MARY KAMIENSKI.PhD.RN.FAEN.FNP.CEN, JIM KEOGH
A SELF-TEACHING GUIDE
McGRAW-HILLNew York Chicago San Francisco Lisbon LondonMadrid Mexico City Milan New Delhi San JuanSeoul Singapore Sydney Toronto
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| Pharmacology Demystified |
Pharmacology is the study of chemicals—drugs—on living tissues and how those
chemicals help diagnose, treat, cure, and prevent disease or correct the pathophysiology
of living tissues. The term pharmacology is derived from two
Greek words: pharmakon, the Greek word for drugs, and logos, the Greek word for science.
Pharmacology has its roots in folklore and tradition that dates back to ancient
times when knowledge of the medicinal effects of plants were passed down
through generations. By 1240 AD, pharmacology moved from the realm of home
remedies to a science where drug standards were established and a measuring
system was developed—called the apothecary system—that was used to measure
quantities of drugs. Because drugs can vary in strength and purity, pharmacological
standards have been developed that govern the manufacturing and
control of drugs. The United States Pharmacopeia National Formulary is the
only official book of drug standards in the United States. If a drug is included in
this book it has met the standards of quality, purity, and strength. These drugs
can use the letters U.S.P. following the official name of the drug. Accurate
dosage and the reliability of the effect the drug will have on a patient is dependent
upon the purity and strength of the drug. Purity is the dilution or mixture of
a drug with other materials to give it a form that can be administered. Drugs may
vary in the strength of their action. The strength of drugs from plants can
depend on where the plant is grown, the age at which the plant is harvested, and
how the harvest is preserved. Drug packaging standards determine what information
needs to be displayed on packages of drugs. You’ll learn more about
these later in this book.
In addition to these standards, there are a number of important laws that have
been enacted to control the sale and distribution of drugs.
Introduction
One of the most important roles of the nurse is to administer medications.
Understanding how a drug interacts with the human body will help a nurse
administer drugs safely to patients.
Pharmacology Demystified shows you:
• How drugs work
• How to calculate the proper dose
• How to administer drugs
• How to evaluate the drug’s effectiveness
• How to avoid common errors when administering drugs
• And much more.
You might be a little apprehensive learning pharmacology, especially if you
have little, if any, experience with drugs. Pharmacology can be mystifying.
However, it becomes demystified as you read Pharmacology Demystified
because your knowledge of basic science is used as the foundation for learning pharmacology.
As you’ll see in Chapter 1, each element of pharmacology is introduced by
combining just the pharmacology element with facts you already know from
your study of basic science.
Pharmacology is different than other basic science that you’ve learned—but
not so different that you won’t be able to quickly build upon your present
knowledge base. All you need is a working knowledge of basic science—and
Pharmacology Demystified—to become knowledgeable in pharmacology.
By the end of this book, you’ll have an understanding of drugs that are used
to cure common disorders. You’ll know how they work, their side effects, adverse
effects, and when they are not to be administered to patients. Furthermore,
you’ll learn how long it takes the drug to take effect and how long the therapeutic effect lasts.
Understanding how a drug interacts with the human body will help a nurse
administer drugs safely to patients.
Pharmacology Demystified shows you:
• How drugs work
• How to calculate the proper dose
• How to administer drugs
• How to evaluate the drug’s effectiveness
• How to avoid common errors when administering drugs
• And much more.
You might be a little apprehensive learning pharmacology, especially if you
have little, if any, experience with drugs. Pharmacology can be mystifying.
However, it becomes demystified as you read Pharmacology Demystified
because your knowledge of basic science is used as the foundation for learning pharmacology.
As you’ll see in Chapter 1, each element of pharmacology is introduced by
combining just the pharmacology element with facts you already know from
your study of basic science.
Pharmacology is different than other basic science that you’ve learned—but
not so different that you won’t be able to quickly build upon your present
knowledge base. All you need is a working knowledge of basic science—and
Pharmacology Demystified—to become knowledgeable in pharmacology.
By the end of this book, you’ll have an understanding of drugs that are used
to cure common disorders. You’ll know how they work, their side effects, adverse
effects, and when they are not to be administered to patients. Furthermore,
you’ll learn how long it takes the drug to take effect and how long the therapeutic effect lasts.
A Look Inside
Pharmacology can be challenging to learn unless you follow the step-by-step
approach that is used in Pharmacology Demystified. Topics are presented in a
systematic order—starting with basic components and then gradually moving on
to those features found on classy web sites.
Each chapter follows a time-tested formula that first explains the topic in an
easy-to-read style and then shows how it is used in a working web page that you
can copy and load yourself. You can then compare your web page with the image
of the web page shown in the chapter to be sure that you’ve coded the web page
correctly. There is little room for you to go wrong.
CHAPTER 1: AN INSIDE LOOK AT PHARMACOLOGY
The mere mention of drugs brings all sorts of images to mind. However, these
impressions are based on our experience as patients. Healthcare providers have
a different view because they see drugs as an arsenal to combat disease. A drug
is more than a pill. It is a compound of chemical elements that interacts with the
body’s chemistry causing a chain reaction of events. Healthcare providers need
a thorough understanding of a drug’s action in order to effectively prescribe and
administer the drug to the patient. Therefore you begin in Chapter 1 learning the
basic concepts of pharmacology.
CHAPTER 2: DRUG ACTION AND DRUG INTERACTIONS
Drugs are not magical. They follow proven scientific principles to interact with
cells in your body to bring about a pharmaceutical response—cure your ills. In
this chapter you’ll learn about the scientific principles that seem to miraculously
make you better when you feel rotten all over. You will learn how drugs stimulate
your body’s own defense mechanism to stamp out pathogens that give you
the sniffles or cause serious diseases.
CHAPTER 3: PHARMACOLOGY AND THE NURSING PROCESS
Remember from your last hospital stay being awakened from a deep sleep by
a nurse saying, “time to take your medicine.” The nurse didn’t enjoy disturbing
you. It was part of standard nursing procedures used to administer medication.
You’ll learn about those procedures in this chapter so you too can wake up your
patients to give them medication.
CHAPTER 4: SUBSTANCE ABUSE
Drugs can wipe out microorganisms that attack our body. However, some drugs
can be abused resulting in an individual becoming dependent on the medication.
Substance abuse is the most publicized aspect of pharmacology—and the
one least understood by patients and healthcare professionals. This chapter
explores drugs that are commonly abused and discusses how to detect substance abuse.
CHAPTER 5: PRINCIPLES OF MEDICATION ADMINISTRATION
Administering medication can be downright dangerous unless you follow timetested
procedures that assure that the patient receives the right drug in the right
dose at the right time using the right route. In this chapter, you’ll learn how this
is done and how to avoid common errors that could harm your patient.
CHAPTER 6: ROUTE OF ADMINISTRATION
The way a drug is administered to a patient is called a route. Your job is to
administer medication using the best route to achieve the desired therapeutic
effect. This depends on a number of factors that include the type of medication
and the patient’s condition. In this chapter, you’ll learn how to administer drugs.
CHAPTER 7: DOSE CALCULATIONS
Although a prescriber specifies a dose of a medication for a patient, a different
dose may be on hand requiring you to calculate the actual dose. With intravenous
medication, the prescriber usually orders a dose to be infused over a specific
period of time. You must calculate the drip rate to properly set the IV. This chapter
shows you how to calculate doses of medication.
CHAPTER 8: HERBAL THERAPY
Herbal therapy is used to treat the common cold, infections, diseases of the
GI tract, and about anything else that ails you. Herbs are naturally grown and
don’t have the quality standards found in prescription and over-the-counter
medications. You’ll learn about the therapeutic effect of herbal therapies in this
chapter and the adverse reactions patients can experience when herbal therapy is
combined with conventional therapy.
CHAPTER 9: VITAMINS AND MINERALS
Vitamins and minerals build a strong, healthy body, so you’ve been told when
you were growing up. It is true. A balanced diet provides the vitamins and minerals
you need to stay healthy. However, many patients don’t have a balanced
diet and therefore experience vitamin and mineral deficiencies. In this chapter,
you’ll learn about vitamins and minerals and how to provide vitamin therapy and
mineral therapy for your patients.
CHAPTER 10: FLUID AND ELECTROLYTE THERAPY
Some diseases and treatment of disease can cause an imbalance in the body’s
fluids and electrolytes needed for muscle contraction and other functions.
Administering electrolyte therapy to the patient restores balance. You’ll learn
how this is done.
CHAPTER 11: NUTRITIONAL SUPPORT THERAPIES
Nutrients are given to patients who are at risk for malnutrition caused by disease
and by treatment given to cure the disease. Nutrients are also given to strengthen
the patient following a trauma such as surgery. In this chapter, you’ll learn about
nutritional support therapies, how to prepare them, how to administer them, and
how to avoid any complications that might arise.
CHAPTER 12: INFLAMMATION
Fortunately, most times the pain goes away and the inflammation subsides
relatively quickly and doesn’t interfere with daily activities. In this chapter,
you’ll learn about the process of inflammation and the medications that are
prescribed to reduce the redness, swelling, warmth, and pain that is associated
with inflammation.
CHAPTER 13: ANTIMICROBIALS—FIGHTING INFECTION
The immune system produces antibodies that seek out, attack, and kill microbials.
However, this natural defense isn’t sufficient for some patients leaving
them with a runny nose, headache, and fever. They need to call in the cavalry.
The cavalry is medication that kills the invading microbial. You’ll learn about
antimicrobial medication in this chapter.
CHAPTER 14: RESPIRATORY DISEASES
The common cold can be annoying. However, some respiratory diseases—such
as emphysema—are debilitating and can slowly choke the life out of a person.
In this chapter, we’ll explore common respiratory diseases and learn about the
medications that are used to manage the symptoms of the disease.
CHAPTER 15: NERVOUS SYSTEM DRUGS
The nervous system is our Internet over which sensory impulses travel the
neural pathways to the brain where they are interpreted and analyzed for
an appropriate response. Sometimes disease or other disorders cause the
impulse to go astray or be misinterpreted. Drugs can be prescribed that restore
the function of the nervous system. You’ll learn about those drugs in this chapter.
CHAPTER 16: NARCOTIC AGONISTS
Make the pain go away. That’s what most of us want when we hurt. However,
pain is subjective and can be difficult for healthcare providers to manage with
the appropriate medication. This chapter explores pain and how healthcare
providers assess and manage pain. You’ll also learn about narcotic and nonnarcotic
analgesics and how they are used to treat pain.
CHAPTER 17: IMMUNOLOGIC AGENTS
When the immune system is compromised through diseases including HIV, the
body loses its ability to fight off microorganisms and destroys its own abnormal
cells, leaving the patient to experience more episodes of infection that can
ultimately lead to death. In this chapter, you’ll learn about the therapies used to
assist the immune system combat preventable diseases and you’ll also learn
about medications that inhibit the growth of HIV.
CHAPTER 18: GASTROINTESTINAL SYSTEM
Problems with the gastrointestinal system can be vomiting, ingesting toxins,
diarrhea, constipation, peptic ulcers, and gastroesophageal reflux disease. Each
is treatable with the proper medication. In this chapter, you’ll learn about common
gastrointestinal disorders and the medications that are frequently prescribed
to treat these conditions.
CHAPTER 19: CARDIAC CIRCULATORY MEDICATIONS
When blood vessels become clogged and the heart is unable to pump blood sufficiently,
the body loses its ability to distribute oxygen, nutrients, and hormones
and remove waste products placing the patient in grave danger. Fortunately,
there are medications that can be taken to treat and prevent cardiovascular disorders.
In this chapter, you’ll learn about drugs that affect the heart and keep the
cardiovascular system humming.
CHAPTER 20: SKIN DISORDERS
Acne, dry skin, a rash, and injuries such as cuts, scrapes, puncture wounds, and
burns are some disorders that affect your skin. Some of these are more annoying
than endangering to your existence. This chapter discusses using medications to
relieve most of the disorders.
CHAPTER 21: ENDOCRINE MEDICATIONS
Hormones are messengers that influence how tissues, organs, and other parts of
your body function. An overproduction or underproduction of hormones can
cause the body to function improperly. Hormones are brought back into balance
by using endocrine medications, which are discussed in this chapter.
CHAPTER 22: DISORDERS OF THE EYE AND EAR
Common eye and ear disorders rarely result in loss of sight and hearing once the
disorder is diagnosed and treated with the proper medication. This chapter takes
a look at common disorders that affect the eyes and the ears and discusses drugs
that are used to treat those disorders.
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File Size
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DOI
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Copyright
| 2006 by The McGraw-Hill Companies, Inc |
Table of Contents
Introduction xiii
CHAPTER 1 An Inside Look at Pharmacology 1
What Is Pharmacology? 2
The Source of Drugs 4
Drugs Names 6
Prescription versus Over-the-Counter Drugs 7
Drug Effects 7
Drug Safety 8
Locating Drug Information 11
Drug Orders 12
The “Five Rights” Way of Drug Administration 16
Summary 20
Quiz 21
CHAPTER 2 Drug Action and Drug Interactions 23
Drug Actions 24
The First Pass Effect 33
Pharmacodynamics 33
Categories of Drug Action 35
Therapeutic Index and Therapeutic Range 35
Side Effects 36
Summary 38
Quiz 39
For more information about this title, click here
CHAPTER 3 Pharmacology and the Nursing Process 41
The Nursing Process 42
Nursing Diagnosis 47
Patient Care Plan 48
Teaching the Patient About Drugs 50
Impact of Cultural Influences in
Drug Administration 52
Mother and the Fetus 54
Pediatrics 54
Elderly 55
Summary 57
Quiz 58
CHAPTER 4 Substance Abuse 61
Drug Misuse and Abuse 61
Behavioral Patterns of Addiction 63
Healthcare Professionals and
Substance Abuse 64
Detecting Substance Abuse 65
Delayed Action 67
Substances That Can Be Abused 71
Dependence versus Tolerance 71
Pathophysiologic Changes Occurring in
Substance Abuse 72
Cultural Aspects of Substance Abuse 72
Commonly Abused Substances 73
Nursing Assessment 77
Summary 78
Quiz 79
CHAPTER 5 Principles of Medication Administration 81
The Nursing Process and
Medication Administration 82
Assessment Required for Specific Drugs 84
Administering Medication 87
Evaluating the Patient After
Administering Medication 92
Controlling Narcotics 93
Summary 94
Quiz 94
CHAPTER 6 Route of Administration 97
Medication and Routes 97
Z-Track Injection Technique 107
Tips for Minimizing Pain 109
Summary 110
Quiz 111
CHAPTER 7 Dose Calculations 113
The Metric System and Medication 113
Converting Metric Units 116
Formulas for Calculating the Desired Dose 117
Parenteral Medications 119
Summary 121
Quiz 122
CHAPTER 8 Herbal Therapy 125
Inside Herbal Therapy 125
Forms of Herbal Therapies 127
Hazards of Herbal Therapeutics 128
Herbals Therapy and the Nursing Process 129
The Do’s and Don’ts about Herbs 130
Commonly Used Herbs 131
Summary 135
Quiz 135
CHAPTER 9 Vitamins and Minerals 137
Vitamins 137
Vitamins and the Nursing Process 148
Summary 154
Quiz 154
CHAPTER 10 Fluid and Electrolyte Therapy 157
Body Fluids 158
Electrolytes 158
Fluid Concentration 159
IV Fluids 160
Blood and Blood Products 161
Fluid Replacement 161
Summary 180
Quiz 181
CHAPTER 11 Nutritional Support Therapies 183
Nutrition 183
Nursing Process 189
The Nursing Processing and
Parenteral Nutritional Therapy 192
Summary 193
Quiz 194
CHAPTER 12 Inflammation 197
An Inside Look at Inflammation 197
Combating Inflammation 199
Summary 201
Quiz 201
CHAPTER 13 Antimicrobials—Fighting Infection 203
Microorganisms—A Small Formidable
Opponent 204
Medication—A Formidable Defender 204
Superinfections 205
Preparing to Administer
Antimicrobial Medication 207
Penicillin, Nursing Diagnosis,
and Collaborative Problems 214
Penicillin and Patient Education 215
Cephalosporins, Nursing Diagnosis,
and Collaborative Problems 217
Macrolides and Drug-Drug Interactions 224
Macrolides, Nursing Diagnosis,
and Collaborative Problems 224
Clindamycins and Drug-Drug Interactions 225
Lincosamides, Nursing Diagnosis,
and Collaborative Problems 225
Vancomycin and Drug-Drug Interactions 227
Vancomycin, Nursing Diagnosis,
and Collaborative Problems 228
Aminoglycosides and
Drug-Drug Interactions 229
Aminoglycosides, Nursing Diagnosis,
and Collaborative Problems 230
Tetracyclines and Drug-Drug Interactions 233
Tetracyclines, Nursing Diagnosis,
and Collaborative Problems 234
Chloramphenicol and
Drug-Drug Interactions 236
Chloramphenicol Nursing Diagnosis,
and Collaborative Problems 236
Fluoroquinolones and
Drug-Drug Interactions 238
Fluoroquinolones, Nursing Diagnosis,
and Collaborative Problems 238
Sulfonamides 241
Tuberculosis 243
Antifungal Drugs (Antimycotic Drugs) 246
Antimalarial 247
Anthelmintic 248
Summary 250
Quiz 251
CHAPTER 14 Respiratory Diseases 253
A Brief Look at Respiration 253
Upper Respiratory Tract Disorders 256
Lower Respiratory Disorders 261
Summary 266
Quiz 267
CHAPTER 15 Nervous System Drugs 269
A Brief Look at the Nervous System 269
Central Nervous System Stimulants 271
CNS Depressants 273
Autonomic Nervous System 281
Cholinergics 287
Anticholinergics 287
Antiparkinsonism-Anticholinergic Drugs 288
Antipsychotics 295
Phenothiazines 296
Depression 297
Summary 301
Quiz 302
CHAPTER 16 Narcotic Agonists 305
A Close Look at Pain 305
Influences on Administrating
Pain Medication 306
Components of Pain 307
The Gate Control Theory 307
Defining Pain 307
Pain Assessment 308
Pharmacologic Management of Pain 309
Summary 311
Quiz 312
CHAPTER 17 Immunologic Agents 315
A Brief Look at Immunity 315
Vaccines 321
Preventing Diseases 322
Summary 325
Quiz 326
CHAPTER 18 Gastrointestinal System 329
A Brief Look at the Gastrointestinal System 329
Summary 344
Quiz 345
CHAPTER 19 Cardiac Circulatory Medications 347
A Brief Look at the Cardiovascular System 347
Circulatory Disorders 364
Summary 369
Quiz 370
CHAPTER 20 Skin Disorders 373
A Brief Look at the Skin 373
Skin Disorders 374
Summary 382
Quiz 383
CHAPTER 21 Endocrine Medications 385
A Brief Look at the Endocrine System 385
Drugs and Hormones 386
Summary 396
Quiz 397
CHAPTER 22 Disorders of the Eye and Ear 399
Eye Disorders 399
Patient Education for Eye Medication 403
Ear Disorders 405
Patient Education for Ear Medication 408
Summary 408
Quiz 409
Final Exam 411
Answers to Quiz and Final Exam Questions 425
Appendix 431
Index 437
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