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Invest in the Best The resources you’ll turn to every day, now and throughout your career. Taber’s® To thrive in the ever-changing world of health care, you need a respected, Order your trusted, and cutting-edge cyclopedic PERFECT PACKAGE TODAY! resource. Taber’s brings meanings to life. 1. Available in your health Davis’s Drug Guide for Nurses® science bookstore. Count on the drug guide that always 2. Call 800.323.3555 (US) puts safety first…with all of the guidance 800.665.1148 (CAN) you need to administer medications 3. Visit www.FADavis.com. competently and safely across the lifespan. Davis’s Comprehensive Handbook of Laboratory and Diagnostic Tests with Nursing Implications The premier mobile and web solution Here’s the information you need to for nursing reference and study with: understand how laboratory and diagnostic tests work, accurately interpret the test • Davis’s Drug Guide • Taber’s Cyclopedic Medical Dictionary results, and provide quality care for • Davis’s Laboratory and Diagnostic Tests patients—pre-, intra-, and post-test. • Diseases and Disorders • Unbound MEDLINE • Grasp™ study system Visit www.ubmed.com/nursing DDG14E_House Ad_2014.indd 1 3/13/14 10:07 AM Name /bks_53148_deglins_dg/53148_fm_1 03/18/2014 08:33AM Plate # 0-Compositepg 3 # 1 Davis’s DRUG GUIDE FOR NURSES(cid:2) FOURTEENTH EDITION APRIL HAZARD VALLERAND, PhD, RN, FAAN Professor of Nursing Wayne State University College of Nursing Detroit, Michigan CYNTHIA A. SANOSKI, BS, PharmD, FCCP, BCPS Chair, Department of Pharmacy Practice Thomas Jefferson University Jefferson School of Pharmacy Philadelphia, Pennsylvania JUDITH HOPFER DEGLIN, PharmD Consultant Pharmacist Hospice of Southeastern Connecticut Norwich, Connecticut With special contributions by: HollyG.Mansell,BSP,PharmD AssistantProfessorofPharmacy CollegeofPharmacyandNutrition UniversityofSaskatchewan Saskatoon,SK,Canada Name /bks_53148_deglins_dg/53148_fm_1 03/13/2014 08:56AM Plate # 0-Composite F.A.DavisCompany 1915ArchStreet Philadelphia,PA 19103 www.fadavis.com Copyright(cid:2)2015byF.A.DavisCompany Copyright(cid:2)1988,1991,1993,1995,1997,1999,2001,2003,2005,2007,2009,2011,2013byF.A. DavisCompany.Allrightsreserved.Thisbookisprotectedbycopyright.Nopartofitmaybereproduced, stored in a retrieval system, or transmittedinanyform orbyanymeans,electronic,mechanical, photocopying,recording,orotherwise,withoutwrittenpermissionfromthepublisher. PrintedintheUnitedStatesofAmerica Lastdigitindicatesprintnumber10987654321 Editor-in-Chief,Nursing:JeanRodenberger DirectorofContentStrategy:DarleneD.Pedersen Publisher,Nursing:RobertG.Martone SeniorAcquisitionsEditor:ThomasA.Ciavarella ProjectEditor:ChristinaL.Snyder DirectorofProduction:MichaelW.Bailey NOTE: As new scientific information becomes available through basic and clinical research, recommendedtreatmentsanddrugtherapiesundergochanges.Theauthorsandpublisherhavedone everythingpossibletomakethisbookaccurate,uptodate,andinaccordwithacceptedstandardsatthe timeofpublication.However,thereaderisadvisedalwaystocheckproductinformation(package inserts)forchangesandnewinformationregardingdoseandcontraindicationsbeforeadministering anydrug.Cautionisespeciallyurgedwhenusingneworinfrequentlyordereddrugs. Vallerand,AprilHazard,author. Davis’sdrugguidefornurses/AprilHazardVallerand,CynthiaA.Sanoski,JudithHopferDeglin. —Fourteenthedition.p.;cm. Drugguidefornurses Includesbibliographicalreferencesandindex. ISBN978-0-8036-3976-8(US) ISBN978-0-8036-3977-5(Canadian) I.Sanoski,CynthiaA.,author.II.Deglin,JudithHopfer,1950– author.III.Title.IV.Title:Drug guidefornurses. [DNLM:1.PharmaceuticalPreparations—administration&dosage—Handbooks.2.Pharmaceutical Preparations—administration & dosage—Nurses’ Instruction. 3. Drug Therapy—nursing— Handbooks. 4. Drug Therapy—nursing—Nurses’ Instruction. 5. Pharmacology, Clinical— methods—Handbooks.6.Pharmacology,Clinical—methods—Nurses’Instruction.QV735] RM301.12 615.1024613—dc23 2014005996 Authorizationtophotocopyitemsforinternalorpersonaluse,ofspecificclients,isgrantedbyF.A.Davis Company for users registered with the Copyright Clearance Center(CCC)TransactionalReporting Service,providedthatthefeeof$.25percopyispaiddirectlytoCCC,222RosewoodDrive,Danvers,MA 01923.ForthoseorganizationsthathavebeengrantedaphotocopylicensebyCCC,aseparatesystem of payment has been arranged. The fee code for users of the Transactional Reporting Service is 8036-3976/140(US)and8036-3977/140(Canadian)(cid:2)$.25. Name /bks_53148_deglins_dg/53148_fm_1 02/18/2014 10:22AM Plate # 0-Composite DEDICATION Tomyson,Ben,whosesensitivityandsenseofhumormakeeventhetoughestdayeasier. Tomydaughter,Katharine,whosededicationandpassioninseekinghergoalsIadmire. Watchingyoubothgrowtobecomewonderfulyoungadultsgivesmesuchprideandjoy.Yoursupport ofmyworkinspiresme.Thankyouforsharingsomuchofyourliveswithme.Iloveyou. AHV Tomywonderfulmother,Geraldine,whohasprovidedhercontinuallove,support,andwisdomasI continuetopursueallofmypersonalandprofessionalgoals. CAS Inlovingmemoryofmyolderchildren,SamanthaAnnandRandyEli,bothstruckandkilledbya drinkingdriveronJanuary9,1997.Theyremainforeverinourhearts.Thewonderandjoytheybrought toourlivescontinuestoinspireus. ToStu,forhiscontinuedsupportandlove. TomydaughterHanna,whosehardwork,talent,andgraceneverceasetoamazeme. TomysonReuben,whosesmilewarmsmyheartandwhoseenergyisboundless. Tomyparents,whoalwaysinspiredme. JHD ACKNOWLEDGMENTS Weofferourthankstothestudentsandnurseswhohaveusedourbookforover25years.Wehope ourbookprovidesyouwiththecurrentknowledgeofpharmacotherapeuticsyouneedtocontinueto givequalitycareinourrapidlychanginghealth-careenvironment. April,Cindy,andJudi Name /bks_53148_deglins_dg/53148_fm_1 02/18/2014 10:22AM Plate # 0-Composite CONSULTANTS MichelleFarkas,PMHNP-BC ThereseJamison,MSN,APRN-BC,ACNP PrivatePractice AssociateProfessor Dearborn,MI MadonnaUniversity JamieCrawley,PhD,RN SchoolofNursing AssistantProfessor Livonia,MI UniversityofWindsor JaneenKidd,RN,BN FacultyofNursing Instructor/SchoolPlacementProjectCoordinator Windsor,ON,Canada UniversityofVictoria LisaE.Davis,PharmD,FCCP,BCPS,BCOP SchoolofNursing AssociateProfessorofClinicalPharmacy Victoria,BC,Canada UniversityoftheSciencesinPhiladelphia NormaPerez,BSN,RN PhiladelphiaCollegeofPharmacy NursingFaculty&ClinicalCoordinator Philadelphia,PA IvyTechCommunityCollege WandaEdwards,PMHCNS-BC,NP SchoolofNursing Instructor(Clinical) Valparaiso,IN WayneStateUniversity KimSubasic,MSN,RN CollegeofNursing TheUniversityofScranton Detroit,MI Scranton,PA DeborahA.Ennis,RN,MSN,CCRN GladdiTomlinson,RN,MSN HarrisburgAreaCommunityCollege ProfessorofNursing Harrisburg,PA HarrisburgAreaCommunityCollege LindaFelver,PhD,RN Harrisburg,PA AssociateProfessor LindaS.Weglicki,PhD,RN,MSN OregonHealth&ScienceUniversity ProgramDirector SchoolofNursing NationalInstituteofNursingResearch Portland,OR OfficeofExtramuralPrograms CharleneC.Gyurko,PhD,RN,CNE Bethesda,MD AssistantProfessor MarcellaWilliams,RN,MS,AOCN(cid:2) PurdueUniversity,NorthCentral AdjunctFaculty SchoolofNursing LansingCommunityHospital Westville,IN StaffNurse,SparrowHealthSystem AltheaDuBoseHayes,RD Lansing,MI RenalDietitian GreenfieldHealthSystem, adivisionofHenryFordHealthSystem Southfield,MI vi Name /bks_53148_deglins_dg/53148_fm_1 02/18/2014 10:22AM Plate # 0-Composite F. A. DAVIS PHARMACOLOGIC PUBLICATIONS ADVISORY BOARD ShamimTejani, EmilyKarwacki-Sheff, PharmD MS,CMSRN,FNP-BC PharmacyClinicalManager LecturerandClinicalInstructor St.Joseph’sHospital&MedicalCenter MassachusettsGeneralHospital Phoenix,AZ InstituteofHealthProfessions Charlestown,MA DebraAbraham, MSN,RN ClinicalInstructor Lecturer BostonCollege UniversityofPennsylvania ChestnutHill,MA SchoolofNursing LauraG.Leahy, Philadelphia,PA MSN,PMH-CNS/FNP,BC PsychiatricAdvancedPracticeNurseClinical AngelaAnnBoggs,PharmD AssociateFaculty/Lecturer ClinicalPharmacist UniversityofPennsylvania UniversityofMarylandBaltimore SchoolofNursing SpringfieldHospitalCenter Philadelphia,PA Sykesville,MD StuartLevine, PharmD InformaticsSpecialist DouglasLeeBoggs, PharmD,MS,BCPP InstituteforSafeMedicationPractices ResearchAssociate HuntingdonValley,PA MarylandPsychiatricResearchCenter UniversityofMarylandSchoolofMedicine GinetteA.Pepper,PhD,RN,FAAN Baltimore,MD HelenLoweBambergerColbyPresidential EndowedChairinGerontologicalNursing HedyCohen,RN,BSN,MS AssociateDeanforResearch&PhDPrograms ClinicalConsultingNurse SaltLakeCity,UT InstituteforSafeMediationPractices Director HuntingdonValley,PA UniversityofUtahHartfordCenterofGeriatric NursingExcellence JaneVincentCorbett, RN,Ed.D SaltLakeCity,UT ProfessorEmerita RosemaryC.Polomano, UniversityofSanFrancisco PhD,RN,FAAN SchoolofNursing AssociateProfessorofPainPractice SanFrancisco,CA UniversityofPennsylvania SchoolofNursing MargaretFalahee,APRN-BC Philadelphia,PA ClinicalAssistantProfessor DebbieRichmond, NP-C,ACRN WayneStateUniversity WayneStateUniversity CollegeofNursing Detroit,MI Detroit,MI DorieSchwertz, PhD,RN,FAAN,FAHA SusanM.Hasenau,PhD,MSN,BSN AssociateProfessor Professor UniversityofIllinois-ChicagoCollegeofNursing MadonnaUniversity DepartmentofMedicalSurgicalNursingand SchoolofNursing AdjunctProfessorofPharmacology Livonia,MI Chicago,IL vii Name /bks_53148_deglins_dg/53148_fm_1 02/18/2014 10:22AM Plate # 0-Composite F.A. DAVIS CANADIAN ADVISORY BOARD AndreaM.Brandt, ArohaPage, BScN,MS RN,BA,BScN,Grad.DipHealthSci,M.Phil(N), PharmacologyInstructor,LeadFaculty,Nursing PhD(UCSF)FRCNA GeorgianCollege AssociateProfessor,SchoolofNursing Barrie,Ontario NipissingUniversity MelanieDeveau, FacultyofApplied&ProfessionalStudies MN-ANP,RN,NP NursePractitioner,CardiovascularProgram NorthBay,Ontario AdjunctLecturer VincentSalyers,Ed.D,MSN,BA DalhousieUniversity-YarmouthSite AssociateDean,FacultyofHealth&Community Yarmouth,NovaScotia Studies LisaKeeping-Burke, MountRoyalUniversity RN,PhD.(McGill) AssistantProfessor,DepartmentofNursingand Calgary,Alberta HealthSciences,UNB MichaelScarcello,RN,HBScN,MA AdjunctAssistantProfessor,SchoolofNursing, ClinicalNurseSpecialistProgramCoordinator, Queen’sUniversity PracticalNursingProgram SaintJohn,NewBrunswick ConfederationCollege Duncan(Stewart)MacLennan, ThunderBay,Ontario MN,NP FacultyLecturer,FacultyofNursing JeffTaylor,BSP,MSc,PhD UniversityofAlberta ProfessorofPharmacy Edmonton,Alberta UniversityofSaskatchewan CraigMiller Saskatoon,SK Instructor-PN JimWohlgemuth,RN,MN,CTN-B AssiniboineCommunityCollege Instructor,NursingEducation&HealthStudies Brandon,Manitoba GrandePrairieRegionalCollege WendyNeander, GrandePrairie,Alberta PhD(c),MN,BScN,BScv AssistantTeachingProfessor,SchoolofNursing UniversityofVictoria Nanaimo,BritishColumbia viii Name /bks_53148_deglins_dg/53148_fm_1 02/18/2014 10:23AM Plate # 0-Composite CONTENTS HOWTOUSEDAVIS’SDRUGGUIDEFORNURSES............................ 1 EVIDENCE-BASEDPRACTICEANDPHARMACOTHERAPEUTICS: ImplicationsforNurses....................................................... 6 PHARMACOGENOMICS......................................................... 9 MEDICATIONERRORS:ImprovingPracticesandPatientSafety............ 12 DETECTINGANDMANAGINGADVERSEDRUGREACTIONS................. 18 OVERVIEWOFRISKEVALUATIONANDMITIGATIONSYSTEMS(REMS)... 22 SPECIALDOSINGCONSIDERATIONS.......................................... 23 ThePediatricPatient......................................................... 23 TheGeriatricPatient......................................................... 23 ThePatientofReproductiveAge.............................................. 24 RenalDisease................................................................ 24 LiverDisease................................................................ 24 HeartFailure................................................................ 24 BodySize.................................................................... 24 DrugInteractions............................................................ 25 EDUCATINGPATIENTSABOUTSAFEMEDICATIONUSE..................... 26 CLASSIFICATIONS.............................................................. 29 Anti-Alzheimer’sagents...................................................... 29 Antianemics................................................................. 30 Antianginals................................................................. 31 Antianxietyagents............................................................ 32 Antiarrhythmics.............................................................. 33 Antiasthmatics............................................................... 34 Anticholinergics............................................................. 35 Anticoagulants............................................................... 36 Anticonvulsants.............................................................. 38 Antidepressants.............................................................. 39 Antidiabetics................................................................. 41 Antidiarrheals............................................................... 43 Antiemetics.................................................................. 44 Antifungals................................................................... 45 Antihistamines............................................................... 46 Antihypertensives............................................................ 47 Anti-infectives................................................................ 49 Antineoplastics............................................................... 50 Antiparkinsonagents......................................................... 52 Antiplateletagents........................................................... 53 Antipsychotics............................................................... 54 Antipyretics.................................................................. 56 Antiretrovirals............................................................... 57 Antirheumatics.............................................................. 58 Antituberculars.............................................................. 59 Antiulceragents.............................................................. 60 Antivirals.................................................................... 62 Betablockers................................................................ 63 ix