nisterine Medications Pharmacology for Health Careers sixth edition Donna F. Gauwitz, R.N., M.S. Nursing Consultant Former Senior Teaching Specialist School of Nursing University of Minnesota Minneapolis, Minnesota and Former Nursing Education Specialist Mayo Clinic Rochester, Minnesota Boston Burr Ridge, IL Dubuque, IA Madison, Wl New York San Francisco St. Louis Bangkok Bogota Caracas Kuala Lumpur Lisbon London Madrid Mexico City Milan Montreal New Delhi Santiago Seoul Singapore Sydney Taipei Toronto
About the Author xiv Preface xvi ;nts xviii Features List xx The Learning System xxiv Chapter i '141 Orientation to Medications 1 Pharmacology 3 Drug Sources 3 Drug Uses 4 Drug Standards 5 Drug Names 5 Drug References 6 Preparing Your Own Drug Cards 8 Drug Legislation 9 You and the Law 13 Chapter 1 Review 15 Chapter 2 Principles of Drug Action 19 Pharmacokinetics 21 Drug Action 21 Factors Affecting Drug Action 24 Drug Effects 26 Adverse Reactions 27 Drug Dependence or Drug Abuse? 31 Chapter 2 Review 32 Chapter 3 Measurement and Dosage Calculations 37 Math Review: Fractions 38 Systems of Measurement 43 Apothecary System 43 Converting Among Measurement Systems 48 Dosage Calculations 48 Chapter 3 Review 58 vii
Chapter 4 Administering Parenteral Medications 66 Orientation to the Parenteral Route 67 Standard Precautions 68 Equipment 69 Drawing up Medications 72 Injection Sites 76 General Procedure for Injections 79 Special Instructions 81 Principles of Intravenous Therapy 83 Practice Procedure 4.1: Drawing up Medication from a Vial 88 Practice Procedure 4.2: Drawing up Medication from an Ampule 89 Practice Procedure 4.3: Administering an Intradermal Injection 90 Practice Procedure 4.4: Administering a Subcutaneous Injection 91 Practice Procedure 4.5: Administering an Intramuscular Injection 92 Chapter 4 Review 93 Chapter S Medication Therapy 99 Forms of Medication 101 Routes of Administration 105 The Medicati on Order 10 8 Types of Drug Orders 111 Questioning a Medication Order 112 Standard Medical Abbreviations 112 Ordering Drugs from the Pharmacy 114 Drug Packaging 115 Storage and Disposal of Drugs 116 Keeping Track of Medication Orders 119 Setting up Medications 122 The Seven Rights: Rules for Giving Medications 124 Reading and Understanding a Medication Label 126 Charting Medications 130 ThePOMR 132 Principles of Charting 133 Practice Procedure 5.1: Transcribe Medication Orders 136 Practice Procedure 5.2: Counting Controlled Substances if an Automated Medication System Is Not Used 137 Practice Procedure 5.3: Recording the Use of Controlled Substances 138 Practice Procedure 5.4: Dispensing Unit-Dose Medications from a Cart if an Automated Dispensing System Is Not Used 139 Practice Procedure 5.5: Filling Out an Incident Report Form or Event Chapter S Review 141 Report Form 140
Chapter 6 Vitamins, Minerals, and Herbs 151 Recommended Daily Allowance (RDA) 152 Vitamins 153 Minerals 158 Electrolytes 161 Herbs 161 Representative Drugs for Vitamin and Mineral Deficiencies 164 Chapter 6 Review 166 Chapter 7 Antibiotics and Antifungals 170 Infection and Immunity 172 Antibiotic Drugs 175 Antifungal Drugs 183 Antiviral Drugs 183 Isolation Procedures 185 Universal Blood and Body Fluid Precautions 188 Representative Antimicrobials 189 Practice Procedure 7.1: Administering Medication to an Isolation Patient 191 Chapter 7 Review 193 Chapter 8 Drugs for the Eye and Ear 197 Structure and Function of the Eye 198 Eye Disorders 200 Drug Therapy for Eye Disorders 201 Structure and Function of the Ear 202 Ear Disorders 203 Drug Therapy for Ear Disorders 204 Representative Drugs for the Eye and Ear 205 Practice Procedure 8.1: Instilling Eyedrops and Eye Ointment 207 Practice Procedure 8.2: Instilling Ear Drops 209 Chapter 8 Review 211 Chapter 9 Drugs for the Skin 215 Integumentary System 217 Skin Disorders 218 Topical Medications 222 General Instructions for Medicating the Skin 226
Representative Drugs for the Skin 229 Practice Procedure 9.1: Applying Topical Medication to the Skin 231 Chapter 9 Review 233 Drugs for the Cardiovascular System 236 Cardiovascular System 238 Cardiovascular Disorders 243 Drugs for Cardiovascular and Blood Disorders 249 Giving Cardiovascular Medications 254 Representative Drugs for the Cardiovascular System 256 Practice Procedure 10.1: Administering Oral, Sublingual, and Buccal Medications 262 Chapter 10 Review 264 Chapter! I Drugs for the Respiratory System 268 Respiratory System 270 Respiratory System Disorders 271 Nicotine Dependence and Smoking Cessation 275 Drugs for Respiratory Disorders 276 Giving Respiratory Drugs 279 Representative Drugs for the Respiratory System 284 Practice Procedure I I.I: Spraying Medication Onto Mucous Membranes of the Mouth or Throat 287 Practice Procedure 11.2: Instilling Nose Drops 2S8 Practice Procedure 11.3: Using a Nasal Spray 290 Practice Procedure 11.4: Oral Inhalation of Metered-Dose Inhalers 291 Practice Procedure 11.5: Administering Oxygen by Mask 292 Practice Procedure 11.6: Administering Oxygen by Cannula 293 Practice Procedure 11.7: Administering Oxygen by Nasal Catheter 295 Chapter 11 Review 297 Chapter 12 Drugs for the Gastrointestinal System 301 Gastrointestinal System 303 Disorders of the Gastrointestinal System 305 Drugs That Affect the Gastrointestinal System 310 Giving Gastrointestinal Medications 317 Representative Drugs for the Gastrointestinal System 320 Practice Procedure 12.1: Inserting a Rectal Suppository 324 Practice Procedure 12.2: Administering Medication Through a Nasogastnc or Gastrostomy Tube 326 Chapter 12 Review 328
Chapter I 3 Drugs for the Urinary System and Fluid Balance 334 Urinary System 336 Disorders of the Kidneys and the Urinary Tract 338 Imbalances of Body Fluids, Electrolytes, and ph 341 Drugs for the Urinary Tract and Fluid Imbalances 343 Giving Drugs That Affect the Urinary System 345 Representative Drugs for the Urinary System and Fluid Imbalances 348 Practice Procedure 13.1: Instilling Medication Into the Bladder Through an Indwelling Catheter 350 Chapter 13 Review 352 Chapter 14 Drugs for the Reproductive System 356 Reproductive System 357 Disorders of the Reproductive System 362 Use of Sex Hormones in Drug Therapy 365 Representative Drugs for the Reproductive System 370 Practice Procedure 14.1: Inserting Vaginal Medication 371 Chapter 14 Review 373 Chapter i S Drugs for the Endocrine System 377 Endocrine System 379 Disorders of the Endocrine System 381 Hormone Therapy 385 Administering Insulin 393 Representative Hormones and Hormonelike Drugs 395 Practice Procedure I S.I: Mixing Regular and Intermediate- Acting Insulin in One Syringe 397 Chapter 15 Re\'iew 399 Chapter 16 Drugs for the Musculoskeletal System 403 Musculoskeletal System 404 Disorders and Drug Treatment of Musculoskeletal Disorders 408 Care of Patients with Musculoskeletal Disorders 413 Representative Drugs for the Musculoskeletal System 414 Chapter 16 Review 417
Drugs for the Nervous and Sensory Systems 421 The Nervous and Sensory Systems 423 Nervous System Disorders 426 Drugs That Affect the CNS 431 Giving Medications for the Nervous and Sensory Systems 435 Representative Drugs for the Nervous and Sensory Systems 437 Chapter 17 Review 441 Chapter 18 Psychotropic Drugs 444 The Nervous System and Emotions 445 Mental Disorders 446 Selection and Use of Psychotropic Drugs 447 Giving Medications 450 Representative Psychotropic Drugs 453 Chapter 18 Review 457 Chapter!9 Antineoplastic Drugs 460 Body Systems 461 Necessary Substances 462 Immunity 463 Cancer and Chemotherapy 463 Representative Antineoplastic Drugs Chapter 19 Review 470 46S Chapter 20 Drugs for the Pediatric Patient 473 Drugs and the Pediatric Patient 474 Physiologic Alterations in the Pediatric Patient 474 Safeguards Critical to Safe Administration of Pediatric Medications 475 What's New in Pediatric Medications 479 Chapter 20 Review 480
Chapter 21 Drugs for the Geriatric Patient 483 Drugs and the Older Adult 484 The Aging Process 484 Pharmacokinetics in the Older Adult 487 Obtaining a Medical and Medication History 490 Administering Medicaiions lo Older Adult Palients 491 Engaging Patients in Their Care 493 Chapter 21 Review 495 Appendix: Abbreviations 500 Glossary 502 Credits 513 Index 5(4