(Test Bank) Patient-Centered Pharmacology: Learning System For The Conscientious Prescriber

Tindall,Sedrak,Boltri, 1

Pharmacology

Test Bank

1st Edition

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Test Bank for Patient-Centered Pharmacology: Learning System For The Conscientious Prescriber, The downloadable file consists of 575 pages, and the total size of the file is 7.06 MB. Purchase now only for highly discounted price.

Author(s): Tindall, Sedrak, Boltri

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Study Note Preview

Patient-Centered Pharmacology: Learning System for the Conscientious Prescriber2585_FM_i-xvi 02/07/13 6:29 PM Page i2585_FM_i-xvi 02/07/13 6:29 PM Page ii Resources for Classroom and Professional Su CCeSS! Think Taber’s is just another dictionary? Take another look! www.Tabers.comDiamond DAVIS’S PA EXAM REVIEW Focused Review for the PANCE and PANRE Pass your PANCE and PANRE exams...guaranteed! Organized in a unique and highly effective dual-learning structure, more than 1,600 questions in the text and on the CD-ROM mirror actual PANCE and PANRE exams. Prepare for success—or your money back! Weber, Vilensky, & Fog PRACTICAL RADIOLOGY A Symptom-Based Approach Master the basics of using medical imaging in patient care. This real-world approach shows you when and how to use medical imaging to diagnose and treat common diseases and disorders—as well as the financial ramifications of various procedures. Sullivan GUIDE TO CLINICAL DOCUMENTATION Documentation requires the utmost skill and accuracy. Are you prepared? Rely on sample notes, writing exercises, and screening tools to help you develop the skills you need to effectively and efficiently document patient care for children and adults in clinical and hospital settings. Sedrak & Massey CLASSROOM TO CLINIC STUDY SYSTEM Personal Professor for Clinical Rotations and PANCE/PANRE Review Prepare for classroom, PANCE, PANRE, or clerkship exam success—guaranteed! Choose how you want to study—by the NCCPA Content Blueprint for PANCE and PANRE exams or by clerkship. Multiple checkpoints assess your progress. ORDER YOUR COPIES TODAY ! www.FADavis.comPatient-Centered Pharmacology: Learning System for the Conscientious Prescriber William N. Tindall, PhD, RPh Professor Emeritus, Family Medicine Wright State UniversityBoonshoft School of Medicine, Dept. of Family MedicineDayton, Ohio Mona M. Sedrak, PhD, PA-C Associate Dean, School of Health and Medical SciencesDivision of Health SciencesAssociate Professor, Physician Assistant ProgramSeton Hall UniversitySouth Orange, New Jersey John M. Boltri, MD, FAAFP Professor and ChairDepartment of Family Medicine and Public Health SciencesWayne State University School of MedicineDetroit, Michigan2585_FM_i-xvi 02/07/13 6:29 PM Page iiiF. A. Davis Company 1915 Arch StreetPhiladelphia, PA 19103www.fadavis.com Copyright © 2014 by F. A. Davis Company Copyright © 2014 by F. A. Davis Company. All rights reserved. This product is protected by copyright. No part of it may be reproduced, stored in a retrieval system, ortransmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without written permission from the publisher. Printed in the United States of America Last digit indicates print number: 10 9 8 7 6 5 4 3 2 1 Acquisitions Editor: Andy McPhee Manager of Content Development: George W. Lang Developmental Editor: Patricia Gillivan Art and Design Manager: Carolyn O’Brien As new scientific information becomes available through basic and clinical research, recommended treatments and drug therapies undergo changes. The author(s) and publisher have done everything possible to make this book accurate, up to date, and in accord with accepted standards at the time of publication. The author(s), editors,and publisher are not responsible for errors or omissions or for consequences from application of the book, and make no warranty, expressed or implied, in regard to thecontents of the book. Any practice described in this book should be applied by the reader in accordance with professional standards of care used in regard to the uniquecircumstances that may apply in each situation. The reader is advised always to check product information (package inserts) for changes and new information regardingdose and contraindications before administering any drug. Caution is especially urged when using new or infrequently ordered drugs. Library of Congress Cataloging-in-Publication Data Patient-Centered Pharmacology: learning system for the conscientious prescriber / [edited by] William N. Tindall, Mona M. Sedrak, John M. Boltri. p. ; cm. Includes bibliographical references and index.ISBN 978-0-8036-2585-3I. Tindall, William N., editor of compilation. II. Sedrak, Mona, editor of compilation. III. Boltri, John M., editor of compilation.[DNLM: 1. Pharmaceutical Preparations. 2. Drug Therapy. QV 55]RM300615.1—dc23 2013007350 Authorization to photocopy items for internal or personal use, or the internal or personal use of specific clients, is granted by F. A. Davis Company for users registeredwith the Copyright Clearance Center (CCC) Transactional Reporting Service, provided that the fee of $.25 per copy is paid directly to CCC, 222 Rosewood Drive,Danvers, MA 01923. For those organizations that have been granted a photocopy license by CCC, a separate system of payment has been arranged. The fee code forusers of the Transactional Reporting Service is: 978-0-8036-2585-3/14 0 + $.25.2585_FM_i-xvi 02/07/13 6:29 PM Page ivDedication I dedicate this book to my three grandchildren, Aidan, Cameron, and Kendall Taylor, who light my days with their love, wonder, and joy; mydaughters, Christine and Laura, who continue to teach me the meaning ofunconditional love; and my best friend and loving wife, Sylvia, for all shehas sacrificed in support of me, my career, and my many pursuits. William N. Tindall I dedicate this book first and foremost to my parents Edward and MarcelleNaim. Mom and Dad, you gave me the courage and the confidence todream big, reach for the stars and beyond, and to never give up. Also, Idedicate this book to the one I lost and that I hope to find fully again oneday. Working on this project helped keep me sane when I found solace inlittle else. My precious child, you were with me in each word I wrote andeach page I turned, as you are now and will forever be. Mona M. Sedrak I dedicate this book to my wife and best friend, Shelley; to my children,Mark, Joe, and Mary; and to my parents, Lillian and Mario. You have alltaught me the meaning of love and what is really important in life—tolove and be loved. John M. Boltri v2585_FM_i-xvi 02/07/13 6:29 PM Page v2585_FM_i-xvi 02/07/13 6:29 PM Page viPreface This textbook is designed to be used as a learning system about medications for students who will one day possess prescribingrights. We believe every clinician should be a conscientious pre-scriber. To us, conscientious prescribing refers to a thoughtful process that always places the patient’s well-being first, aheadof every prescribing decision, before any prescription is written, and includes appropriate follow-up after the patient has com-pleted the course of medication. Being a conscientious prescriber is based on the following tenets: 1.That each time a medication is chosen, the choice shouldbe based on a substantial body of literature supporting thedecision. 2.That for most patients, monotherapy is a better choicethan polytherapy. 3.That low doses are preferred over high doses. 4.That short-term therapy is preferred over long-term therapy. 5.That although newer medications may have promotionaladvantages, there is not always the best evidence availableto support these advantages until clinical trials are con-ducted to prove the existence of significant “risk-benefit”advantages. 6.That before any prescription is written, the clinician must consider the patient’s lifestyle behaviors, adherence issues,economic issues, mind-body-spiritual issues, health-riskissues, age, weight, and other physical issues that mightaffect pharmacodynamic and pharmacokinetic parametersand hence final outcomes. 7.That after a prescription is written, treatment failure can be the result of inappropriate prescribing, dosing or dosageerrors, misdiagnoses of its need, interference by other illnesses, administration of concurrent foods or drugs, environmental factors, or genetic issues. 8.That a conscious effort should be made to confirm a pa-tient’s response to a medication, manage adverse reactions,change the dosage, or discontinue the medication. 9.That patient education is vital for compliance. 10.That all patients should know at least the following drug information before they leave the clinician’s office: nameof the medication, indication, expected side effects, andcontraindications. 11.That sophisticated clinical, financial, and administrativesystems in health care can change quickly, requiring clini-cians to remain vigilant about therapeutic decisions andbe focused on which treatments benefit the patient’shealth most effectively.Our approach is based on the belief that clinicians must always put the patient first in any decision regarding drugchoices. Putting the patient first allows you to assess the patientas a unique individual in need of your skills as a conscientiousclinician. Organization The text is designed as a teaching tool and not as a reference,with our goal of making you think twice before prescribingonce. In other words we hope to make you a more conscientiousprescriber. Whereas a typical college course in pharmacologyfocuses on the pharmacokinetics and pharmacodynamics ofdrugs by grouping similar chemical classes of medications to-gether, this textbook presents similar information, but groupsmedications by the patient’s clinical problem(s) or issues,thereby emphasizing the clinical application of the informationpresented. The book is divided into three units. The first unit presents basic pharmacological principles that, once mastered, make iteasier to assimilate the rest of the text. The second unit containschapters that focus on the treatment of patients with commondiseases and disorders seen in primary care, such as hyperten-sion, diabetes, infections, and so forth. The third unit focuseson the treatment of patients that fall under specific patient populations with special considerations. These include pediatricpatients, women, men, and the elderly. Each chapter progresses from general information that cli- nicians need to know about the drugs discussed in the chapter,including conscientious prescribing and patient educationpoints applicable to all drugs in a particular class. It covers spe-cific information about individual drugs, including mechanismof action, pharmacokinetics, dosage and administration, clinicaluses, adverse reactions, interactions, contraindications, conscien-tious considerations, and patient and family education. Here are other elements to the chapters: ■Generic and trade names are given for each drug in this format: generic name (Trade Name). ■Adverse reactions are listed by system. Life-threatening adverse reactions are printed in capital letters, whereascommon side effects are printed in regular text. These listsare not exhaustive; readers are advised to consult a drugguide for a complete list of adverse reactions. ■Conscientious Considerations are clinical tips for clinicians. ■Patient/Family Education content conveys informationthat clinicians should communicate to patients about thedrugs they are prescribed. vii2585_FM_i-xvi 02/07/13 6:29 PM Page vii■Spotlight features focus on treating specific conditions with the drugs discussed in the chapter. ■Special Case boxes discuss treatment of uncommon condi-tions such as digitalis and cyanide toxicity. ■Other boxes and tables highlight and summarize importantinformation for easy access. ■Implications for pregnant, pediatric, and geriatric patientsare given for each class of drugs discussed. ■Learning Exercises present case studies related to the chaptercontent and are followed by critical thinking questions designed to apply the content to real-world prescribing situ-ations. Answers to the critical thinking questions are foundat the end of the book. Each chapter coordinates with the companion online web- site, providing a comprehensive learning system that reinforceskey concepts. Web Resources for Instructors The Instructor’s area on Davis Plus (http://davisplus.fadavis.com Keyword Tindall) provides online support through chapter out-lines and learning objectives, PowerPoint presentations for eachchapter, additional case studies for class discussion or homeworkassignments, and a test bank for each of the 26 chapters. Web Resources for Students Because the patient should be your first consideration in theclinical application of any medication, you as a learner are thefirst consideration in our learning program. Thus, the authorshave prepared a unique group of ancillary learning products tosupport you as a learner and help you improve your understand-ing of the clinical application of pharmacological principles. The Web resources include chapter outlines and learning objectives, pre- and post-study chapter quizzes, additional casestudies for independent study, links to helpful websites, and a“Create Your Own Formulary and Drug Card” system. Wefirmly believe that our approach will help further develop yourbasic problem-solving and decision-making skills related toprescribing medications, thereby improving your criticalthinking skills. Real-World Constraints No teaching text can cover every drug used in a modern society,especially when new drugs are continuingly being introduced.However, this textbook and its companion pieces are designedto focus your attention on common medicinal agents likely tobe encountered in primary care settings and also likely to befound on a typical prescription benefit list. Any attempt to builda working knowledge of drug therapy will be tempered by real-world constraints such as the following: ■Alternative therapies ■Guidelines and algorithms suggested by government agencies ■Use of some medicines based on local habits and customs ■Therapeutic choices that vary by health plan benefits■Accepted knowledge that any patient at any time maychange his or her medication regimen due to individualeconomics, compliance behavior, health risks, multipletherapeutic needs, and other demands. Importance of Study We study medications to prepare for that ultimate clinical actof prescribing a medication in such a way that the patient will adhere to its regimen and ultimately obtain the best benefit. Themental gymnastics that go into this process are conscientious, and when done so illuminate a path to better patient care. We needto fuse pharmacology, therapeutics, practical realities, market realities, and the human side of medicine together in the learn-ing process. You can then see at the onset of your career howyour choice of drugs to prescribe can affect health outcomes. Studying pharmacology is much different from studying other scientific and medical topics. Many students are temptedto use rote memorization to learn drug actions, names, side effects, contraindications, and so forth. Approaching the studyof pharmacology in this manner is, frankly, a waste of time. Webelieve the best way to truly learn pharmacology is to focus ondistinguishing information about each class of drugs. You thencan better understand similar drugs used to treat similar condi-tions. For example, if agents used to treat cancer seek out anddestroy fast-growing cells, is it not logical to assume they woulddo the same to the host taking them? Of course. So cells in theblood, gastrointestinal tract, hair, and certain other organs bearthe brunt of those agents and tend to manifest as side effects—such a bone marrow suppression, enteritis, and hair loss—all related to damage done to fast turnover cells. As you undertake the important task of becoming a consci- entious prescriber, instead of trying to memorize facts, ask your-self a series of questions. ■If this is what a drug is doing to combat a disease, what isthe body doing to combat the presence of the drug? ■How much of this drug should I give to achieve the desiredoutcome and not harm the patient? ■What information do I need to know about the patient andthe patient’s health status to prescribe safely? ■What information do I need to tell the patient about his orher health and prescribed regimen so that the patient feelslike a partner in health-care decisions and is encouraged totake responsibility for his or her health? We hope that this approach and the approaches we offer throughout the book afford you the ability to separate the forestfrom the trees and understand that, at the end of the day, everyday, it is truly all about the patient. Providing patient-centeredmedicine, putting the patient first, and prescribing conscientiouslyare at the root of providing quality patient care. We thank you forallowing us to play a small, yet important, part in your education. W ILLIAM N. T INDALL , P HD, RPH MONA M. S EDRAK , P HD, PA-C AND JOHN M. B OLTRI , MDviii Preface2585_FM_i-xvi 02/07/13 6:29 PM Page viiiContributors Richard Ackermann, Sr., MD, Geriatrician, Family Practitioner Family Health Center Director, Geriatric Fellowship Macon, Georgia Justin B. Beverly, MD, Pediatrician Family Health CenterPrimary Pediatrics of MaconMcDonough, Georgia Florence T. Baralatei, MD, Geriatrician, Family Practitioner Family Health CenterMacon, Georgia David E. Burtner, MD, Family Practitioner Family Health CenterMacon, Georgia Edward K. Clark, MD, Pediatrician Children’s Health CenterMacon, Georgia Y . Monique Davis-Smith, MD, Family Practitioner Health Services of Central Georgia Director, Residency ProgramMacon, Georgia Sabry A. Gabriel, MD, Family Practitioner Mercer Health SystemsProfessor, Family Medicine, Mercer UniversityMacon, Georgia Fred S. Girton, MD, Family Practitioner Health Services of Central GeorgiaProfessor and Chairman, Dept. Family Medicine, Mercer University Macon, Georgia Alice A. House, MD, Family Practitioner Byron Family Health CareByron, Georgia Steven A. House, MD, Family Practitioner Family Practice PhysiciansAssociate Professor, Assistant Director, Family ResidencyUniversity of KentuckyGlasgow, Kentucky Kathy A. Kemle, MS, PA-C, Family Practitioner Health Services of Central Georgia Assistant Professor, Assistant Director, Division of Geriatrics, Mercer University Macon, Georgia Hugh L. McLaurin, MD, Family Practitioner Family Health CenterAssistant Professor of Family Medicine Macon, Georgia Dipesh R. Patel, MD, Geriatrician and Family Practitioner Family Health CenterAssistant Professor, Family Medicine Macon, Georgia W. Patrick Roche, III, MD, Family Practitioner & Internal Medicine Family Health CenterMacon, Georgia Roberta J. Weintraut, MD, Family Practitioner Family Health Center Assistant ProfessorMacon, Georgia Ancillaries Mary Banahan, MS, PA-C, LCCE Chair, Physician Assistant Admissions Committee, Assistant Professor Touro College Physician Assistant ProgramManhattan, New York Georgina Ferriero, MSPA PA-C Hospitalist Physician Assistant Evangelical Community HospitalLewisburg, Pennsylvania Pamela Gregory-Fernandez, MS, PA-C, GEA, DFAAPA Assistant Professor–Industry ProfessionalCollege of Pharmacy and Health SciencesPhysician Assistant EducationSt. John’s UniversityQueens, New York ix2585_FM_i-xvi 02/07/13 6:29 PM Page ixSandra Kaminski, MS, PA-C Assistant Professor, PA Program School of Health and Medical SciencesSeton Hall UniversitySouth Orange, New Jersey Krisie Kupryk, MS, PA-C Emergency Department, Physician Assistant Overlook HospitalSummitt, New Jersey Michelle McWeeney, MS, PA-C Assistant Professor, PA ProgramSchool of Health and Medical SciencesSeton Hall UniversitySouth Orange, New Jersey Raffi Manjikian, MS Adjunct Instructor Department of PhysicsSeton Hall UniversitySouth Orange, New Jersey Jurga Marshall, MS, PA-C Clara Maass Medical Center Emergency DepartmentSt. Mary’s Hospital Emergency DepartmentBelleville, New Jersey Jennifer Hofmann Ribowsky, MS, RPA-C Academic Faculty/Pre-clinical Coordinator Pace University–Lenox Hill Hospital Physician Assistant Program New York, New York Denise Rizzolo, PhD, PA-C Associate Professor, PA ProgramSchool of Health and Medical SciencesSeton Hall UniversitySouth Orange, New Jersey Abby Saunders, MS, PA-C Assistant Professor, PA ProgramSchool of Health and Medical SciencesSeton Hall UniversitySouth Orange, New Jersey Lauren Seavy, MPA, PA-C Instructor, PA ProgramSchool of Health and Medical SciencesSeton Hall UniversitySouth Orange, New Jersey Sue Wulff, MS, PA-C Chair, Physician Assistant DepartmentSchool of Education and Health SciencesUniversity of DaytonDayton, Ohiox Contributors2585_FM_i-xvi 02/07/13 6:29 PM Page xReviewers Marcie L. Baird, MS, RN, FNP-C Assistant Professor School of NursingIndiana Wesleyan UniversityMarion, Indiana Julie P . Balk, DNP , FNP-BC Associate ProfessorSchool of Nursing and Health SciencesWestminster CollegeSalt Lake City, Utah Jeffrey A. Bates, PharmD, CGP Assistant ProfessorPharmaceutical SciencesCollege of PharmacyFerris State University Big Rapids, Michigan Clint C. Blankenship, PharmD, PA-C Assistant ProfessorMedical University of South CarolinaCharleston, South Carolina Gilbert A. Boissonneault, PhD, PA-C ProfessorDivision of Physician Assistant StudiesUniversity of KentuckyLexington, Kentucky Anthony Brenneman, MPAS, PA-C Director of Clinical EducationAssistant ProfessorPhysician Assistant ProgramUniversity of IowaIowa City, Iowa James B. Caputo, PharmD Assistant ProfessorPhysician Assistant ProgramMorosky College of Health Professions and SciencesGannon UniversityErie, Pennsylvania DeShana Collett, MSPAS, PA-C ProfessorPhysician Assistant StudiesUniversity of KentuckyLexington, KentuckyTheresa E. Coyner, RN, MSN, NP Nurse PractitionerRandall DermatologyWest Lafayette, Indiana Deborah A. Crowe, DNP , FNP-BC APRN, Adjunct FacultyNursing DepartmentIndiana Wesleyan UniversityGlennallen, Arkansas Randy D. Danielsen, PhD, PA-C Dean and ProfessorAT Still UniversityMesa, Arizona Amy M. Drab, MPAS, PA-C Associate ProfessorPhysician Assistant DepartmentKettering CollegeKettering, Ohio Katherine Erdman, MPAS, PA-C Assistant Director and Assistant ProfessorSchool of Allied Health SciencesBaylor College of Medicine Houston, Texas Alison C. Essary, MHPE, PA-C Program Director, Associate ProfessorPhysician Assistant ProgramMidwestern UniversityGlendale, Arizona Cynthia L. Fritz, FNP , BC, NP-C Nurse PractitionerIU Goshen PhysiciansElkhart, Indiana Jennifer Gentry, RN, MSN, ANP BC, GNP , ACH PN, FPCN Nurse PractitionerAdvanced Clinical Practice and Palliative MedicineDuke University HospitalDurham, North Carolina Larry E. Gerson, PhD, MS, MPAS, PA-C Director of Clinical EducationPhysician Assistant StudiesTrevecca Nazarene UniversityNashville, Tennessee xi2585_FM_i-xvi 02/07/13 6:29 PM Page xiDarla Gowan, RN-BC, MN, FNP-BC Assistant Professor for Graduate Nursing Primary Care CoordinatorGraduate Nursing Studies, Division of School of NursingIndiana Wesleyan UniversityMarion, Indiana Joellen W. Hawkins, RN, WHNP-BC, PhD FAAN, FAANP Professor EmeritusMaternal Child Health DepartmentWilliam F. Connell School of Nursing Boston CollegeAuburndale, Massachusetts Jill Isaacs, APRN, NP-C InstructorSchool of NursingCreighton UniversityOmaha, Nebraska Monica M. Jones, DNP , FNP-BC Assistant Professor of NursingSchool of NursingDelta State UniversityCleveland, Mississippi Jamiley Maynard, PhD, FNP , BC Adjunct ProfessorNursing DepartmentIndiana Wesleyan UniversityTerre Haute, Indiana Melissa M. Menacho, ACNP , MSN Critical Care Nurse PractitionerMedicine-Neurology DepartmentDuke University Medical CenterDurham, North Carolina Charlene M. Morris, MPAS, DFAAPA Physician AssistantFamily Medicine DepartmentPamlico Medical CenterBayboro, North Carolina Jacqueline A. Morse, PharmD, BCPS Assistant ProfessorPharmacy Practice DepartmentFerris State UniversityGrand Rapids, Michigan John T. Musser, MD PhysicianEmory UniversityAtlanta, Georgia Shannon R. Myatt, RN, MSN, CPNP Nurse PractitionerAdolescent Medicine DepartmentCincinnati Children’s Hospital Medical CenterCincinnati, OhioTerry Neal, EdD, MSN, FNP-BC Associate ProfessorDivision of Graduate Studies in NursingIndiana Wesleyan UniversityMarion, Indiana Joan M. Nelson, ANP , BC, DNP Associate ProfessorCollege of NursingUniversity of ColoradoAurora, Colorado Diane Nunez, RN, MS, ANP-C Clinical Associate ProfessorCollege of Nursing and Healthcare InnovationArizona State UniversityPhoenix, Arizona Debra Perlsweig, PharmD Independent ConsultantAston, Pennsylvania Megan Rourke, PA-C Certified Physician AssistantAvon, Connecticut Jeb Sheidler, PA-C, MPAS, DFAAPA, ATC Associate ProfessorPhysician Assistant DepartmentKettering CollegeKettering, Ohio Sharon Schulling, PhD, MSN, FNP-BC Associate Professor, Research CoordinatorGraduate School of NursingIndiana Wesleyan UniversityMarion, Indiana Richard Seides, EdD, NP-C Assistant ProfessorNursing DepartmentSeton Hall UniversityS. Orange, New Jersey Emily K. Sheff, CMSRN, FNP , BC InstructorSchool of NursingMassachusetts General Hospital Institute of Health Professions Braintree, Massachusetts Laurel R. Spence, MS, PA-C Assistant ProfessorSchool of Allied Health SciencesPhysician Assistant StudiesBaylor College of MedicineHouston, Texasxii Reviewers2585_FM_i-xvi 02/07/13 6:29 PM Page xiiBetty J. Sylvest, DNS, RN, CNE Robert E. Smith School of Nursing Delta State UniversityCleveland, MississippiDonald H. Yager, DHSc, PA-C, MT(ASCP) Director of Clinical StudiesSchool of Physician Assistant StudiesSouth CollegeKnoxville, TennesseeReviewers xiii2585_FM_i-xvi 02/07/13 6:29 PM Page xiiiAcknowledgments To complete a project of this size is impossible without the help of a dedicated team of individuals. Many people work behindthe scenes and rarely get proper acknowledgment. Thus, the au-thors wish to thank first and foremost Patricia Gillivan, devel-opmental editor, for all her efforts in seeing to the developmentand publication of this manuscript. The road has been a longand bumpy one, and your guidance and input has been invalu-able. We thank God that you were assigned to this project andthat you were brave enough to take us on! We would like to thank the students and faculty at Kettering College PA Program, Kettering, Ohio, because they were thefirst to be subjected to the content of this textbook. Your con-tinual feedback informed us of the merits of this project andtaught us how to be better educators.Additionally, we would like to give special thanks to all our contributing authors at Mercer University Department ofFamily Medicine and elsewhere. Without your dedication andwillingness to share your clinical expertise, this project wouldnot have been possible. Your trust, insights, and belief in teach-ing pharmacology using a patient-first approach have trulymade this book possible. Thanks to each and every one of you. Finally, the authors wish to acknowledge the support given by their spouses, Sylvia Tindall, Samy Sedrak, and ShelleyBoltri, who sacrificed much by allowing us to use family timeto complete this immense project. xiv2585_FM_i-xvi 02/07/13 6:29 PM Page xiv