Pharmacotherapy: A Pathophysiologic Approach 8th Edition PDF

ta hi vi r9 p. 9 pe -U rs ni ia te ns dV s. R ir G Pharmacotherapy G A...

ta hi vi r9 p. 9 pe -U rs ni ia te ns dV s. R ir G Pharmacotherapy G A Pathophysiologic Approach R dV Eighth Edition te ni -U ir s. ns 9 r9 ia hi rs ta pe p. vi  G R dV NOTICE Medicine is an ever-changing science. As new research and clinical experience broaden our knowledge, changes in treatment and drug therapy are required. te 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 gener- ni ally 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 -U ir 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 s. herein is in every respect accurate or complete, and they disclaim all responsibil- ity for any errors or omissions or for the results obtained from use of the informa- ns tion contained in this work. Readers are encouraged to confirm the information 9 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 r9 ia 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 hi or in the contraindications for administration. This recommendation is of par- rs ticular importance in connection with new or infrequently used drugs. ta pe p. vi Pharmacotherapy A Pathophysiologic Approach Eighth Edition G R Joseph T. DiPiro, PharmD, FCCP Executive Dean and Professor, South Carolina dV College of Pharmacy, University of South Carolina, Columbia South Carolina and Medical University of South Carolina, Charleston, South Carolina Robert L. Talbert, PharmD, FCCP, BCPS, CLS te Professor, College of Pharmacy, University of Texas at Austin, ni Pharmacotherapy Division, Professor, School of Medicine, University of Texas Health Science Center at San Antonio, Pharmacotherapy Education & Research Center -U ir (PERC), UTHSCSA-PERC, San Antonio, Texas Gary C. Yee, PharmD, FCCP, BCOP s. ns Professor and Associate Dean for Academic Affairs, College of 9 Pharmacy, University of Nebraska Medical Center, Omaha, Nebraska r9 Gary R. Matzke, PharmD, FCP, FCCP, FASN ia Professor and Associate Dean for Clinical Research and Public Policy, hi School of Pharmacy, Professor of Internal Medicine, Nephrology Division, rs School of Medicine, Virginia Commonwealth University, Richmond, Virginia ta pe Barbara G. Wells, PharmD, FCCP, BCPP Dean and Professor, Executive Director of the Research Institute of Pharmaceutical Sciences, School of Pharmacy, p. The University of Mississippi, Oxford, Mississippi L. Michael Posey, BSPharm vi 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 Copyright © 2011 by The McGraw-Hill Companies, Inc. All rights reserved. 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. ISBN: 978-0-07-178499-3 MHID: 0-07-178499-3 The material in this eBook also appears in the print version of this title: ISBN: 978-0-07-170354-3, MHID: 0-07-170354-3. 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. To contact a G representative please e-mail us at [email protected]. R Summary: “The most comprehensive, widely used, and evidence-based pharmacotherapy text available. Hailed by Doody’s Review Service as “one of the best in pharmacy” Pharmacotherapy: A Pathophysiologic Approach is unmatched in its ability to help students develop a mastery of evidence-based medicine for optimum patient outcomes. The eighth edition will feature the addition of SI units throughout and an increased number of global examples and clinical questions. Features dV unparalleled guidance in the development of pharmaceutical care plans. Fullcolor presentation. Key Concepts in each chapter. Critical Presentation boxes summarize common disease signs and symptoms. Clinical Controversy boxes examine complicated issues you face when providing drug therapy. NEW material added to the online learning center. EXPANDED evidence-based recommendations. EXPANDED coverage of timely issues such as palliative care and pain medicine. Therapeutic recommendations in each disease-specific chapter”—Provided by publisher. te Please tell the authors and publisher what you think of this book by sending your comments to [email protected]. Please put the author and title of ni the book in the subject line. TERMS OF USE -U ir This is a copyrighted work and The McGraw-Hill Companies, Inc. (“McGrawHill”) and its licensors reserve all rights in and to the work. Use of this work is subject s. 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 ns McGraw-Hill’s 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 9 the work may be terminated if you fail to comply with these terms. r9 ia THE WORK IS PROVIDED “AS IS.” McGRAW-HILL AND ITS LICENSORS MAKE NO GUARANTEES OR WARRANTIES AS TO THE ACCURACY, ADEQUACY OR COMPLETENESS OF OR RESULTS TO BE OBTAINED FROM USING THE WORK, INCLUDING ANY INFORMATION THAT CAN hi BE ACCESSED THROUGH THE WORK VIA HYPERLINK OR OTHERWISE, AND EXPRESSLY DISCLAIM ANY WARRANTY, EXPRESS OR IMPLIED, rs INCLUDING BUT NOT LIMITED TO IMPLIED WARRANTIES OF MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE. McGraw-Hill and its licensors do not warrant or guarantee that the functions contained in the work will meet your requirements or that its operation will be uninterrupted or error free. ta pe Neither McGraw-Hill nor its licensors shall be liable to you or anyone else for any inaccuracy, error or omission, regardless of cause, in the work or for any damages resulting therefrom. McGraw-Hill has no responsibility for the content of any information accessed through the work. 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 p. arises in contract, tort or otherwise. vi  G R DEDICATION dV To our patients, who have challenged and inspired us te and given meaning to all our endeavors. ni To practitioners who continue to improve patient health outcomes and thereby serve as role models for their colleagues and students -U ir while clinging tenaciously to the highest standards of practice. s. To our mentors, whose vision provided educational and training programs that encouraged our professional growth and challenged us ns to be innovators in our patient care, research, and education. 9 r9 To our faculty colleagues for their efforts and support for our mission ia to provide a comprehensive and challenging educational hi foundation for the pharmacists of the future. rs And finally to our families for the time that they have sacrificed ta pe so that this eighth edition would become a reality. p. vi This page intentionally left blank  vii CONTENTS Contributors.......................................xiii 11. Geriatrics................................ 21 Foreword........................................ xxvii Emily R. Hajjar, Shelly L. Gray, David R.P. Guay, Catherine I. Starner, Foreword to the First Edition.......................xxix Steven M. Handler, and Joseph T. Hanlon Preface...........................................xxxi 12. Palliative Care............................ 23 Jill Astolfi SECTION 1 13. Pharmacoepidemiology.................... 25 Foundation Issues Andy Stergachis, Thomas K. Hazlet, and Denise Boudreau Section Editor: L. Michael Posey 14. Clinical Toxicology........................... 27 1. Pharmacoeconomics: Principles, Peter A. Chyka Methods, and Applications.................. 1 Lisa Sanchez Trask 15. Emergency Preparedness: Identification and Management of Biologic Exposures.......... 51 2. Health Outcomes and Health-Related Colleen M. Terriff, Jason E. Brouillard, Quality of Life............................. 3 Lisa T. Costanigro, and Jessica S. Oftebro Stephen Joel Coons 16. Emergency Preparedness: Identification and 3. Health Literacy and Medication Use.......... 5 Management of Chemical and Radiologic Oralia V. Bazaldua and Sunil Kripalani Exposures................................ 53 4. Cultural Competency....................... 7 Greene Shepherd and Richard B. Schwartz Jeri J. Sias, Amanda M. Loya, José O. Rivera, Arthur A. Islas, and Ulysses J. Urquidi SECTION 2 5. Principles and Practices of Medication Safety........................ 9 Cardiovascular Disorders Scott M. Mark, Jeffrey D. Little, Section Editor: Robert L. Talbert Sarah E. Adkins, and Robert J. Weber 17. Cardiovascular Testing........................ 55 6. Evidence-Based Medicine.................. 11 Richard A. Lange and L. David Hillis Elaine Chiquette and L. Michael Posey 18. Cardiac Arrest............................... 83 7. Documentation of Pharmacy Services........ 13 Jeffrey F. Barletta and Jeffrey L. Wilt George E. MacKinnon III and Neil J. MacKinnon 19. Hypertension............................... 101 8. Clinical Pharmacokinetics and Joseph J. Saseen and Eric J. Maclaughlin Pharmacodynamics........................ 15 Larry A. Bauer 20. Systolic Heart Failure........................ 137 Robert B. Parker and Larisa H. Cavallari 9. Pharmacogenetics......................... 17 Larisa H. Cavallari and Y. W. Francis Lam 21. Diastolic Heart Failure and the Cardiomyopathies........................... 173 10. Pediatrics................................ 19 Jean M. Nappi and Robert L. Page II Milap C. Nahata and Carol Taketomo The complete chapter, learning objectives, and other resources can be found at www.pharmacotherapyonline.com. viii 22. Acute Decompensated SECTION 4 Heart Failure................................ 191 Gastrointestinal Disorders CONTENTS Jo E. Rodgers and Craig R. Lee Section Editor: Joseph T. DiPiro 23. Ischemic Heart Disease....................... 209 Robert L. Talbert 38. Evaluation of the Gastrointestinal Tract....................................... 539 24. Acute Coronary Syndromes................... 241 Keith M. Olsen and Grant F. Hutchins Sarah A. Spinler and Simon De Denus 39. Gastroesophageal Reflux Disease.............. 549 25. The Arrhythmias............................ 273 Dianne B. Williams and Robert R. Schade Cynthia A. Sanoski and Jerry L. Bauman 40. Peptic Ulcer Disease......................... 563 26. Venous Thromboembolism................... 311 Rosemary R. Berardi and Randolph V. Fugit Daniel M. Witt, Edith A. Nutescu, and Stuart T. Haines 41. Inflammatory Bowel Disease.................. 587 Brian A. Hemstreet 27. Stroke...................................... 353 Susan C. Fagan and David C. Hess 42. Nausea and Vomiting........................ 607 Cecily V. DiPiro and Robert J. Ignoffo 28. Dyslipidemia................................ 365 Robert L. Talbert 43. Diarrhea, Constipation, and Irritable Bowel Syndrome............................ 621 29. Peripheral Arterial Disease.................... 389 Patricia H. Powell and Virginia H. Fleming Barbara J. Hoeben and Robert L. Talbert 44. Portal Hypertension and Cirrhosis............. 639 30. Use of Vasopressors and Julie M. Sease Inotropes in the Pharmacotherapy of Shock.................................... 399 45. Drug-Induced Liver Disease.................. 659 Robert Maclaren, Maria I. Rudis, William R. Kirchain and Rondall E. Allen and Joseph F. Dasta 46. Pancreatitis................................. 669 31. Hypovolemic Shock.......................... 421 Scott Bolesta and Patricia A. Montgomery Brian L. Erstad 47. Viral Hepatitis.............................. 685 Paulina Deming SECTION 3 48. Drug Therapy Individualization in Respiratory Disorders Patients with Hepatic Disease and Genetic Alterations in Drug Section Editor: Robert L. Talbert Metabolizing Activity........................ 705 32. Introduction to Pulmonary Y. W. Francis Lam Function Testing......................... 437 49. Celiac Disease............................ 717 Jay I. Peters and Stephanie M. Levine Robert A. Mangione and Priti N. Patel 33. Asthma.................................... 439 H. William Kelly and Christine A. Sorkness SECTION 5 34. Chronic Obstructive Pulmonary Disease.......................... 471 Renal Disorders Dennis M. Williams and Sharya V. Bourdet Section Editor: Gary R. Matzke 35. Pulmonary Arterial Hypertension............. 497 50. Clinical Assessment of Kidney Function........ 719 Rebecca Moote, Rebecca L. Attridge, Thomas C. Dowling and Deborah J. Levine 51. Acute Kidney Injury......................... 741 36. Drug-Induced Pulmonary Disease............. 511 William Dager and Jenana Halilovic Hengameh H. Raissy, Michelle Harkins, and Patricia L. Marshik 52. Chronic Kidney Disease: Progression-Modifying Therapies.............. 767 37. Cystic Fibrosis.............................. 525 Vimal K. Derebail, Abhijit V. Kshirsagar, Chanin C. Wright and Yolanda Y. Vera and Melanie S. Joy The complete chapter, learning objectives, and other resources can be found at www.pharmacotherapyonline.com.  ix 53. Chronic Kidney Disease: 69. Pain Management.......................... 1045 Management of Complications................ 787 Terry J. Baumann, Jennifer M. Strickland, CONTENTS Joanna Q. Hudson and Chris M. Herndon 54. Hemodialysis and Peritoneal Dialysis....... 817 70. Headache Disorders........................ 1061 Kevin M. Sowinski and Mariann D. Churchwell Deborah S. Minor 55. Drug-Induced Kidney Disease................. 819 Thomas D. Nolin and Jonathan Himmelfarb SECTION 7 56. Glomerulonephritis.......................... 837 Psychiatric Disorders Alan H. Lau Section Editor: Barbara G. Wells 57. Drug Therapy Individualization for Patients with Chronic Kidney Disease.......... 861 71. Evaluation of Psychiatric Illness.............. 1077 Mark E. Schneiderhan, Leigh Anne Nelson, Gary R. Matzke and Stuart Munro 58. Disorders of Sodium and Water 72. Childhood Disorders........................ 1087 Homeostasis................................ 873 Julie A. Dopheide and Stephen R. Pliszka James D. Coyle and Gary R. Matzke 59. Disorders of Calcium and Phosphorus 73. Eating Disorders........................... 1101 Homeostasis................................ 891 Steven C. Stoner Amy Barton Pai 74. Substance-Related Disorders: Overview and Depressants, Stimulants, 60. Disorders of Potassium and Magnesium and Hallucinogens.......................... 1113 Homeostasis................................ 909 Paul L. Doering Donald F. Brophy and Jane Frumin 75. Substance-Related Disorders: Alcohol, 61. Acid-Base Disorders......................... 923 Nicotine, and Caffeine...................... 1131 John W. Devlin and Gary R. Matzke Paul L. Doering and Robin Moorman Li 76. Schizophrenia.............................. 1147 SECTION 6 M. Lynn Crismon, Tami R. Argo, Neurologic Disorders and Peter F. Buckley Section Editor: Barbara G. Wells 77. Major Depressive Disorder.................. 1173 Christian J. Teter, Judith C. Kando, 62. Evaluation of Neurologic Illness............... 943 and Barbara G. Wells Susan C. Fagan and Fenwick T. Nichols 78. Bipolar Disorder........................... 1191 63. Alzheimer’s Disease.......................... 947 Shannon J. Drayton Patricia W. Slattum, Russell H. Swerdlow, and Angela Massey Hill 79. Anxiety Disorders I: Generalized Anxiety, Panic, 64. Multiple Sclerosis............................ 963 and Social Anxiety Disorders................. 1209 Jacquelyn L. Bainbridge and John R. Corboy Sarah T. Melton and Cynthia K. Kirkwood 65. Epilepsy.................................... 979 80. Anxiety Disorders II: Susan J. Rogers and Jose E. Cavazos Posttraumatic Stress Disorder 66. Status Epilepticus........................... 1007 and Obsessive-Compulsive Disorder................................... 1229 Stephanie J. Phelps, Collin A. Hovinga, and James W. Wheless Cynthia K. Kirkwood, Lisa B. Phipps, and Barbara G. Wells 67. Acute Management of the Brain Injury Patient......................... 1019 81. Sleep Disorders............................. 1241 Bradley A. Boucher and Shelly D. Timmons John M. Dopp and Bradley G. Phillips 68. Parkinson’s Disease......................... 1033 82. Disorders Associated with Jack J. Chen, Merlin V. Nelson, Intellectual Disabilities................... 1253 and David M. Swope Nancy Brahm, Jerry Mckee, and Douglas Stewart The complete chapter, learning objectives, and other resources can be found at www.pharmacotherapyonline.com. x SECTION 8 SECTION 11 CONTENTS Endocrinologic Disorders Immunologic Disorders Section Editor: Robert L. Talbert Section Editor: Gary C. Yee 83. Diabetes Mellitus........................... 1255 95. Function and Evaluation of the Curtis L. Triplitt and Charles A. Reasner Immune System............................ 1487 Philip D. Hall, Nicole Weimert Pilch, 84. Thyroid Disorders.......................... 1303 and Daniel H. Atchley Jacqueline Jonklaas and Robert L. Talbert 96. Systemic Lupus Erythematosus and 85. Adrenal Gland Disorders.................... 1327 Other Collagen-Vascular Disorders........... 1505 Steven M. Smith and John G. Gums Jeffrey C. Delafuente and Kimberly A. Cappuzzo 86. Pituitary Gland Disorders................... 1345 97. Allergic and Pseudoallergic Amy Heck Sheehan, Jack A. Yanovski, Drug Reactions............................. 1521 and Karim Anton Calis Lynne M. Sylvia and Joseph T. DiPiro 98. Solid-Organ Transplantation................. 1537 Heather J. Johnson and Kristine S. Schonder SECTION 9 Gynecologic and Obstetric SECTION 12 Disorders Rheumatologic Disorders Section Editor: Barbara G. Wells Section Editor: L. Michael Posey 87. Pregnancy and Lactation: Therapeutic Considerations.................. 1361 99. Osteoporosis and Other Metabolic Bone Diseases.............................. 1559 Kristina E. Ward and Barbara M. O’Brien Mary Beth O’Connell and Sheryl F. Vondracek 88. Contraception.............................. 1377 100. Rheumatoid Arthritis....................... 1583 Sarah P. Shrader, Kelly R. Ragucci, Arthur A. Schuna and Vanessa A. Diaz 89. Menstruation-Related Disorders.............. 1393 101. Osteoarthritis.............................. 1599 Lucinda M. Buys and Mary Elizabeth Elliott Elena M. Umland, Lara Carson Weinstein, and Edward M. Buchanan 102. Gout and Hyperuricemia.................... 1621 90. Endometriosis.............................. 1409 Michael E. Ernst and Elizabeth C. Clark Deborah A. Sturpe SECTION 13 91. Hormone Therapy in Women................ 1417 Sophia N. Kalantaridou, Devra K. Dang, Ophthalmic and Otolaryngological Disorders Susan R. Davis, and Karim Anton Calis Section Editor: L. Michael Posey 103. Glaucoma................................. 1633 Richard G. Fiscella, Timothy S. Lesar, SECTION 10 and Deepak P. Edward Urologic Disorders 104. Allergic Rhinitis............................ 1649 Section Editor: L. Michael Posey J. Russell May and Philip H. Smith 92. Erectile Dysfunction........................ 1437 Mary Lee SECTION 14 93. Benign Prostatic Hyperplasia................. 1455 Dermatologic Disorders Mary Lee Section Editor: L. Michael Posey 94. Urinary Incontinence....................... 1467 105. Dermatologic Drug Reactions Eric S. Rovner, Jean Wyman, and Common Skin Conditions............... 1661 Thomas Lackner, and David R.P. Guay Rebecca M. Law and David T.S. Law The complete chapter, learning objectives, and other resources can be found at www.pharmacotherapyonline.com.  xi 106. Acne Vulgaris.............................. 1673 121. Tuberculosis............................... 1931 Debra J. Sibbald Charles A. Peloquin and Rocsanna Namdar CONTENTS 107. Psoriasis................................... 1693 122. Gastrointestinal Infections and Rebecca M. Law and Wayne P. Gulliver Enterotoxigenic Poisonings.................. 1951 Steven Martin and Rose Jung 108. Atopic Dermatitis.......................... 1707 Rebecca M. Law and Po Gin Kwa 123. Intraabdominal Infections................... 1969 Joseph T. DiPiro and Thomas R. Howdieshell SECTION 15 124. Parasitic Diseases........................... 1981 Hematologic Disorders J. V. Anandan Section Editor: Gary C. Yee 125. Urinary Tract Infections and Prostatitis....... 1995 Elizabeth A. Coyle and Randall A. Prince 109. Anemias.................................. 1717 Kristen Cook, Beata A. Ineck, and William L. Lyons 126. Sexually Transmitted Diseases................ 2011 Leroy C. Knodel 110. Coagulation Disorders...................... 1741 Betsy Bickert Poon, Char Witmer, and Jane Pruemer 127. Bone and Joint Infections.................... 2029 Edward P. Armstrong and Allan D. Friedman 111. Sickle Cell Disease.......................... 1765 C. Y. Jennifer Chan and Reginald Moore 128. Severe Sepsis and Septic Shock............... 2041 S. Lena Kang-Birken and Karla Killgore-Smith 112. Drug-Induced Hematologic Disorders.................................. 1781 129. Superficial Fungal Infections................. 2055 Christine N. Hansen and Amy F. Rosenberg Thomas E. R. Brown, Linda D. Dresser, and Thomas W. F. Chin SECTION 16 130. Invasive Fungal Infections................... 2073 Peggy L. Carver Infectious Diseases 131. Infections in Immunocompromised Section Editor: Joseph T. DiPiro Patients................................... 2105 113. Laboratory Tests to Direct Atimicrobial Douglas N. Fish Pharmacotherapy........................... 1797 132. Antimicrobial Prophylaxis in Surgery......... 2131 Michael J. Rybak, Jeffrey R. Aeschlimann, and Kerry L. Laplante Salmaan Kanji 114. Antimicrobial Regimen Selection............. 1813 133. Vaccines, Toxoids, and Other Immunobiologics........................... 2147 David S. Burgess Mary S. Hayney 115. Central Nervous System Infections............ 1825 134. Human Immunodeficiency Virus Infection.... 2169 Isaac F. Mitropoulos, Elizabeth D. Hermsen, and John C. Rotschafer Peter L. Anderson, Thomas N. Kakuda, and Courtney V. Fletcher 116. Lower Respiratory Tract Infections........... 1845 Martha G. Blackford, Mark L. Glover, and Michael D. Reed SECTION 17 117. Upper Respiratory Tract Infections........... 1867 Oncologic Disorders Christopher Frei, Bradi Frei, and George Zhanel Section Editor: Gary C. Yee 118. Influenza.................................. 1881 135. Cancer Treatment and Chemotherapy......... 2191 Jessica C. Njoku and Elizabeth D. Hermsen Patrick J. Medina and Stacy S. Shord 119. Skin and Soft-Tissue Infections............... 1893 136. Breast Cancer.............................. 2229 Douglas N. Fish, Susan L. Pendland, Laura Boehnke Michaud, Chad M. Barnett, and Larry H. Danziger and Francisco J. Esteva 120. Infective Endocarditis....................... 1913 137. Lung Cancer............................... 2271 Angie Veverka and Michael A. Crouch Deborah A. Frieze and Val R. Adams The complete chapter, learning objectives, and other resources can be found at www.pharmacotherapyonline.com. xii 138. Colorectal Cancer.......................... 2287 SECTION 18 Lisa E. Davis, Weijing Sun, and Patrick J. Medina CONTENTS Nutritional Disorders 139. Prostate Cancer............................ 2319 Section Editor: Gary R. Matzke LeAnn B. Norris and Jill M. Kolesar 149. Assessment of Nutrition Status, 140. Lymphomas............................... 2333 and Nutrition Requirements................. 2473 Alexandre Chan and Gary C. Yee Katherine Hammond Chessman 141. Ovarian Cancer............................ 2361 and Vanessa J. Kumpf Judith A. Smith and Judith K. Wolf 150. Medication Administration Considerations 142. Acute Leukemias........................... 2377 with Specialized Nutrition Support........... 2493 Betsy Bickert Poon and Dianne M. Brundage Roland N. Dickerson and Gordon S. Sacks 143. Chronic Leukemias......................... 2401 151. Parenteral Nutrition........................ 2505 Christopher A. Fausel and Patrick J. Kiel Todd W. Mattox and Catherine M. Crill 144. Multiple Myeloma.......................... 2417 152. Enteral Nutrition........................... 2527 Timothy R. McGuire and Casey B. Williams Vanessa J. Kumpf and Katherine Hammond Chessman 145. Myelodysplastic Syndromes............... 2431 153. Nutritional Considerations in Major Organ Failure.............................. 2545 Julianna A. Burzynski and Tracey Walsh-Chocolaad Brian M. Hodges and Mark DeLegge 146. Renal Cell Carcinoma.................... 2433 Christine M. Walko, Ninh M. La-Beck, 154. Obesity.................................... 2567 and Mark D. Walsh Judy T. Chen, Amy Heck Sheehan, Jack A. Yanovski, and Karim Anton Calis 147. Melanoma................................. 2435 Cindy L. O’Bryant and Jamie C. Poust 148. Hematopoietic Stem Cell Transplantation............................ 2455 Glossary......................................... 2585 Janelle B. Perkins and Gary C. Yee Index.......................................... 2613 The complete chapter, learning objectives, and other resources can be found at www.pharmacotherapyonline.com.  xiii CONTRIBUTORS Val R. Adams, PharmD, FCCP, BCOP Daniel H. Atchley, PhD, MS, MT-ASCP Associate Professor, Department of Pharmacy Practice and Associate Professor and Director of Assessment, Harding University Science, University of Kentucky, College of Pharmacy, Lexington, College of Pharmacy, Harding University, Searcy, Arkansas Kentucky Chapter 95 Chapter 137 Rebecca L. Attridge, PharmD, MSC Sarah E. Adkins, PharmD Assistant Professor, Department of Pharmacy Practice, The Ohio State University, College of Pharmacy, Columbus, Ohio Feik School of Pharmacy, University of The Incarnate Word, Chapter 5 San Antonio, Texas Chapter 35 Jeffrey R. Aeschlimann, PharmD Associate Professor, University of Connecticut School Jacquelyn L. Bainbridge PharmD, FCCI of Pharmacy, Storrs, Connecticut Professor, Department of Clinical Pharmacy and Department of Chapter 113 Neurology, University of Colorado - Denver, Aurora, Colorado Chapter 64 Rondall E. Allen, B.S. PharmD Associate Dean for Student Affairs and Curricular Assessment, Jeffrey F. Barletta, PharmD, FCCM Clinical Assistant Professor, Xavier University of Louisiana, Associate Professor, Department of Pharmacy Practice, College of Pharmacy, New Orleans, Louisiana Midwestern University, College of Pharmacy, Glendale, Arizona Chapter 45 Chapter 18 J. V. Anandan, PharmD Chad M. Barnett, PharmD, BCOP Pharmacy Specialist, Center for Drug Use Analysis and Clinical Pharmacy Specialist, Breast Oncology, University Information, Henry Ford Hospital and Adjunct Associate of Texas M.D. Anderson Cancer Center, Houston, Texas Professor, Eugene Apppelbaum College of Pharmacy and Chapter 136 Health Sciences, Wayne State University, Detroit, Michigan Chapter 124 Larry A. Bauer, PharmD, FCP, FCCP Professor, Departments of Pharmacy and Laboratory Medicine, Peter L. Anderson, PharmD Schools of Pharmacy and Medicine, University of Washington, Associate Professor, Department of Pharmoceutical Sciences, Seattle, Washington School of Pharmacy, University of Colorado - Denver, Aurora, Chapter 8 Colorado Chapter 134 Jerry L. Bauman, PharmD, FCCP, FACC Dean, University of Illinois at Chicago College of Pharmacy, Tami R. Argo, PharmD, MS, BCPP Professor, Departments of Pharmacy Practice and Medicine, Clinical Pharmacy Specialist-Psychiatry, Iowa City Veterans Section of Cardiology, University of Illinois at Chicago, Affairs Medical Center, Iowa City, Iowa Chicago, Illinois Chapter 76 Chapter 25 Edward P. Armstrong, PharmD Terry J. Baumann, BS, PharmD Professor, Department of Pharmacy Practice and Science, College Clinical Manager and Clinical Pharmacist, Munson Medical of Pharmacy, University of Arizona, Tuscon, Arizona Center, Traverse City, Michigan Chapter 127 Chapter 69 Jill Astolfi, PharmD Oralia V. Bazaldua, PharmD, FCCP, BCPS Client Relations Liaison, Hospice Pharmacia, a service of Associate Professor, Department of Family & Community Medicine, excelleRx, Inc., an Omnicare company The University of Texas Health Science Center at San Antonio Chapter 12 Chapter 3 xiv Rosemary R. Berardi, PharmD, FCCP, FASHP, FAPHA Edward M. Buchanan, MD CONTRIBUTORS Professor of Pharmacy, College of Pharmacy, University of Thomas Jefferson University, Jefferson Medical College, Michigan, Ann Arbor, Michigan Philadelphia, Pennsylvania Chapter 40 Chapter 89 Martha G. Blackford, PharmD Peter F. Buckley, MD Division of Clinical Pharmacology and Toxicology, Department of Professor and Chairman, Psychiatry and Health Behavior, Pediatrics, Children’s Hospital Medical Center, Akron Children’s Senior Associate Dean for Leadership Development, Medical Hospital, Akron, Ohio College of Georgia, Augusta, Georgia Chapter 116 Chapter 76 Scott Bolesta, PharmD, BCPS David S. Burgess, PharmD, FCCP Assistant Professor, Department of Pharmacy Practice, James T. Doluisio Regents Clinical Professor and Head, Clinical Pharmacists, Mercy Hospital, Scranton, Pennsylvania Pharmacotherapy, College of Pharmacy, The University of Texas Chapter 46 at Austin, Clinical Professor, Department of Medicine, Division of Infectious Diseases, Director, Pharmacotherapy Education and Bradley A. Boucher, PharmD, FCCP, FCCM Research Center School of Medicine, The University of Texas Professor of Clinical Pharmacy, Department of Clinical Pharmacy, Health Science Center, San Antonio, Texas College of Pharmacy, and Associate Professor of Neurosurgery, Chapter 114 Department of Neurosurgery, College of Medicine, University of Tennessee, Memphis, Tennessee Julianna A. Burzynski, PharmD, BCPS, BCOP Clinical Pharmacy Specialist, Hematology/Oncology, Chapter 67 Mayo Clinic, Rochester, Minnesota Denise Boudreau, RPh, PhD Chapter 145 Scientific Investigator, Group Health Center for Health Studies, Lucinda M. Buys, PharmD, BCPS Seattle, Washington Associate Professor (Clinical), Department of Pharmacy Practice Chapter 13 and Science, University of Iowa College of Pharmacy and the Sharya V. Bourdet, PharmD, BCPS Siouxland Medical Education Foundation, Sioux City, Iowa Critical Care Pharmacist/Clinical Inpatient Program Manager, Chapter 101 Veterans Affairs Medical Center, Health Sciences Clinical Karim Anton Calis, PharmD, MPH, FASHP, FCCP Assistant Professor, School of Pharmacy, University of California, Adjunct Clinical Investigator, Program in Developmental San Francisco, San Francisco, California Endocrinology and Genetics, Eunice Kennedy Shriver National Chapter 34 Institute of Child Health and Human Development, National Nancy Brahm, PharmD, MS, BCPP, CGP Institutes of Health; Clinical Professor, University of Maryland and Virginia Commonwealth University, Richmond, Virginia Clinical Associate Professor, Department of Clinical and Administrative Sciences, College of Pharmacy, University Chapters 86, 91, and 154 of Oklahoma, Tulsa, Oklahoma Kimberly A. Cappuzzo, PharmD, MS, CGP Chapter 82 Senior Regional Medical Liason, Metabolic Bone Team, Scientific Donald F. Brophy, PharmD, MSc, FCCP, FASN, BCPS Affairs, Amgen, Richmond, Virginia Professor and Chairman Department of Pharmacotherapy & Chapter 96 Outcomes Science, School of Pharmacy and Professor of Internal Peggy L. Carver, PharmD, FCCP Medicine, Virginia Commonwealth University Medical College Associate Professor, Department of Clinical, Social, and of Virginia Campus, Richmond, Virginia Administrative Sciences, The University of Michigan, College Chapter 60 of Pharmacy, Clinical Pharmacist, The University of Michigan Health System Jason E. Brouillard, PharmD Chapter 130 Critical Care Pharmacist, Sacred Heart Medical Center, Spokane, WA, Adjunct Clinical Instructor, Department of Pharmacotherapy Larisa H. Cavallari, PharmD, FCCP, BCPS College of Pharmacy, Washington State University, Spokane, Associate Professor, Department of Pharmacy Practice, Washington College of Pharmacy, University of Illinois at Chicago Chapter 15 Chapters 9 and 20 Thomas E. R. Brown, PharmD Jose E. Cavazos, MD, PhD Associate Professor, Leslie Dan Faculty of Pharmacy, University of Associate Professor of Neurology, Pharmacology and Physiology, Toronto and Sunnybrook Health Science Center, Toronto, Ontario University of Texas Health Science Center, San Antonio, Texas Chapter 129 Chapter 65 Dianne M. Brundage, PharmD, FCCP, BCPS, BCOP Alexandre Chan, PharmD, BCPS, BCOP Oncology Clinical Pharmacy Specialist, Park Nicollet Health Assistant Professor, Department of Pharmacy, Faculty of Science, Services Methodist Hospital, Assistant Professor, College of National University of Singapore, Clinical Pharmacist, Department Pharmacy, University of Minnesota, Minneapolis, Minnesota of Pharmacy, National Cancer Centre, Singapore, Singapore Chapter 142 Chapter 140  xv C. Y. Jennifer Chan, PharmD Stephen Joel Coons, PhD CONTRIBUTORS Clinical Associate Professor of Pediatrics, University of Texas Director, Patient-Reported Outcomes Consortium, Health Science Center at San Antonio, Clinical Assistant Professor Critical Path Institute, Tucson, Arizona of Pharmacy, University of Texas in Austin, San Antonio, Texas Chapter 2 Chapter 111 John R. Corboy, MD Jack J. Chen, PharmD, BCPS, CGP Professor, Neurology, University of Colorado School of Associate Professor (Neurology), Movement Disorders Center, Medicine, Co-Director, Rocky Mountain Multiple Sclerosis Schools of Medicine and Pharmacy, Loma Linda University, Center at Anschutz Medical Center, Staff Neurologist, Loma Linda, California Denver Veteran’s Affairs Medical Center, Aurora, Colorado Chapter 68 Chapter 64 Judy T. Chen, PharmD, BCPS Lisa T. Costanigro, PharmD, BCPS Clinical Assistant Professor of Pharmacy Practice Purdue Staff Pharmacist, Paudre Valley Health System, University - School of Pharmacy and Pharmaceutical Sciences Fort Collins, Colorado West Lafayette, Indiana Chapter 15 Chapter 154 Elizabeth A. Coyle, PharmD, BCPS Katherine Hammond Chessman, PharmD, Clinical Associate Professor, University of Houston FCCP, BCPS, BCNSP College of Pharmacy, Houston, Texas Professor, Department of Pharmacy and Clinical Sciences, South Chapter 125 Carolina College of Pharmacy, MUSC Campus, Clinical Pharmacy Specialist, Pediatrics/Pediatric Surgery, Department of Pharmacy James D. Coyle Services, Medical University of South Carolina Children’s Assistant Professor of Clinical Pharmacy, College of Pharmacy, Hospital, Charleston, South Carolina The Ohio State University, Columbus, Ohio Chapters 149 and 152 Chapter 58 Thomas W. F. Chin*, BScPhm, PharmD, FCSHP Catherine M. Crill, PharmD, BCPS, BCNSP Clinical Pharmacy Specialist/leader- Antimicrobials & Infectious Associate Professor, Departments of Clinical Pharmacy and Diseases, St. Michael’s Hospital and Assistant Professor, Pediatrics, The University of Tennessee Health Science Center, Leslie Dan Faculty of Pharmacy, University of Toronto, Memphis, Tennessee Toronto, Ontario Chapter 151 Chapter 129 M. Lynn Crismon, PharmD Elaine Chiquette, PharmD. BCPS Dean, James T. Doluisio Regents Chair & Behren’s Centennial Director, Research & Development Strategic Relations, Amylin Professor, College of Pharmacy, The University of Texas at Pharmaceuticals, Inc., San Antonio, Texas Austin, Austin, Texas Chapter 6 Chapter 76 Mariann D. Churchwell, PharmD, BCPS Michael A. Crouch, PharmD, FASHP, BCPS Assistant Professor, University of Toledo College of Pharmacy, Professor and Associate Dean, Gatton College of Pharmacy, Toledo, Ohio East Tennessee State University, Johnson City, Tennessee Chapter 54 Chapter 120 Peter A. Chyka, PharmD, FAACT, DABAT William Dager, PharmD, BCPS, FCSHP, FCCP, FCCM Professor, Department of Clinical Pharmacy; Associate Dean, Pharmacist Specialist, UC Davis Medical Center, Clinical Professor Knoxville Campus, University of Tennessee College of Pharmacy, of Pharmacy, UC San Francisco School of Pharmacy, Clinical Knoxville, Tennessee Professor of Medicine, UC Davis School of Medicine, Clinical Professor of Pharmacy, Touro School of Pharmacy, Sacramento, Chapter 14 California Elizabeth C. Clark, MD, MPH Chapter 51 Assistant Professor, Department of Family Medicine, University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Devra K. Dang, PharmD, BCPS, CDE Medical School, New Brunswick, New Jersey Associate Clinical Professor, University of Connecticut School of Pharmacy, Storrs, Connecticut Chapter 102 Chapter 91 Kristen Cook, PharmD, BCPS Assistant Professor, Department of Pharmacy Practice, University of Larry H. Danziger, PharmD Nebraska Medical Center College of Pharmacy, Clinical Pharmacist, Professor of Pharmacy, College of Pharmacy, University Nebraska-Western Iowa VA Healthcare System, Omaha, Nebraska of Illinois at Chicago, Chicago, Illinois Chapter 109 Chapter 119 *Deceased xvi Joseph F. Dasta, MSc, FCCM, FCCP Joseph T. DiPiro, PharmD, FCCP CONTRIBUTORS Professor Emeritus, The Ohio State University, Columbus, Ohio, Executive Dean and Professor, South Carolina College of Adjunct Professor, University of Texas, Austin, Texas Pharmacy, Medical University of South Carolina and the Chapter 30 University of South Carolina Chapters 97 and 123 Lisa E. Davis, PharmD, BCPS, BCOP Associate Professor of Clinical Pharmacy, Philadelphia Paul L. Doering, MS College of Pharmacy, University of the Sciences in Philadelphia, Distinguished Service Professor of Pharmacy Practice, College Philadelphia, Pennsylvania of Pharmacy, University of Florida, Gainesville, Florida Chapter 138 Chapters 74 and 75 Susan R. Davis, MBBS, FRACP, PhD Julie A. Dopheide, PharmD, BCPP Department of Medicine, Monash University, Melbourne, Australia Associate Professor, Clinical Pharmacy, Psychiatry and the Chapter 91 Behavioral Sciences, University of Southern California Schools of Pharmacy and Medicine, Los Angeles, California Jeffrey C. Delafuente, MS, FCCP, FASCP Chapter 72 Associate Dean for Professional Education and Professor of Pharmacotherapy and Outcomes Science, Virginia John M. Dopp, PharmD Commonwealth University School of Pharmacy, Richmond, Assistant Professor, School of Pharmacy, University of Wisconsin, Virginia Madison, Wisconsin Chapter 96 Chapter 81 Mark DeLegge, MD, FACG, CNSP, AGAF, FASGE Thomas C. Dowling, PharmD, PhD, FCP Professor of Medicine and Director Digestive Disease Center, Associate Professor and Vice Chair, Department of Pharmacy Director of Nutrition, Medical University of South Carolina, Practice and Science, University of Maryland School of Pharmacy, Charleston, South Carolina Baltimore, Maryland Chapter 153 Chapter 50 Paulina Deming, PharmD Shannon J. Drayton, PharmD, BCPP University of New Mexico College of Pharmacy, Project ECHO Assistant Professor, Department of Clinical Pharmacy and Hepatitis C Community Clinic, Alburquerque, New Mexico Outcomes Research, South Carolina College of Pharmacy, Chapter 47 MUSC Campus, Charleston, South Carolina Simon De Denus, B.Pharm, MSC, PhD Chapter 78 Faculty of Pharmacy, University de Montreal, Linda D. Dresser, PharmD Montreal Heart Institute, Montreal, Quebec Assistant Professor Leslie Dan Faculty of Pharmacy, University Chapter 24 of Toronto and University Health Network, Toronto, Canada Vimal K. Derebail, MD Chapter 129 Clinical Assistant Professor UNC Kidney Center, Division of Nephrology and Hypertension, University of North Carolina at Deepak P. Edward, MD, FACS Chapel Hill Summa Health System and Northeastern Ohio Universities Chapter 52 College of Medicine, Akron, Ohio Chapter 103 John W. Devlin, PharmD, FCCP, FCCM, BCPS Associate Professor, Northeastern University School of Pharmacy, Mary Elizabeth Elliott, PharmD, PhD Adjunct Associate Professor, Tufts University School of Medicine, Associate Professor, Pharmacy Practice Division, University of Boston, Massachusetts Wisconsin-Madison School of Pharmacy, Madison, Wisconsin, Chapter 61 Clinical Pharmacist, Osteoporosis Clinic, VA Medical Center, Madison, Wisconsin Vanessa A. Diaz, MD, MS Chapter 101 Medical University of South Carolina, Department of Family Medicine, Charleston, South Carolina Michael E. Ernst, PharmD Chapter 88 Professor (Clinical), Department of Pharmacy Practice and Science, College of Pharmacy; and Department of Family Roland N. Dickerson, PharmD, BCNSP, FACN, FCCP Medicine, Carver College of Medicine, The University of Iowa, Professor of Clinical Pharmacy, University of Tennessee Health Iowa City, Iowa Science Center, Memphis, Tennessee Chapter 102 Chapter 150 Brian L. Erstad, PharmD, FCCM, FCCP, FASHP Cecily V. DiPiro, PharmD Professor, Department of Pharmacy Practice and Science, Consultant Pharmacist, Mt. Pleasant, South Carolina University of Arizona College of Pharmacy, Tucson Arizona Chapter 42 Chapter 31  xvii Francisco J. Esteva, MD, PhD Jane Frumin, PharmD CONTRIBUTORS Director, Breast Cancer Translational Research Laboratory, Assistant Professor, Clinical and Administrative Sciences, Professor, Departments of Breast Medical Oncology and College of Notre Dame of Maryland School of Pharmacy, Molecular and Cellular Oncology, University of Texas M.D. Baltimore, Maryland Anderson Cancer Center, Houston, Texas Chapter 60 Chapter 136 Randolph V. Fugit, PharmD, BCPS Susan C. Fagan, PharmD, BCPS, FCCP Internal Medicine Clinical Specialist, Denver Veterans Affairs Jowdy Professor, Associate Head, Assistant Dean, University Medical Center, Clinical Assistant Professor, Clinical Pharmacy of Georgia College of Pharmacy, Augusta, Georgia Practice, University of Colorado Denver Health Sciences Center, Chapters 27 and 62 Denver, Colorado Christopher A. Fausel, PharmD, BCPS, BCOP Chapter 40 Clinical Director, Oncology Pharmacy Services, Indiana Mark L. Glover, BS Pharm, PharmD University Simon Cancer Center, Indianapolis, Indiana Associate Professor and Director, West Palm Beach Chapter 143 program, Department of Pharmacy Practice, College of Pharmacy, Nova Southeastern University, Palm Beach Richard G. Fiscella, PharmD, MPH Gardens, Florida Clinical Professor, Department of Pharmacy Practice and Chapter 116 Adjunct Assistant Professor, Department of Ophthalmology, University of Illinois at Chicago, Chicago, Illinois Shelly L. Gray, PharmD, MS Chapter 103 Professor, School of Pharmacy, University of Washington, Douglas N. Fish, PharmD Seattle, Washington Professor, Department of Clinical Pharmacy, University of Chapter 11 Colorado Denver School of Pharmacy, Clinical Specialist in David R.P. Guay, PharmD Infectious Diseases/Critical Care, University of Colorado Professor, Department of Experimental and Clinical Hospital, Aurora, Colorado Pharmacology, College of Pharmacy, University of Minnesota, Chapters 119 and 131 Division of Geriatrics, Health Partners Inc., Minneapolis, Virginia H. Fleming, PharmD Minnesota Clinical Assistant Professor, Department of Clinical and Chapters 11 and 94 Administrative Pharmacy, University of Georgia College Wayne P. Gulliver, MD, FRCP of Pharmacy, Athens, Georgia Professor of Medicine and Dermatology, and Chair, Chapter 43 Discipline of Medicine, Faculty of Medicine, Memorial Courtney V. Fletcher, PharmD University of Newfoundland, St. John’s Newfoundland Dean and Professor, College of Pharmacy, University and Labrador, Canada of Nebraska Medical Center, Omaha, Nebraska Chapter 107 Chapter 134 John G. Gums, PharmD, FCCP Bradi Frei, PharmD, BCPS, BCOP Professor of Pharmacy and Medicine, Associate Chair, Assistant Professor, Department of Pharmacy Practice, Department of Pharmacotherapy and Translational Research, University of the Incarnate Word, San Antonio, Texas Director of Clinical Research in Family Medicine Departments of Pharmacotherapy and Translational Research and Community Chapter 117 Health and Family Medicine, University of Florida Christopher Frei, PharmD, MSc, BCPS Chapter 85 Assistant Professor, Pharmacotherapy Division, College of Pharmacy, The University of Texas at Austin; Clinical Assistant Stuart T. Haines, PharmD, FCCP, FASHP, FAPHA Professor, Department of Medicine, Division of Infectious Professor, Department of Pharmacy Practice and Science, Diseases and Pharmacotherapy Education & Research Center, University of Maryland School of Pharmacy, Baltimore, Maryland School of Medicine, The University of Texas Health Science and Clinical Pharmacy Specialist, Patient Care Services, West Palm Center at San Antonio, Texas Beach, Virginia Medical Center Chapter 117 Chapter 26 Allan D. Friedman, MD, MPH Emily R. Hajjar, PharmD, BCPS, CGP Professor and Chair, Division of General Pediatrics, Department of Associate Professor, Jefferson School of Pharmacy, Thomas Pediatrics, Virginia Commonwealth University, Richmond, Virginia Jefferson University, Philadelphia, Pennsylvania Chapter 127 Chapter 11 Deborah A. Frieze, PharmD, BCOP Jenana Halilovic, PharmD, BCPS Inpatient Pharmacy Manager, University of Washington Assistant Professor, Thomas J Long School of Pharmacy, Medical Center, Clinical Assistant Professor, University University of the Pacific, Stockton, California and Clinical of Washington School of Pharmacy, Seattle, Washington Pharmacist, UC Davis Medical Center, Sacramento, California Chapter 137 Chapter 51 xviii Philip D. Hall, PharmD, FCCP, BCPS, BCOP David C. Hess, MD CONTRIBUTORS Professor, South Carolina College of Pharmacy, Medical Professor and Chairman, Department of Neurology, Medical University of South Carolina, Charleston, South Carolina College of Georgia, Augusta, Georgia Chapter 95 Chapter 27 Steven M. Handler, Md, PhD Angela Massey Hill, PharmD, BCPP Assistant Professor, University of Pittsburgh School of Medicine, Florida A & M University, College of Pharmacy, Professor and Department of Biomedical Informatics and Division of Geriatric Division Director of Pharmacy Practice, Tallahassee, Florida Medicine, Geriatric Research Education and Clinical Center Chapter 63 (GRECC), Veterans Affairs Pittsburgh Healthcare Center (VAPHS), Pittsburgh, Pennsylvania L. David Hillis, MD Chapter 11 Professor and Chair, Department of Medicine, University of Texas Health Science Center, San Antonio, Texas Joseph T. Hanlon, PharmD, MS Chapter 17 Professor of Medicine, Pharmacy and Epidemiology, University of Pittsburgh and Health Scientist, CHERP/GRECC, Pittsburgh Jonathan Himmelfarb, MD Veterans Affairs Pittsburgh Health System, Pittsburgh, Professor of Medicine, Joseph W. Eschbach, MD, Endowed Pennsylvania Chair for Kidney Research, Director, Kidney Research Institute, Chapter 11 Department of Medicine, Division of Nephrology, University of Washington, Seattle, Washington Christine N. Hansen, PharmD Chapter 55 Clinical Pharmacy Specialist, Department of Pharmacy, Lakeland Regional Medical Center, Lakeland, Florida Brian M. Hodges, PharmD, BCPS, BCNSP Chapter 112 Assistant Professor, Department of Clinical Pharmacy, West Michelle Harkins, MD Virginia University School of Pharmacy, West Virginia Associate Professor of Medicine, Pulmonary and Chapter 153 Critical Care, University of New Mexico Health Sciences Center, Albuquerque, New Mexico Barbara J. Hoeben, PharmD, MSPharm, BCPS Pharmacy Flight Commander, Davis-Monthan Air Force Base, Chapter 36 Tucson, Arizona Mary S. Hayney, PharmD, MPH Chapter 29 Professor of Pharmacy (CHS), University of Wisconsin School of Pharmacy Collin A. Hovinga, PharmD Chapter 133 University of Tennessee Health Science Center, LeBonheur Children’s Medical Center, Memphis, Tennessee Thomas K. Hazlet, PharmD, DrPH Chapter 66 Associate Professor, Pharmaceutical Outcomes Research & Policy Program, School of Pharmacy, University of Thomas R. Howdieshell, MD, FACS, FCCP Washington, Seattle, Washington Professor of Surgery, Trauma/Surgical Critical Care, Chapter 13 University of New Mexico HSC, Albuquerque, New Mexico Chapter 123 Brian A. Hemstreet, PharmD, BCPS Associate Professor, Department of Clinical Pharmacy, Joanna Q. Hudson, PharmD, BCPS, FASN University of Colorado, Denver School of Pharmacy, Associate Professor, Departments of Clinical Pharmacy and Aurora, Colorado Medicine (Nephrology), The University of Tennessee Health Chapter 41 Science Center, Memphis, Tennessee Chapter 53 Elizabeth D. Hermsen, PharmD, MBA, BCPS-ID Antimicrobial Stewardship Program Coordinator, Pharmacy Grant F. Hutchins, MD Relations & Clinical Decision Support, The Nebraska Medical Assistant Professor Gastroenterology/Hepatology, Director of Center; Adjunct Assistant Professor, Department of Pharmacy Advanced Endoscopy, University of Nebraska Medical Center, Practice, University of Nebraska Medical Center, College of Omaha, Nebraska Pharmacy; Adjunct Assistant Professor, Section of Infectious Chapter 38 Diseases, Department of Internal Medicine, University of Nebraska Medical Center, College of Medicine, Omaha, Nebraska Robert J. Ignoffo, PharmD Chapters 115 and 118 Touro University, Vallejo, California Chapter 42 Chris M. Herndon, PharmD, BCPS, CPE Assistant Professor, Department of Pharmacy Practice, Beata A. Ineck, PharmD, BCPS, CDE Southern Illinois University, Edwardsville School of Pharmacy, Home Based Primary Care, Clinical Pharmacist, Boise VA Edwardsville, Illinois Medical Center, Boise, Idaho Chapter 69 Chapter 109  xix Arthur A. Islas, MD, MPH, CAQ–Sports Patrick J. Kiel, PharmD, BCPS, BCOP CONTRIBUTORS Medicine, FAWM Clinical Pharmacy Specialist, Hematology/Stem Cell Associate Professor, Department of Family & Community Transplant, Indiana University Simon Cancer Center, Medicine, Paul L. Foster School of Medicine, Texas Tech Indianapolis, Indiana University Health Science Center, El Paso, Texas Chapter 143 Chapter 4 Karla Killgore-Smith, PharmD, BCPS Heather J. Johnson, PharmD, BCPS, FASN Clinical Pharmacist, Santa Barbara Cottage Hospital, Adjunct Assistant Professor, Department of Pharmacy and Professor of Pharmacy, University of Pacific, Santa Barbara, Therapeutics, University of Pittsburgh School of Pharmacy, California Clinical Pharmacist, University of Pittsburgh Medical Center, Chapter 128 Pittsburgh, Pennsylvania William R. Kirchain, PharmD, CDE Chapter 98 Wilbur and Mildred Robichaux Endowed Professor, Division of Jacqueline Jonklaas, MD, PhD Clinical and Administrative Sciences, College of Pharmacy, Xavier Associate Professor, Division of Endocrinology, Georgetown University of Louisiana, New Orleans, Louisiana University Medical Center, Washington DC Chapter 45 Chapter 84 Cynthia K. Kirkwood, PharmD, BCPP Melanie S. Joy, PharmD, PhD, FCCP, FASN Associate Professor of Pharmacy, Vice Chair for Education, Associate Professor, School of Medicine, Division of Nephrology Department of Pharmacotherapy and Outcome Science, School of & Hypertension, UNC Kidney Center, and Associate Professor, Pharmacy, Virginia Commonwealth University, Richmond, Virginia School of Pharmacy, Division of Pharmacotherapy and Chapters 79 and 80 Experimental Therapeutics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina Leroy C. Knodel, PharmD Chapter 52 Associate Professor, Department of Surgery, The University of Texas Health Science Center, San Antonio, San Antonio, Texas, Rose Jung, PharmD, MPH, BCPS Clinical Associate Professor, College of Pharmacy, The University Visiting Associate Professor, Department of Pharmacy Practice, of Texas at Austin, Austin, Texas University of Toledo, College of Pharmacy, Toledo, Ohio Chapter 126 Chapter 122 Jill M. Kolesar, PharmD, BCPS, FCCP Thomas N. Kakuda, PharmD Professor of Pharmacy, University of Wisconsin, School of Director, Clinical Pharmacology, Tibotec, Inc., Titusville, New Jersey Pharmacy, University of Wisconsin Carbone Cancer Center, Madison, Wisconsin Chapter 134 Chapter 139 Sophia N. Kalantaridou, MD, PhD Sunil Kripalani, MD, MSc Associate Professor, Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology, University of Ioannina Associate Professor and Chief, Section of Hospital Medicine, Medical School, Ioannina, Greece Vanderbilt University, Nashville, Tennessee Chapter 91 Chapter 3 Judith C. Kando, PharmD, BCPP Abhijit V. Kshirsagar, MD, MPH Ortho-McNeil Janssen Scientific Affairs, LLC, Tewksbury, Associate Professor of Medicine Division of Nephrology and Massachusetts Hypertension, UNC Kidney Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina Chapter 77 Chapter 52 S. Lena Kang-Birken, PharmD, FCCP Associate Professor, Department of Pharmacy Practice, Thomas J. Vanessa J. Kumpf, PharmD, BCNSP Long School of Pharmacy and Health Sciences, University of The Clinical Specialist, Nutrition Support, Vanderbilt University Pacific, Stockton, California Medical Center, Nashville, Tennessee Chapter 128 Chapters 149 and 152 Salmaan Kanji, PharmD Po Gin Kwa, MD, FRCP Clinical Pharmacy Specialist (ICU), Department of Pharmacy and Clinical Associate Professor, Faculty of Medicine, Memorial Critical Care, The Ottawa Hospital, Associate Scientist, Clinical University of Newfoundland, St. John’s Newfoundland, Canada Epidemiology Program, Ottawa Hospital Institute, Ottawa, Ontario Chapter 108 Chapter 132 Ninh M. La-Beck, PharmD H. William Kelly, PharmD Assistant Professor, Center for Immunotherapeutic Research and Professor Emeritus Pediatrics, University of New Mexico Health Department of Pharmacy Practice, School of Pharmacy, Texas Sciences Center, Albuquerque, New Mexico Tech University Health Sciences Center, Abilene, Texas Chapter 33 Chapter 146 xx Thomas Lackner, PharmD Deborah J. Levine CONTRIBUTORS Experimental and Clinical Pharmacology, College of Pharmacy, Associate Professor of Medicine, Division of Pulmonary University of Minnesota, Minneapolis, Minnesota and Critical Care, University of Texas, San Antonio, Chapter 94 San Antonio, Texas Chapter 35 Y. W. Francis Lam, PharmD, FCCP Professor of Pharmacology, University of Texas Health Science Stephanie M. Levine, MD Center at San Antonio, Associate Professor of Medicine, Professor of Medicine, Division of Pulmonary Diseases and University of Texas Health Science Centre at San Antonio, Clinical Critical Care Medicine, University of Texas Health Science Center, Associate Professor of Pharmacy, University of Texas at Austin, San Antonio, San Antonio, Texas Austin, Texas Chapter 32 Chapters 9 and 48 Robin Moorman Li, PharmD Richard A. Lange, MD, MBA Assistant Professor Department of Pharmacotherapy and Professor and Executive Vice Chairman, Department of Translational Research, College of Pharmacy, University Medicine, The University of Texas Health Science Center, of Florida, Gainesville, Florida San Antonio, Texas Chapter 75 Chapter 17 Kerry L. Laplante, PharmD Jeffrey D. Little, PharmD, MPH University of Rhode Island, Department of Pharmacy Practice, Pharmacy Manager, Finance and Ancillary Services, Children’s Infectious Diseases Research Laboratory, Providence Veterans Mercy Hospital and Clinics, Kansas City, Missouri Affairs Medical Center, Division of Infectious Diseases, Chapter 5 Department of Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island Amanda M. Loya, PharmD Chapter 113 Clinical Assistant Professor, University of Texas at El Paso College of Health Sciences and University of Texas at Austin College of Alan H. Lau, PharmD, FCCP Pharmacy, El Paso, Texas Professor of Pharmacy Practice and Director, International Chapter 4 Clinical Pharmacy Education College of Pharmacy University of Illinois at Chicago, Chicago, Illinois William L. Lyons, MD Chapter 56 Associate Professor, Section of Geriatrics, Department David T.S. Law, BSc, MD, PhD, CCFP of Internal Medicine, University of Nebraska Medical Center, Omaha, Nebraska Assistant Professor, Department of Community and Family Medicine, University of Toronto, and Staff Physician, Department Chapter 109 of Family Practice, The Scarborough Hospital and Rouge Valley Health System, Scarborough, Ontario, Canada