and urine output. The consequences of AKI can be serious,
based on separate criteria for serum creatinine (Scr) and especially in hospitalized patients, among whom complications and
urine output. mortality are particularly high. Early recognition along with sup-
2 AKI is a common complication in hospitalized patients and
is associated with high morbidity and mortality, especially in
critically ill.
portive therapy is the focus of management for those with estab-
lished AKI, as there is no therapy that directly reverses the injury.
Individuals at risk, such as those with history of chronic kidney
disease (CKD), need to have their hemodynamic status carefully
treatment pathways
3 AKI is categorized based on three distinct types of injury:
monitored and their exposure to nephrotoxins minimized. A thor-
(a) prerenaldecreased renal blood ow, (b) intrinsic
ough patient workup is often necessary and includes past medical

4
structural damage within the kidney, and (c) postrenalan
obstruction is present within the urine collection system.
Conventional formulas used to determine estimated
glomerular ltration rate (eGFR) and creatinine clearance
and surgical history, medication use, physical examination, and
multiple laboratory tests. Management goals include maintenance
of blood pressure, fluid, and electrolyte homeostasis, all of which
New drug monitoring tables have been added
may be dramatically altered. Additional therapies designed to elimi-
should not be used to estimate renal function in patients nate or minimize the insult that precipitated AKI include discon-

Most of the disease-oriented chapters have


with AKI. This may be especially true for medication dosing tinuation of the offending drug (i.e., the nephrotoxin), aggressive
adjustments. hydration, maintenance of renal perfusion, and renal replacement
5 Prevention is of utmost importance since there are very therapy (RRT).
few therapeutic options available for the treatment of In this chapter, the definition, classification, epidemiology, and

6
established AKI.
Supportive management remains the primary approach to
prevent or reduce the complications associated with AKI.
Supportive therapies include renal replacement therapy
common etiologies of AKI are presented. Methods to recognize and
assess the extent of kidney function loss are also discussed. Finally,
preventive strategies for patients at risk and management approaches
for those with established AKI are reviewed.
incorporated evidence-based treatment
7
(RRT), nutritional support, avoidance of nephrotoxins, and
blood pressure and uid management.
For those patients with prolonged or severe AKI, RRT is the
DEFINITION AND CLASSIFICATION guidelines when available, include ratings
cornerstone of support along with an aggressive approach OF ACUTE KIDNEY INJURY
8
to uid, electrolyte, and waste management.
Drug dosing for AKI patients receiving continuous renal
replacement therapy (CRRT) or sustained low-eciency
1 Over the past 10 years, several efforts by a broad consensus
of experts have been made to standardize the definition and clas-
sification of AKI. In 2004, the Acute Dialysis Quality Initiative
of the level of evidence to support the key
therapeutic approaches
dialysis (SLED) is poorly characterized. Dosing regimens (ADQI) group published a consensus-derived definition and clas-
should be individualized and therapeutic drug monitoring sification system called the Risk, Injury, Failure, Loss of Kidney
utilized whenever possible. Function, and End-Stage Kidney Disease (RIFLE) classification.1
9 Diuretic resistance is a common phenomenon in the patient In 2007, a modified version of RIFLE was developed by the Acute
with AKI and can be addressed with sodium restriction, Kidney Injury Network (AKIN) and these criteria are presented
combination diuretic therapy, or a continuous infusion of a in Table 28-12 (see Table 28-1 for an overview of all classification
loop diuretic. systems). Both classification systems are now widely accepted and
have been validated to predict outcomes in thousands of patients Twenty-four online-only chapters are available
611
at www.pharmacotherapyonline.com
Key Concepts summarize
must-know information in
each chapter

Dipi_FM_i-xxxviii.indd vi 10/24/13 12:12 PM


1535
TABLE 754 Topical Drugs Used in the Treatment of Open-Angle Glaucoma
Pharmacologic Common
Drug Properties Brand Names Dose Form Strength (%) Usual Dosea Mechanism of Action
-Adrenergic Blocking Agents
Betaxolol Relative 1-selective Generic Solution 0.5 One drop twice a day All reduce aqueous production
of ciliary body
Betoptic-S Suspension 0.25 One drop twice a day
Carteolol Nonselective, intrinsic Generic Solution 1 One drop twice a day

CHAPTER
sympathomimetic
activity
Levobunolol Nonselective Betagan Solution 0.25, 0.5 One drop twice a day
Metipranolol Nonselective OptiPranolol Solution 0.3 One drop twice a day
Timolol Nonselective Timoptic, Solution 0.25, 0.5 One drop every dayone
Betimol, Istalol to two times a day

Valuable tables encapsulate Nonspecic Adrenergic Agonists


Timoptic-XE Gelling solution 0.25, 0.5 One drop every daya 75

Glaucoma
Dipivefrin Epinephrine prodrug Propine Solution 0.1 One drop twice a day Increased aqueous humor
outow

important information 2-Adrenergic Agonists


Apraclonidine Specic 2-agonists Iopidine Solution 0.5, 1 One drop two to three
times a day
Both reduce aqueous humor
production; brimonidine known
to also increase uveoscleral
outow; only brimonidine has
primary indication
Brimonidine Alphagan P Solution 0.15, 0.1 One drop two to three
times a day
Cholinergic Agonists Direct Acting
Carbachol Irreversible Carboptic, Solution 1.5, 3 One drop two to three All increase aqueous humor
Isopto times a day outow through trabecular
Carbachol meshwork
Pilocarpine Irreversible Isopto Carpine, Solution 0.25, 0.5, 1, 2, 4, One drop two to three
Pilocar 6, 8, 10 times a day
One drop four times a day
Pilopine HS Gel 4 Every 24 hours at bedtime
Cholinesterase Inhibitors
Echothiophate Phospholine Solution 0.125 Once or twice a day
1481 Iodide
Carbonic Anhydrase Inhibitors
Hematopoietic
M-CSF stem cell Topical
Brinzolamide Carbonic anhydrase Azopt Suspension 1 Two to three times a day All reduce aqueous humor
Bone resorption type II inhibition production of ciliary body
Dorzolamide Trusopt Generic Solution 2 Two to three times a day
Systemic
RANKL
Acetazolamide Generic Tablet 125 mg, 250 mg 125250 mg two to four
RANK times a day
PTH

CHAPTER
Injection 500 mg/vial 250500 mg
Diamox Capsule 500 mg 500 mg twice a day
Sequels
Osteoblast Mature Methazolamide Generic Tablet 25 mg, 50 mg 2550 mg two to three
osteoclast times a day
Prostaglandin Analogs

Bone resorption inhibition


OPG
CbI
TRAF 6 73 Latanoprost Prostanoid agonist Xalatan Solution 0.005 One drop every night Increases aqueous uveoscleral
outow and to a lesser extent
NF B trabecular outow
Src

Osteoporosis and Other Metabolic Bone Diseases


Bimatoprost Prostamide agonist Lumigan Solution 0.01, 0.03 One drop every night
PI3K
Travoprost Prostanoid agonist Travatan Z Solution 0.004 One drop every night
FAK
v3 Tauprost Prostanoid agonist Zioptan Preservative 0.0015% One drop every night
integrins free solution
H+ Combinations
H+ H+ Trap, Cathepsin K Timolol Cosopt Generic Solution Timolol 0.5% One drop twice daily
NCP, collagen,
H+ H+ dorzolamide dorzolamide 2%
Ca+, Mg+,Phos other
enzymes Timolol Combigan Solution Timolol 0.5% One drop twice daily
brimonidine brimonide 0.2%
B
Brinzolamide Simrinza Brinzolamide 1% One drop three times
brimonidine brimonidine 0.2% daily
Mesenchymal a
Use of nasolacrimal occlusion will increase the number of patients successfully treated with longer dosage intervals.
cell
PTH or PTHrP
PPAR Wnt
BMP
RunX2 Bone
Adipocyte
formation Wnt
inhibition
Bone formation Osteoblast
Sclerostin sFRP
differentiation
Wnt DKK-1

LRP k LRP
PTH 5/6
5/6 r
e
m
FZD
PTHrP e
Axin n

GSK-3 -catenin
Axin

GSK-3
Full-color illustrations enhance
Cytoplasm
Nucleus Target
-catenin
degradation
and clarify the text
genes

Osteoblast
C
FIGURE 732 (Continued ) B. Molecular level detail of major pathways during bone resorption steps 2 and 3, which also showcase
drug targets for approved and investigational agents. (Ca+, calcium ion; Cbl, a ubiquitin ligase; FAK, focal adhesion kinase; H+, hydrogen
ion; M-CSF, macrophage colony-stimulating factor; Mg+, magnesium ion; NCP, noncollagenous protein; NF-B, nuclear factor kappa B;
OPG, osteoprotegerin; Pl3K, phosphatidylinositol 3-kinase; Phos, phosphorus; PTH, parathyroid hormone; RANK, receptor activator
of nuclear factor-B; RANKL, receptor activator of nuclear factor-B ligand; src, tyrosine-protein kinase; TRAF-6, tumor necrosis factor
receptor associated factor 6; Trap, tartrate-resistant acid phosphate.) C. Molecular level detail of major pathways during bone formation
steps 4 and 5, which also showcase drug targets for approved and investigational agents. (BMP, bone morphogenetic protein; DKK-1,
Dickko-1; FZD, frizzled element; GSK-3, glycogen synthase kinase-3; LRP5/6, lipoprotein receptor-related protein 5 or 6; PPAR-,
peroxisome proliferator-activated receptor- ; PTH, parathyroid hormone; PTHrP, parathyroid hormone-related protein; runX2, runt-
related transcription factor; sFRP, secreted frizzled related protein; Wnt, wingless tail ligand.)

1341

CLINICAL PRESENTATION Erectile Dysfunction


General Physical examination may reveal signs of
Men are aected emotionally in many dierent ways hypogonadism (e.g., gynecomastia, small testicles,
Depression decreased body hair or beard, and decreased
Performance anxiety muscle mass), which may contribute to erectile
Marital diculties and avoidance of sexual intimacy dysfunction. The patient may have an abnormally

CHAPTER
(patients are often brought to a physician by their curved penis when erect, decreased pulses in
partners) the pelvic region (suggesting impaired vascular
Nonadherence to medications patient believes are ow to the penis), or decreased anal sphincter
causing erectile dysfunction tone (suggesting impaired nerve function to the

Clinical Presentation tables summarize Symptoms


Erectile dysfunction or inability to have sexual
intercourse
corpora). Men older than 50 years should undergo
a digital rectal examination to determine whether
an enlarged prostate is contributing to the patients
erectile dysfunction
66
disease signs and symptoms

Erectile Dysfunction
Signs Laboratory Tests
If completing an International Index of Erectile If the patient has signs of hypogonadism and
Dysfunction survey, results are consistent with low complains of decreased libido, a serum testosterone
satisfaction with the quality of erectile function concentration may be below the normal range,
Medical history may identify concurrent medical which would be consistent with a hormonal cause of
illnesses, past surgical procedures that interfere erectile dysfunction
with good vascular ow to the penis or damage If the patient has an enlarged prostate noted on
nerve function to the corpora, or mental disorders digital rectal examination, a blood sample for
associated with decreased reception of sexual stimuli prostate-specic antigen should be obtained. If
Medication history may reveal prescription or elevated, the patient should be evaluated for a
nonprescription medications that could cause prostate disorder, which could contribute to erectile
erectile dysfunction dysfunction

Pharmacotherapy Casebook provides the case studies


students need to learn how to identify and resolve A complete listing of the patients prescription and nonpre-
scription medications and dietary supplements should be reviewed
by the clinician, who should identify drugs that may be contributing
to erectile dysfunction. If possible, causative agents should be dis-
should undergo additional testing to reclassify them into the low- or
high-risk group. The high-risk group should defer sexual activity.
Patients in the low-risk group may start specific treatment for erec-
tile dysfunction.8,1820

the drug therapy problems most likely encountered continued or the dose should be reduced.
A physical examination of the patient should include a check
for hypogonadism (i.e., signs of gynecomastia, small testicles, and
decreased beard or body hair). The penis should be evaluated for
TREATMENT
Erectile Dysfunction
in real-world practice. This new edition is packed diseases associated with abnormal penile curvature (e.g., Peyronies
disease), which are associated with erectile dysfunction. Femoral
and lower extremity pulses should be assessed to provide an indica-
tion of vascular supply to the genitals. Anal sphincter tone and other
Desired Outcomes
The goal of treatment is improvement in the quantity and quality of

with patient cases and makes the ideal study genital reflexes should be checked for the integrity of the nerve sup-
ply to the penis. A digital rectal examination in patients 50 years or
older is needed to rule out benign prostatic hyperplasia, which may
contribute to erectile dysfunction.
penile erections suitable for intercourse and considered satisfactory
by the patient and his partner. Simple as this may sound, healthcare
providers must ensure that patients and their partners have reason-
able expectations for any therapies that are initiated. Furthermore,

companion to the 9th edition of DiPiros Selected laboratory tests should be obtained to identify the
presence of underlying diseases that could cause erectile dysfunc-
tion. They include a fasting serum blood glucose and lipid profile.
only patients with erectile dysfunction should be treated. Patients
who have normal sexual function should not seekor be encour-
aged to seektreatment in an effort to enhance sexual function or

Pharmacotherapy: A Pathophysiologic Approach.


Serum testosterone levels should be checked in patients older than enable increased activity. In addition, treatment should be well toler-
50 years and in younger patients who complain of decreased libido ated and be of reasonable cost.
and erectile dysfunction. At least two early morning serum testos-
terone levels on different days are needed to confirm the presence
of hypogonadism.17 General Approach to Treatment
Finally, erectile dysfunction is a potential marker for arterio- 3 The Third Princeton Consensus Conference is a widely accepted

Online Learning Center is designed to benet the


sclerosis. Therefore, older patients and those at intermediate and multidisciplinary approach to managing erectile dysfunction that
high risk for cardiovascular disease should undergo a cardiovas- maps out a stepwise treatment plan.2022 The first step in clinical
cular risk assessment before starting on drug treatment for erectile management of erectile dysfunction is to identify and, if possible,
dysfunction. By doing so, patients will be categorized into low-, reverse underlying causes. Risk factors for erectile dysfunction,

student and faculty. Both learning objectives and


intermediate-, or high-risk groups for cardiovascular morbidity including hypertension, coronary artery disease, dyslipidemia,
related to sexual intercourse. Patients in the intermediate-risk group diabetes mellitus, smoking, or chronic ethanol abuse, should be

self-assessment questions for each chapter are


available online at www.accesspharmacy.com

Visit www.mhpharmacotherapy.com
Dipi_FM_i-xxxviii.indd vii 10/24/13 12:12 PM
Dipi_FM_i-xxxviii.indd viii 10/24/13 12:12 PM
Contents

e|CHAPTERS To access the eChapters please go to www.dipiroonlinechapters.com


McGraw-Hill reserves the right to change the manner of distribution of these chapters to the customer.

e|CHAPTER 1 Health Literacy and Medication Use e|CHAPTER 12 Emergency Preparedness:


Oralia V. Bazaldua, Dewayne A. Davidson, Identication and Management
and Sunil Kripalani of Chemical and Radiological
Exposures
e|CHAPTER 2 Cultural Competency Greene Shepherd and Richard B. Schwartz
Jeri J. Sias, Amanda M. Loya,
Jos O. Rivera, and Arthur A. Islas e|CHAPTER 13 Cardiovascular Testing
Richard A. Lange and L. David Hillis
e|CHAPTER 3 Principles and Practices
of Medication Safety e|CHAPTER 14 Introduction to Pulmonary
Robert J. Weber and Shawn E. Johnson Function Testing
Tamara D. Simpson, Jay I. Peters,
e|CHAPTER 4 Evidence-Based Medicine and Stephanie M. Levine
Elaine Chiquette and L. Michael Posey
e|CHAPTER 15 Drug-Induced Pulmonary Diseases
e|CHAPTER 5 Clinical Pharmacokinetics and Hengameh H. Raissy and Michelle Harkins
Pharmacodynamics
Larry A. Bauer e|CHAPTER 16 Evaluation of the Gastrointestinal
Tract
e|CHAPTER 6 Pharmacogenetics Keith M. Olsen and Grant F. Hutchins
Larisa H. Cavallari and Y. W. Francis Lam
e|CHAPTER 17 Drug-Induced Liver Disease
e|CHAPTER 7 Pediatrics William R. Kirchain and Rondall E. Allen
Milap C. Nahata and Carol Taketomo
e|CHAPTER 18 Evaluation of Kidney Function
e|CHAPTER 8 Geriatrics Thomas C. Dowling
Emily R. Hajjar, Shelly L. Gray,
Patricia W. Slattum, Catherine I. Starner, e|CHAPTER 19 Evaluation of Neurologic Illness
Robert L. Maher Jr, Lauren R. Hersh, Susan C. Fagan, Ahmed Alhusban,
and Joseph T. Hanlon and Fenwick T. Nichols
e|CHAPTER 9 Palliative Care e|CHAPTER 20 Evaluation of Psychiatric Illness
Jill Astol Mark E. Schneiderhan, Leigh Anne Nelson,
and Timothy Dellenbaugh
e|CHAPTER 10 Clinical Toxicology
Peter A. Chyka e|CHAPTER 21 Function and Evaluation
of the Immune System
e|CHAPTER 11 Emergency Preparedness and Philip D. Hall and Nicole Weimert Pilch
Response: Biologic Exposures
Colleen M. Terri, Jason E. Brouillard, e|CHAPTER 22 Allergic and Pseudoallergic
and Lisa T. Costanigro Drug Reactions
Lynne M. Sylvia

ix

Dipi_FM_i-xxxviii.indd ix 10/24/13 12:12 PM


x

e|CHAPTER 23 Dermatologic Drug Reactions and e|CHAPTER 25 Laboratory Tests to Direct


Common Skin Conditions Antimicrobial Pharmacotherapy
Rebecca M. Law and David T.S. Law Michael J. Rybak, Jerey R. Aeschlimann,
and Kerry L. LaPlante
e|CHAPTER 24 Drug-Induced Hematologic Disorders
Kamakshi V. Rao
CONTENTS

Contributors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xv
Foreword . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xxxiii SECTION 2 Respiratory Disorders 369
Foreword to the First Edition . . . . . . . . . . . . . . . . . . . . . . . . . . . .xxxv
Section Editor: Robert L. Talbert
Preface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xxxvii
15. Asthma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 369
H. William Kelly and Christine A. Sorkness
SECTION 1 Cardiovascular Disorders 1
16. Chronic Obstructive Pulmonary Disease . . . . . . . . . . 401
Section Editor: Robert L. Talbert Sharya V. Bourdet and Dennis M. Williams

1. Cardiovascular Testing. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 17. Pulmonary Arterial Hypertension . . . . . . . . . . . . . . . . . 429


Richard A. Lange and L. David Hillis Rebecca L. Attridge, Rebecca Moote,
and Deborah J. Levine
2. Cardiac Arrest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .29
Jerey F. Barletta and Jerey L. Wilt
18. Cystic Fibrosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 441
Chanin C. Wright and Yolanda Y. Vera
3. Hypertension . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .49
Joseph J. Saseen and Eric J. MacLaughlin

4. Chronic Heart Failure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .85


Robert B. Parker, Jean M. Nappi, and Larisa H. Cavallari
SECTION 3 Gastrointestinal Disorders 455
Section Editor: Joseph T. DiPiro
5. Acute Decompensated Heart Failure . . . . . . . . . . . . . . 123
Jo E. Rodgers and Brent N. Reed 19. Gastroesophageal Reux Disease . . . . . . . . . . . . . . . . . 455
Dianne B. May and Satish SC Rao
6. Ischemic Heart Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . 141
Robert L. Talbert 20. Peptic Ulcer Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 471
Bryan L. Love and Matthew N. Thoma
7. Acute Coronary Syndromes . . . . . . . . . . . . . . . . . . . . . . . 175
Sarah A. Spinler and Simon de Denus 21. Inammatory Bowel Disease. . . . . . . . . . . . . . . . . . . . . . 497
Brian A. Hemstreet
8. The Arrhythmias . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 207
Cynthia A. Sanoski and Jerry L. Bauman 22. Nausea and Vomiting. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 517
Cecily V. DiPiro and Robert J. Ignoo
9. Venous Thromboembolism . . . . . . . . . . . . . . . . . . . . . . . 245
Daniel M. Witt and Nathan P. Clark 23. Diarrhea, Constipation, and Irritable
Bowel Syndrome . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 531
10. Stroke . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 279 Patricia H. Fabel and Kayce M. Shealy
Susan C. Fagan and David C. Hess
24. Portal Hypertension and Cirrhosis . . . . . . . . . . . . . . . . 549
11. Hyperlipidemia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 291 Julie M. Sease
Robert L. Talbert
25. Pancreatitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 565
12. Peripheral Arterial Disease . . . . . . . . . . . . . . . . . . . . . . . . 319 Scott Bolesta and Patricia A. Montgomery
Barbara J. Hoeben and Robert L. Talbert
26. Viral Hepatitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 583
13. Use of Vasopressors and Inotropes Paulina Deming
in the Pharmacotherapy of Shock . . . . . . . . . . . . . . . . . 329
Robert Maclaren and Joseph F. Dasta 27. Celiac Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 603
Robert A. Mangione and Priti N. Patel
14. Hypovolemic Shock . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 351
Brian L. Erstad

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xi
45. Headache Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 943
SECTION 4 Renal Disorders 611 Deborah S. Minor and Marion R. Woord
Section Editor: Gary R. Matzke

28. Acute Kidney Injury . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 611


William Dager and Jenana Halilovic SECTION 6 Psychiatric Disorders 959

29. Chronic Kidney Disease. . . . . . . . . . . . . . . . . . . . . . . . . . . 633 Section Editor: Barbara G. Wells

CONTENTS
Joanna Q. Hudson and Lori D. Wazny
46. Attention Decit/Hyperactivity Disorder . . . . . . . . . . 959
30. Hemodialysis and Peritoneal Dialysis . . . . . . . . . . . . . . 665 Julie A. Dopheide and Stephen R. Pliszka
Kevin M. Sowinski, Mariann D. Churchwell, and Brian S. Decker
47. Eating Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 973
31. Drug-Induced Kidney Disease . . . . . . . . . . . . . . . . . . . . 687 Steven C. Stoner and Valerie L. Ruehter
Thomas D. Nolin
48. Substance-Related Disorders I: Overview and
32. Glomerulonephritis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 705 Depressants, Stimulants, and Hallucinogens . . . . . . 985
Alan H. Lau Paul L. Doering and Robin Moorman Li

33. Drug Therapy Individualization for Patients 49. Substance-Related Disorders II: Alcohol,
with Chronic Kidney Disease . . . . . . . . . . . . . . . . . . . . . . 729 Nicotine, and Caeine . . . . . . . . . . . . . . . . . . . . . . . . . . . 1003
Rima A. Mohammad and Gary R. Matzke Paul L. Doering and Robin Moorman Li

34. Disorders of Sodium and Water Homeostasis . . . . . . 745 50. Schizophrenia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1019
Katherine Hammond Chessman and Gary R. Matzke M. Lynn Crismon, Tami R. Argo, and Peter F. Buckley

35. Disorders of Calcium and Phosphorus 51. Major Depressive Disorder . . . . . . . . . . . . . . . . . . . . . . . 1047
Homeostasis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 765 Christian J. Teter, Judith C. Kando, and Barbara G. Wells
Amy Barton Pai
52. Bipolar Disorder . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1067
36. Disorders of Potassium and Magnesium Shannon J. Drayton and Christine M. Pelic
Homeostasis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 783
Donald F. Brophy
53. Anxiety Disorders I: Generalized Anxiety, Panic,
and Social Anxiety Disorders. . . . . . . . . . . . . . . . . . . . . 1083
37. AcidBase Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 797 Sarah T. Melton and Cynthia K. Kirkwood
John W. Devlin and Gary R. Matzke
54. Anxiety Disorders II: Posttraumatic Stress
Disorder and Obsessive-Compulsive Disorder . . . . 1103
Cynthia K. Kirkwood, Sarah T. Melton, and
Barbara G. Wells
SECTION 5 Neurologic Disorders 817
55. Sleep Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1115
Section Editor: Barbara G. Wells John M. Dopp and Bradley G. Phillips
38. Alzheimers Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 817 56. Disorders Associated with
Patricia W. Slattum, Emily P. Peron, and Angela Massey Hill Intellectual Disabilities . . . . . . . . . . . . . . . . . . . . . . . . . . 1127
Nancy C. Brahm, Jerry R. McKee, and Douglas W. Stewart
39. Multiple Sclerosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 835
Jacquelyn L. Bainbridge, Augusto Miravalle,
and John R. Corboy

40. Epilepsy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 855


Susan J. Rogers and Jose E. Cavazos
SECTION 7 Endocrinologic Disorders 1143
Section Editor: Robert L. Talbert
41. Status Epilepticus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 883
Stephanie J. Phelps and James W. Wheless 57. Diabetes Mellitus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1143
Curtis L. Triplitt, Thomas Repas, and Carlos A. Alvarez
42. Acute Management of the Brain Injury Patient . . . . 895
Bradley A. Boucher and G. Christopher Wood 58. Thyroid Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1191
Jacqueline Jonklaas and Robert L. Talbert
43. Parkinsons Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 911
Jack J. Chen and David M. Swope 59. Adrenal Gland Disorders . . . . . . . . . . . . . . . . . . . . . . . . . 1217
Eric Dietrich, Steven M. Smith, and John G. Gums
44. Pain Management . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 925
Terry J. Baumann, Chris M. Herndon, and 60. Pituitary Gland Disorders . . . . . . . . . . . . . . . . . . . . . . . . 1237
Jennifer M. Strickland Joseph K. Jordan, Amy Heck Sheehan, Jack A. Yanovski,
and Karim Anton Calis

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xii
74. Gout and Hyperuricemia . . . . . . . . . . . . . . . . . . . . . . . . 1505
SECTION 8 Gynecologic and Obstetric Michelle A. Fravel, Michael E. Ernst, and Elizabeth C. Clark
Disorders 1253
Section Editor: Barbara G. Wells

61. Pregnancy and Lactation: Therapeutic SECTION 12 Ophthalmic and Otolaryngological


Considerations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1253 Disorders 1525
CONTENTS

Kristina E. Ward and Barbara M. OBrien


Section Editor: L. Michael Posey
62. Contraception . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1271
Sarah P. Shrader and Kelly R. Ragucci
75. Glaucoma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1525
Richard G. Fiscella, Timothy S. Lesar, and Deepak P. Edward
63. Menstruation-Related Disorders . . . . . . . . . . . . . . . . . 1287
Elena M. Umland and Jacqueline Klootwyk
76. Allergic Rhinitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1541
J. Russell May and Philip H. Smith
64. Endometriosis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1305
Deborah A. Sturpe and Kathleen J. Pincus

65. Hormone Therapy in Women . . . . . . . . . . . . . . . . . . . . 1315


Sophia N. Kalantaridou, Devra K. Dang,
SECTION 13 Dermatologic Disorders 1555
and Karim Anton Calis Section Editor: L. Michael Posey

77. Acne Vulgaris . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1555


Debra Sibbald
SECTION 9 Urologic Disorders 1337 78. Psoriasis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1579
Section Editor: L. Michael Posey Rebecca M. Law and Wayne P. Gulliver

66. Erectile Dysfunction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1337 79. Atopic Dermatitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1595


Rebecca M. Law and Po Gin Kwa
Mary Lee

67. Benign Prostatic Hyperplasia . . . . . . . . . . . . . . . . . . . . 1361


Mary Lee

68. Urinary Incontinence . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1377


SECTION 14 Hematologic Disorders 1605
Eric S. Rovner, Jean Wyman, and Sum Lam Section Editor: Gary C. Yee

80. Anemias . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1605


Kristen Cook and William L. Lyons
SECTION 10 Immunologic Disorders 1397 81. Coagulation Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . 1625
Betsy Bickert Poon, Char Witmer, and Jane Pruemer
Section Editors: Gary R. Matzke and Gary C. Yee
82. Sickle Cell Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1643
69. Systemic Lupus Erythematosus . . . . . . . . . . . . . . . . . . 1397
C. Y. Jennifer Chan and Melissa Frei-Jones
Beth H. Resman-Targo

70. Solid-Organ Transplantation . . . . . . . . . . . . . . . . . . . . . 1413


Kristine S. Schonder and Heather J. Johnson
SECTION 15 Infectious Diseases 1661
Section Editor: Joseph T. DiPiro

SECTION 11 Rheumatologic Disorders 1437 83. Antimicrobial Regimen Selection . . . . . . . . . . . . . . . . 1661


Grace C. Lee and David S. Burgess
Section Editor: L. Michael Posey
84. Central Nervous System Infections . . . . . . . . . . . . . . . 1675
71. Osteoarthritis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1437 Ramy H. Elshaboury, Elizabeth D. Hermsen, Jessica S. Holt,
Lucinda M. Buys and Mary Elizabeth Elliott Isaac F. Mitropoulos, and John C. Rotschafer
72. Rheumatoid Arthritis . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1459 85. Lower Respiratory Tract Infections . . . . . . . . . . . . . . . 1695
Kimberly Wahl and Arthur A. Schuna Martha G. Blackford, Mark L. Glover, and Michael D. Reed
73. Osteoporosis and Other Metabolic 86. Upper Respiratory Tract Infections . . . . . . . . . . . . . . . 1717
Bone Diseases. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1477 Christopher Frei and Bradi Frei
Mary Beth OConnell and Jill S. Borchert

Dipi_FM_i-xxxviii.indd xii 10/24/13 12:12 PM


xiii
87. Inuenza. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1731 106. Lung Cancer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2141
Jessica C. Njoku and Elizabeth D. Hermsen Val R. Adams and Susanne M. Arnold

88. Skin and Soft-Tissue Infections . . . . . . . . . . . . . . . . . . . 1743 107. Colorectal Cancer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2159
Douglas N. Fish and Susan L. Pendland Lisa E. Davis, Weijing Sun, and Patrick J. Medina

89. Infective Endocarditis . . . . . . . . . . . . . . . . . . . . . . . . . . . 1769 108. Prostate Cancer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2193


Angie Veverka, Michael A. Crouch, and Brian L. Odle LeAnn B. Norris and Jill M. Kolesar

CONTENTS
90. Tuberculosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1787 109. Lymphomas . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2209
Rocsanna Namdar, Michael Lauzardo, and Alexandre Chan and Gary C. Yee
Charles A. Peloquin
110. Ovarian Cancer. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2237
91. Gastrointestinal Infections and Judith A. Smith and Judith K. Wolf
Enterotoxigenic Poisonings . . . . . . . . . . . . . . . . . . . . . . 1807
Steven Martin and Rose Jung 111. Acute Leukemias . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2255
Betsy Bickert Poon and Amy Hateld Seung
92. Intraabdominal Infections . . . . . . . . . . . . . . . . . . . . . . . 1821
Keith M. Olsen, Alan E. Gross, and Joseph T. DiPiro 112. Chronic Leukemias . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2277
Christopher A. Fausel and Patrick J. Kiel
93. Parasitic Diseases. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1835
JV Anandan 113. Multiple Myeloma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2295
Casey B. Williams and Timothy R. McGuire
94. Urinary Tract Infections and Prostatitis . . . . . . . . . . . 1849
Elizabeth A. Coyle and Randall A. Prince 114. Myelodysplastic Syndromes . . . . . . . . . . . . . . . . . . . . . 2313
Julianna A. Merten, Kristen B. McCullough,
95. Sexually Transmitted Diseases . . . . . . . . . . . . . . . . . . . 1867 and Mrinal M. Patnaik
Leroy C. Knodel
115. Renal Cell Carcinoma . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2331
96. Bone and Joint Infections . . . . . . . . . . . . . . . . . . . . . . . . 1885 Christine M. Walko and Ashley E. Simmons
Edward P. Armstrong and Ziad Shehab
116. Melanoma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2347
97. Severe Sepsis and Septic Shock . . . . . . . . . . . . . . . . . . 1897 Cindy L. OBryant and Jamie C. Poust
S. Lena Kang-Birken
117. Hematopoietic Stem Cell Transplantation . . . . . . . . 2367
98. Supercial Fungal Infections . . . . . . . . . . . . . . . . . . . . . 1911 Susanne Liewer and Janelle Perkins
Thomas E. R. Brown and Linda D. Dresser

99. Invasive Fungal Infections . . . . . . . . . . . . . . . . . . . . . . . 1931


Peggy L. Carver SECTION 17 Nutritional Disorders 2385
100. Infections in Immunocompromised Patients . . . . . 1963 Section Editor: Gary R. Matzke
Douglas N. Fish and Scott W. Mueller
118. Assessment of Nutrition Status and Nutrition
101. Antimicrobial Prophylaxis in Surgery . . . . . . . . . . . . . 1991 Requirements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2385
Salmaan Kanji Katherine Hammond Chessman and Vanessa J. Kumpf
102. Vaccines, Toxoids, and Other Immunobiologics . . . 2007 119. Parenteral Nutrition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2405
Mary S. Hayney Todd W. Mattox and Catherine M. Crill
103. Human Immunodeciency Virus Infection. . . . . . . . 2031 120. Enteral Nutrition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2427
Peter L. Anderson, Thomas N. Kakuda, and Courtney V. Fletcher Vanessa J. Kumpf and Katherine Hammond Chessman

121. Obesity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2445


Amy Heck Sheehan, Judy T. Chen, Jack A. Yanovski,
SECTION 16 Oncologic Disorders 2055 and Karim Anton Calis

Section Editor: Gary C. Yee


Glossary 2465
104. Cancer Treatment and Chemotherapy . . . . . . . . . . . 2055 Index 2495
Stacy S. Shord and Patrick J. Medina

105. Breast Cancer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2101


Chad M. Barnett, Laura Boehnke Michaud,
and Francisco J. Esteva

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Dipi_FM_i-xxxviii.indd xiv 10/24/13 12:12 PM
Contributors
Val R. Adams, PharmD, FCCP, BCOP Peter L. Anderson, PharmD
Associate Professor Associate Professor
Department of Pharmacy Practice and Science Department of Pharmaceutical Sciences
College of Pharmacy Skaggs School of Pharmacy and Pharmaceutical Sciences
University of Kentucky University of Colorado Anschutz Medical Campus
Lexington, Kentucky Aurora, Colorado
Chapter 106 Chapter 103

Jerey R. Aeschlimann, PharmD Tami R. Argo, PharmD, MS


Associate Professor Clinical Pharmacy Specialist-Psychiatry
Department of Pharmacy Practice Department of Pharmacy
School of Pharmacy Iowa City Veterans Affairs Health Care System
University of Connecticut Iowa City, Iowa
Storrs, Connecticut Chapter 50
eChapter 25
Edward P. Armstrong, PharmD
Ahmed Alhusban, PharmD, PhD Professor
Assistant Professor Department of Pharmacy Practice and Science
Department of Clinical Pharmacy College of Pharmacy
Jordan University of Science and Technology University of Arizona
Irbid, Jordan Tucson, Arizona
eChapter 19 Chapter 96

Rondall E. Allen, PharmD Susanne M. Arnold, MD


Clinical Associate Professor Professor
Associate Dean for Student Affairs Department of Internal Medicine
Division of Clinical and Administrative Sciences Division of Medical Oncology
Xavier University of Louisiana College of Pharmacy Markey Cancer Center
New Orleans, Louisiana University of Kentucky
eChapter 17 Lexington, Kentucky
Chapter 106
Carlos A. Alvarez, PharmD, MSc, MSCS, BCPS
Assistant Professor Jill Astol, PharmD
Department of Pharmacy Practice Philadelphia, Pennsylvania
Texas Tech University Health Sciences Center eChapter 9
Dallas, Texas
Chapter 57 Rebecca L. Attridge, PharmD, MSc, BCPS
Assistant Professor
JV Anandan, PharmD Department of Pharmacy Practice
Adjunct Associate Professor University Incarnate Word Feik School of Pharmacy
Eugene Applebaum College of Pharmacy Adjunct Assistant Professor
Wayne State University, Detroit The University of Texas Health Science Center at San Antonio
Pharmacy Specialist Division of Pulmonary Diseases and Critical Care Medicine
Center for Drug Use Analysis and Information San Antonio, Texas
Henry Ford Hospital Chapter 17
Department of Pharmacy Services
Detroit, Michigan
Chapter 93

xv

Dipi_FM_i-xxxviii.indd xv 10/24/13 12:12 PM


xvi
Jacquelyn L. Bainbridge, PharmD, FCCP Scott Bolesta, PharmD, BCPS
Professor Associate Professor
Department of Clinical Pharmacy and Neurology Department of Pharmacy Practice
University of Colorado Wilkes University
Anschutz Medical Campus Wilkes-Bare, Pennsylvania
Skaggs School of Pharmacy and Pharmaceutical Sciences Clinical Pharmacist
CONTRIBUTORS

Aurora, Colorado Regional Hospital of Scranton


Chapter 39 Scranton, Pennsylvania
Chapter 25
Jerey F. Barletta, PharmD, FCCM
Associate Professor and Vice Chair Jill S. Borchert, PharmD, BCPS, FCCP
Department of Pharmacy Practice Professor and Vice Chair
Midwestern University Department of Pharmacy Practice
College of Pharmacy Midwestern University Chicago College of Pharmacy
Glendale, Arizona Downers Grove, Illinois
Chapter 2 Chapter 73

Chad M. Barnett, PharmD, BCOP Bradley A. Boucher, PharmD, FCCP, FCCM


Clinical Pharmacy Specialist-Breast Oncology Professor of Clinical Pharmacy and Associate Professor
Division of Pharmacy of Neurosurgery
Clinical Pharmacy Services Department of Clinical Pharmacy
University of Texas MD Anderson Cancer Center University of Tennessee Health Science Center
Houston, Texas Memphis, Tennessee
Chapter 105 Chapter 42

Larry A. Bauer, PharmD, FCP, FCCP Sharya V. Bourdet, PharmD, BCPS


Professor Critical Care Pharmacist/Clinical Inpatient Program Manager
Department of Pharmacy Pharmacy Service
School of Pharmacy Veterans Affairs Medical Center
Adjunct Professor Health Sciences Clinical Associate Professor
Department of Laboratory Medicine Department of Clinical Pharmacy
School of Medicine School of Pharmacy, University of California
University of Washington San Francisco, California
Seattle, Washington Chapter 16
eChapter 5
Nancy C. Brahm, PharmD, MS, BCPP, CGP
Jerry L. Bauman, PharmD, FCCP, FACC Clinical Professor
Dean The University of Oklahoma, College of Pharmacy
College of Pharmacy, University of Illinois at Chicago Tulsa, Oklahoma
Professor Chapter 56
Departments of Pharmacy Practice and Medicine,
Section of Cardiology Donald F. Brophy, PharmD, MSc, FCCP, FASN, BCPS
Colleges of Pharmacy and Medicine, University of Illinois McFarlane Professor and Chairman
at Chicago Department of Pharmacotherapy and Outcomes Sciences
Chicago, Illinois Virginia Commonwealth University School of Pharmacy
Chapter 8 Richmond, Virginia
Chapter 36
Terry J. Baumann, PharmD, BCPS
Clinical Manager, Pain Practitioner Jason E. Brouillard, PharmD, MBA
Department of Pharmacy Clinical Pharmacy Advisor
Munson Medical Center TheraDoc
Traverse City, Michigan Hospira, Inc.
Chapter 44 Spokane, Washington
eChapter 11
Oralia V. Bazaldua, PharmD, FCCP, BCPS
Associate Professor Thomas E. R. Brown, PharmD
Department of Family and Community Medicine Associate Professor
The University of Texas Health Science Center at San Antonio Leslie Dan Faculty of Pharmacy
San Antonio, Texas University of Toronto and Womens College Hospital
eChapter 1 Toronto, Ontario, Canada
Chapter 98
Martha G. Blackford, PharmD
Clinical Pharmacologist & Toxicologist Peter F. Buckley, MD
Clinical Pharmacology and Toxicology Dean
Department of Pediatrics Medical College of Georgia
Akron Childrens Hospital Georgia Regents University
Akron, Ohio Augusta, Georgia
Chapter 85 Chapter 50

Dipi_FM_i-xxxviii.indd xvi 10/24/13 12:12 PM


xvii
David S. Burgess, PharmD, FCCP Alexandre Chan, PharmD, MPH, BCPS, BCOP
Professor and Chair Associate Professor
Department of Pharmacy Practice and Science Department of Pharmacy
College of Pharmacy, University of Kentucky Faculty of Science
Lexington, Kentucky National University of Singapore
Chapter 83 Associate Consultant Clinical Pharmacist

CONTRIBUTORS
Department of Pharmacy
Lucinda M. Buys, PharmD, BCPS National Cancer Centre Singapore
Associate Professor Singapore, Singapore
Department of Pharmacy Practice and Science Chapter 109
University of Iowa
College of Pharmacy and The Siouxland Medical C. Y. Jennifer Chan, PharmD
Education Foundation Clinical Assistant Professor of Pharmacy
Sioux City, Iowa Pharmacotherapy Education and Research Center
Chapter 71 University of Texas at Austin College of Pharmacy
Adjunct Associate Professor of Pediatrics
Karim Anton Calis, PharmD, MPH, FASHP, FCCP Department of Pediatrics
Clinical Investigator University of Texas Health Science Center
Office of the Clinical Director San Antonio, Texas
Eunice Kennedy Shriver National Institute of Child Health Chapter 82
and Human Development
National Institutes of Health Jack J. Chen, PharmD, BCPS
Bethesda, Maryland Associate Professor
Clinical Professor Department of Neurology
Department of Pharmacy Practice and Science Movement Disorders Clinic
School of Pharmacy, University of Maryland Schools of Medicine and Pharmacy
Baltimore, Maryland Loma Linda University
Clinical Professor Loma Linda, California
Department of Pharmacotherapy and Outcomes Science Chapter 43
School of Pharmacy
Virginia Commonwealth University Judy T. Chen, PharmD, BCPS
Richmond, Virginia Clinical Associate Professor
Chapters 60, 65, and 121 Department of Pharmacy Practice
Purdue University College of Pharmacy
Peggy L. Carver, PharmD, FCCP Clinical Pharmacy Specialist
Associate Professor of Pharmacy The Jane Pauley Community Health Center, Inc.
Clinical Pharmacist, Infectious Diseases Indianapolis, Indiana
Department of Clinical, Social, and Administrative Sciences Chapter 121
University of Michigan College of Pharmacy and University
of Michigan Health System Katherine Hammond Chessman, BSPharm, PharmD
Ann Arbor, Michigan Professor
Chapter 99 Clinical Pharmacy and Outcomes Sciences
South Carolina College of Pharmacy, MUSC Campus
Larisa H. Cavallari, PharmD Clinical Pharmacy Specialist, Pediatrics/Pediatric Surgery
Associate Professor Department of Pharmacy Services
Department of Pharmacy Practice The Childrens Hospital of South Carolina
University of Illinois at Chicago Charleston, South Carolina
Chicago, Illinois Chapters 34, 118, and 120
eChapter 6
Chapter 4 Elaine Chiquette
San Antonio, Texas
Jose E. Cavazos, MD, PhD eChapter 4
Professor
Departments of Neurology, Pharmacology and Physiology Mariann D. Churchwell, PharmD, BCPS
Assistant Dean for MD/PhD Program Associate Professor
The University of Texas Health Science Center at San Antonio University of Toledo College of Pharmacy
San Antonio, Texas Toledo, Ohio
Chapter 40 Chapter 30

Peter A. Chyka, PharmD, FAACT, DPNAP, DABAT


Professor and Executive Associate Dean
Department of Clinical Pharmacy
University of Tennessee Health Science Center
College of Pharmacy
Knoxville, Tennessee
eChapter 10

Dipi_FM_i-xxxviii.indd xvii 10/24/13 12:12 PM


xviii
Elizabeth C. Clark, MD, MPH Michael A. Crouch, PharmD, FASHP, BCPS
Assistant Professor Executive Associate Dean and Professor
Family Medicine and Community Health Department of Pharmacy Practice
Rutgers University, Robert Wood Johnson Medical School Gatton College of Pharmacy
New Brunswick, New Jersey East Tennessee State University
Chapter 74 Johnson City, Tennessee
CONTRIBUTORS

Chapter 89
Nathan P. Clark, PharmD, BCPS
Clinical Pharmacy Supervisor William Dager, PharmD, BCPS (AQ Cardiology)
Clinical Pharmacy Pharmacist Specialist
Anticoagulation and Anemia Service UC Davis Medical Center
Kaiser Permanente Clinical Professor of Pharmacy
Aurora, Colorado UC San Francisco School of Pharmacy
Chapter 9 Clinical Professor of Medicine
UC Davis School of Medicine
Kristen Cook, PharmD, BCPS Clinical Professor of Pharmacy
Assistant Professor Touro School of Pharmacy
Department of Pharmacy Practice Sacramento, California
College of Pharmacy Chapter 28
University of Nebraska Medical Center
Omaha, Nebraska Devra K. Dang, PharmD, BCPS, CDE
Chapter 80 Associate Clinical Professor
University of Connecticut
John R. Corboy, MD School of Pharmacy
Professor Storrs, Connecticut
Department of Neurology Chapter 65
University of Colorado School of Medicine
Co-Director Joseph F. Dasta, MSc, FCCM, FCCP
Rocky Mountain MS Center Adjunct Professor
University of Colorado The University of Texas
Anschutz Medical Campus Professor Emeritus
Aurora, Colorado The Ohio State University
Chapter 39 Austin, Texas
Chapter 13
Lisa T. Costanigro, PharmD, BCPS
Staff Pharmacist Dewayne A. Davidson, PharmD
Poudre Valley Health System Assistant Professor
Fort Collins, Colorado Department of Family and Community Medicine
eChapter 11 The University of Texas Health Science Center at San Antonio
San Antonio, Texas
Elizabeth A. Coyle, PharmD, FCCM, BCPS eChapter 1
Assistant Dean of Assessment
Clinical Professor Lisa E. Davis, BS, PharmD
University of Houston Professor of Clinical Pharmacy
College of Pharmacy Philadelphia College of Pharmacy
Houston, Texas University of the Sciences in Philadelphia
Chapter 94 Philadelphia, Pennsylvania
Chapter 107
Catherine M. Crill, PharmD, BCPS, BCNSP, FCCP
Associate Professor Brian S. Decker, MD, PharmD, MS
Departments of Clinical Pharmacy and Pediatrics Assistant Professor of Clinical Medicine
The University of Tennessee Health Science Center Department of Medicine, Division of Nephrology
Memphis, Tennessee Indiana University School of Medicine
Chapter 119 Indianapolis, Indiana
Chapter 30
M. Lynn Crismon, PharmD
Dean Timothy Dellenbaugh, MD
James T. Doluisio Regents Chair and Behrens Centennial Professor Associate Professor
College of Pharmacy Department of Psychiatry
The University of Texas at Austin University of Missouri-Kansas City
Austin, Texas Center for Behavioral Medicine
Chapter 50 Kansas City, Missouri
eChapter 20

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xix
Paulina Deming, PharmD Thomas C. Dowling, PharmD, PhD, FCP
Associate Professor Associate Professor and Vice Chair
Department of Pharmacy Practice Department of Pharmacy Practice and Science
College of Pharmacy University of Maryland School of Pharmacy
University of New Mexico Health Sciences Center Baltimore, Maryland
Albuquerque, New Mexico eChapter 18

CONTRIBUTORS
Chapter 26
Shannon J. Drayton, PharmD, BCPP
Simon de Denus, B.Pharm, MSc, PhD Associate Professor
Research Pharmacist Clinical Pharmacy and Outcomes Sciences
Montreal Heart Institute South Carolina College of Pharmacy
Associate Professor Medical University of South Carolina
Faculty of Pharmacy Universit de Montral Charleston, South Carolina
Universit de Montral Beaulieu-Saucier Chapter 52
Chair in Pharmacogenomics
Montreal, Quebec Linda D. Dresser, PharmD, FCSHP
Chapter 7 Assistant Professor
Leslie Dan Faculty of Pharmacy
John W. Devlin, PharmD, FCCP, FCCM University of Toronto
Associate Professor University Health Network, Toronto
Department of Pharmacy Practice Ontario, Canada
Bouve College of Health Professions Chapter 98
Northeastern University
Boston, Massachusetts Deepak P. Edward, MD
Chapter 37 Jonas S Friedenwald Professor of Ophthalmology and Pathology
Department of Ophthalmology
Eric Dietrich, PharmD Wilmer Eye Institute
Post Doctoral Fellow Johns Hopkins University
Family Medicine College of Pharmacy and Medicine Baltimore, Maryland
University of Florida Chapter 75
Gainesville, Florida
Chapter 59 Mary Elizabeth Elliott, PharmD, PhD
Associate Professor
Cecily V. DiPiro, PharmD Pharmacy Practice Division
Consultant Pharmacist School of Pharmacy
Mount Pleasant, South Carolina University of Wisconsin
Chapter 22 Madison, Wisconsin
Chapter 71
Joseph T. DiPiro, PharmD, FCCP
Executive Dean and Professor Ramy H. Elshaboury, PharmD
South Carolina College of Pharmacy Pharmacy Resident in Infectious Diseases
University of South Carolina and Medical University Department of Pharmacy
of South Carolina Abbott Northwestern Hospital, Part of Allina Health
Charleston and Columbia, South Carolina Minneapolis, Minnesota
Chapter 92 Chapter 84

Paul L. Doering, MS Michael E. Ernst, PharmD


Distinguished Service Professor of Pharmacy Practice Emeritus Professor (Clinical)
Department of Pharmacotherapy and Translational Research Department of Pharmacy Practice and Science
College of Pharmacy College of Pharmacy and Department of Family Medicine
University of Florida Carver College of Medicine
Gainesville, Florida The University of Iowa
Chapters 48 and 49 Iowa City, Iowa
Chapter 74
Julie A. Dopheide, PharmD, BCPP
Associate Professor of Clinical Pharmacy, Psychiatry Brian L. Erstad, PharmD, FCCM, FCCP, FASHP
and the Behavioral Sciences Professor
University of Southern California School of Pharmacy Department of Pharmacy Practice and Science
and Keck School of Medicine University of Arizona College of Pharmacy
Los Angeles, California Tucson, Arizona
Chapter 46 Chapter 14

John M. Dopp, PharmD


Associate Professor
School of Pharmacy
University of Wisconsin
Madison, Wisconsin
Chapter 55

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xx
Francisco J. Esteva, MD, PhD Bradi Frei, PharmD, MS, BCPS, BCOP
Director Associate Professor
Breast Medical Oncology Program Department of Pharmacy Practice
Division of Hematology-Oncology Feik School of Pharmacy
Department of Medicine University of the Incarnate Word
Associate Director of Clinical Investigation San Antonio, Texas
CONTRIBUTORS

New York University Cancer Institute Chapter 86


New York University Langone Medical Center
New York, New York Christopher Frei, PharmD, MS, BCPS
Chapter 105 Associate Professor
Division of Pharmacotherapy
Patricia H. Fabel, PharmD College of Pharmacy
Clinical Assistant Professor The University of Texas at Austin
Clinical Pharmacy and Outcomes Sciences Austin, Texas
South Carolina College of Pharmacy, University Chapter 86
of South Carolina Campus
Columbia, South Carolina Melissa Frei-Jones, MD, MSCI
Chapter 23 Assistant Professor
Department of Pediatrics
Susan C. Fagan, PharmD, BCPS, FCCP Division of Hematology/Oncology
Jowdy Professor, Assistant Dean School of Medicine
Department of Clinical and Administrative Pharmacy University of Texas Health Science Center
University of Georgia College of Pharmacy San Antonio, Texas
Augusta, Georgia Chapter 82
eChapter 19
Chapter 10 Mark L. Glover, PharmD
Medical Writer
Christopher A. Fausel, PharmD, MHA, BCOP Global Medical Writing
Clinical Manager, Oncology Pharmacy PPD
Department of Pharmacy Wilmington, North Carolina
Indiana University Simon Cancer Center Chapter 85
Indianapolis, Indiana
Chapter 112 Shelly L. Gray, PharmD, MS
Professor and Vice Chair for Curriculum and Instruction
Richard G. Fiscella, PharmD, MPH Department of Pharmacy
Clinical Professor Emeritus Director
Department of Pharmacy Practice Geriatric Pharmacy Program and Plein Certificate
University of Illinois at Chicago School of Pharmacy
Chicago, Illinois University of Washington
Chapter 75 Seattle, Washington
eChapter 8
Douglas N. Fish, PharmD
Professor and Chair Alan E. Gross, PharmD, BCPS
Department of Clinical Pharmacy Clinical Assistant Professor
Skaggs School of Pharmacy and Pharmaceutical Sciences Department of Pharmacy Practice
University of Colorado Anschutz Medical Campus College of Pharmacy
Clinical Specialist in Infectious Diseases/Critical Care University of Nebraska Medical Center
University of Colorado Hospital Adjunct Assistant Professor
Aurora, Colorado Department of Medicine
Chapters 88 and 100 College of Medicine
Section of Infectious Diseases
Courtney V. Fletcher, PharmD University of Nebraska Medical Center
Dean and Professor Omaha, Nebraska
Departments of Pharmacy Practice and Medicine Chapter 92
College of Pharmacy
University of Nebraska Medical Center Wayne P. Gulliver, MD, FRCPC
Omaha, Nebraska Professor of Dermatology and Medicine
Chapter 103 Memorial University of Newfoundland
St. Johns Newfoundland and Labrador
Michelle A. Fravel, PharmD Canada
Assistant Professor (Clinical) Chapter 78
Department of Pharmacy Practice and Science
and Department of Pharmaceutical Care
University of Iowa College of Pharmacy and University
of Iowa Hospitals and Clinics
Iowa City, Iowa
Chapter 74

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xxi
John G. Gums, PharmD, FCCP Chris M. Herndon, PharmD, BCPS, CPE
Professor of Pharmacy and Translational Research Associate Professor
Department of Family Medicine Department of Pharmacy Practice
College of Pharmacy and Medicine Southern Illinois University Edwardsville
University of Florida Edwardsville, Illinois
Gainesville, Florida Chapter 44

CONTRIBUTORS
Chapter 59
Lauren R. Hersh, MD
Emily R. Hajjar, PharmD, BCPS, BCAP, CGP Instructor
Associate Professor Department of Family and Community Medicine
Department of Pharmacy Practice Thomas Jefferson University
Jefferson School of Pharmacy Philadelphia, Pennsylvania
Thomas Jefferson University eChapter 8
Philadelphia, Pennsylvania
eChapter 8 David C. Hess, MD
Professor and Chairman
Jenana Halilovic, PharmD, BCPS, AAHIVP Department of Neurology
Assistant Professor Medical College of Georgia
Department of Pharmacy Practice Augusta, Georgia
Thomas J Long School of Pharmacy and Health Sciences Chapter 10
Stockton, California
Chapter 28 Angela Massey Hill, PharmD, BCPP, CPH
Professor and Chair
Philip D. Hall, PharmD, FCCP, BCPS, BCOP Department of Pharmacotherapeutics
Campus Dean and Professor University of South Florida College of Pharmacy
South Carolina College of Pharmacy Tampa, Florida
Medical University of South Carolina Chapter 38
Charleston, South Carolina
eChapter 21 L. David Hillis, MD
Professor and Chair
Joseph T. Hanlon, PharmD, MS Department of Medicine
Professor University of Texas Health Science Center
Department of Medicine, Pharmacy and Therapeutics, and San Antonio, Texas
Epidemiology eChapter 13
University of Pittsburgh Chapter 1
Pittsburgh, Pennsylvania
eChapter 8 Barbara J. Hoeben, PharmD, MSPharm, BCPS
Pharmacy Flight Commander
Michelle Harkins, MD Davis-Monthan Air Force Base
Associate Professor of Medicine Tucson, Arizona
Department of Internal Medicine Chapter 12
University of New Mexico Health Sciences Center
Albuquerque, New Mexico Jessica S. Holt, PharmD, BCPS, AQ-ID
eChapter 15 Infectious Diseases Pharmacy Coordinator
Department of Pharmacy
Mary S. Hayney, PharmD, MPH, FCCP, BCPS Abbott Northwestern Hospital, Part of Allina Health
Professor of Pharmacy Minneapolis, Minnesota
University of Wisconsin School of Pharmacy Chapter 84
Madison, Wisconsin
Chapter 102 Joanna Q. Hudson, PharmD, BCPS, FASN, FCCP
Associate Professor
Brian A. Hemstreet, PharmD, FCCP, BCPS Departments of Clinical Pharmacy and Medicine (Nephrology)
Associate Professor The University of Tennessee Health Science Center
Department of Clinical Pharmacy Memphis, Tennessee
University of Colorado Skaggs School of Pharmacy Chapter 29
and Pharmaceutical Sciences
Aurora, Colorado Grant F. Hutchins, MD
Chapter 21 Assistant Professor, Internal Medicine
Division of Gastroenterology-Hepatology
Elizabeth D. Hermsen, PharmD, MBA, BCPS-ID University of Nebraska Medical Center
Clinical Scientific Director Omaha, Nebraska
Cubist Pharmaceuticals, Inc. eChapter 16
Lexington, Massachusetts
Adjunct Associate Professor
Department of Pharmacy Practice
College of Pharmacy, University of Nebraska Medical Center
Omaha, Nebraska
Chapters 84 and 87

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xxii
Robert J. Ignoo, PharmD, FASHP, FCSHP Judith C. Kando, PharmD, BCPP
Professor of Pharmacy Senior Ana Medical Specialist
Touro University California Sunovion Pharmaceuticals Inc.
Clinical Professor Emeritus Marlborough, Massachusetts
University of California Chapter 51
San Francisco, California
S. Lena Kang-Birken, PharmD, FCCP
CONTRIBUTORS

Chapter 22
Associate Professor
Arthur A. Islas, MD, MPH Department of Pharmacy Practice
Associate Professor and Director of Sports Medicine School of Pharmacy and Health Sciences
Department of Family and Community Medicine University of the Pacific
Paul L. Foster School of Medicine Stockton, California
Texas Tech University Health Sciences Center-El Paso Chapter 97
El Paso, Texas
eChapter 2 Salmaan Kanji, PharmD, BSc, Pharm, ACPR
Clinical Pharmacy Specialist
Heather J. Johnson, PharmD, BCPS The Ottawa Hospital
Assistant Professor Associate Scientist
Department of Pharmacy and Therapeutics Ottawa Hospital Research Institute
University of Pittsburgh School of Pharmacy Adjunct Professor of Pharmacy
Pittsburgh, Pennsylvania University of Montreal
Chapter 70 Assistant Professor of Medicine
University of Ottawa
Shawn E. Johnson, PharmD, MPH Pharmacy, Clinical Epidemiology
Clinical Generalist Pharmacist Ottawa, Ontario, Canada
Department of Pharmacy Chapter 101
The Ohio State University Wexner Medical Center
Columbus, Ohio H. William Kelly, PharmD
eChapter 3 Professor Emeritus Pediatrics
Department of Pediatrics
Jacqueline Jonklaas, MD, PhD University of New Mexico Health Sciences Center
Associate Professor Albuquerque, New Mexico
Division of Endocrinology Chapter 15
Department of Medicine
Georgetown University Patrick J. Kiel, PharmD, BCPS, BCOP
Washington, District of Columbia Clinical Pharmacy Specialist, Hematology/Stem Cell Transplant
Chapter 58 Department of Pharmacy
Indiana University Simon Cancer Center
Joseph K. Jordan, PharmD Indianapolis, Indiana
Associate Professor Chapter 112
Drug Information Specialist
Department of Pharmacy Practice William R. Kirchain, PharmD, CDE
Butler University College of Pharmacy and Health Sciences Wilbur and Mildred Robichaux Endowed Professorship
Indiana University Health Division of Clinical and Administrative Sciences
Indianapolis, Indiana Xavier University of Louisiana
Chapter 60 College of Pharmacy
New Orleans, Louisiana
Rose Jung, PharmD, MPH, BCPS eChapter 17
Clinical Associate Professor
Department of Pharmacy Practice Cynthia K. Kirkwood, PharmD, BCPP
College of Pharmacy and Pharmaceutical Sciences Professor
University of Toledo Vice Chair for Education
Toledo, Ohio Department of Pharmacotherapy and Outcomes Science
Chapter 91 School of Pharmacy
Virginia Commonwealth University
Thomas N. Kakuda, PharmD Richmond, Virginia
Scientific Director Chapters 53 and 54
Department of Clinical Pharmacology
Janssen Research & Development, LLC Jacqueline Klootwyk, PharmD, BCPS
Titusville, New Jersey Assistant Professor of Pharmacy Practice
Chapter 103 Jefferson School of Pharmacy
Thomas Jefferson University
Sophia N. Kalantaridou, MD, PhD Philadelphia, Pennsylvania
Professor of Obstetrics and Gynecology Chapter 63
Department of Obstetrics and Gynecology
University of Ioannina Medical School
Ioannina, Greece
Chapter 65

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xxiii
Leroy C. Knodel, PharmD Kerry L. LaPlante, PharmD, BS
Associate Professor Associate Professor of Pharmacy
Department of Surgery Department of Pharmacy Practice
The University of Texas Health Science Center University of Rhode Island College of Pharmacy
San Antonio, Texas Infectious Diseases Pharmacotherapy Specialist
Clinical Professor Pharmacy Services

CONTRIBUTORS
College of Pharmacy Providence Veterans Affairs Medical Center
The University of Texas at Austin Adjunct Associate Professor of Medicine
Austin, Texas Division of Infectious Diseases
Chapter 95 Warren Alpert School of Medicine
Brown University
Jill M. Kolesar, PharmD, BCPS, FCCP Kingston, Rhode Island
Professor eChapter 25
School of Pharmacy
University of Wisconsin Alan H. Lau, PharmD, FCCP
Madison, Wisconsin Professor
Chapter 108 Department of Pharmacy Practice
Director, International Clinical Pharmacy Education
Sunil Kripalani, MD, MSc University of Illinois at Chicago, College of Pharmacy
Associate Professor Chicago, Illinois
Section of Hospital Medicine Chapter 32
Division of General Internal Medicine and Public Health
Department of Medicine Michael Lauzardo, MD, MSc
Vanderbilt University Chief
Nashville, Tennessee Division of Infectious Diseases and Global Medicine
eChapter 1 Director
Southeastern National Tuberculosis Center
Vanessa J. Kumpf, PharmD, BCNSP College of Medicine
Clinical Specialist, Nutrition Support University of Florida
Center for Human Nutrition Gainesville, Florida
Vanderbilt Medical Center Chapter 90
Nashville, Tennessee
Chapters 118 and 120 David T.S. Law, BSc, MD, PhD, CCFP
Assistant Professor
Po Gin Kwa, MD, FRCPC Department of Family and Community Medicine
Clinical Assistant, Professor of Pediatrics Faculty of Medicine
Faculty of Medicine University of Toronto
Memorial University of Newfoundland and Pediatrician Staff, Department of Family Practice
Eastern Health The Scarborough Hospital and Rouge Valley Health System
St. Johns, Newfoundland, Canada Scarborough, Ontario, Canada
Chapter 79 eChapter 23
Sum Lam, PharmD, CGP, BCPS, FASCP Rebecca M. Law, PharmD
Associate Clinical Professor School of Pharmacy and Discipline of Family Medicine
Department of Clinical Pharmacy Practice Faculty of Medicine
St. Johns University Memorial University of Newfoundland
Queens, New York St. Johns Newfoundland, Canada
Chapter 68 eChapter 23
Y. W. Francis Lam, PharmD, FCCP Chapters 78 and 79
Professor of Pharmacology and Medicine Grace C. Lee, PharmD, BCPS
Department of Pharmacology Clinical Instructor
The University of Texas Health Science Center at San Antonio Division of Pharmacotherapy
San Antonio, Texas College of Pharmacy
Clinical Associate Professor of Pharmacy University of Texas at Austin
University of Texas at Austin Austin, Texas
Austin, Texas Chapter 83
eChapter 6
Mary Lee, PharmD, BCPS, FCCP
Richard A. Lange, MD, MBA Professor of Pharmacy Practice
Professor and Executive Vice Chairman Chicago College of Pharmacy
Department of Medicine Midwestern University
The University of Texas Health Science Center Downers Grove, Illinois
San Antonio, Texas Chapters 66 and 67
eChapter 13
Chapter 1

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xxiv
Timothy S. Lesar, PharmD William L. Lyons, MD
Director of Clinical Pharmacy Services Associate Professor
Patient Care Services Director Section of Geriatrics
Department of Pharmacy Department of Internal Medicine
Albany Medical Center University of Nebraska Medical Center
Albany, New York Omaha, Nebraska
CONTRIBUTORS

Chapter 75 Chapter 80

Deborah J. Levine, MD, FCCP Robert MacLaren, BBSc, PharmD, MPH, FCCM, FCCP
Associate Professor of Medicine Professor
Division of Pulmonary and Critical Care Department of Clinical Pharmacy
University of Texas Skaggs School of Pharmacy and Pharmaceutical Sciences
San Antonio, Texas University of Colorado Denver
Chapter 17 Aurora, Colorado
Chapter 13
Stephanie M. Levine, MD
Professor of Medicine Eric J. MacLaughlin, PharmD, FASHP, FCCP, BCPS
Division of Pulmonary Diseases and Critical Care Medicine Professor and Interim Chair
The University of Texas Health Science Center Department of Pharmacy Practice
San Antonio, Texas Professor
eChapter 14 Departments of Family Medicine and Internal Medicine
Texas Tech University Health Sciences Center School of Pharmacy
Robin Moorman Li, PharmD, BCACP Amarillo, Texas
Assistant Director Chapter 3
Jacksonville Campus
Clinical Assistant Professor Robert L. Maher Jr, PharmD, CGP
Department of Pharmacotherapy and Translational Research Assistant Professor of Pharmacy Practice
University of Florida, College of Pharmacy Clinical, Social, and Administrative Sciences Division
Gainesville, Florida Duquesne University Mylan School of Pharmacy
Chapters 48 and 49 Pittsburgh, Pennsylvania
eChapter 8
Susanne Liewer, PharmD, BCOP
Clinical Pharmacy Coordinator, Stem Cell Transplant Robert A. Mangione, EdD, RPh
Department of Pharmaceutical and Nutrition Care Provost and Professor of Pharmacy
The Nebraska Medical Center Office of the Provost
Clinical Assistant Professor St. Johns University
Department of Pharmacy Practice Queens, New York
College of Pharmacy Chapter 27
University of Nebraska Medical Center
Omaha, Nebraska Steven Martin, PharmD
Chapter 117 Professor and Chairman
Department of Pharmacy Practice
Bryan L. Love, PharmD College of Pharmacy and Pharmaceutical Sciences
Associate Professor The University of Toledo
Department of Clinical Pharmacy and Outcomes Science Toledo, Ohio
South Carolina College of Pharmacy Chapter 91
Clinical Pharmacy Specialist
Departments of Pharmacy and Gastroenterology/Hepatology Todd W. Mattox, PharmD, BCNSP
William Jennings Bryan Dorn Veterans Affairs Medical Center Critical Care
Columbia, South Carolina Nutrition Support Pharmacy Specialist
Chapter 20 Department of Pharmacy
Moffitt Cancer Center
Amanda M. Loya, PharmD Tampa, Florida
Clinical Associate Professor Chapter 119
University of Texas at El Paso
UT Austin Cooperative Pharmacy Program Gary R. Matzke, PharmD, FCP, FCCP, FASN, FNAP
University of Texas at El Paso College of Health Sciences Professor and Director
University of Texas at Austin College of Pharmacy Pharmacy Practice Transformation Initiatives
Adjunct Clinical Assistant Professor and Founding Director
Department of Family and Community Medicine ACCP/ASHP/VCU Congressional Health Care Policy
Texas Tech University Health Sciences CenterEl Paso Fellow Program
El Paso, Texas Department of Pharmacotherapy and Outcome Sciences
eChapter 2 School of Pharmacy, Virginia Commonwealth University
Richmond, Virginia
Chapters 33, 34, and 37

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xxv
Dianne B. May, PharmD, BCPS Deborah S. Minor, PharmD
Clinical Associate Professor Executive Vice Chair and Professor
Department of Clinical and Administrative Pharmacy Department of Medicine, School of Medicine
Division of Experience Programs Associate Professor, School of Pharmacy
College of Pharmacy University of Mississippi Medical Center
University of Georgia Jackson, Mississippi

CONTRIBUTORS
Augusta, Georgia Chapter 45
Chapter 19
Augusto Miravalle, MD
J. Russell May, PharmD Assistant Professor
Clinical Professor Department of Neurology
Department of Clinical and Administrative Pharmacy University of Colorado School of Medicine
University of Georgia College of Pharmacy Associate Director
Augusta, Georgia Neurology Residency Program
Chapter 76 University of Colorado
Anschutz Medical Campus
Kristen B. McCullough, PharmD, BCPS, BCOP Aurora, Colorado
Clinical Pharmacist Chapter 39
Department of Pharmacy Services
Mayo Clinic Isaac F. Mitropoulos, BS, PharmD
Rochester, Minnesota Senior Medical Education and Research Liaison
Chapter 114 Department of Medical Affairs
Optimer Pharmaceuticals, Inc.
Timothy R. McGuire, PharmD, FCCP, BCOP Chapel Hill, North Carolina
Associate Professor Chapter 84
Department of Pharmacy Practice
College of Pharmacy Rima A. Mohammad, PharmD, BCPS
University of Nebraska Medical Center Assistant Professor
Omaha, Nebraska Department of Pharmacy and Therapeutics
Chapter 113 School of Pharmacy
University of Pittsburgh
Jerry R. McKee, PharmD, MS, BCPP Pittsburgh, Pennsylvania
Regional Dean Chapter 33
Associate Professor of Pharmacy
Wingate University Hendersonville Campus Patricia A. Montgomery, PharmD
Hendersonville, North Carolina Adjunct Professor
Chapter 56 Thomas J. Long School of Pharmacy and Health Sciences
University of the Pacific
Patrick J. Medina, PharmD, BCOP Sacramento, California
Associate Professor Chapter 25
The University of Oklahoma
College of Pharmacy Rebecca Moote, PharmD, MSc, BCPS
Oklahoma City, Oklahoma Assistant Professor
Chapters 104 and 107 Department of Pharmacy Practice
Regis University School of Pharmacy
Sarah T. Melton, PharmD, BCPP, BCACP, CGP, FASCP Denver, Colorado
Associate Professor of Pharmacy Practice Chapter 17
Department of Pharmacy Practice
Gatton College of Pharmacy at East Tennessee State University Scott W. Mueller, PharmD
Johnson City, Tennessee Assistant Professor
Chapters 53 and 54 Department of Clinical Pharmacy
Skaggs School of Pharmacy and Pharmaceutical Sciences
Julianna A. Merten, PharmD, BCPS, BCOP University of Colorado Anschutz Medical Campus
Clinical Pharmacy Specialist Clinical Specialist in Critical Care
Department of Pharmacy Services University of Colorado Hospital
Mayo Clinic Aurora, Colorado
Rochester, Minnesota Chapter 100
Chapter 114
Milap C. Nahata, PharmD, MS, FCCP
Laura Boehnke Michaud, PharmD, BCOP, FASHP Professor of Pharmacy
Manager, Clinical Pharmacy Services Pediatrics and Internal Medicine
Division of Pharmacy Division Chair
Clinical Pharmacy Services Pharmacy Practice and Administration College of Pharmacy
The University of Texas M. D. Anderson Cancer Center Ohio State University
Houston, Texas Associate Director of Pharmacy
Chapter 105 The Ohio State University Medical Center
Columbus, Ohio
eChapter 7

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xxvi
Rocsanna Namdar, PharmD, BCPS Cindy L. OBryant, PharmD, BCOP
Assistant Professor Associate Professor
Department of Clinical Pharmacy Department of Clinical Pharmacy
University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences
Skaggs School of Pharmacy and Pharmaceutical Sciences Clinical Specialist in Oncology
Aurora, Colorado University of Colorado Cancer Center
CONTRIBUTORS

Chapter 90 Aurora, Colorado


Chapter 116
Jean M. Nappi, BS, PharmD, FCCP, BCPS
Professor Mary Beth OConnell, PharmD, BCPS, FASHP, FCCP
Department of Clinical Pharmacy and Outcome Sciences Associate Professor
South Carolina College of PharmacyMUSC Campus Department of Pharmacy Practice
Professor Eugene Applebaum College of Pharmacy and Health Sciences
Department of Medicine Wayne State University
Medical University of South Carolina Detroit, Michigan
Charleston, South Carolina Chapter 73
Chapter 4
Brian L. Odle, PharmD
Leigh Anne Nelson, PharmD, BCPP Assistant Professor
Associate Professor Department of Pharmacy Practice
Division of Pharmacy Practice and Administration Gatton College of Pharmacy
School of Pharmacy East Tennessee State University
University of Missouri-Kansas City Johnson City, Tennessee
Kansas City, Missouri Chapter 89
eChapter 20
Keith M. Olsen, PharmD, FCCP, FCCM
Fenwick T. Nichols III, MD Professor and Chair
Professor of Neurology Department of Pharmacy Practice
Medical College of Georgia College of Pharmacy
Augusta, Georgia University of Nebraska Medical Center
eChapter 19 Omaha, Nebraska
eChapter 16
Jessica C. Njoku, PharmD, BCPS Chapter 92
Infectious Diseases and Antimicrobial Stewardship Coordinator
Department of Pharmacy Amy Barton Pai, PharmD, BCPS, FASN, FCCP
Baylor University Medical Center Associate Professor
Dallas, Texas Department of Pharmacy Practice
Chapter 87 Albany College of Pharmacy and Health Sciences
Albany, New York
Thomas D. Nolin, PharmD, PhD, FCCP, FCP, FASN Chapter 35
Assistant Professor
Department of Pharmacy and Therapeutics Robert B. Parker, PharmD, FCCP
Center for Clinical Pharmaceutical Sciences Professor
Department of Medicine, Renal-Electrolyte Division Department of Clinical Pharmacy
University of Pittsburgh Schools of Pharmacy and Medicine University of Tennessee College of Pharmacy
Pittsburgh, Pennsylvania Memphis, Tennessee
Chapter 31 Chapter 4

LeAnn B. Norris, PharmD, BCPS, BCOP Priti N. Patel, PharmD, BCPS


Assistant Professor Associate Clinical Professor
Clinical Pharmacy and Outcomes Sciences College of Pharmacy and Health Sciences
South Carolina College of Pharmacy St. Johns University
Columbia, South Carolina Queens, New York
Chapter 108 Chapter 27

Barbara M. OBrien, MD Mrinal M. Patnaik, MBBS, MD


Assistant Professor Assistant Professor of Oncology and Internal Medicine
Division of MFM Division of Hematology
Director Department of Internal Medicine
Perinatal Genetics Mayo Clinic
Co-Director Prenatal Diagnosis Center Rochester, Minnesota
Associate Director Chaper 114
Core Clerkship in Obstetrics and Gynecology
Providence, Rhode Island
Chapter 61

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xxvii
Christine M. Pelic, MD Nicole Weimert Pilch, PharmD, MSCR, BCPS
Assistant Professor Clinical Specialist
Department of Psychiatry Solid Organ Transplantation
Medical University of South Carolina Clinical Assistant Professor
Charleston, South Carolina Department of Pharmacy and Clinical Sciences
Chapter 52 South Carolina College of Pharmacy

CONTRIBUTORS
MUSC Campus
Charles A. Peloquin, PharmD Medical University of South Carolina
Professor Department of Pharmacy Services
College of Pharmacy and Emerging Pathogens Institute Charleston, South Carolina
University of Florida eChapter 21
Gainesville, Florida
Chapter 90 Kathleen J. Pincus, PharmD, BCPS
Assistant Professor
Susan L. Pendland, MS, PharmD Department of Pharmacy Practice and Sciences
Adjunct Associate Professor of Pharmacy Practice University of Maryland
University of Illinois at Chicago School of Pharmacy
Chicago, Illinois Baltimore, Maryland
Clinical Staff Pharmacist, St. Joseph Berea Hospital Chapter 64
Berea, Kentucky
Chapter 88 Stephen R. Pliszka, MD
Professor and Chief
Janelle Perkins, PharmD, BCOP Division of Child and Adolescent Psychiatry
Associate Professor Department of Psychiatry
Departments of Pharmacotherapeutics, The University of Texas Health Science Center at San Antonio
Clinical Research and Oncologic Sciences San Antonio, Texas
Colleges of Pharmacy and Medicine Chapter 46
University of South Florida
Tampa, Florida Betsy Bickert Poon, PharmD
Chapter 117 Assistant Director of Pharmacy
Pediatric Hematology/Oncology/Stem Cell Transplant Specialist
Emily P. Peron, PharmD, MS, BCPS, FASCP Walt Disney Pavilion at Florida Hospital for Children
Assistant Professor Orlando, Florida
Geriatric Pharmacotherapy Program Chapters 81 and 111
Department of Pharmacotherapy and Outcomes Science
Virginia Commonwealth University L. Michael Posey, BSPharm, MA
School of Pharmacy Associate Vice President
Richmond, Virginia Periodicals Department
Chapter 38 American Pharmacists Association
Washington, District of Columbia
Jay I. Peters, MD eChapter 4
Professor and Chief
Division of Pulmonary Critical Care Jamie C. Poust, PharmD, BCOP
University of Texas Health Science Center Oncology Pharmacy Specialist
San Antonio, Texas Department of Pharmacy
eChapter 14 University of Colorado Hospital
Anschutz Inpatient Pavilion
Stephanie J. Phelps, PharmD, BSPharm Aurora, Colorado
Professor Chapter 116
Clinical Pharmacy and Pediatrics
College of Pharmacy and Pediatrics Randall A. Prince, PharmD, PhD
The University of Tennessee Health Science Center Professor
Memphis, Tennessee University of Houston College of Pharmacy
Chapter 41 Houston, Texas
Chapter 94
Bradley G. Phillips, PharmD, BCPS, FCCP
Milliken-Reeve Professor and Head Jane Pruemer, PharmD, BCOP
Department of Clinical and Administrative Pharmacy Professor of Clinical Pharmacy Practice
University of Georgia College of Pharmacy Department of Pharmacy Practice and Administrative Sciences
Athens, Georgia James L. Winkle College of Pharmacy
Chapter 55 University of Cincinnati
Cincinnati, Ohio
Chapter 81

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xxviii
Kelly R. Ragucci, PharmD, FCCP, BCPS, CDE Beth H. Resman-Targo, PharmD, FCCP
Professor and Chair Clinical Professor
Clinical Pharmacy and Outcomes Sciences Department of Pharmacy
South Carolina College of Pharmacy Clinical and Administrative Sciences
Medical University of South Carolina Campus University of Oklahoma College of Pharmacy
Charleston, South Carolina Oklahoma City, Oklahoma
CONTRIBUTORS

Chapter 62 Chapter 69

Hengameh H. Raissy, PharmD Jos O. Rivera, PharmD


Research Associate Professor of Pediatrics Director and Clinical Professor
Pulmonary Division University of Texas at El Paso
School of Medicine UT Austin Cooperative Pharmacy Program
University of New Mexico University of Texas at El Paso College of Health Sciences
Albuquerque, New Mexico University of Texas at Austin College of Pharmacy
eChapter 15 Assistant Dean and Clinical Professor
El Paso, Texas
Kamakshi V. Rao, PharmD, BCOP, CPP, FASHP eChapter 2
Clinical Pharmacist Practitioner
Oncology/Bone Marrow Transplant Jo E. Rodgers, PharmD, FCCP, BCPS
University of North Carolina Hospitals and Clinics Clinical Associate Professor
Clinical Assistant Professor Division of Pharmacotherapy and Experimental Therapeutics
Division of Practice Advancement and Clinical Education UNC Eshelman School of Pharmacy
University of North Carolina Eshelman School of Pharmacy Chapel Hill, North Carolina
Chapel Hill, North Carolina Chapter 5
eChapter 24
Susan J. Rogers, PharmD, BCPS
Satish SC Rao, MD, PhD, FRCP Assistant Clinical Professor at Austin
Professor of Medicine Clinical Pharmacy Specialist Neurology
Chief, Section of Gastroenterology/Hepatology South Texas Healthcare System
Director Audie L. Murphy Memorial Veterans Hospital
Digestive Health Center San Antonio, Texas
Department of Medicine Chapter 40
Georgia Regents University
Medical College of Georgia John C. Rotschafer, PharmD, FCCP
Augusta, Georgia Professor
Chapter 19 Experimental and Clinical Pharmacology
University of Minnesota
Brent N. Reed, PharmD, BCPS College of Pharmacy
Assistant Professor Minneapolis, Minnesota
Department of Pharmacy Practice and Science Chapter 84
University of Maryland School of Pharmacy
Clinical Pharmacy Specialist Eric S. Rovner, MD
Department of Pharmacy Professor of Urology
University of Maryland Medical Center Department of Urology
Baltimore, Maryland Medical University of South Carolina
Chapter 5 Charleston, South Carolina
Chapter 68
Michael D. Reed, PharmD
Director Valerie L. Ruehter, PharmD, BCPP
Department of Clinical Pharmacology and Toxicology Clinical Assistant Professor
The Rebecca D. Considine Research Institute Director of Experiential Learning
Akron Childrens Hospital University of Missouri-Kansas City School of Pharmacy
Akron, Ohio Kansas City, Missouri
Chapter 85 Chapter 47

Thomas Repas, DO, FACP, FACOI, FNLA, FACE, CDE Michael J. Rybak, PharmD, MPH
Clinical Assistant Professor Professor of Pharmacy and Medicine
Department of Internal Medicine Director
Sanford School of Medicine Anti Infective Research Laboratory
University of South Dakota Department of Pharmacy Practice
Sioux Falls, South Dakota Eugene Applebaum College of Pharmacy
Chapter 57 Wayne State University
Detroit, Michigan
eChapter 25

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xxix
Cynthia A. Sanoski, PharmD, BCPS, FCCP Kayce M. Shealy, PharmD
Chair Assistant Professor
Department of Pharmacy Practice Department of Pharmacy Practice
Jefferson School of Pharmacy Presbyterian College School of Pharmacy
Thomas Jefferson University Clinton, South Carolina
Philadelphia, Pennsylvania Chapter 23

CONTRIBUTORS
Chapter 8
Amy Heck Sheehan, PharmD
Joseph J. Saseen, PharmD, FASHP, FCCP, BCPS Associate Professor
Professor and Vice Chair Department of Pharmacy Practice
Department of Clinical Pharmacy Purdue University College of Pharmacy
Professor Drug Information Specialist
Department of Family Medicine Indiana University Health System
University of Colorado Anschutz Medical Campus Indianapolis, Indiana
Skaggs School of Pharmacy and Pharmaceutical Sciences Chapters 60 and 121
Aurora, Colorado
Chapter 3 Ziad Shehab, MD
Professor
Mark E. Schneiderhan, PharmD, BCPP Departments of Pediatrics and Pathology
Associate Professor University of Arizona College of Medicine
Department of Pharmacy Practice and Pharmaceutical Sciences Tucson, Arizona
Department of Psychiatry Chapter 96
University of Minnesota, College of Pharmacy
Duluth/Human Development Center Greene Shepherd, PharmD
Duluth, Minnesota Clinical Professor
eChapter 20 Department of Practice Advancement and Clinical Education
UNC Eshelman School of Pharmacy
Kristine S. Schonder, PharmD Asheville, North Carolina
Assistant Professor eChapter 12
Department of Pharmacy and Therapeutics
University of Pittsburgh School of Pharmacy Stacy S. Shord, PharmD, BCOP, FCCP
Pittsburgh, Pennsylvania Reviewer
Chapter 70 Office of Clinical Pharmacology
Office of Translational Science
Arthur A. Schuna, MS, BCACP Center for Drug Evaluation and Research
Clinical Coordinator U.S. Food and Drug Administration
Department of Pharmacy Service Silver Spring, Maryland
William S. Middleton VA Hospital Chapter 104
Clinical Professor
Department of Pharmacy Practice Sarah P. Shrader, PharmD, BCPS, CDE
University of Wisconsin School of Pharmacy Clinical Associate Professor
Madison, Wisconsin Department of Pharmacy Practice
Chapter 72 University of Kansas
School of Pharmacy
Richard B. Schwartz, MD Lawrence, Kansas
Professor and Chair Chapter 62
Department of Emergency Medicine
Medical College of Georgia Jeri J. Sias, PharmD, MPH
Augusta, Georgia Clinical Associate Professor
eChapter 12 University of Texas at El Paso
UT Austin Cooperative Pharmacy Program
Julie M. Sease, PharmD, BCPS, BCACP University of Texas at El Paso College of Health Sciences
Associate Professor University of Texas at Austin College of Pharmacy
Department of Pharmacy Practice Adjunct Clinical Assistant Professor
Presbyterian College School of Pharmacy Department of Family and Community Medicine
Clinton, South Carolina Texas Tech University Health Sciences CenterEl Paso
Chapter 24 El Paso, Texas
eChapter 2
Amy Hateld Seung, PharmD, BCOP
Oncology Pharmacy Clinical Specialist Debra Sibbald, BScPhm, RPh, ACPR, MA, PhD
PGY2 Oncology Residency Director Senior Lecturer
Department of Pharmacy Division of Pharmacy Practice
Sidney Kimmel Comprehensive Cancer Center Leslie Dan Faculty of Pharmacy
Johns Hopkins Hospital University of Toronto
Baltimore, Maryland Director
Chapter 111 Department of Assessment Services
Centre for the Evaluation of Health Professionals Educated Abroad
Toronto, Ontario
Chapter 77

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xxx
Ashley E. Simmons, PharmD Sarah A. Spinler, PharmD, FCCP, FAHA, BCPS
Post-Doctoral Fellow Professor of Clinical Pharmacy
Division of Pharmacotherapy and Experimental Therapeutics Philadelphia College of Pharmacy
University of North Carolina Eshelman School of Pharmacy University of the Sciences in Philadelphia
University of North Carolina Philadelphia, Pennsylvania
Chapel Hill, North Carolina Chapter 7
CONTRIBUTORS

Chapter 115
Catherine I. Starner, PharmD, BCPS
Tamara D. Simpson, MD Senior Health Outcomes Researcher
Associate Professor of Medicine Medication Therapy Management
Division of Pulmonary and Critical Care Prime Therapeutics, LLC
University of Texas Health Science Center at San Antonio Adjunct Assistant Professor
San Antonio, Texas Experimental and Clinical Pharmacology
eChapter 14 College of Pharmacy
University of Minnesota
Patricia W. Slattum, PharmD, PhD Minneapolis, Minnesota
Director, Geriatric Pharmacotherapy Program eChapter 8
Department of Pharmacotherapy and Outcomes Science
Virginia Commonwealth University, School of Pharmacy Douglas W. Stewart, DO, MPH
Richmond, Virginia Associate Professor
eChapter 8 Department of Pediatrics
Chapter 38 School of Community Medicine
The University of Oklahoma
Judith A. Smith, PharmD, BCOP, CPHQ, FCCP, FISOPP Tulsa, Oklahoma
Associate Professor and Director, Pharmacology Research Chapter 56
Department of Gynecologic Oncology and Reproductive Medicine
Division of Surgery Steven C. Stoner, PharmD, BCPP
Program Director, Oncology Translational Research Fellowship Clinical Professor and Chair
Division of Pharmacy UMKC School of Pharmacy
University of Texas M.D. Anderson Cancer Center Division of Pharmacy Practice and Administration
Houston, Texas Kansas City, Missouri
Chapter 110 Chapter 47

Philip H. Smith, MD Jennifer M. Strickland, PharmD, BCPS


Assistant Professor Director of Clinical Strategy
Department of Allergy and Immunology Millennium Laboratories
Medical College of Georgia School of Medicine Assistant Clinical Professor
Augusta, Georgia University of Florida
Chapter 76 College of Pharmacy
Lakeland, Florida
Steven M. Smith, PharmD, MPH Chapter 44
Assistant Professor
Department of Clinical Pharmacy Deborah A. Sturpe, PharmD, BCPS, MA
Skaggs School of Pharmacy and Pharmaceutical Sciences Associate Professor
University of Colorado Department of Pharmacy Practice and Science
Aurora, Colorado University of Maryland School of Pharmacy
Chapter 59 Baltimore, Maryland
Chapter 64
Christine A. Sorkness, PharmD
Professor of Pharmacy and Medicine Weijing Sun, MD, FACP
Department of Pharmacy Practice Professor
University of Wisconsin School of Pharmacy Department of Medicine
Madison, Wisconsin School of Medicine
Chapter 15 University of Pittsburgh Cancer Institute
Pittsburgh, Pennsylvania
Kevin M. Sowinski, PharmD, FCCP Chapter 107
Professor and Associate Head for Faculty Affairs
Department of Pharmacy Practice David M. Swope, MD
School of Pharmacy and Pharmaceutical Sciences Associate Professor
Purdue University, West Lafayette and Indianapolis, Indiana Department of Neurology
Adjunct Professor School of Medicine
Department of Medicine Loma Linda University
School of Medicine Loma Linda, California
Indiana University Chapter 43
Indianapolis, Indiana
Chapter 30

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xxxi
Lynne M. Sylvia, PharmD Elena M. Umland, BS, PharmD
Senior Clinical Pharmacy SpecialistCardiology Associate Dean for Academic Affairs
Department of Pharmacy Professor of Pharmacy Practice
Tufts Medical Center Jefferson School of Pharmacy
Clinical Professor Thomas Jefferson University
Northeastern University Philadelphia, Pennsylvania

CONTRIBUTORS
School of Pharmacy Chapter 63
Boston, Massachusetts
eChapter 22 Yolanda Y. Vera, PharmD
Pediatric Patient Care Pharmacist
Carol Taketomo, PharmD Department of Pharmacy
Director of Pharmacy and Clinical Nutrition McLane Childrens Hospital
Childrens Hospital of Los Angeles Temple, Texas
Adjunct Assistant Professor of Pharmacy Practice Chapter 18
University of Southern California
School of Pharmacy Angie Veverka, PharmD, BCPS
Los Angeles, California PGY1 Pharmacy Residency Director, Clinical Specialist,
eChapter 7 Internal Medicine
Department of Pharmacy
Robert L. Talbert, PharmD, FCCP, BCPS, FAHA Carolinas Medical Center
Professor Charlotte, North Carolina
Pharmacotherapy Division Chapter 89
College of Pharmacy
University of Texas at Austin Kimberly Wahl, PharmD
Professor Ambulatory Care Clinical Pharmacist
Department of Medicine Department of Pharmacy
School of Medicine Ralph H. Johnson VA Medical Center, Myrtle Beach CBOC
University of Texas Health Science Center at San Antonio Myrtle Beach, South Carolina
San Antonio, Texas Chapter 72
Chapters 6, 11, 12, and 58 Christine M. Walko, PharmD, BCOP
Colleen M. Terri, PharmD, BCPS (AQ-ID), Assistant Professor
Division of Pharmacotherapy and Experimental Therapeutics
AAHIVP, MPH International Medicine
Institute of Pharmacogenomics and Individualized Therapy
Clinical Associate Professor
University of North Carolina Eshelman School of Pharmacy
Department of Pharmacotherapy
Lineberger Comprehensive Cancer Center
Washington State University, College of Pharmacy
University of North Carolina
Deaconess Hospital
Chapel Hill, North Carolina
Spokane, Washington
Chapter 115
eChapter 11
Kristina E. Ward, BS, PharmD, BCPS
Christian J. Teter, PharmD, BCPP
Clinical Associate Professor of Pharmacy Practice
Assistant Professor, Psychopharmacology
Director, Drug Information Services
College of Pharmacy
Department of Pharmacy Practice
University of New England
University of Rhode Island
Portland, Maine
College of Pharmacy
Chapter 51
Kingston, Rhode Island
Matthew N. Thoma, MD Chapter 61
Assistant Professor of Clinical Medicine
Department of Internal Medicine
Lori D. Wazny, PharmD
Clinical Pharmacist
University of South Carolina School of Medicine
Manitoba Renal Program
Staff Gastroenterologist
Winnipeg, Manitoba, Canada
Department of Gastroenterology/Hepatology
Chapter 29
WJB Dorn VA Medical Center
Columbia, South Carolina Robert J. Weber, PharmD, MS
Chapter 20 Senior Director, Pharmaceutical Services
Department of Pharmacy
Curtis L. Triplitt, PharmD, CDE
The Ohio State University Wexner Medical Center
Clinical Assistant Professor
Columbus, Ohio
Department of Medicine
eChapter 3
Division of Diabetes
University of Texas Health Science Center at San Antonio Barbara G. Wells, PharmD, FCCP, FASHP
Texas Diabetes Institute Dean Emeritus and Professor Emeritus
University Health System Department of Pharmacy Practice
San Antonio, Texas University of Mississippi, School of Pharmacy
Chapter 57 Oxford, Mississippi
Chapters 51 and 54

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xxxii
James W. Wheless, MD Marion R. Woord, MD, MPH
Professor and Chief of Pediatric Neurology Professor
LeBonheur Chair in Pediatric Neurology Department of Medicine
University of Tennessee Health Science Center University of Mississippi Medical Center
Director Jackson, Mississippi
LeBonheur Comprehensive Epilepsy Program and Chapter 45
CONTRIBUTORS

Neuroscience Institute
LeBonheur Childrens Hospital Judith K. Wolf, MD
Memphis, Tennessee Adjunct Professor of Gynecologic Oncology
Chapter 41 Division Chief of Surgery
Banner MD Anderson Cancer Center
Casey B. Williams, PharmD, BCOP Clinical Professor
Director of Clinical Research University of Texas MD Anderson Cancer Center
Sanford Research/University of South Dakota Gilbert, Arizona
Assistant Clinical Professor Chapter 110
Department of Internal Medicine
University of South Dakota Sanford School of Medicine G. Christopher Wood, PharmD, FCCP, FCCM, BCPS
Adjunct Assistant Clinical Professor Associate Professor of Clinical Pharmacy
Department of Pharmacy Practice Department of Clinical Pharmacy
University of Kansas School of Pharmacy University of Tennessee Health Science Center
Sioux Falls, South Dakota Memphis, Tennessee
Chapter 113 Chapter 42

Dennis M. Williams, PharmD, BCPS, AE-C Chanin C. Wright, PharmD


Associate Professor and Vice Chair Assistant Professor
Division of Pharmacotherapy and Experimental Therapeutics Department of Pediatrics
University of North Carolina Eshelman School of Pharmacy Texas A&M College of Pharmacy
Chapel Hill, North Carolina McLane Childrens Hospital and Clinics Scott & White
Chapter 16 Temple, Texas
Chapter 18
Jerey L. Wilt, MD, FACP, FCCP
Director Jean Wyman, MN, PhD
Department of Medical Critical Care Services Professor
Borgess Medical Center Cora Meidl Siehl Chair in Nursing Research
Department of Pulmonary Curriculum Adult and Gerontological Health Cooperative
Western Michigan University School of Medicine School of Nursing
Kalamazoo, Michigan University of Minnesota
Chapter 2 Minneapolis, Minnesota
Chapter 68
Char Witmer, MD, MSCE
Assistant Professor Jack A. Yanovski, MD, PhD
Department of Pediatrics Chief, Section on Growth and Obesity
The Childrens Hospital of Philadelphia Program in Developmental Endocrinology and Genetics
Philadelphia, Pennsylvania Eunice Kennedy Shriver National Institute of Child Health and
Chapter 81 Human Development
National Institutes of Health
Daniel M. Witt, PharmD, FCCP, BCPS Bethesda, Maryland
Senior Director Clinical Pharmacy Research and Applied Chapters 60 and 121
Pharmacogenomics
Kaiser Permanente Colorado Gary C. Yee, PharmD, FCCP, BCOP
Department of Pharmacy Professor and Associate Dean
Clinical Associate Professor Department of Pharmacy Practice
University of Colorado College of Pharmacy
Skaggs School of Pharmacy and Pharmaceutical Sciences University of Nebraska Medical Center
Aurora, Colorado Omaha, Nebraska
Chapter 9 Chapter 109

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Foreword
This edition of Pharmacotherapy: A Pathophysiologic Approach tered around the provision of coordinated care and characterized by
comes at a time of unprecedented change in health care. While some a payment model that seeks to tie reimbursements to quality metrics
would argue that the health care system has been slow to change, the and reductions in the total cost of care for a population of patients.
environment of today is rapidly evolving. This requires that health PCMHs will require pharmacists to serve as integral members of
care professionals, including pharmacists, are not only responsive the collaborative team, responsible for ensuring the safe, effective,
and adaptive to change, but able to identify innovative strategies and and affordable use of medications. Likewise, the ACO model strives
new approaches to delivering care that contribute meaningfully to to improve quality and reduce total cost of care within health care
the transformation that is needed. organizations. Innovative and targeted strategies to improve drug
There are significant deficiencies in the way health care is therapy outcomes will be critical in any effort to improve total qual-
delivered, including poor coordination, variation in quality, and an ity of care. Further, the ACO model provides a unique opportunity
inability to integrate team-based approaches, all of which impact the for pharmacy to demonstrate the true value-added proposition of
quality of care provided to individuals and contribute to rising health pharmacists in health care, thereby informing payment reform and
care costs. This is especially true in caring for individuals and popu- sustainability of clinical pharmacy services.
lations living with chronic disease, which is the leading cost driver Numerous opportunities to transform health care delivery
in the U.S. health care system. This edition of Pharmacotherapy: exist today; however, to ensure continued improvement of health
A Pathophysiologic Approach will prepare future practitioners with and health care will require that health professions education be
the foundational knowledge critical in the management of these reengineered to better prepare students to meet the future needs of
diseases. society. Education must be restructured to reduce the almost exclu-
Medications remain the most common and powerful of all sive focus on the acquisition of knowledge and to place greater
health care interventions, yet are associated with serious harm. In emphasis on the skills and behaviors that will be essential for stu-
2011, more than 4 billion prescriptions were written annually in dents to survive in a rapidly changing health care environment. In
the U.S with prescription spending reaching nearly $320 billion. pharmacy education, students must have an in-depth understanding
The adverse consequences of medication use are a major contribu- of the foundations of pharmacy, the pharmaceutical sciences, and
tor to poor quality care and cost the health care industry billions pharmacotherapy, but they must also be given ample opportunity
of dollars each year. In 2007, hospital-based adverse drug events to think critically, solve complex problems, communicate clearly,
were estimated to be nearly 450,000 per year, with higher num- and work with others. Students must spend more time in real-world
bers in long-term care facilities (800,000), and the outpatient set- patient care settings and be immersed in complex systems of care,
ting (550,000). While this imposes serious impact on the health of interacting with others to achieve shared goals and functioning in
patients and the health care system as a whole, most troubling is and leading teams toward improvement and change. In Flexners
that medication-related harm occurs at every step in the medication 1910 report on medical education, he noted that just as scientists
use processmanufacturing, purchasing, prescribing, dispensing, must inquire, analyze, identify solutions, and continually refine
administering, and monitoringand is largely preventable. It is not their approach toward discovery, so, too, must practitioners if they
surprising that in a 2007 Institute of Medicine report, the appro- are to advance the practice of medicine and health care. To cultivate
priate use and management of drug therapy was acknowledged as these habits of mind, students must learn how to approach and
a critical issue that must be addressed to improve national health solve complex problems through engagement in inquiry, discovery,
care. This is important for the profession of pharmacy as we strive and innovation rather than relying on memorization of facts. As
to position ourselves to contribute meaningfully to the delivery of schools of pharmacy move forward with new and innovative cur-
high-quality patient care and play an integral role in transforming ricular designs as outlined in the 20112012 Argus Commission
our health care system. Report, authoritative textbooks like Pharmacotherapy: A Patho-
Patient-centered medical homes (PCMHs) and accountable care physiologic Approach will become an important and integral part
organizations (ACOs) are among the most promising approaches of student foundational learning.
to delivering higher-quality, cost-effective care and present unique Building a solid foundation and expertise that is deeply rooted
opportunities for improving drug therapy outcomes. Central to the in the pharmaceutical sciences and pharmacotherapy is critical
PCMH is the patient having a personal physician and collaborative to ensuring that pharmacists are well positioned to improve drug
team to provide continuous and coordinated primary care that takes therapy outcomes. It is this unique expertise that differentiates
a whole person orientation. ACOs are healthcare organizations cen- us, as pharmacists, from any other profession. This edition of

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xxxiv
Pharmacotherapy: A Pathophysiologic Approach will equip phar- therapy, so, too, must each of us take measureable steps toward
macy students and practitioners with the knowledge and perspec- transforming our health care system. These are unprecedented
tive to be the health care professional most skilled in the provision times of change and opportunity for the profession of pharmacy to
of drug therapy management. As students and practitioners we shape the future of health care and improve drug therapy outcomes
must not lose sight of the opportunity we have to influence and for patients and society.
shape health care delivery both now and in the future. Just as we Robert A. Blouin
take measureable steps to optimize and personalize ones drug Mary Roth McClurg
FOREWORD

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Foreword to the First Edition
Evidence of the maturity of a profession is not unlike that character- is a component of our covenant with society and is as important as
izing the maturity of an individual; a childs utterances and behavior any other facet of that relationship existing between a profession
typically reveal an unrealized potential for attainment, eventually, and those it serves.
of those attributes characteristic of an appropriately confident, inde- The recognition by BPS of pharmacotherapy as an area of spe-
pendently competent, socially responsible, sensitive, and productive cialty practice in pharmacy will serve as an important statement by
member of society. the profession that we have matured sufficiently to be competent and
Within a period of perhaps 15 or 20 years, we have witnessed a willing to take unprecedented responsibilities in the collaborative,
profound maturation within the profession of pharmacy. The utter- pharmacotherapeutic management of patient-specific problems. It
ances of the profession, as projected in its literature, have evolved commits pharmacy to an intention that will not be uniformly or rap-
from mostly self-centered and self-serving issues of trade protection idly accepted within the established health care community. None-
to a composite of expressed professional interests that prominently theless, this formal action places us on the road to an avowed goal,
include responsible explorations of scientific/technological ques- and acceptance will be gained as the pharmacotherapists prolifer-
tions and ethical issues that promote the best interests of the clientele ate and establish their importance in the provision of optimal, cost-
served by the profession. With the publication of Pharmacotherapy: effective drug therapy.
A Pathophysiologic Approach, pharmacys utterances bespeak a Suspecting that other professions in other times must have
matured practitioner who is able to call upon unique knowledge and faced similar quests for recognition of their unique knowledge and
skills so as to function as an appropriately confident, independently skills I once searched the literature for an example that might paral-
competent pharmacotherapeutics expert. lel pharmacys modern-day aspirations. Writing in the Philadelphia
In 1987, the Board of Pharmaceutical Specialties (BPS), in Medical Journal, May 27, 1899, D. H. Galloway, MD, reflected
denying the petition filed by the American College of Clinical Phar- on the need for specialty training and practice in a field of medi-
macy (ACCP) to recognize clinical pharmacy as a specialty, con- cine lacking such expertise at that time. In an article entitled The
ceded nonetheless that the petitioning party had documented in its Anesthetizer as a Speciality, Galloway commented:
petition a specialist who does in fact exist within the practice of
The anesthetizer will have to make his own place in
pharmacy and whose expertise clearly can be extricated from the
medicine: the profession will not make a place for him,
performance characteristics of those in general practice. A refiled
and not until he has demonstrated the value of his services
petition from ACCP requests recognition of pharmacotherapy as a
will it concede him the position which the importance of
Specialty Area of Pharmacy Practice. While the BPS had issued no
his duties entitles him to occupy. He will be obliged to
decision when this book went to press, it is difficult to comprehend
define his own rights, duties and privileges, and he must
the basis for a rejection of the second petition.
not expect that his own estimate of the importance of
Within this book one will find the scientific foundation for the
his position will be conceded without opposition. There
essential knowledge required of one who may aspire to specialty
are many surgeons who are unwilling to share either the
practice as a pharmacotherapist. As is the case with any such pub-
credit or the emoluments of their work with anyone, and
lication, its usefulness to the practitioner or the future practitioner
their opposition will be overcome only when they are
is limited to providing such a foundation. To be socially and profes-
shown that the importance of their work will not be less-
sionally responsible in practice, the pharmacotherapists foundation
ened, but enhanced, by the increased safety and dispatch
must be continually supplemented and complemented by the flow
with which operations may be done. . . .
of information appearing in the primary literature. Of course this
is not unique to the general or specialty practice of pharmacy; it is It has been my experience that, given the opportunity for one-
essential to the fulfillment of obligations to clients in any occupation on-one, collaborative practice with physicians and other health
operating under the code of professional ethics. professionals, pharmacy practitioners who have been educated and
Because of the growing complexity of pharmacotherapeutic trained to perform at the level of pharmacotherapeutics specialists
agents, their dosing regimens, and techniques for delivery, phar- almost invariably have convinced the former that the importance
macy is obligated to produce, recognize, and remunerate specialty of their work will not be lessened, but enhanced, by the increased
practitioners who can fulfill the professions responsibilities to safety and dispatch with which individualized problems of drug
society for service expertise where the competence required in a therapy could be managed in collaboration with clinical pharmacy
particular case exceeds that of the general practitioner. It simply practitioners.

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xxxvi
FOREWORD TO THE FIRST EDITION
It is fortuitousthe coinciding of the release of Pharmacother- responsibility in the safe, effective, and economical use of drugs and
apy: A Pathophysiologic Approach with ACCPs petitioning of BPS drug products, bode well for the future of the profession and for the
for recognition of the pharmacotherapy specialist. The utterances of improvement of patient care with drugs.
a maturing profession as revealed in the contents of this book, and Charles A. Walton, PhD
the intraprofessional recognition and acceptance of a higher level of San Antonio, Texas

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Preface
With each edition of Pharmacotherapy: A Pathophysiologic The ninth edition builds on and expands the foundation of
Approach the pace of change in health care seems to accelerate, and previous editions. Most of the disease-oriented chapters have
this continues to be true for the 9th edition. At this time, pharmacists incorporated updated evidence-based treatment guidelines that
across the United States are actively contributing their expertise as include, when available, ratings of the level of evidence to support
integrated and virtual members of the new health care delivery mod- the key therapeutic approaches. Also, in this edition new features
els that are being implemented as part of the Affordable Care Act have been added:
through accountable care organizations and patient-centered medical
homes. These emerging care models have improved outcomes for Most chapters have a section on personalized
Medicare and Medicaid beneficiaries and now are poised to affect the pharmacotherapy.
care of most individuals. Pharmacists throughout the world are rec- The diagnostic flow diagrams, treatment algorithms, dos-
ognizing their potential to improve access to affordable high-quality ing guideline recommendations, and monitoring approaches
care in their country. As expectations and opportunities for pharma- that were present in the last edition have been revised with
cists expand, the need for state-of-the-art, patient-centered education color codes to clearly distinguish treatment pathways.
and training becomes more acute. The Editors and authors of PAPA
The Drug Dosing tables have been reformatted for clarity
continue to strive to make this text relevant to patient-focused phar-
and consistency.
macists and other health care providers in this dynamic era.
The 9th edition of Pharmacotherapy: A Pathophysiologic New Drug Monitoring tables have been added.
Approach is the product of the editorial teams reflection on what
are the core pathophysiological and therapeutic elements that stu- The texts digital home, Access Pharmacy (www.access
dents and young practioners need. As a result, we have streamlined pharmacy.com), has become the primary access point for many in
the offerings in this edition and placed a portion of the foundational the United States and around the world. Users of Access Pharmacy
chapters on the web to make them accessible to a broader audience. will find many features to enhance their learning and information
Most importantly, each chapter of the book has been revised and retrieval. Thoughtful and provocative updates to PAPA chapters
updated to reflect the latest in evidence-based information and rec- are added as new information mandates to keep our readers rel-
ommendations. We trust that you will find that this edition balances evant in these times of rapid advancements. Also, the site has many
the need for accurate, thorough, and unbiased information about the new features such as education guides, Goodman & Gilmans
treatment of diseases by presenting concise illustrative analyses of animations, virtual cases, and many other textbooks. As in pre-
the multiplicity of therapeutic options. vious editions, the text coordinates well with Pharmacotherapy:
With each edition, the editors recommit to our founding A Patient-focused Approach, which includes in-depth patient cases
precepts: with questions and answers.
Twenty-four chapters of this edition are being published
Advance the quality of patient care through evidence-based online and are available to all users in the Online Learning Cen-
medication therapy management based on sound pharmaco- ter at www.pharmacotherapyonline.com The chapters chosen for
therapeutic principles. online publication include seven, which describe and critique the
Enhance the health of our communities by incorporating available means to assess major organ system function, and five,
contemporary health promotion and disease-prevention which characterize the adverse effects of drugs on organ systems.
strategies in our practice environments. They join the 12 foundational chapters, which provide overviews
of pharmacy skills in medication safety, pharmacokinetics, and
Motivate young practitioners to enhance the breadth, depth,
pharmacogenetics, and patient-centered considerations such as
and quality of care they provide to their patients.
health literacy, cultural competency, pediatrics, and geriatrics;
Challenge established pharmacists and other primary-care finally, there are three chapters that address public health, clinical
providers to learn new concepts and refine their understand- toxicology, and emergency preparedness. The Online Learning
ing of the pathophysiologic tenets that undergird the devel- Center continues to provide unique features designed to benefit
opment of individualized therapeutic regimens. students, practitioners, and faculty around the world. The site
Present the pharmacy and health care communities with includes learning objectives and self-assessment questions for
innovative patient assessment, triage, and pharmacotherapy each chapter. In closing, we acknowledge the many hours that
management skills. Pharmacotherapys more than 300 authors contributed to this

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xxxviii
labor of love. Without their devotion to the cause of improved family of resources, insights into trends in publishing and higher
pharmacotherapy and dedication in maintaining the accuracy, education, and the critical attention to detail so necessary in
clarity, and relevance of their chapters, this text would unques- pharmacotherapy.
tionably not be possible. In addition, we thank Michael Weitz, The Editors
Brian Kearns, and James Shanahan and their colleagues at March 2014
McGraw-Hill for their consistent support of the Pharmacotherapy
PREFACE

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