1. Pharmacotherapy A Pathophysiologic Approach Seventh Edition

2. 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. 3. Pharmacotherapy A Pathophysiologic Approach Seventh Edition Joseph T. DiPiro, PharmD, FCCP Executive Dean and Professor, South Carolina College of Pharmacy, University of South Carolina, Columbia, South Carolina and Medical University of South Carolina, Charleston, South CarolinaRobert L. Talbert, PharmD, FCCP, BCPS, CLS SmithKline Professor, College of Pharmacy, University of Texas at Austin, Professor, Department of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, TexasGary C. Yee, PharmD, FCCP, BCOP Professor, Department of Pharmacy Practice, College of Pharmacy, University of Nebraska Medical Center, Omaha, NebraskaGary R. Matzke, PharmD, FCP, FCCP Professor of Pharmacy and Pharmaceutics and Associate Dean for Clinical Research and Public Policy, School of Pharmacy, Professor of Internal Medicine, Nephrology Division, School of Medicine, Virginia Commonwealth University, Richmond, VirginiaBarbara G. Wells, PharmD, FASHP, FCCP, BCPP Dean and Professor, Executive Director of the Research Institute of Pharmaceutical Sciences, School of Pharmacy, The University of Mississippi, Oxford, MississippiL. Michael Posey, BSPharm Editorial Director, Periodicals Department, American Pharmacists Association, Washington, D.C.New York Chicago San Francisco Lisbon London Madrid Mexico City Milan New Delhi San Juan Seoul Singapore Sydney Toronto 4. Copyright 2008, 2005, 2002 by The McGraw-Hill Companies, Inc. All rights reserved. Manufactured 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 database or retrieval system, without the prior written permission of the publisher. 0-07-164325-7 The material in this eBook also appears in the print version of this title: 0-07-147899-X. All trademarks are trademarks of their respective owners. Rather than put a trademark symbol after every occurrence of a trademarked name, we use names in an editorial fashion only, and to the benefit of the trademark owner, with no intention of infringement of the trademark. Where such designations appear in this book, they have been printed with initial caps. McGraw-Hill eBooks are available at special quantity discounts to use as premiums and sales promotions, or for use in corporate training programs. For more information, please contact George Hoare, Special Sales, at george_hoare@mcgraw-hill.com or (212) 904-4069. TERMS OF USE This is a copyrighted work and The McGraw-Hill Companies, Inc. (McGraw-Hill) and its licensors reserve all rights in and to the work. Use of this work is subject to these terms. Except as permitted under the Copyright Act of 1976 and the right to store and retrieve one copy of the work, you may not decompile, disassemble, reverse engineer, reproduce, modify, create derivative works based upon, transmit, distribute, disseminate, sell, publish or sublicense the work or any part of it without McGraw-Hills prior consent. You may use the work for your own noncommercial and personal use; any other use of the work is strictly prohibited. Your right to use the work may be terminated if you fail to comply with these terms. THE WORK IS PROVIDED AS IS. 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Under no circumstances shall McGraw-Hill and/or its licensors be liable for any indirect, incidental, special, punitive, consequential or similar damages that result from the use of or inability to use the work, even if any of them has been advised of the possibility of such damages. This limitation of liability shall apply to any claim or cause whatsoever whether such claim or cause arises in contract, tort or otherwise. DOI: 10.1036/007147899X 5. 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 seventh edition would become a reality.Copyright 2008, 2005, 2002 by The McGraw-Hill Companies, Inc. Click here for terms of use. 6. IN MEMORIAM Mario M. Zeolla (19742007) earned his Bachelor of Science and Doctor of Pharmacy degrees from the Albany College of Pharmacy, completed a Community Pharmacy Residency at the University of Maryland School of Pharmacy, and was a Board Certified Pharmacotherapy Specialist. In his brief but productive career as a pharmacy practitioner and educator at the Albany College of Pharmacy, Dr. Zeolla quickly rose to the rank of Associate Professor in the Department of Pharmacy Practice. In addition, he was the Patient Care Pharmacist at Eckerd (and later Brooks) Pharmacy in Loudonville, New York, where he developed innovative community-based clinical pharmacy services. He was an author in previous editions of Pharmacotherapy: A Pathophysiologic Approach and published several scholarly papers related to community pharmacy practice and dietary supplements/herbal therapies. Dr. Zeolla was considered one of the brightest stars on the Albany College of Pharmacy faculty and a passionate advocate for pharmacy. He was a popular teacher, trusted advisor, and beloved peer.Copyright 2008, 2005, 2002 by The McGraw-Hill Companies, Inc. Click here for terms of use. 7. For more information about this title, click hereviiCONTENTSContributors. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xiii Foreword . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xxvii Foreword to the First Edition. . . . . . . . . . . . . . . . . . . . . . . xxix Preface. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xxxi11. Emergency Preparedness: Identification and Management of Biological Exposures. . . . . . . . 91Colleen M. Terriff, Jason E. Brouillard, Lisa T. Costanigro, and Jessica S. Gruber12. Emergency Preparedness: Identification and Management of Chemical and Radiological Exposures . . . . . . . . . . . . . . . . . . . . 93 Greene Shepherd and Richard B. SchwartzSECTION 1 Foundation IssuesSECTION 2Section Editor: L. Michael Posey1. Pharmacoeconomics: Principles, Methods, and Applications.......................... 1Lisa A. Sanchez2. Health Outcomes and Quality of Life......... 3Stephen Joel Coons3. Evidence-Based Medicine................... 5Elaine Chiquette and L. Michael Posey4. Documentation of Pharmacy Services 5. Clinical Pharmacokineticsand Pharmacodynamics . . . . . . . . . . . . . . . . . . . . . . . 9 Larry A. Bauer6. Pharmacogenetics . . . . . . . . . . . . . . . . . . . . . . . . . . . 31 Larisa H. Cavallari and Y. W. Francis Lam7. Pediatrics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47 Milap C. Nahata and Carol Taketomo8. Geriatrics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57 Catherine I. Starner, Shelly L. Gray, David R. P. Guay, Emily R. Hajjar, Steven M. Handler, and Joseph T. Hanlon. . . . . . . . . . . . . . . . . . . 67Andy Stergachis, Thomas K. Hazlet, and Denise Boudreau10. Clinical Toxicology . . . . . . . . . . . . . . . . . . . . . . . . . . 69 Peter A. ChykaSection Editor: Robert L. Talbert13. Cardiovascular Testing . . . . . . . . . . . . . . . . . . . . . . . 95 Robert Chilton and Robert L. Talbert14. Cardiopulmonary Arrest . . . . . . . . . . . . . . . . . . . . . 123 Jeffrey F. Barletta and Jeffrey L. Wilt15. Hypertension . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 139 ........ 7George E. MacKinnon, III and Neil J. MacKinnon9. PharmacoepidemiologyCardiovascular DisordersJoseph J. Saseen and Eric J. MacLaughlin16. Heart Failure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 173 Robert B. Parker, Jo E. Rodgers, and Larisa H. Cavallari17. Ischemic Heart Disease . . . . . . . . . . . . . . . . . . . . . . 217 Robert L. Talbert18. Acute Coronary Syndromes . . . . . . . . . . . . . . . . . . 249 Sarah A. Spinler and Simon de Denus19. The Arrhythmias . . . . . . . . . . . . . . . . . . . . . . . . . . . 279 Cynthia A. Sanoski, Marieke Dekker Schoen, and Jerry L. Bauman20. Diastolic Heart Failure and the Cardiomyopathies . . . . . . . . . . . . . . . . . . . 315 Jean M. Nappi and Robert L. Page, II21. Venous Thromboembolism . . . . . . . . . . . . . . . . . . 331 Stuart T. Haines, Daniel M. Witt, and Edith A. Nutescu22. Stroke. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 373 Susan C. Fagan and David C. HessThe complete chapter, learning objectives, and other resources can be found at www.pharmacotherapyonline.com. 8. viii23. Hyperlipidemia. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38538. Diarrhea, Constipation, and IrritableCONTENTSBowel Syndrome . . . . . . . . . . . . . . . . . . . . . . . . . . . 617Robert L. Talbert24. Peripheral Arterial Disease . . . . . . . . . . . . . . . . . . . 409 Barbara J. Hoeben and Robert L. Talbert25. Use of Vasopressors and Inotropes in the Pharmacotherapy of Shock . . . . . . . . . . . . . 417 Robert MacLaren, Maria I. Rudis, and Joseph F. Dasta26. Hypovolemic Shock . . . . . . . . . . . . . . . . . . . . . . . . . 441 Brian L. ErstadWilliam J. Spruill and William E. Wade39. Portal Hypertension and Cirrhosis . . . . . . . . . . . . 633 Julie M. Sease, Edward G. Timm, and James J. Stragand40. Drug-Induced Liver Disease. . . . . . . . . . . . . . . . . . 651 William R. Kirchain and Rondall E. Allen41. Pancreatitis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 659 Rosemary R. Berardi and Patricia A. Montgomery42. Viral Hepatitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 675SECTION 3Paulina Deming, Renee-Claude Mercier, and Manjunath P. PaiRespiratory Disorders43. Drug Therapy Individualization in PatientsSection Editor: Robert L. Talbert27. Introduction to Pulmonary Function Testing. . . . 455 Jay I. Peters and Stephanie M. Levinewith Hepatic Disease or Genetic Alterations in Drug Metabolizing Activity . . . . . . . . . . . . . . . . 693 Y. W. Francis Lam28. Asthma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 463 H. William Kelly and Christine A. Sorkness29. Chronic Obstructive Pulmonary Disease. . . . . . . . 495 Dennis M. Williams and Sharya V. Bourdet30. Pulmonary Hypertension. . . . . . . . . . . . . . . . . 519Robert L. Talbert, Rebecca Boudreaux, and Rebecca L. Owens31. Drug-Induced Pulmonary Diseases . . . . . . . . . . . . 521 Hengameh H. Raissy, Michelle Harkins, and Patricia L. Marshik32. Cystic Fibrosis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 535 Gary MilavetzSECTION 5 Renal Disorders Section Editor: Gary R. Matzke44. Quantification of Renal Function . . . . . . . . . . . . . 705 Thomas C. Dowling45. Acute Renal Failure . . . . . . . . . . . . . . . . . . . . . . . . . 723 William Dager and Anne P. Spencer46. Chronic Kidney Disease: Progression-Modifying Therapies . . . . . . . . . . . . . 745 Melanie S. Joy, Abhijit Kshirsagar, and Nora FranceschiniSECTION 4 Gastrointestinal Disorders Section Editor: Joseph T. DiPiro33. Evaluation of the Gastrointestinal Tract . . . . . . . . 547 Keith M. Olsen, Marie A. Chisholm, and Mark W. Jackson34. Gastroesophageal Reflux Disease . . . . . . . . . . . . . . 555 Dianne B. Williams and Robert R. Schade35. Peptic Ulcer Disease . . . . . . . . . . . . . . . . . . . . . . . . . 569 Rosemary R. Berardi and Lynda S. Welage36. Inflammatory Bowel Disease. . . . . . . . . . . . . . . . . . 589 Brian A. Hemstreet and Joseph T. DiPiro37. Nausea and Vomiting . . . . . . . . . . . . . . . . . . . . . . . 607 Cecily V. DiPiro47. Chronic Kidney Disease: Management of Complications . . . . . . . . . . . . . . . 765 Joanna Q. Hudson48. Hemodialysis and Peritoneal Dialysis. . . . . . . 793Edward F. Foote and Harold J. Manley49. Drug-Induced Kidney Disease . . . . . . . . . . . . . . . . 795 Thomas D. Nolin and Jonathan Himmelfarb50. Glomerulonephritis. . . . . . . . . . . . . . . . . . . . . . . . . 811 Alan H. Lau51. Drug Therapy Individualization for Patients with Renal Insufficiency. . . . . . . . . . . . . . 833 Gary R. Matzke and Reginald F. Frye52. Disorders of Sodium and Water Homeostasis . . . 845 James D. Coyle and Melanie S. JoyThe complete chapter, learning objectives, and other resources can be found at www.pharmacotherapyonline.com. 9. ix53. Disorders of Calcium and Amy Barton Pai, Mark Rohrscheib, and Melanie S. Joy54. Disorders of Potassium and Magnesium Homeostasis . . . . . . . . . . . . . . . . . . . . 877 Donald F. Brophy and Todd W. B. Gehr55. AcidBase Disorders . . . . . . . . . . . . . . . . . . . . . . . . 889 John W. Devlin, Gary R. Matzke, and Paul M. Palevsky66. Eating Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . 1041 Steven C. Stoner67. Alzheimers Disease . . . . . . . . . . . . . . . . . . . . . . . . 1051 Patricia W. Slattum, Russell H. Swerdlow, and Angela Massey Hill68. Substance-Related Disorders: Overview and Depressants, Stimulants, and Hallucinogens. . . . 1067 Paul L. Doering and Lisa A. Boothby69. Substance-Related Disorders: Alcohol, Nicotine, and Caffeine . . . . . . . . . . . . . . . . . . . . . . 1083 Paul L. Doering, W. Klugh Kennedy, and Lisa A. BoothbySECTION 6 Neurologic Disorders Section Editor: Barbara G. Wells56. Evaluation of Neurologic Illness . . . . . . . . . . . . . . 909 Susan C. Fagan and Fenwick T. Nichols57. Multiple Sclerosis . . . . . . . . . . . . . . . . . . . . . . . . . . 913 Jacquelyn L. Bainbridge and John R. Corboy58. Epilepsy. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 927 Susan J. Rogers and Jose E. Cavazos59. Status Epilepticus. . . . . . . . . . . . . . . . . . . . . . . . . . . 953 Stephanie J. Phelps, Collin A. Hovinga, and James W. Wheless60. Acute Management of the Brain Injury Patient . . .965 Bradley A. Boucher and Shelly D. Timmons61. Parkinsons Disease . . . . . . . . . . . . . . . . . . . . . . . . . 977 Jack J. Chen, Merlin V. Nelson, and David M. Swope62. Pain Management . . . . . . . . . . . . . . . . . . . . . . . . . . 98970. Schizophrenia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1099 M. Lynn Crismon, Tami R. Argo, and Peter F. Buckley71. Depressive Disorders . . . . . . . . . . . . . . . . . . . . . . . 1123 Christian J. Teter, Judith C. Kando, Barbara G. Wells, and Peggy E. Hayes72. Bipolar Disorder . . . . . . . . . . . . . . . . . . . . . . . . . . . 1141 Shannon J. Drayton and Benjamin L. Weinstein73. Anxiety Disorders I: Generalized Anxiety, Panic, and Social Anxiety Disorders. . . . . . . . . . . 1161 Cynthia K. Kirkwood and Sarah T. Melton74. Anxiety Disorders II: Posttraumatic Stress Disorder and Obsessive-Compulsive Disorder . . . . . . . . . . 1179 Cynthia K. Kirkwood, Eugene H. Makela, and Barbara G. Wells75. Sleep Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1191 John M. Dopp and Bradley G. Phillips76. Developmental Disabilities. . . . . . . . . . . . . . . 1203Nancy Brahm, Jerry McKee, and Robert C. BrownTerry J. Baumann and Jennifer Strickland63. Headache Disorders . . . . . . . . . . . . . . . . . . . . . . . 1005 Deborah S. Minor and Marion R. WoffordSECTION 8 Endocrinologic Disorders Section Editor: Robert L. TalbertSECTION 7 Psychiatric Disorders Section Editor: Barbara G. Wells64. Evaluation of Psychiatric Illness . . . . . . . . . . . . . 1021 Patricia A. Marken, Mark E. Schneiderhan, and Stuart Munro65. Childhood Disorders. . . . . . . . . . . . . . . . . . . . . . . 1029 Julie Ann Dopheide, Jane Tran Tesoro, and Michael Malkin77. Diabetes Mellitus . . . . . . . . . . . . . . . . . . . . . . . . . . 1205 Curtis L. Triplitt, Charles A. Reasner, II, and William L. Isley78. Thyroid Disorders . . . . . . . . . . . . . . . . . . . . . . . . . 1243 Steven I. Sherman and Robert L. Talbert79. Adrenal Gland Disorders. . . . . . . . . . . . . . . . . . . . 1265 John G. Gums and Shawn Anderson80. Pituitary Gland Disorders . . . . . . . . . . . . . . . . . . . 1281 Amy Heck Sheehan, Jack A. Yanovski, and Karim Anton CalisThe complete chapter, learning objectives, and other resources can be found at www.pharmacotherapyonline.com.CONTENTSPhosphorus Homeostasis . . . . . . . . . . . . . . . . . . . . 861 10. xCONTENTSSECTION 9SECTION 12Gynecologic DisordersRheumatologic DisordersSection Editor: Barbara G. WellsSection Editor: L. Michael Posey81. Pregnancy and Lactation: Therapeutic Considerations . . . . . . . . . . . . . . . . . 1297 Denise L. Walbrandt Pigarelli, Connie K. Kraus, and Beth E. Potter82. Contraception. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1313 Lori M. Dickerson, Sarah P. Shrader, and Vanessa A. Diaz83. Menstruation-Related Disorders . . . . . . . . . . . . . 1329 Elena M. Umland, Lara C. Weinstein, and Edward Buchanan84. Endometriosis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1345 Deborah A. Sturpe93. Osteoporosis and Other Metabolic Bone Diseases. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1483 Mary Beth OConnell and Sheryl F. Vondracek94. Rheumatoid Arthritis . . . . . . . . . . . . . . . . . . . . . . 1505 Arthur A. Schuna95. Osteoarthritis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1519 Lucinda M. Buys and Mary Elizabeth Elliott96. Gout and Hyperuricemia . . . . . . . . . . . . . . . . . . . 1539 Michael E. Ernst, Elizabeth C. Clark, and David W. Hawkins85. Hormone Therapy in Women . . . . . . . . . . . . . . . 1351 Sophia N. Kalantaridou, Susan R. Davis, and Karim Anton CalisSECTION 13 Ophthalmic and Otolaryngologic Disorders Section Editor: L. Michael PoseySECTION 10 Urologic Disorders Section Editor: L. Michael Posey86. Erectile Dysfunction. . . . . . . . . . . . . . . . . . . . . . . . 136997. Glaucoma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1551 Richard G. Fiscella, Timothy S. Lesar, and Deepak P. Edward98. Allergic Rhinitis . . . . . . . . . . . . . . . . . . . . . . . . . . . 1565 J. Russell May and Philip H. SmithMary Lee87. Management of Benign Prostatic Hyperplasia . . . . . . . . . . . . . . . . . . . . . . . 1387 Mary Lee88. Urinary Incontinence. . . . . . . . . . . . . . . . . . . . . . . 1399 Eric S. Rovner, Jean Wyman, Thomas Lackner, and David GuaySECTION 14 Dermatologic Disorders Section Editor: L. Michael Posey99. Dermatologic Drug Reactions and Self-Treatable Skin Disorders. . . . . . . . . . . . . . . . 1577 Nina H. Cheigh100. Acne Vulgaris. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1591 SECTION 11 Immunologic Disorders Section Editor: Gary C. Yee89. Function and Evaluation of the Immune System . . . . . . . . . . . . . . . . . . . . . . . . . . . 1417 Philip D. Hall and Nicole A. WeimertDennis P. West, Amy Loyd, Kimberly A. Bauer, Lee E. West, Laura Scuderi, and Giuseppe Micali101. Psoriasis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1603 Dennis P. West, Amy Loyd, Lee E. West, Kimberly A. Bauer, Maria Letizia Musumeci, and Giuseppe Micali102. Atopic Dermatitis . . . . . . . . . . . . . . . . . . . . . . . . . 1619 Nina H. Cheigh90. Systemic Lupus Erythematosus and Other Collagen-Vascular Diseases . . . . . . . . . . . . . . . . . . 1431 Jeffrey C. Delafuente and Kimberly A. Cappuzzo91. Allergic and Pseudoallergic Drug Reactions . . . . 1447 Joseph T. DiPiro92. Solid-Organ Transplantation . . . . . . . . . . . . . . . . 1459 Kristine S. Schonder and Heather J. JohnsonSECTION 15 Hematologic Disorders Section Editor: Gary C. Yee103. Hematopoiesis . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1627 William P. Petros and Michael Craig 11. xi104. Anemias . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1639 105. Coagulation Disorders . . . . . . . . . . . . . . . . . . . . . 1665 Betsy Bickert Poon and Char Witmer106. Sickle Cell Disease . . . . . . . . . . . . . . . . . . . . . . . . . 1685 C. Y. Jennifer Chan and Reginald H. Moore107. Drug-Induced Hematologic Disorders . . . . . . . . 1701 Dale H. Whitby and Thomas E. Johns122. Bone and Joint Infections . . . . . . . . . . . . . . . . . . . 1933 Edward P. Armstrong and Allan D. Friedman123. Sepsis and Septic Shock . . . . . . . . . . . . . . . . . . . . . 1943 S. Lena Kang-Birken and Joseph T. DiPiro124. Superficial Fungal Infections. . . . . . . . . . . . . . . . . 1957 Thomas E. R. Brown and Thomas W. F. Chin125. Invasive Fungal Infections. . . . . . . . . . . . . . . . . . . 1973 Peggy L. Carver126. Infections in Immunocompromised Patients . . . 2003 SECTION 16 Infectious Diseases Section Editor: Joseph T. DiPiro108. Laboratory Tests to Direct Antimicrobial Pharmacotherapy . . . . . . . . . . . . . 1715 Michael J. Rybak and Jeffrey R. Aeschlimann109. Antimicrobial Regimen Selection . . . . . . . . . . . . 1731 David S. BurgessDouglas N. Fish127. Antimicrobial Prophylaxis in Surgery . . . . . . . . . 2027 Salmaan Kanji and John W. Devlin128. Vaccines, Toxoids, and Other Immunobiologics . . . . . . . . . . . . . . . . . . . . 2041 Mary S. Hayney129. Human Immunodeficiency Virus Infection . . . . 2065 Peter L. Anderson, Thomas N. Kakuda, and Courtney V. Fletcher110. Central Nervous System Infections . . . . . . . . . . . 1743 Isaac F. Mitropoulos, Elizabeth D. Hermsen, Jeremy A. Schafer, and John C. Rotschafer111. Lower Respiratory Tract Infections . . . . . . . . . . . 1761 Mark L. Glover and Michael D. Reed112. Upper Respiratory Tract Infections. . . . . . . . . . . 1779 Yasmin Khaliq, Sarah Forgie, and George Zhanel113. Influenza. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1791 Elizabeth D. Hermsen and Mark E. Rupp114. Skin and Soft-Tissue Infections . . . . . . . . . . . . . . 1801 Douglas N. Fish, Susan L. Pendland, and Larry H. Danziger115. Infective Endocarditis . . . . . . . . . . . . . . . . . . . . . . 1821 Michael A. Crouch and Angie Veverka116. Tuberculosis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1839 Charles A. Peloquin117. Gastrointestinal Infections and . . . . . . . . . . . . . . 1857 Enterotoxigenic Poisonings Steven Martin and Rose Jung118. Intraabdominal Infections . . . . . . . . . . . . . . . . . . 1875 Joseph T. DiPiro and Thomas R. Howdieshell119. Parasitic Diseases . . . . . . . . . . . . . . . . . . . . . . . . . . 1887 J. V. Anandan120. Urinary Tract Infections and Prostatitis . . . . . . . 1899 Elizabeth A. Coyle and Randall A. Prince121. Sexually Transmitted Diseases . . . . . . . . . . . . . . . 1915 Leroy C. KnodelSECTION 17 Oncologic Disorders Section Editor: Gary C. Yee130. Cancer Treatment and Chemotherapy . . . . . . . . 2085 Patrick J. Medina and Chris Fausel131. Breast Cancer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2121 Laura Boehnke Michaud, Janet L. Espirito, and Francisco J. Esteva132. Lung Cancer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2157 Jeannine S. McCune and Deborah A. Frieze133. Colorectal Cancer. . . . . . . . . . . . . . . . . . . . . . . . . . 2175 Patrick J. Medina, Weijing Sun, and Lisa E. Davis134. Prostate Cancer. . . . . . . . . . . . . . . . . . . . . . . . . . . . 2207 Jill M. Kolesar135. Lymphomas . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2219 Val R. Adams and Gary C. Yee136. Ovarian Cancer. . . . . . . . . . . . . . . . . . . . . . . . . . . . 2245 Judith A. Smith and Judith K. Wolf137. Acute Leukemias. . . . . . . . . . . . . . . . . . . . . . . . . . . 2259 Helen L. Leather and Betsy Bickert Poon138. Chronic Leukemias . . . . . . . . . . . . . . . . . . . . . . . . 2281 Amy M. Pick, Marcel Devetten, and Timothy R. McGuire139. Multiple Myeloma . . . . . . . . . . . . . . . . . . . . . . . . . 2295 Timothy R. McGuireCONTENTSBeata A. Ineck, Barbara J. Mason, and William L. Lyons 12. xii140. Myelodysplastic Syndromes. . . . . . . . . . . . . . 2309CONTENTSJulianna A. Burzynski and Trevor McKibbin141. Skin Cancer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2311 Rowena N. Schwartz and Lindsay J. Corporon142. Hematopoietic Stem Cell Transplantation . . . . . 2331 Janelle B. Perkins and Gary C. Yee144. Prevalence and Significance of Malnutrition . . . 2367 Gordon Sacks and Catherine M. Crill145. Parenteral Nutrition . . . . . . . . . . . . . . . . . . . . . . . 2379 Todd W. Mattox and Pamela D. Reiter146. Enteral Nutrition. . . . . . . . . . . . . . . . . . . . . . . . . . 2399 Vanessa J. Kumpf and Katherine Hammond Chessman147. Nutritional Considerations in Major SECTION 18 Nutrition Disorders Section Editor: Gary R. Matzke143. Assessment of Nutrition Status and Nutrition Requirements . . . . . . . . . . . . . . . . . . . . 2349 Katherine Hammond Chessman and Vanessa J. KumpfOrgan Failure. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2417 Brian M. Hodges and Mark DeLegge148. Obesity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2437 John V. St. Peter and Charles J. BillingtonGlossary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2455 Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2581The complete chapter, learning objectives, and other resources can be found at www.pharmacotherapyonline.com. 13. xiiiCONTRIBUTORSVal R. Adams, PharmD, FCCP, BCOPJeffrey F. Barletta, PharmD, FCCMAssociate Professor, University of Kentucky, College of Pharmacy, Lexington, Kentucky Chapter 135Clinical Specialist-Critical Care, Department of Pharmacy, Spectrum Health, Adjunct Assistant Professor, College of Pharmacy, Ferris State University, Grand Rapids, Michigan Chapter 14Jeffrey R. Aeschlimann, PharmD University of Connecticut, School of Pharmacy, Storrs, Connecticut Chapter 108Rondall E. Allen, PharmD Clinical Assistant Professor and Assistant Dean for Program Assessment, Xavier University of Louisiana College of Pharmacy, New Orleans, Louisana Chapter 40J. V. Anandan, PharmD Adjunct Associate Professor, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University; Pharmacy Specialist, Center for Drug Use Analysis and Information, Department of Pharmacy Services, Henry Ford Hospital, Detroit, Michigan Chapter 119Peter L. Anderson, PharmD Assistant Professor, School of Pharmacy, University of Colorado, Denver, Colorado Chapter 129Shawn Anderson, PharmDKimberly A. Bauer, MD Clinical Research Fellow, Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois Chapters 100 and 101Larry A. Bauer, PharmD, FCP, FCCP Professor, Departments of Pharmacy and Laboratory Medicine, University of Washington, Seattle, Washington Chapter 5Jerry L. Bauman, PharmD, FACC, FCCP Professor and Dean, College of Pharmacy; Professor, Department of Medicine, College of Medicine, University of Illinois, Chicago, Illinois Chapter 19Terry J. Baumann, PharmD, BCPS Clinical Manager, Munson Medical Center, Traverse City, Michigan; Adjunct Assistant Professor of Pharmacy, Ferris State University, College of Pharmacy, Big Rapids, Michigan Chapter 62Rosemary R. Berardi, PharmD, FCCP, FASHP, FAPhAPostdoctoral Fellow, Colleges of Pharmacy and Medicine, Departments of Pharmacy Practice and Family Medicine, University of Florida, Gainesville, Florida Chapter 79Professor of Pharmacy, College of Pharmacy, University of Michigan; Clinical Pharmacist, Gastrointestinal/Liver Diseases, Department of Pharmacy, University of Michigan Health System, Ann Arbor, Michigan Chapters 35 and 41Tami R. Argo, PharmD, MS, BCPPCharles J. Billington, MDClinical Assistant Professor, Department of Pharmacy Practice, College of Pharmacy, University of Texas at Austin, Austin, Texas Chapter 70Professor, Department of Medicine, University of Minnesota, Minneapolis VA Medical Center, Minneapolis, Minnesota Chapter 148Edward P. Armstrong, PharmDLisa A. Boothby, PharmD, BCPSProfessor, Department of Pharmacy Practice and Science, College of Pharmacy, University of Arizona, Tucson, Arizona Chapter 122Coordinator, Drug Information Services, Columbus Regional Healthcare System; Affiliate Clinical Associate Professor, Auburn University Harrison School of Pharmacy, Columbus, Georgia Chapters 68 and 69Jacquelyn L. Bainbridge, PharmD Associate Professor, Department of Clinical Pharmacy and Department of Neurology, University of Colorado at Denver and The Health Sciences Center, Denver, Colorado Chapter 57Bradley A. Boucher, PharmD, FCCP, FCCM Professor, Department of Clinical Pharmacy, College of Pharmacy, University of Tennessee, Memphis, Tennessee Chapter 60Copyright 2008, 2005, 2002 by The McGraw-Hill Companies, Inc. Click here for terms of use. 14. xivCONTRIBUTORSSharya V. Bourdet, PharmD, BCPSJulianna A. Burzynski, PharmD, BCPS, BCOPCritical Care Pharmacist, Veterans Affairs Medical Center, San Francisco, Health Sciences Assistant Clinical Professor, School of Pharmacy, University of California, San Francisco, San Francisco, California Chapter 29Pharmacy Specialist-Hematology/Oncology, Mayo Clinic, Rochester, Minnesota Chapter 140Denise Boudreau, RPh, PhD Scientific Investigator, Group Health Center for Health Studies, Seattle, Washington Chapter 9Rebecca Boudreaux, PharmD Clinical Instructor, College of Pharmacy, University of Texas at Austin; Department of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, Texas Chapter 30Nancy Brahm, PharmD, MS, BCPP Clinical Associate Professor, Department of Pharmacy, Clinical and Administrative Sciences, University of Oklahoma College of Pharmacy, Tulsa, Oklahoma Chapter 76Lucinda M. Buys, PharmD Associate Professor , Clinical and Administrative Pharmacy Division, University of Iowa, College of Pharmacy and the Siouxland Medical Education Foundation, Sioux City, Iowa Chapter 95Karim Anton Calis, PharmD, MPH, FASHP, FCCP Director, Drug Information Service and Clinical Specialist, Endocrinology and Womens Health, Mark O. Hatfield Clinical Research Center, National Institutes of Health, Bethesda, Maryland; Professor of Pharmacy, School of Pharmacy, Virginia Commonwealth University, Richmond, Virginia; Clinical Professor, Department of Pharmacy Practice and Science, School of Pharmacy, University of Maryland, Baltimore, Maryland; Clinical Professor, Department of Pharmacy Practice, School of Pharmacy, Shenandoah University, Winchester, Virginia Chapters 80 and 85Donald F. Brophy, PharmD, MSc, FCCP, BCPSKimberly A. Cappuzzo, PharmD, MS, CGPAssociate Professor of Pharmacy and Internal Medicine, Virginia Commonwealth University Medical College of Virginia Campus, School of Pharmacy, Richmond, Virginia Chapter 54Assistant Professor of Pharmacy, School of Pharmacy, Virginia Commonwealth University; Clinical Pharmacist/Geriatric Pharmacotherapy Specialist, Virginia Commonwealth University Medical Center, Richmond, Virginia Chapter 90Jason E. Brouillard, PharmD Adjunct Clinical Instructor, Department of Pharmacotherapy, College of Pharmacy, Washington State University; Critical Care Pharmacist, Department of Pharmacy, Sacred Heart Medical Center, Spokane, Washington Chapter 11Peggy L. Carver, PharmD, FCCP Associate Professor of Pharmacy, College of Pharmacy, and Clinical Pharmacist, University of Michigan Health System, Ann Arbor, Michigan Chapter 125Robert C. Brown, MDLarisa H. Cavallari, PharmD, BCPSAdjunct Clinical Associate Professor, University of Oklahoma College of Pharmacy, Department of Pharmacy, Clinical and Administrative Sciences, Oklahoma City, Oklahoma Chapter 76Assistant Professor, Department of Pharmacy Practice, University of Illinois College of Pharmacy, Chicago, Illinois Chapters 6 and 16Thomas E. R. Brown, PharmD Associate Professor, Leslie Dan Faculty of Pharmacy, University of Toronto, and Clinical Coordinator, Womens Health Sunnybrook Health Sciences Centre, Toronto, Ontario Chapter 124Edward M. Buchanan, MD Department of Family Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania Chapter 83Peter F. Buckley, MD Professor and Chairman, Department of Psychiatry, Associate Dean of Leadership Development, Medical College of Georgia, Augusta, Georgia Chapter 70David S. Burgess, PharmD, FCCP Clinical Professor of Pharmacy and Medicine, Center for Advancement of Research and Education in Infectious Diseases, University of Texas at Austin College of Pharmacy and Pharmacotherapy Education and Research Center, University of Texas Health Science Center, San Antonio, Texas Chapter 109Jose E. Cavazos, MD, PhD Director of Research and Education, South Texas Comprehensive Epilepsy Center, University of Texas Health Science Center, San Antonio, Texas Chapter 58C. Y. Jennifer Chan, PharmD Clinical Assistant Professor of Pharmacy, University of Texas in Austin, College of Pharmacy, Clinical Associate Professor of Pediatrics, University of Texas Health Science Center in San Antonio; Clinical Manager, Pediatric Pharmacy Services, Methodist Childrens Hospital, San Antonio, Texas Chapter 106Nina H. Cheigh, PharmD Clinical Associate Professor, University of Illinois College of Pharmacy, Rye, New York Chapters 99 and 102Jack J. Chen, PharmD, BCPS, CGP Loma Linda University, School of Medicine, Department of Neurology and School of Pharmacy, Department of Pharmacotherapy, Outcomes and Research, Loma Linda, California Chapter 61 15. xvAssociate Professor, Department of Pharmacy and Clinical Sciences, South Carolina College of Pharmacy, MUSC Campus; Clinical Pharmacy Specialist, Pediatrics/Pediatric Surgery, Department of Pharmacy Services, Medical University of South Carolina Childrens Hospital, Charleston, South Carolina Chapters 143 and 146Robert Chilton, DO, FACC, FAHA Professor, Department of Medicine, University of Texas Health Science Center, San Antonio, Texas Chapter 13Thomas W. F. Chin, PharmD, BSc, FCSHP Clinical Pharmacy Specialist/Leader-Antimicrobials and Infectious Diseases, St. Michaels Hospital; Assistant Professor, Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada Chapter 124Elaine Chiquette, PharmD, BCPS Senior Medical Science Division, Medical Affairs, Amylin Pharmaceuticals, Inc., San Antonio, Texas Chapter 3Marie A. Chisholm-Burns, PharmD, MPH, FCCP, FASHP Professor and Head, Department of Pharmacy Practice and Science, University of Arizona College of Pharmacy, Tuscon, Arizona Chapter 33Peter A. Chyka, PharmD, FAACT, DABAT Professor, Department of Clinical Pharmacy and Associate Dean, Knoxville Campus, College of Pharmacy, University of Tennessee, Knoxville, Tennessee Chapter 10Elizabeth C. Clark, MD, MPH University of Medicine and Denistry of New Jersey, Robert Wood Johnson Medical School, Department of Family Medicine, Somerset, New Jersey Chapter 96Stephen Joel Coons, PhD Professor, Department of Pharmacy Practice and Service, College of Pharmacy, University of Arizona, Tuscon, Arizona Chapter 2John R. Corboy, MD Professor, Department of Neurology, University of Colorado School of Medicine; Denver Veterans Affairs Medical Center, Denver, Colorado Chapter 57Lindsay J. Corporon, PharmD, BCDP Assistant Professor of Pharmacy and Therapeutics, University of Pittsburgh, School of Pharmacy; Clinical Specialist in Oncology, Magee Womens Hospital, Pittsburgh, Pennsylvania Chapter 141Elizabeth A. Coyle, PharmD, BCPS Clinical Associate Professor, University of Houston College of Pharmacy, Houston, Texas Chapter 120James D. Coyle, PharmD Assistant Professor of Clinical Pharmacy, College of Pharmacy, Ohio State University, Columbus, Ohio Chapter 52Michael Craig, MD Assistant Professor, Department of Medicine, Section of Hematology/Oncology, West Virginia University, Morgantown, West Virginia Chapter 103Catherine M. Crill, PharmD, BCPS, BCNSP Associate Professor, Department of Clinical Pharmacy; Assistant Professor, Department of Pediatrics, University of Tennessee Health Science Center, Memphis, Tennessee Chapter 144M. Lynn Crismon, PharmD, FCCP, BCPP Dean, James T. Doluisio Chair and Behrens Professor, College of Pharmacy, University of Texas at Austin, Austin, Texas Chapter 70Michael A. Crouch, PharmD, BCPS Associate Professor of Pharmacy and Medicine, Virginia Commonwealth University, Medical College of Virginia Campus, Richmond, Virginia Chapter 115William E. Dager, PharmD, FCSHP Pharmacist Specialist, UC Davis Medical Center, Clinical Professor of Medicine, UC Davis School of Medicine, Sacramento, California; Clinical Professor of Pharmacy, UC San Francisco School of Pharmacy, San Francisco, California Chapter 45Joseph F. Dasta, MSc, FCCM, FCCP Professor Emeritus, Ohio State University, College of Pharmacy, Columbus, Ohio; Adjunct Professor, University of Texas, Austin, Texas Chapter 25Lisa E. Davis, PharmD, FCCP, BCPS, BCOP Associate Professor and Vice Chair of Research, Philadelphia College of Pharmacy, University of the Sciences in Philadelphia, Philadelphia, Pennsylvania Chapter 133Susan R. Davis, MD, PhD, FRAPC Chair of Womens Health, Department of Medicine, Monash University, Clayton, Victoria, Australia Chapter 85Lisa T. Costanigro, Pharm DLarry H. Danziger, PharmDInfectious Diseases Pharmacy Resident; Deaconess Medical Center, Washington State University College of Pharmacy, Spokane, Washington Chapter 11Professor of Pharmacy, Department of Pharmacy Practice, Interim Vice Chancellor for Research, University of Illinois, Chicago, Illinois Chapter 114CONTRIBUTORSKatherine Hammond Chessman, PharmD, FCCP, BCPS, BCNSP 16. xviCONTRIBUTORSSimon de Denus, MSc, BPharmJulie Ann Dopheide, PharmD, BCPPAssistant Professor, Faculty of Pharmacy, University of Montreal, Montreal Heart Institute, Montreal, Quebec, Canada Chapter 18Associate Professor of Clinical Pharmacy, Psychiatry and the Behavioral Sciences, University of Southern California Schools of Pharmacy and Medicine, Los Angeles, California Chapter 65Jeffrey C. Delafuente, MS, FCCP, FASCP Associate Dean for Professional Education; Professor of Pharmacy and Director of Geriatric Programs, School of Pharmacy, Virginia Commonwealth University, Richmond, Virginia Chapter 90John M. Dopp, PharmD Assistant Professor, Pharmacy Practice Division, School of Pharmacy, University of Wisconsin-Madison, Madison, Wisconsin Chapter 75Mark DeLegge, MDThomas C. Dowling, PharmD, PhDProfessor and Director, Digestive Disease Center, School of Medicine, Medical University of South Carolina, Charleston, South Carolina Chapter 147Associate Professor, Director, Renal Clinical Pharmacology Lab, School of Pharmacy, University of Maryland, Baltimore, Maryland Chapter 44Paulina Deming, PharmDAssistant Professor, Department of Pharmacy and Clinical Sciences, South Carolina College of Pharmacy, Medical University of South Carolina Campus, Charleston, South Carolina Chapter 72Assistant Professor, College of Pharmacy and Department of Internal Medicine, University of New Mexico, Albuquerque, New Mexico Chapter 42Marcel Devetten, MD Associate Professor of Medicine and Director of Hematopoietic Cell Transplant Program, University of Nebraska Medical Center, Omaha, Nebraska Chapter 138John W. Devlin, PharmD, FCCP, FCCM, BCPS Associate Professor, Department of Pharmacy Practice, School of Pharmacy, Northeastern University; Adjunct Associate Professor, School of Medicine, Tufts University, Boston, Massachusetts Chapters 55 and 127Vanessa A. Diaz, MD, MS Assistant Professor, Department of Family Medicine, Medical University of South Carolina, Charleston, South Carolina Chapter 82Lori M. Dickerson, PharmD, FCCP, BCPS Associate Professor and Associate Residency Program Director, Department of Family Medicine, Medical University of South Carolina, Charleston, South Carolina Chapter 82Cecily V. DiPiro, PharmD Consultant Pharmacist, Mt. Pleasant, South Carolina Chapter 37Joseph T. DiPiro, PharmD, FCCP Executive Dean and Professor, South Carolina College of Pharmacy, Medical University of South Carolina, Charleston, South Carolina; University of South Carolina, Columbia, South Carolina Chapters 36, 91, 118, and 123Shannon J. Drayton, PharmDDeepak P. Edward, MD, FACS Chair and Program Director; Professor/NEOUCOM, Department of Ephthalmology, Summa Health System, Akron, Ohio Chapter 97Mary Elizabeth Elliott, PharmD, PhD Associate Professor and Vice-Chair, Pharmacy Practice Division, School of Pharmacy, University of Wisconsin-Madison, Madison, Wisconson, Clinical Pharmacist, Osteoporosis Clinic, VA Medical Center, Madison, Wisconsin Chapter 95Michael E. Ernst, PharmD, BCPS Associate Professor (Clinical), Division of Clinical and Administrative Pharmacy, College of Pharmacy; Department of Family Medicine, Carver College of Medicine, University of Iowa, Iowa City, Iowa Chapter 96Brian L. Erstad, PharmD Professor, Department of Pharmacy Practice and Science, College of Pharmacy, University of Arizona, Tucson, Arizona Chapter 26Janet L. Espirito, PharmD, BCOP Clinical Pharmacy Specialist-Breast Oncology, Division of Pharmacy, University of Texas M.D. Anderson Cancer Center, Houston, Texas Chapter 131Francisco J. Esteva, MD, PhD Associate Professor of Medicine, Departments of Breast Medical Oncology and Molecular and Cellular Oncology, University of Texas, M.D. Anderson Cancer Center, Houston, Texas Chapter 131Susan C. Fagan, PharmD, BCPS Paul L. Doering, MS Distinguished Service Professor of Pharmacy Practice, College of Pharmacy, University of Florida, Gainesville, Florida Chapters 68 and 69Professor, Clinical and Administrative Pharmacy, College of Pharmacy, University of Georgia and Adjunct Professor of Neurology, Medical College of Georgia, Augusta, Georgia Chapters 22 and 56 17. xviiMark L. Glover, PharmD, BS PharmClinical Pharmacist, Hematology/Oncology/BMT, Indiana University Cancer Center, Indianapolis, Indiana Chapter 130Associate Professor and Director, West Palm Beach Program, Department of Pharmacy Practice, College of Pharmacy, Nova Southeastern University, Palm Beach Gardens, Florida Chapter 111Richard G. Fiscella, BS Pharm, MPH Clinical Professor, Department of Pharmacy Practice, Adjunct Assistant Professor, Department of Ophthalmology, University of Illinois, Chicago, Illinois Chapter 97Douglas N. Fish, PharmD Professor, Department of Clinical Pharmacy, School of Pharmacy; Clinical Associate Professor, Division of Respiratory and Critical Care Medicine, School of Medicine, University of Colorado, Denver, Colorado Chapters 114 and 126Courtney V. Fletcher, PharmD Dean and Professor, College of Pharmacy, University of Nebraska Medical Center, Omaha, Nebraska Chapter 129Edward F. Foote, PharmD, FCCP, BCPS Professor and Chair, Pharmacy Practice Department, Nesbitt College of Pharmacy and Nursing, Wilkes-Barre University, WilkesBarre, Pennsylvania Chapter 48Sarah Forgie, MD, FRCP(C) Assistant Professor, Pediatrics, Division of Infectious Diseases, University of Alberta; Associate Director, Infection Control, Stollery Childrens Hospital, Edmonton, Alberta, Canada Chapter 112Nora Franceschini, MD, MPH Department of Epidemiology, School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina Chapter 46Allan D. Friedman, MD, MPH Professor and Chair, Division of General Pediatrics, Virginia Commonwealth University, Richmond, Virginia Chapter 122Deborah A. Frieze, PharmD, BCOP Clinical Pharmacist, Hematology/Oncology; Clinical Instructor, Seattle Cancer Care Alliance; University of Washington Medical Center, Seattle, Washington Chapter 132Shelly L. Gray, PharmD, MS Professor, School of Pharmacy, University of Washington, Seattle, Washington Chapter 8Jessica S. Gruber, PhD, MPH Washington State University, College of Pharmacy, Deaconess Medical Center, Spokane, Washington Chapter 11David R. P. Guay, Pharm D Professor, Department of Experimental and Clinical Pharmacology, College of Pharmacy, University of Minnesota; Department of Geriatrics, Health Partners, Inc., Minneapolis, Minnesota Chapters 8 and 88John G. Gums, PharmD Professor of Pharmacy and Medicine, Departments of Pharmacy Practice and Family Medicine, Director of Clinical Research in Family Medicine, University of Florida, Gainesville, Florida Chapter 79Stuart T. Haines, PharmD, BCPS Professor and Vice Chair, University of Maryland School of Pharmacy; Clinical Specialist, University of Maryland Medical System, Baltimore, Maryland Chapter 21Emily R. Hajjar, PharmD Assistant Professor, Jefferson School of Pharmacy, Thomas Jefferson University, Philadelphia, Pennsylvania Chapter 8Philip D. Hall, PharmD, FCCP, BCPS, BCOP Associate Dean and Associate Professor, South Carolina College of Pharmacy, Medical University of South Carolina Campus, Hollings Cancer Center, Charleston, South Carolina Chapter 89Steven M. Handler, MP, MS, CMD Assistant Professor, Department of Medicine, Division of Geriatic Medicine and Department of Biomedical Informatics, University of Pittsburgh, Pittsburgh, Pennsylvania Chapter 8Joseph T. Hanlon, PharmD, MS, BCPSAssociate Professor, Departments of Pharmacy Practice and Pharmaceutics, College of Pharmacy, University of Florida, Gainesville, Florida Chapter 51Professor, Division of Geriatrics and Gerontology, Department of Medicine, School of Medicine; Department of Pharmacy and Therapeutics, School of Pharmacy, University of Pittsburgh; Research Health Scientist, Center for Health Equity Research and Promotion, Geriatric Research Education (CHERP) and Clinical Center (GRECC), Pittsburgh, Pennsylvania Chapter 8Todd W. B. Gehr, MDMichelle Harkins, MDProfessor and Chairman, Division of Nephrology, Department of Internal Medicine, Virginia Commonwealth University, Richmond, Virginia Chapter 54Associate Professor, Department of Internal Medicine, Pulmonary and Critical Care, University of New Mexico Health Sciences Center, Albuquerque, New Mexico Chapter 31Reginald F. Frye, PharmD, PhDCONTRIBUTORSChris Fausel, PharmD, BCPS, BCOP 18. xviiiCONTRIBUTORSDavid W. Hawkins, PharmDThomas R. Howdieshell, MD, FACS, FCCPProfessor and Dean, California Northstate College of Pharmacy, Sacramento, California Chapter 96Professor of Surgery, Section of Trauma/Surgical Critical Care, Department of Surgery, University of New Mexico Health Sciences Center, Albuquerque, New Mexico Chapter 118Peggy E. Hayes, PharmD President, Hayes CNS Services, LLC, San Diego, California Chapter 71Mary S. Hayney, PharmD, FCCP, BCPS Associate Professor of Pharmacy (CHS) University of WisconsinMadison, School of Pharmacy, Madison, Wisconsin Chapter 128Thomas K. Hazlet, PharmD, DrPH Pharmaceutical Outcomes Research and Policy Program University of Washington School of Pharmacy, Seattle, Washington Chapter 9Brian A. Hemstreet, PharmD, BCPS Assistant Professor, University of Colorado at Denver and Health Sciences Center School of Pharmacy, Department of Clinical Pharmacy, Denver, Colorado Chapter 36Elizabeth D. Hermsen, PharmD, MBA, BCPS Antimicrobial Specialist and Research Associate, Nebraska Medical Center; Adjunct Assistant Professor, University of Nebraska Medical Center, College of Pharmacy and Medicine, Omaha, Nebraska Chapters 110 and 113David C. Hess, MD Professor and Chair, Department of Neurology, Medical College of Georgia, Augusta, Georgia Chapter 22Angela Massey Hill, PharmD, BCPP Professor, Division Director of Pharmacy Practice, Florida A&M University College of Pharmacy, Tallahassee, Florida Chapter 67Jonathan Himmelfarb, MD Director, Division of Nephrology and Transplantation; Associate Chair for Research, Department of Medicine; Director of Clinical and Translational Research, Maine Medical Center, Portland, Maine Chapter 49Brian M. Hodges, PharmD, BCPS, BCNSP Assistant Professor, Department of Clinical Pharmacy, School of Pharmacy, West Virginia University, Morgantown, West Virginia Chapter 147Barbara J. Hoeben, PharmD, MSPharm, BCPSJoanna Q. Hudson, PharmD, BCPS, FASN Associate Professor, Departments of Clinical Pharmacy and Medicine (Nephrology), Schools of Pharmacy and Medicine, University of Tennessee; Clinical Pharmacist, Methodist University Hospital, Memphis, Tennessee Chapter 47Beata A. Ineck, PharmD, BCPS, CDE Inpatient Clinical Staff Pharmacist, St. Lukes Meridian Medical Center, Meridian, Idaho Chapter 104William L. Isley, MD Consultant, Mayo Clinic; Associate Professor of Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota (Deceased) Chapter 77Mark W. Jackson, MD Gastroenterologist, Fort Sanders Regional Medical Center and Baptist Hospital of East Tennessee, Knoxville, Tennesseee Chapter 33Thomas E. Johns, PharmD, BCPS Assistant Director, Clinical Pharmacy Services, Shands at the University of Florida, Gainesville, Florida Chapter 107Heather J. Johnson, PharmD, BCPS, FASN Assistant Professor, School of Pharmacy, University of Pittsburgh; Clinical Pharmacist, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania Chapter 92Melanie S. Joy, PharmD Associate Professor, Division of Nephrology and Hypertension, UNC Kidney Center, School of Medicine, Division of Pharmacotherapy and Experimental Therapeutics, School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina Chapters 46 and 52Rose Jung, PharmD, BCPS Prestige Associate Professor, Department of Pharmacy Practice, University of Toledo, College of Pharmacy, Toledo, Ohio Chapter 117Thomas N. Kakuda, PharmD Director, Human Pharmacokinetics, Tibotec, Inc., Yardley, Pennsylvania Chapter 129Clinical Pharmacy Flight Commander, 59 MDW, Wilford Hall Medical Center, Lackland Airforce Base; Clinical Assistant Professor, Department of General Medicine, University of Texas Health Science Center, San Antonio, Texas Chapter 24Sophia N. Kalantaridou, MD, PhDCollin A. Hovinga, PharmDJudith C. Kando, PharmD, BCPPAssistant Professor, Pharmacy and Pediatrics, University of Tennessee Health Science Center, Memphis, Tennessee Chapter 59Senior Scientific Affairs Liaison, Ortho-McNeil Janssen Scientific Affairs, LLC, Tewksbury, Massachusetts Chapter 71Associate Professor of Obstetrics and Gynecology, Division of Reproductive Endocrinology, University of Ioannina Medical School, Ioannina, Greece Chapter 85 19. xixThomas Lackner, PharmDAssociate Professor, Department of Pharmacy Practice, Thomas J. Long School of Pharmacy and Health Sciences, University of the Pacific, Stockton, California Chapter 123Professor, Department of Experimental and Clinical Pharmacy, College of Pharmacy, University of Minnesota, Minneapolis, Minnesota Chapter 88Salmaan Kanji, PharmD, MScY. W. Francis Lam, PharmD, FCCPClinical Pharmacy Specialist, Ottawa Health Research Institute, Ottawa, Ontario, Canada Chapter 127Associate Professor of Pharmacology and Medicine, Clinical Associate Professor of Pharmacy, Departments of Pharmacology and Medicine, University of Texas Health Science Center, San Antonio, Texas Chapters 6 and 43H. William Kelly, PharmD Professor Emeritus, Department of Pediatrics, School of Medicine, University of New Mexico Health Sciences Center, Albuquerque, New Mexico Chapter 28W. Klugh Kennedy, PharmD, BCPP Clinical Associate Professor , University of Georgia College of Pharmacy; Associate Professor, Mercer University School of Medicine, Savannah, Georgia Chapter 69Alan H. Lau, PharmD Professor, Department of Pharmacy Practice, College of Pharmacy, University of Illinois, Chicago, Illinois Chapter 50Helen L. Leather, BPharm Clinical Pharmacy Specialist BMT/Leukemia, Shands at the University of Florida, Department of Pharmacy, Gainesville, Florida Chapter 137Yasmin Khaliq, PharmDMary Lee, PharmD, BCPS, FCCPOttawa Hospital, Ottawa, Ontario, Canada Chapter 112Professor of Pharmacy Practice, Chicago College of Pharmacy; Vice President and Chief Academic Officer, Pharmacy and Health Science Education, Midwestern University, Downers Grove, Illinois Chapters 86 and 87William R. Kirchain, PharmD Wilbur and Mildred Robichaux Endowed Professor of Pharmacy, Xavier University, College of Pharmacy, New Orleans, Louisana Chapter 40Cynthia K. Kirkwood, PharmD, BCPP Associate Professor of Pharmacy, Vice Chair for Education, Department of Pharmacy, School of Pharmacy, Virginia Commonwealth University, Richmond, Virginia Chapters 73 and 74Leroy C. Knodel, PharmD Associate Professor, Department of Surgery, University of Texas Health Science Center, San Antonio, Texas; Clinical Associate Professor, College of Pharmacy, University of Texas, Austin, Texas Chapter 121Jill M. Kolesar, PharmD, FCCP, BCPS Associate Professor, School of Pharmacy, University of Wisconsin, Madison, Wisconsin Chapter 134Connie R. Kraus, PharmD, BCPS Clinical Professor, School of Pharmacy, University of WisconsinMadison, Madison, Wisconsin Chapter 81Abhijit Kshirsagar, MD, MPHTimonthy S. Lesar, PharmD Director of Pharmacy, Patient Care Service Director, Department of Pharmacy, Albany Medical Center, Albany, New York Chapter 97Stephanie M. Levine, MD Professor of Medicine, Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, San Antonio, Texas Chapter 27Amy Loyd, DO, CPT, MC Resident, Army Medical Corps, Brooke Army Medical Center, San Antonio, Texas Chapters 100 and 101William L. Lyons, MD Assistant Professor, Section of Geriatrics and Gerontology, University of Nebraska Medical Center, Omaha, Nebraska Chapter 104George E. MacKinnon, III, PhD, RPh, FASHP Vice President of Academic Affairs, American Association of Colleges of Pharmacy, Alexandria, Virginia Chapter 4Assistant Professor of Medicine, Division of Nephrology and Hypertension, UNC Kidney Center, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina Chapter 46Neil J. MacKinnon, PhD, RPh, FCSHPVanessa J. Kumpf, PharmD, BCNSPRobert MacLaren, PharmD, BScClinical Specialist, Nutrition Support, Vanderbilt University Medical Center, Nashville, Tennessee Chapters 143 and 146Associate Professor, Department of Clinical Pharmacy, University of Colorado, Denver, School of Pharmacy, Aurora, Colorado Chapter 25Associate Director for Research and Associate Professor, Dalhousie University College of Pharmacy, Halifax, Nova Scotia, Canada Chapter 4CONTRIBUTORSS. Lena Kang-Birken, PharmD, FCCP 20. xxCONTRIBUTORSEric J. MacLaughlin, PharmD, BS PharmTimothy R. McGuire, PharmD, FCCP, BCOPAssociate Professor, Texas Tech University Health Sciences Center, School of Pharmacy, Amarillo, Texas Chapter 15Associate Professor, College of Pharmacy, University of Nebraska Medical Center, Omaha, Nebraska Chapters 138 and 139Eugene H. Makela, PharmD, BCPPJerry R. McKee, PharmD, MS, BCPPAssociate Professor, Schools of Pharmacy and Medicine, West Virginia University, Morgantown, West Virginia Chapter 74Clinical Assistant Professor, Department of Pharmacotherapy, University of North Carolina School of Pharmacy, Chapel Hill, North Carolina; Pharmacy Director-Broughton Hospital, Morganton, North Carolina Chapter 76Michael Malkin, MD Director, Juvenile Court Mental Health Services, Los Angeles County Department of Mental Health; Assistant Professor, UCLA Department of Psychiatry, Los Angeles, California Chapter 65Harold J. Manley, PharmD, FASN, FCCP, BCPS Director of Clinical Pharmacy, Village Health Disease Management, Glenmont, New York Chapter 48Patricia A. Marken, PharmD, FCCP, BCPP Professor and Chair of Pharmacy Practice, School of Pharmacy; Professor of Psychiatry, School of Medicine, University of Missouri, Kansas City, Missouri Chapter 64Patricia L. Marshik, PharmD Associate Professor, University of New Mexico Health Sciences Center, College of Pharmacy, Albuquerque, New Mexico Chapter 31Steven Martin, PharmD, BCPS, FCCP, FCCM Professor and Chairman, Department of Pharmacy Practice, University of Toledo, College of Pharmacy, Toledo, Ohio Chapter 117Barbara J. Mason, PharmD, FASHP Professor and Vice Chair, Idaho State University College of Pharmacy; Ambulatory Core Clinical Pharmacist, Boise VA Medical Center, Boise, Idaho Chapter 104Todd W. Mattox, PharmD, BCNSP Coordinator, Nutrition Support Team, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida Chapter 145Gary R. Matzke, PharmD, FCP, FCCP Professor of Pharmacy and Pharmaceutics and Associate Dean for Clinical Research and Public Policy, School of Pharmacy, Professor of Internal Medicine, Nephrology Division, School of Medicine, Virginia Commonwealth University, Richmond, Virginia Chapters 51 and 55J. Russell May, PharmD, FASHP Clinical Professor, Department of Clinical and Administrative Pharmacy, University of Georgia College of Pharmacy; Clinical Pharmacy Specialist, Medical College of Georgia, Augusta, Georgia Chapter 98Jeannine S. McCune, PharmD, BCPS, BCOP Associate Professor, University of Washington, School of Pharmacy; Affiliate Investigator, Fred Hutchinson Cancer Research Center, Seattle, Washington Chapter 132Trevor McKibbin, PharmD, BCPS, MSc Assistant Professor, Department of Clinical Pharmacy, College of Pharmacy, University of Tennessee Health Science Center, Memphis, Tennessee Chapter 140Patrick J. Medina, PharmD, BCOP Associate Professor, University of Oklahoma College of Pharmacy, Oklahoma City, Oklahoma Chapters 130 and 133Sarah T. Melton, PharmD, BCPP, CGP Adjunct Associate Professor of Pharmacy Practice, University of Appalachia College of Pharmacy; Clinical Pharmacist, Lebanon, Virginia Chapter 73Giuseppe Micali, MD Professor and Chairman, Dermatology Clinic, University of Catania, Catania, Italy Chapters 100 and 101Laura Boehnke Michaud, PharmD, BCOP, FASHP Manager, Clinical Pharmacy and Clinical Pharmacy Specialist Breast Oncology, University of Texas M. D. Anderson Cancer Center, Houston, Texas Chapter 131Gary Milavetz, PharmD, RPh, BS, FCCP Associate Professor of Pharmacy, Division of Clinical and Administrative Pharmacy, College of Pharmacy, University of Iowa, Iowa City, Iowa Chapter 32Deborah S. Minor, PharmD Associate Professor, Department of Medicine, School of Medicine, University of Mississippi Medical Center, Jackson, Mississippi Chapter 63Isaac F. Mitropoulos, PharmD Research Fellow, Experimental and Clinical Pharmacology, College of Pharmacy, University of Minnesota, Minneapolis, Minnesota Chapter 110Patricia A. Montgomery, PharmD Clinical Pharmacy Specialist, Mercy General Hospital, Sacramento, California Chapter 41Reginald H. Moore, MD Clinical Associate Professor, Department of Pediatrics, University of Texas Health Science Center, San Antonio, Texas Chapter 106 21. xxiAmy Barton Pai, PharmD, BCPS, FASNChair, Department of Psychiatry, School of Medicine, University of Missouri-Kansas City, Kansas City, Missouri Chapter 64Associate Professor of Pharmacy, College of Pharmacy; School of Medicine, University of New Mexico, Albuquerque, New Mexico Chapter 53Maria Letizia Musumeci, MD, PhDPaul M. Palevsky, MDAssistant, Dermatology Clinic, University of Catania, Catania, Italy Chapter 101Chief Renal Section, VA Pittsburgh Healthcare System; Professor of Medicine, Renal-Electrolyte Division, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania Chapter 55Milap C. Nahata, PharmD, MS, FCCP Professor of Pharmacy, Pediatrics and Internal Medicine; Division Chair, Pharmacy Practice and Administration, Ohio State University, College of Pharmacy, Associate Director, Department of Pharmacy, Ohio State University Medical Center, Columbus, Ohio Chapter 7Jean M. Nappi, PharmD, FCCP, BCPSRobert B. Parker, PharmD, FCCP Professor, University of Tennessee College of Pharmacy, Memphis, Tennessee Chapter 16Professor of Pharmacy and Clinical Sciences, South Carolina College of Pharmacy-MUSC Campus; Professor of Medicine, Medical University of South Carolina, Charleston, South Carolina Chapter 20Charles A. Peloquin, PharmDMerlin V. Nelson, MD, PharmDSusan L. Pendland, PharmD, MSNeurologist, Affiliated Community Medical Centers, Willmar, Minnesota Chapter 61Adjunct Associate Professor, Department of Pharmacy Practice, College of Pharmacy, University of Illinois at Chicago, Chicago, Illinois; Clinical Staff Pharmacist, Saint Joseph Berea Hospital, Berea, Kentucky Chapter 114Fenwick T. Nichols, III, MD Professor, Department of Neurology, Medical College of Georgia, Augusta, Georgia Chapter 56Thomas D. Nolin, PharmD, PhD Clinical Pharmacologist, Department of Pharmacy Services, Division of Nephrology and Transplantation, Department of Medicine, Maine Medical Center, Portland, Maine Chapter 49Edith A. Nutescu, PharmD, FCCP Clinical Associate Professor, Director, Antithrombosis Center, University of Chicago College of Pharmacy and Medical Center, Chicago, Illinois Chapter 21Mary Beth OConnell, PharmD, BCPS Department of Pharmacy Practice, Wayne State University, Detroit, Michigan Chapter 93Keith M. Olsen, PharmD, FCCP, FCCM Professor and Chair, Department of Pharmacy Practice, College of Pharmacy, University of Nebraska Medical Center, Omaha, Nebraska Chapter 33Director, Infectious Disease Pharmacokinetics Laboratory, National Jewish Medical and Research Center, Denver, Colorado Chapter 116Janelle B. Perkins, Pharm D Assistant Professor, Department of Interdisciplinary Oncology, Blood and Marrow Transplant Program, Moffitt Cancer Center, Tampa, Florida Chapter 142Jay I. Peters, MD Professor of Medicine, Pulmonary/Critical Care Division, University of Texas Health Science Center, San Antonio, Texas Chapter 27William P. Petros, PharmD, FCCP Mylan Chair of Pharmacology, Professor of Pharmacy and Medicine, West Virginia University Health Sciences Center; Associate Director of Anti-Cancer Drug Development, Mary Babb Randolph Cancer Center, Morgantown, West Virginia Chapter 103Stephanie J. Phelps, PharmD, BCPS Professor, Department of Clinical Pharmacy, University of Tennessee, Memphis, Tennessee Chapter 59Rebecca L. Owens, PharmDBradley G. Phillips, PharmD, BCPS, FCCPClinical Instructor, College of Pharmacy, University of Texas, Austin, Texas; Department of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, Texas Chapter 30Milliken-Reeve Professor and Head, Department of Clinical and Administrative Pharmacy, College of Pharmacy, University of Georgia, Athens, Georgia Chapter 75Robert L. Page, II, PharmD, CGP, BCPSAmy M. Pick, PharmD, BCOPAssociate Professor of Clinical Pharmacy and Physical Medicine; Clinical Specialist, Division of Cardiology, UHCSC, Schools of Pharmacy and Medicine, Denver, Colorado Chapter 20Assistant Professor of Pharmacy Practice, Creighton University School of Pharmacy and Health Professions; Clinical Pharmacist, Nebraska Methodist Hospital, Omaha, Nebraska Chapter 138CONTRIBUTORSStuart Munro, MD 22. xxiiCONTRIBUTORSDenise L. Walbrandt Pigarelli, PharmD, BC-ADMMark Rohrscheib, MDClinical Associate Professor, University of Wisconsin-Madison, School of Pharmacy, Madison, Wisconsin Chapter 81Assistant Professor, Department of Internal Medicine, Division of Nephrology, University of New Mexico Health Sciences Center, Albuquerque, New Mexico Chapter 53Betsy Bickert Poon, PharmD Oncology/Stem Cell Transplant Clinical Pharmacist, Childrens Hospital of Philadelphia, Philadelphia, Pennsylvania Chapters 105 and 137L. Michael Posey, BSPharm Editorial Director, Periodicals Department, American Pharmacists Association, Washington, D.C. Chapter 3Beth E. Potter, MD Associate Professor, Department of Family Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin Chapter 81Randall A. Prince, PharmD Professor, University of Houston, College of Pharmacy, Houston, Texas Chapter 120Hengameh H. Raissy, PharmD University of New Mexico, School of Medicine, Albuquerque, New Mexico Chapter 31Charles A. Reasner, II, MD Professor, Department of Endocrinology, Metabolism, and Diabetes, University of Texas Health Science Center: Medical Director, Texas Diabetes Institute, San Antonio, Texas Chapter 77Michael D. Reed, PharmD, FCCP, FCP Director, Division of Clinical Pharmacology and Toxicology, Department of Pediatrics, Childrens Hospital Medical Center, Akron, Ohio Chapter 111Pamela D. Reiter, PharmDJohn C. Rotschafer, PharmD, FCCP Professor, Department of Experimental and Clinical Pharmacy, College of Pharmacy, University of Minnesota, Minneapolis, Minnesota Chapter 110Eric S. Rovner, MD Associate Professor of Urology, Department of Urology, Medical University of South Carolina, Charleston, South Carolina Chapter 88Maria I. Rudis, PharmD, FCCM Assistant Professor of Clinical Pharmacy, School of Pharmacy; Assistant Professor of Clinical Emergency Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California Chapter 25Mark E. Rupp, MD Professor, Department of Internal Medicine, University of Nebraska Medical Center; Medical Director, Department of Healthcare Epidemiology, Nebraska Medical Center, Omaha, Nebraska Chapter 113Michael J. Rybak, PharmD, MPH Professor of Pharmacy and Medicine, Associate Dean for Research, Director, Anti-Infective Research Laboratory, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, Michigan Chapter 108Gordon Sacks, PharmD Clinical Professor and Chair, Pharmacy Practice Division, School of Pharmacy, University of Wisconsin-Madison, Madison, Wisconsin Chapter 144Lisa Sanchez, PharmD PE Applications, Highlands Ranch, Colorado Chapter 1Clinical Pharmacy Specialist, Pediatric ICU and Trauma, The Childrens Hospital of Denver; Clinical Associate Professor, University of Colorado of Denver Health Sciences Center, School of Pharmacy, Denver, Colorado Chapter 145Cynthia A. Sanoski, PharmD, BSJo E. Rodgers, PharmD, BCPS (AQ Cardiology)Joseph J. Saseen, PharmD, FCCP, BCPSClinical Assistant Professor, Department of Pharmacotherapy and Experimental Therapeutics, School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina Chapter 16Associate Professor, University of Colorado-Denver, Department of Clinical Pharmacy, School of Pharmacy; Department of Family Medicine, School of Medicine, Aurora, Colorado Chapter 15Susan J. Rogers, PharmD, BCPSRobert R. Schade, MD, FACP, AGAF, FACG, FASGEAssistant Clinical Professor, University of Texas at Austin; Clinical Pharmacy Specialist Neurology, South Texas Healthcare System, Audie L. Murphy Memorial Veterans Hospital, San Antonio, Texas Chapter 58Professor of Medicine, Chief, Division of Gastroenterology/ Hepatology, Medical College of Georgia, Division of Gastroenterology/Hepatology, Augusta, Georgia Chapter 34Associate Professor of Clinical Pharmacy, Department of Pharmacy Practice and Pharmacy Administration, Philadelphia College of Pharmacy, University of the Sciences, Philadelphia, Pennsylvania Chapter 19 23. xxiiiSarah P. Shrader, PharmD, BCPSManager of Formulary Development, Prime Therapeutics, Eagan, Minnesota Chapter 110Assistant Professor, Department of Pharmacy and Clinical Sciences, South Carolina College of Pharmacy-MUSC Campus, Charleston, South Carolina Chapter 82Mark E. Schneiderhan, PharmD, BCPP Clinical Assistant Professor, Department of Pharmacy Practice, Clinical Pharmacist, Department of Psychiatry, University of Illinois, College of Pharmacy, Chicago, Illinois Chapter 64Marieke Dekker Schoen, PharmD, BCPS Clinical Associate Professor, Department of Pharmacy and Department of Medicine, University of Illinois, Chicago, Illinois Chapter 19Kristine S. Schonder, PharmDPatricia W. Slattum, PharmD, PhD Associate Professor, Geriatric Pharmacotherapy Program, Department of Pharmacy, School of Pharmacy, Virginia Commonwealth University, Richmond, Virginia Chapter 67Judith A. Smith, PharmD, FCCP, BCOP Assistant Professor, Department of Gynecologic Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas Chapter 136Assistant Professor, Pharmacy and Therapeutics Department, School of Pharmacy, University of Pittsburgh; Clinical Pharmacist, Thomas E. Starzl Transplantation Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania Chapter 92Philip H. Smith, MDArthur A. Schuna, MSChristine A. Sorkness, PharmDClinical Coordinator, William S. Middleton VA Medical Center, Clinical Professor, University of Wisconsin-Madison, School of Pharmacy, Madison, Wisconsin Chapter 94Professor, Department of Pharmacy Practice, School of Pharmacy; Professor, Department of Medicine, Division of Allergy, Pulmonary and Critical Care Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin Chapter 28Richard B. Schwartz, MD Associate Professor, Department of Emergency Medicine, Medical College of Georgia, Augusta, Georgia Chapter 12Rowena N. Schwartz, PharmD, BCOP Director of Weinberg and Oncology Pharmacy, Johns Hopkins Hospital, Baltimore, Maryland Chapter 141Laura Scuderi, MD Assistant, Dermatology Clinic, University of Catania, Catania, Italy Chapter 100Julie M. Sease, PharmD, BCPS Clinical Assistant Professor, Department of Clinical Pharmacy and Outcome Sciences, South Carolina, College of Pharmacy, University of South Carolina, Columbia, South Carolina Chapter 39Amy Heck Sheehan, PharmD Associate Professor of Pharmacy Practice, Purdue University School of Pharmacy and Pharmaceutical Sciences, Indianapolis, Indiana Chapter 80Greene Shepherd, PharmD Clinical Associate Professor, College of Pharmacy, University of Georgia, Augusta, Georgia Chapter 12Steven I. Sherman, MD Chair and Professor, Department of Endocrine Neoplasia and Hormonal Disorders, University of Texas M.D. Anderson Cancer Center; Adjunct Associate Professor, Baylor College of Medicine, Houston, Texas Chapter 78Section of Allergy and Immunology, Rheumatology, Department of Internal Medicine, Medical College of Georgia, Augusta, Georgia Chapter 98Anne P. Spencer, PharmD Associate Professor, Department of Clinical Pharmacy and Outcome Sciences, South Carolina College of Pharmacy, Medical University of South Carolina, Charleston, South Carolina Chapter 45Sarah A. Spinler, PharmD, BCPS (AQ Cardiology) Professor, College of Pharmacy, University of the Sciences, Philadelphia, Pennsylvania Chapter 18William J. Spruill, PharmD, FCCP, FASHP Professor, University of Georgia, College of Pharmacy, Athens, Georgia Chapter 38John V. St. Peter, BCPS Adjunct Associate Professor of Pharmacy, College of Pharmacy, University of Minnesota, Minneapolis, Minnesota; Clinical and Outcomes Manager, Takeda Pharmaceuticals North America, Deerfield, Illinois Chapter 48Catherine I. Starner, PharmD, BCPS, CGP Senior Clinical Pharmacist, Prime Theapeutics; Clinical Assistant Professor, University of Minnesota, College of Pharmacy, Eagan, Minnesota Chapter 8Andy Stergachis, PhD, RPh Professor of Epidemiology and Global Health, Adjunct Professor of Pharmacy, University of Washington, Seattle, Washington Chapter 9CONTRIBUTORSJeremy A. Schafer, PharmD 24. xxivCONTRIBUTORSSteven C. Stoner, PharmD, BCPPEdward G. Timm, PharmD, MSUMKC School of Pharmacy, Division of Pharmacy Practice, Clinical Associate Professor, Kansas City, Missouri Chapter 66Senior Clinical Pharmacy Specialist, Critical Care and Adjunct Assistant Professor, Albany Medical Center Hospital and Albany College of Pharmacy, Albany, New York Chapter 39James J. Stragand, MD, PhD, FACG, FACP Attendant Gastroenterologist, St. Charles Medical Center, Bend, Oregon Chapter 39Jennifer Strickland, PharmD, BCPS Pain and Palliative Care Specialists, Lakeland Regional Medical Center, Lakeland, Florida Chapter 62Deborah A. Sturpe, PharmD, BCPS Assistant Professor, Department of Pharmacy Practice and Science, University of Maryland, School of Pharmacy, Baltimore, Maryland Chapter 84Weijing Sun, MD Associate Professor of Medicine, University of Pennsylvania, Abramson Cancer Center, Philadelphia, Pennsylvania Chapter 133Russell H. Swerdlow, MD Professor of Neurology, Molecular and Integrative Physiology, University of Kansas School of Medicine, Kansas City, Kansas Chapter 67David M. Swope, MD Associate Professor of Neurology, Loma Linda University, Loma Linda, California Chapter 61Carol Taketomo, PharmD Pharmacy Manager, Childrens Hospital of Los Angeles, Adjunct Assistant Professor of Pharmacy Practice, University of Southern California School of Pharmacy, Los Angeles, California Chapter 7Robert L. Talbert, PharmD, FCCP, BCPS, CLSShelly D. Timmons, MD, PhD, FACS Semmes-Murphey Clinic, Assistant Professor and Chief of Neurotrauma Division, University of Tennesee Health Science Center, Memphis, Tennessee Chapter 60Curtis L. Triplitt, PharmD, CDE Texas Diabetes Institute; Assistant Professor, Department of Medicine, Division of Diabetes, University of Texas Health Science Center, San Antonio, Texas Chapter 77Elena M. Umland, PharmD Associate Dean for Academic Affairs, Jefferson School of Pharmacy, Thomas Jefferson University, Philadelphia, Pennsylvania Chapter 83Angie Veverka, PharmD Assistant Professor of Pharmacy, Wingate University School of Pharmacy, Wingate, North Carolina Chapter 115Sheryl F. Vondracek, PharmD, FCCP, BCPS Associate Professor, Department of Clinical Pharmacy, University of Colorado-Denver; School of Pharmacy, Aurora, Colorado Chapter 93William E. Wade, PharmD, FASHP, FCCP Professor, College of Pharmacy, University of Georgia, Athens, Georgia Chapter 38Nicole A. Weimert, PharmD, BCPSSmithKline Professor, College of Pharmacy, University of Texas at Austin; Professor, Department of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, Texas Chapters 13, 17, 23, 24, 30, and 78Clinical Specialist, Solid Organ Transplantation, Department of Pharmacy Services; Assistant Clinical Professor, South Carolina College of Pharmacy, Medical University of South Carolina Campus, Charleston, South Carolina Chapter 89Colleen M. Terriff, PharmDBenjamin L. Weinstein, MDAssistant Professor, Pharmacy Department, College of Pharmacy, Washington State University; Clinical Pharmacist, Deaconess Medical Center, Spokane, Washington Chapter 11Assistant Professor, Department of Psychiatry, Medical University of South Carolina, Charleston, South Carolina Chapter 72Jane Tran Tesoro, PharmD, BCPPLara C. Weinstein, MDClinical Pharmacist, Juvenile Court Mental Health Services, Los Angeles, California Chapter 65Assistant Professor, Department of Family and Community Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania Chapter 83Christian J. Teter, PharmD, BCPPLynda S. Welage, PharmD, FCCPAssistant Professor, School of Pharmacy, Northwestern University, Boston, Massachusetts; Clinical Research Pharmacist, Alcohol and Drug Abuse Treatment Program, McLean Hospital, Belmont, Massachusetts Chapter 71Professor of Pharmacy, College of Pharmacy and Associate Dean for Academic Affairs, University of Michigan; Clinical Pharmacist, Critical Care, Department of Pharmacy, University of Michigan Health-System, Ann Arbor, Michigan Chapter 35 25. xxvChar Witmer, MDDean and Professor, Executive Director of the Research Institute of Pharmaceutical Sciences, School of Pharmacy, University of Mississippi, Oxford, Mississippi Chapters 71 and 74Assistant Professor, Department of Pediatrics, Division of Hematology, Philadelphia, Pennsylvania Chapter 105Lee E. West, BS Clinical Pharmacist, Northwestern Memorial Hospital, Chicago, Illinois Chapters 100 and 101Daniel M. Witt, PharmD, FCCP, BCPS, CACP Manager, Clinical Pharmacy Services, Kaiser Permanente Colorado, Aurora, Colorado Chapter 21Dennis P. West, PhD, FCCP, CIPMarion R. Wofford, MD, MPHVincent W. Foglia Family Research Professor of Dermatology; Director, Dermatology Program, Chair for Administrative Review, IRB, Office for the Protection of Research Subjects, Feinberg School of Medicine, Chicago, Illinois Chapters 100 and 101Associate Professor, Department of Medicine, School of Medicine, University of Mississippi Medical Center, Jackson, Mississippi Chapter 63James W. Wheless, MDAssociate Professor, Department of Gynecologic Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas Chapter 136Professor and Chief of Pediatric Neurology, LeBonheur Chair in Pediatric Neurology, University of Tennessee Health Science Center; Director, Neuroscience Institute and LeBonheur Comprehensive Epilepsy Program, LeBonheur Childrens Medical Center, Memphis, Tennessee Chapter 59Dale H. Whitby, PharmD, BCPS Pediatric Editor, Clinical Pharmacology, Gold Standard, Inc., Tampa, Florida Chapter 107Dennis M. Williams, PharmD, BCPS Associate Professor, Division of Pharmacotherapy and Experiemental Therapeutics, School of Pharmacy, University of North Carolina, Chapel Hill, North Carolina Chapter 29Dianne B. Williams, PharmD, BCPS Drug Information and Formulary Coordinator, MCG Health, Inc.; Associate Clinical Professor, University of Georgia College of Pharmacy, Augusta, Georgia Chapter 34Jeffrey L. Wilt, MD, FACP, FCCP Program Director, Critical Care Fellowship, Michigan State University, Kalamazoo Center for Medical Studies; Associate Professor, College of Human Medicine, Michigan State University, Kalamazoo, Michigan Chapter 14Judith K. Wolf, MDJean Wyman, PhD, RN Professor and Cora, Meldi Siehl Chair in Nursing Research; Clinical Director, Minnesota Continence Associates, University of Minnesota School of Nursing, Minneapolis, Minnesota Chapter 88Jack A. Yanovski, MD, PhD Head, Unit on Growth and Obesity, Program on Developmental Endocrinology and Genetics, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland Chapter 80Gary C. Yee, PharmD, FCCP, BCOP Professor, Department of Pharmacy Practice, College of Pharmacy, University of Nebraska Medical Center, Omaha, Nebraska Chapters 135 and 142George Zhanel, PharmD, PhD Professor, Department of Medical Microbiology; Faculty of Medicine, University of Manitoba; Coordinator, Antimicrobial Resistance Program, Departments of Clinical Microbiology and Medicine, Health Sciences Center of Clinical Microbiology and Medicine, Health Sciences Centre, Winnipeg, Manitoba, Canada Chapter 112CONTRIBUTORSBarbara G. Wells, PharmD, FASHP, FCCP, BCPP 26. This page intentionally left blank 27. xxviiFOREWORDIts a safe assumption that you didnt purchase this seventh edition of Pharmacotherapy: A Pathophysiologic Approach for its foreword. Its probable that most of you will never read these musings. The value of this text lies in its succeeding pages, in the collective knowledge and wisdom conveyed by its authors, and in its ability to help you provide better care for your patients. Its also a safe assumption that manyperhaps mostreaders had not yet begun their careers in pharmacy when the first edition of Pharmacotherapy: A Pathophysiologic Approach was published in 1988. This seventh edition will mark the texts 20th anniversary. Noting this milestone, its appropriate to reflect on a few then and now comparisons. Knowing the time required to conceive and create a new publication of the scope and depth of Pharmacotherapy: A Pathophysiologic Approach, I imagine that work began on its first edition sometime around 1985. In February of that year, about 150 pharmacy practitioners and educators gathered in Hilton Head, South Carolina for an Invitational Conference on Directions for Clinical Pharmacy Practice. Organized by the American Society of Hospital (now Health-System) Pharmacists (ASHP), the conference objectives included an evaluation of the status of clinical pharmacy practice and education, and identification of practical ways for advancing clinical practice.1 Today, most readers of Pharmacotherapy: A Pathophysiologic Approach would probably concisely describe their professional mission as ensuring optimal medication therapy outcomes for patients, or something to that effect. But in 1985, pharmacys perception of its professional mission could probably best be described by the concept of drug use control as articulated by Don Brodie: assuring optimal safety in the distribution and use of medications.2 Our emphasis had been focused more on the distribution of medicines and was only just beginning to emphasize how those medicines were used. The Hilton Head Conference, as it came to be known, helped to catalyze a change in how organized pharmacy and individual pharmacists viewed their professional missiontheir societal purpose. As noted by Max Ray, who was key in organizing the conference as a member of the ASHP staff at the time, the conference represented . . . a commitment to the establishment of pharmacy as a true clinical profession. Subsequently, a more specific definition of clinical pharmacy would emerge, the practice philosophy embodied by pharmaceutical care, and today, the set of pharmacist services referred to as medication therapy management. In 1985, 361 pharmacists graduated from ASHP accredited residency programs. By 2006, that number had increased to nearly 1500 per year. In 1985, 33 schools of pharmacy awarded the Doctor of Pharmacy (PharmD) degree to 812 graduates (most as post-baccalaureate degrees). Responding to evolving trends and future needs within the profession, the Accreditation Council for Pharmacy Education (ACPE) began to implement new accreditation standards and guidelines in 2000. The PharmD degree is now pharmacys entrylevel degree. Accordingly, the number of PharmD graduates has increased more than ten-fold (9040 in 2006). In 1988, Pharmacotherapy and Nutritional Support were formally recognized as specialtyareas of pharmacy practice by the Board of Pharmaceutical Specialties. Psychiatric Pharmacy and Oncology Pharmacy followed in 1992 and 1996, respectively. By 2007, more than 5200 pharmacy specialists had become board certified in one or more of these clinical specialties. Research in a variety of care settings has demonstrated the beneficial impact of pharmacists services on the clinical, humanistic, and economic outcomes of medication use.3,4 Research conducted by pharmacists contributes important new knowledge to rational pharmacotherapy. Weve made real progress. But is it good enough? Our focus has shifted from predominantly emphasizing the control of drug distribution to assuring that our patients receive the optimal benefits and outcomes from their use of medicines. Or has it? In 1985, spending for prescription drugs in the United States was just over $22 billion. By 2005, that figure had increased to just over $200 billion (i.e., almost ten-fold in 20 years!), and is predicted to rise to almost $500 billion in 2016.5 A hefty sum indeed, but not the complete picture. Consider that in addition to these costs for the medications themselves, an additional $177 billion is estimated to be spent annually because of treatment failure or drug-related morbidity and mortality among ambulatory patients alone.6 Add to this the human and financial costs associated with medication errors, drug-related problems among nursing home residents, and adverse drug events among hospitalized patients, and the real cost is truly staggering.7,8 It is not hyperbole to say that we are in the midst of a public health crisis. In 2004, the Joint Commission of Pharmacy Practitioners (JCPP) and the eleven national pharmacy organizations that comprise its membership endorsed a future vision of pharmacy practice: Pharmacists will be the health care professionals responsible for providing patient care that ensures optimal medication therapy outcomes. The JCPP vision statement goes on to describe pharmacy practice and how pharmacy will benefit patients and society in 2015.9 It is my hope that all readers of Pharmacotherapy: A Pathophysiologic Approach would adopt this statement not just as a lofty vision for the future of our profession but as their own professional mission the reason we exist today! But consider, by optimal do we mean as good as can be expected under the circumstances the way many dictionaries would define the word? Or do we mean best possible? If were satisfied with the former definition, then lets declare victory and break out the champagne. However, I hope you agree that we could do better for our patients. This public health crisis demands rapid and significant transformation of our medication use system and more effective deployment of resources within that system. One such resource is the nations pharmacists. As significant as our accomplishments of the past 20 years may appear to be, we cannot rely on a similar, largely evolutionary process as we address this crisis of medication use over the next decade or two. On the whole, todays generation of pharmacists is better educated and trained as clinicians than any other in our history. But as important as that foundation is, it will not suffice alone.Copyright 2008, 2005, 2002 by The McGraw-Hill Companies, Inc. Click here for terms of use. 28. xxviiiFOREWORDOur pharmacy practicesfrom the corner drug store in rural America to the most specialized tertiary care centermust adopt a philosophy of practice that emphasizes the pharmacists patient care responsibilities. The use of support personnel and technology must be optimized so pharmacists can devote the majority of their effort to these patient care responsibilities. Management must adopt different benchmarks for assessing pharmacist productivity. No longer should the key measurement be the number of prescriptions filled. Our metrics must focus instead on patient outcomes that are affected by pharmacists medication therapy management and other patient care responsibilities (e.g., wellness, disease prevention). Of course, this practice model must be economically viable. Currently, payment for pharmacy services is largely based on payment for the drug product and the act of dispensing it. Concerted efforts are underway to change the payment policies of both private and government payers and develop the infrastructure needed to enable a different paradigm. However, we cannot wait until all of the payment ducks have been put in a row to broadly implement the philosophy and model of practice alluded to above.We should not expect private and government health plans to cover pharmacists medication therapy management and other patient care services if their customers (i.e., our patients) arent demanding that they do so. In turn, we should not expect our customers (e.g., patients, other health professionals) to demand something they have not personally experienced and come to value. It is our responsibility to create that demand through every encounter with a patient, caregiver, family member, or other health professional. It must begin with us. With our professional knowledge, skills, and attitudes. With a commitment to care for, and about, patients. With a commitment to drive change in a system that needs a lot of change. Our patients need and deserve nothing less than our true best.References5.1.2. 3.4Directions for clinical practice in pharmacy. Proceedings of an invitational conference conducted by the ASHP Research and Education Foundation and the American Society of Hospital Pharmacists. February 1013, 1985. Am J Health Syst Pharm 1985;42:12871292. Brodie DC. Drug use control: Keystone to pharmaceutical service. Drug Intell Clin Pharm 1967;1:6365 Schumock GT, Butler MG, Meek PD, et al. Evidence of the economic benefit of clinical pharmacy services: 19962000. Pharmacotherapy 2003;23:113132. Schumock GT, Meek PD, Ploetz PA, Vermeulen LC. Economic evaluations of clinical pharmacy services