FUNDAMENTALS OF PHARMACOLOGY AN APPLIED APPROACH FOR NURSING AND HEALTH Visit the Fundamentals of Pharmacology, second editionCompanion Website at http://www.routledge.com/cw/gailbraith-9780131869011/ to find valuable studentlearning material including: • Multiple choice questions to help test your learning • Annotated links to relevant sites on the web • Drug updates and help with drug calculations 2 S E C O N D E D I T I O N This page intentionally left blank FUNDAMENTALS OF PHARMACOLOGY: AN APPLIED APPROACH FOR NURSING AND HEALTH ALAN GALBRAITH SHANE BULLOCK ELIZABETH MANIAS BARRY HUNT ANN RICHARDS 2 S E C O N D E D I T I O N First published 2007 by Pearson Education Limited Published 2013 by Routledge 2 Park Square, Milton Park, Abingdon, Oxon OX14 4RN 711 Third Avenue, New York, NY 10017, USA Routledge is an imprint of the Taylor & Francis Group, an informa business ISBN: 1741031443 by Alan Galbraith, Shane Bullock and Elizabeth Manias. Copyright © 2004. Copyright © 2007, Taylor & Francis. The rights of Alan Galbraith, Shane Bullock, Elizabeth Manias, Barry Hunt and Ann Richards to be identified as authors of this work have been asserted by them in accordance with the Copyright, Designs and Patents Act 1988. All rights reserved. No part of this book may be reprinted or reproduced or utilised in any form or by any electronic, mechanical, or other means, now known or hereafter invented, including photocopying and recording, or in any information storage or retrieval system, without permission in writing from the publishers. Notices Knowledge and best practice in this field are constantly changing. As new research and experience broaden our understanding, changes in research methods, professional practices, or medical treatment may become necessary. Practitioners and researchers must always rely on their own experience and knowledge in evaluating and using any information, methods, compounds, or experiments described herein. In using such information or methods they should be mindful of their own safety and the safety of others, including parties for whom they have a professional responsibility. To the fullest extent of the law, neither the Publisher nor the authors, contributors, or editors, assume any liability for any injury and/or damage to persons or property as a matter of products liability, negligence or otherwise, or from any use or operation of any methods, products, instructions, or ideas contained in the material herein. ISBN 13: 978-0-13-186901-1 (pbk) British Library Cataloging-in-Publication Data A catalogue record for this book is available from the British Library Library of Congress Cataloging-in-Publication Data Fundamentals of pharmacology : an applied approach for nursing and health / Alan Galbraith...[et al.]. — 2nd ed. p. ; cm. Includes bibliographical references and index. ISBN 978-0-13-186901-1 1. Pharmacology. 2. Nursing. I. Galbraith, Alan. [DNLM]: 1. Pharmacology—Nurses’ Instruction. 2. Pharmaceutical Preparations— Nurses’ Instruction. QV 4 F981 2007] RM300.F87 2007 615′.1—dc22 2007012828 Typeset in 10.5/12.5pt Bembo by 35 BRIEF CONTENTS Guided tour xxxiv List of figures xxxviii List of tables xlii Preface xlv Acknowledgements xlvii SECTION I PHARMACOLOGY WITHIN THE SOCIAL CONTEXT 1 CHAPTER 1 An historical perspective 2 CHAPTER 2 Sociocultural aspects 8 SECTION II PHARMACOLOGY WITHIN THE PROFESSIONAL CONTEXT 17 CHAPTER 3 Drug administration and the law 19 CHAPTER 4 Ethical issues 28 CHAPTER 5 The roles and responsibilities of nurses 36 CHAPTER 6 The roles and responsibilities of other health-care professionals 42 SECTION III DRUG ADMINISTRATION AND PROFESSIONAL RESPONSIBILITIES 51 CHAPTER 7 Drug formulations, storage and routes of administration 52 CHAPTER 8 The clinical decision-making process 72 CHAPTER 9 Drug administration strategies and documentation 77 CHAPTER 10 Medication errors 81 CHAPTER 11 Management of common adverse drug reactions 85 SECTION IV GENERAL ASPECTS OF PHARMACOLOGY 105 CHAPTER 12 Drug nomenclature 106 CHAPTER 13 Pharmacokinetics: absorption and distribution 109 CHAPTER 14 Pharmacokinetics: metabolism and excretion 115 CHAPTER 15 Drug interactions 122 CHAPTER 16 Pharmacodynamics 127 CHAPTER 17 Drug development, evaluation and safety 137 CHAPTER 18 Pharmacogenetics 145 CHAPTER 19 Pharmacokinetic factors that modify drug action 152 CHAPTER 20 Paediatric pharmacology and pharmacology in older people 157 SECTION V TOXICOLOGY 169 CHAPTER 21 Poisoning and envenomation 170 CHAPTER 22 Management of clinical overdose 177 CHAPTER 23 Contemporary drugs of abuse 187 CHAPTER 24 Drug abuse in sport 196 SECTION VI AUTONOMIC PHARMACOLOGY 205 CHAPTER 25 General aspects of autonomic pharmacology 206 CHAPTER 26 Adrenergic pharmacology 213 CHAPTER 27 Cholinergic pharmacology 238 SECTION VII CHEMICAL MEDIATORS 261 CHAPTER 28 Introduction to chemical mediators 262 CHAPTER 29 Histamine and antihistamines 265 vi BRIEF CONTENTS CHAPTER 30 Prostaglandins and serotonin 271 CHAPTER 31 Nitric oxide and the endothelins 281 SECTION VIII MODULATION OF BEHAVIOUR, COGNITION AND MOTOR ACTIVITY 289 CHAPTER 32 General concepts of central nervous system pharmacology 290 CHAPTER 33 Antipsychotic drugs 295 CHAPTER 34 Anxiolytics and hypnotics 305 CHAPTER 35 Antidepressants and mood stabilisers 313 CHAPTER 36 Drugs used in neurodegenerative disorders 328 CHAPTER 37 Antiseizure drugs and muscle relaxants 341 CHAPTER 38 Central nervous system stimulants 355 SECTION IX DRUGS USED TO RELIEVE PAIN AND PRODUCE ANAESTHESIA 363 CHAPTER 39 Narcotic analgesics 364 CHAPTER 40 Non-steroidal anti-inflammatory, antipyretic and analgesic drugs 379 CHAPTER 41 General anaesthesia 393 CHAPTER 42 Local anaesthesia 403 SECTION X MODULATION OF OXYGENATION AND PERFUSION 413 CHAPTER 43 Drugs used to lower blood lipids 414 CHAPTER 44 Antihypertensive drugs 425 CHAPTER 45 Drugs used to promote tissue perfusion 444 CHAPTER 46 Anticoagulants, thrombolytics and antiplatelet drugs 457 CHAPTER 47 Diuretics and other renal drugs 472 CHAPTER 48 Drugs used to treat cardiac insufficiency 482 CHAPTER 49 Fluid and potassium imbalances 503 CHAPTER 50 Antianaemic drugs 518 CHAPTER 51 Drugs used to maintain gas exchange 525 CHAPTER 52 Over-the-counter respiratory medicines 542 SECTION XI MODULATION OF GASTROINTESTINAL FUNCTION 555 CHAPTER 53 Upper gastrointestinal tract drugs 556 CHAPTER 54 Lower gastrointestinal tract drugs 567 CHAPTER 55 Nausea and vomiting 582 SECTION XII MODULATION OF BODY GROWTH, DEVELOPMENT AND METABOLISM 589 CHAPTER 56 Drugs and the pituitary gland 590 CHAPTER 57 The thyroid and the pancreas 601 CHAPTER 58 The adrenal cortex and the gonads 626 CHAPTER 59 Hyperuricaemia and gout 650 CHAPTER 60 Obesity 658 SECTION XIII NUTRITIONAL AND NATURAL THERAPIES 669 CHAPTER 61 Vitamins 670 CHAPTER 62 Minerals 682 CHAPTER 63 Amino acids 690 CHAPTER 64 Enteral and parenteral nutrition 694 CHAPTER 65 Herbal medicines 704 SECTION XIV MODULATION OF CELLULAR GROWTH AND PROLIFERATION 719 CHAPTER 66 Introduction to chemotherapy 721 CHAPTER 67 Sulphonamides and trimethoprim 727 CHAPTER 68 Antibacterial drugs 732 CHAPTER 69 Antituberculotic and antileprotic drugs 751 BRIEF CONTENTS vii CHAPTER 70 Antiseptics and disinfectants 760 CHAPTER 71 Antiparasitic drugs 768 CHAPTER 72 Antimalarial drugs 777 CHAPTER 73 Antiviral drugs 785 CHAPTER 74 Antifungal drugs 797 CHAPTER 75 Vaccines and immunomodulating drugs 805 CHAPTER 76 Cytotoxic drugs 821 CHAPTER 77 Gene therapies 838 SECTION XV DRUGS USED TOPICALLY 847 CHAPTER 78 Drugs used in diseases of the skin 848 CHAPTER 79 Drugs and the eye 862 APPENDIX A Common prescription terminology 881 APPENDIX B Common US generic drugs names 882 APPENDIX C SI units 883 APPENDIX D Drug calculations 886 APPENDIX E Common symbols used in medication charts 890 APPENDIX F Common word mix-ups 891 APPENDIX G Drug–herb interactions 892 Glossary 894 Index 904 CONTENTS Guided tour xxxiv List of figures xxxviii List of tables xlii Preface xlv Acknowledgements xlvii SECTION I PHARMACOLOGY WITHIN THE SOCIAL CONTEXT 1 CHAPTER 1 An historical perspective 2 Objectives 2 Key terms 2 Drugs and society 3 The ages of pharmacology 3 The age of natural substances 4 The age of synthetic agents 5 The age of biotechnology 6 Summary 7 CHAPTER 2 Sociocultural aspects 8 Objectives 8 Key terms 8 Drug advertising 9 Over-the-counter preparations 10 Common characteristics of over-the-counter preparations 11 Generic versus brand-name preparations 12 Drug therapy in the older person 13 Polypharmacy 13 Nurses and polypharmacy 14 Drug therapy in ethnic groups 14 Summary 16 Further reading 16 Web resources 16 SECTION II PHARMACOLOGY WITHIN THE PROFESSIONAL CONTEXT 17 CHAPTER 3 Drug administration and the law 19 Objectives 19 Key terms 19 The Medicines Act 1968 20 The Misuse of Drugs Act 1971 21 Requisitions 22 Safe custody of drugs 23 Drug addiction 23 Nurses, midwives and health visitors: Standards for the Administration of Medicines 23 Management of errors and incidents in the administration of medicines 24 CONTENTS ix Non-medical prescribing 24 Independent nurse and pharmacist prescribing 24 Supplementary prescribing 26 Patient group directions 26 Summary 26 Questions 27 CHAPTER 4 Ethical issues 28 Objectives 28 Key terms 28 Autonomy 29 Informed and valid consent 29 Rights of refusal 31 Veracity 31 The law and therapeutic privilege 32 Exceptions to veracity 32 Non-maleficence 32 Euthanasia 32 Withholding and withdrawing treatment 33 Beneficence 33 Duty of beneficence 33 Problems with paternalism 34 Conflicts with other principles 34 Justice 34 Allocation of scarce resources 34 Confidentiality 35 Difficulties in maintaining confidentiality 35 Conclusion 35 Summary 35 CHAPTER 5 The roles and responsibilities of nurses 36 Objectives 36 Key terms 36 Patient adherence 37 Patient education 38 Learning principles 38 Teaching principles 38 Patient advocacy 39 The nurse practitioner role 40 Nursing research 40 Summary 41 CHAPTER 6 The roles and responsibilities of other health-care professionals 42 Objectives 42 Key terms 42 The prescriber 43 The pharmacist 43 The physiotherapist 45 The podiatrist 45 The dietician 46 The paramedic 46 The naturopath 46 Summary 47 Case studies 48 Further reading 49 Web resources 50
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