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Applied
Therapeutics
Anniversary
Edition
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V O L U M E O N E
APPLIED THERAPEUTICS
The Clinical Use of Drugs
T W E L F T H E d i t i o n
V O L U M E O N E
APPLIED THERAPEUTICS
The Clinical Use of Drugs
T W E L F T H E d i t i o n
CAROLINE S. ZEIND, PHARMD
Vice President for Academic Affairs/Provost Professor of Pharmacy Practice Academic Affairs Massachusetts College of Pharmacy and Health Sciences Boston, Massachusetts
MICHAEL G. CARVALHO, BS, PHARMD, BCPP
Professor Emeritus of Pharmacy Practice School of Pharmacy—Boston Massachusetts College of Pharmacy and Health Sciences Boston, Massachusetts
JUDY W. CHENG, PHARMD, MPH, BCPS, FCCP
Professor and Chair School of Pharmacy—Boston Massachusetts College of Pharmacy and Health Sciences
Boston, Massachusetts
KATHY ZAIKEN, PHARMD
Professor of Pharmacy Practice Director, International Pharmacy Residency Program School of Pharmacy—Boston Massachusetts College of Pharmacy and Health Sciences Boston, Massachusetts
TRISHA LAPOINTE, PHARMD, BCPS, FASHP
Professor of Pharmacy Practice School of Pharmacy—Boston Massachusetts College of Pharmacy and Health Sciences Boston, Massachusetts
Acquisitions Editor: Matt Hauber Development Editors: Kelly Horvath/Deborah Bordeaux Editorial Coordinator: Venugopal Loganathan Editorial Assistant: Parisa Saranj Marketing Manager: Phyllis Hitner Production Project Manager: Catherine Ott Manager of Graphic Arts and Design: Steve Druding Art Director: Jennifer Clements Manufacturing Coordinator: Margie Orzech Prepress Vendor: S4Carlisle Publishing Services
Twelfth Edition
Copyright © 2024 Wolters Kluwer.
Copyright © 2018, 2013, 2009, 2005 by Lippincott Williams & Wilkins, a Wolters Kluwer business. All rights reserved. This book is protected by copyright. No part of this book may be reproduced or transmitted in any form or by any means, including as photocopies or scanned-in or other electronic copies, or utilized by any information storage and retrieval system without written permission from the copyright owner, except for brief quotations embodied in critical articles and reviews. Materials appearing in this book prepared by individuals as part of their official duties as U.S. government employees are not covered by the above­mentioned copyright. To request permission, please contact Wolters Kluwer at Two Commerce Square, 2001 Market Street, Philadelphia, PA 19103, via email at permissions@lww.com, or via our website at shop.lww.com (products and services).
9 8 7 6 5 4 3 2 1
Printed in Mexico
Library of Congress Cataloging-in-Publication Data
ISBN-13: 978-1-975167-09-7
Cataloging in Publication data available on request from publisher.
This work is provided “as is,” and the publisher disclaims any and all warranties, express or implied, including any warranties as to accuracy, comprehensiveness, or currency of the content of this work.
This work is no substitute for individual patient assessment based upon healthcare professionals’ examination of each patient and consideration of, among other things, age, weight, gender, current or prior medical conditions, medication history,
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laboratory data and other factors unique to the patient. The publisher does not provide medical advice or guidance and this work is merely a reference tool. Healthcare professionals, and not the publisher, are solely responsible for the use of this work including all medical judgments and for any resulting diagnosis and treatments.
Given continuous, rapid advances in medical science and health information, independent professional verification of medical diagnoses, indications, appropriate pharmaceutical selections and dosages, and treatment options should be made and healthcare professionals should consult a variety of sources. When prescribing medication, healthcare professionals are advised to consult the product information sheet (the manufacturer’s package insert) accompanying each drug to verify, among other things, conditions of use, warnings and side effects and identify any changes in dosage schedule or contraindications, particularly if the medication to be administered is new, infrequently used or has a narrow therapeutic range. To the maximum extent permitted under applicable law, no responsibility is assumed by the publisher for any injury and/or damage to persons or property, as a matter of products liability, negligence law or otherwise, or from any reference to or use by any person of this work.
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Dedication
As we near the 50th anniversary of Applied Therapeutics, the editors wish to honor Dr.
Mary Anne Koda-Kimble and Dr. Lloyd Young who created Applied Therapeutics, the gold standard textbook used in the teaching of patient-centered drug therapeutics. Their vision and legendary contributions have advanced health professions education for generations of healthcare students who are making a difference in the lives of their patients and the communities in which they serve.
After embarking on the twelfth edition of Applied Therapeutics, the COVID-19 pandemic brought forward unexpected challenges to a dedicated team of over 200 contributors for this edition. Many of our contributors served in dual roles as health professions educators and as healthcare providers on the front lines managing the pandemic. We dedicate this twelfth edition to them, as well as the health professions students who demonstrated resilience to advance their education and training during the pandemic. Finally, we wish to thank our
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families for their patience and unwavering support as we navigated through the winding roads of this journey and completed this twelfth edition of the textbook.
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Preface
Health professions education was significantly affected by the COVID-19 pandemic, as there was a significant need to adapt the delivery of clinical education. Many health professions programs redesigned curriculum to incorporate virtual educational tools with enhancements to online education. The pandemic has shown us more than ever the importance of educating students who are able to think critically and to utilize problem-solving skills to address healthcare challenges. Approximately five decades later, the founding principle for this textbook—a patient-centric, case-based approach to learning—remains the cornerstone of health professions education. Our authors present approximately 900 patient cases that stimulate the reader to integrate and apply therapeutic principles in the context of specific clinical situations. Health professions students and practitioners gain a glimpse into the minds of expert clinicians as they work to assess and solve therapeutic problems and develop their own critical thinking and problem-solving skills.
Readers familiar with past editions of the book will notice that the overall design of the book is consistent with the eleventh edition, which incorporates a Core Principles section at the beginning of each chapter, providing the most important “take home” information from the chapter. Each Core Principle is mapped to specific cases within the chapter where the principle is discussed in detail. Key references and websites are listed at the end of each chapter, whereas the full reference lists for each chapter have been moved online.
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Building upon the excellent foundation of case-based learning provided in previous editions, the twelfth edition has incorporated changes to meet the evolving educational needs of health professions educators and students across the globe. The editors and contributors have utilized the five Institute of Medicine (IOM) core competencies as a broad framework for proposing case studies and questions within the textbook: patient-centered care, interprofessional teams, evidence-based practice, quality improvement, and informatics. In addition, the Accreditation Council for Pharmacy Education (ACPE) Accreditation Standards 2016, the Center for the Advancement of Pharmacy Education (CAPE) Educational Outcomes, and the North American Pharmacist Licensure Examination (NAPLEX) revised competency statements have served as road maps for the editorial team and contributors in designing the twelfth edition.
Featuring contributions from more than 200 experienced health professions educators, every chapter has been revised and updated to reflect our ever-changing knowledge of drugs and the application of this knowledge to the individualized therapy of patients. Given the importance of incorporating Interprofessional Practice and Education (IPE) within health professions curricula, we have dedicated a chapter on IPE, as well as an array of IPE case studies prepared by contributors that are representative of various sections of the textbook. These IPE cases, along with answer guides, will be available for instructors on the textbook’s website (see the “Additional Resources” section).
We welcome your feedback as we undertake planning for the next edition. The authors have drawn on information from the literature, current standards, and their own clinical experiences to share the process involved in making sound and thoughtful therapeutic decisions. However, it remains the responsibility of every practitioner
to evaluate the appropriateness of a particular opinion in the context of the actual clinical situation, bearing in mind any recent developments in the field. We strongly urge students and practitioners to consult several appropriate information sources when working with new and unfamiliar drugs.
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