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Illustrated pharmacology for nurses This page intentionally left blank Illustrated pharmacology for nurses Terje Simonsen MD, Specialist in Clinical Pharmacology & Chief Physician, Department of Clinical Pharmacology, University Hospital of Tromsø, Norway Jarle Aarbakke MD, Professor of Pharmacology, University of Tromsø, Specialist in Clinical Pharmacology, Department of Clinical Pharmacology, University Hospital of Tromsø, Norway Ian Kay PhD, Department of Biological Sciences, Manchester Metropolitan University, Manchester, UK Paul SinnottRGN, BSc (Hons), Division of Medicine (Acute Medicine), Manchester Royal Infirmary, Manchester, UK Iain Coleman PhD, Biomedical Sciences Division, School of Applied Sciences, University of Wolverhampton, Wolverhampton, UK Illustrated by Roy Lysaa Dr(Scient), Post. Doc. Pharmacology, Institute of Pharmacy, University of Tromsø, Norway Hodder Arnold AMEMBER OF THE HODDER HEADLINE GROUP First published in two volumes in Norway in 1997 by Fagbokforlaget Vigmostad & Bjørke AS Published in two volumes in Denmark in 1999 by Glydendalske Boghandel, Nordisk Forlag A/S Published in two volumes in Sweden in 2001 by Bokforlaget Natur och Kultur This edition published in 2006 by Hodder Arnold,an imprint ofHodder Education and a member ofthe Hodder Headline Group, 338 Euston Road,London NW1 3BH http://www.hoddereducation.com Distributed in the United States ofAmerica by Oxford University Press Inc., 198 Madison Avenue,New York,NY10016 Oxford is a registered trademark ofOxford University Press © 2006 Terje Simonsen,Jarle Aarbakke,Roy Lysaa,Ian Kay,Paul Sinnott,Iain Coleman All rights reserved.Apart from any use permitted under UK copyright law, this publication may only be reproduced,stored or transmitted,in any form, or by any means with prior permission in writing ofthe publishers or in the case ofreprographic production in accordance with the terms oflicences issued by the Copyright Licensing Agency.In the United Kingdom such licences are issued by the Copyright Licensing Agency:90 Tottenham Court Road,London W1T 4LP. Whilst the advice and information in this book are believed to be true and accurate at the date ofgoing to press,neither the author[s] nor the publisher can accept any legal responsibility or liability for any errors or omissions that may be made.In particular (but without limiting the generality ofthe preceding disclaimer) every effort has been made to check drug dosages; however it is still possible that errors have been missed.Furthermore, dosage schedules are constantly being revised and new side-effects recognized.For these reasons the reader is strongly urged to consult the drug companies’printed instructions before administering any ofthe drugs recommended in this book. British Library Cataloguing in Publication Data A catalogue record for this book is available from the British Library Library ofCongress Cataloging-in-Publication Data A catalog record for this book is available from the Library ofCongress ISBN-10 0 340 80972 8 ISBN-13 978 0 340 80972 3 1 2 3 4 5 6 7 8 9 10 Commissioning Editor:Georgina Bentliff/Clare Christian Project Editor:Clare Patterson Production Controller:Jane Lawrence Cover Designer:Nichola Smith Indexer:Laurence Errington Typeset in 10/12 pts Minion by Charon Tec Ltd,Chennai,India www.charontec.com Printed and bound in Italy What do you think about this book? Or any other Hodder Arnold title? Please send your comments to www.hoddereducation.com contents Preface vii Acknowledgements ix SECTION I: DRUGS AND THEIR USE 1. Drug development 3 2. Regulation and management ofdrug therapy and drug errors 10 3. Classification and nomenclature ofdrugs 19 SECTION II: FACTORS AFFECTING DRUG ACTION 4. Pharmacodynamics ofdrugs 23 5. Pharmacokinetics ofdrugs 37 6. Administration ofdrugs and drug formulations 60 7. Adverse effects ofdrugs 70 8. Drug interactions 77 9. Individual variations in drug responses 83 10. Dosing ofdrugs 89 SECTION III: PHARMACOLOGY of organ systems 11. Structure and function ofthe nervous system 99 12. Drugs used in neurological disorders 114 13. Drugs used in psychiatric disorders 132 14. Drugs with central and peripheral analgesic effect 147 15. Drugs used in inflammatory and autoimmune joint diseases 163 16. Antimicrobial drugs 175 17. Drugs used to treat diseases in the cardiovascular system 223 18. Drugs used to treat diseases ofthe pulmonary system 265 19. Drugs used to treat gastrointestinal diseases 278 20. Drugs used to treat diseases ofthe blood 296 21. Drugs used to treat endocrinological disorders 309 22. Drugs used in allergy,for immune suppression and in cancer treatment 333 23. Drugs used to treat functional disorders ofthe bladder,prostatic hyperplasia and erectile dysfunction 351 24. Drugs used to treat diseases ofthe skin 362 25. Drugs in anaesthesia 377 SECTION IV: DRUG USE IN SPECIAL SITUATIONS 26. The use ofdrugs during pregnancy and the breastfeeding period 393 27. Children and drugs 403 28. The elderly and drugs 409 29. Drugs ofabuse 415 30. Poisoning 428 Index 447 This page intentionally left blank preface With our advancing understanding of the pathophysiology of diseases, drug therapy is playing an increasingly important role in the treatment and care ofpatients.The development ofnew drugs offers the possibility ofan effective treatment or cure for patients who,a few years ago,could not be treated,or who were treated only to lessen their symptoms. The correct use ofdrugs is a cornerstone in the modern treatment ofdis- ease.For medical staffinvolved in drug treatment,this means an increasing demand for drug knowledge – an understanding of the effects and side effects of drugs, individual responses to drugs, interactions with other drugs,indications for use and contraindications,as well as an understand- ing of how and why these effects occur.Equipped with the right informa- tion, it is possible to judge whether certain changes, expressed through specific symptoms and findings in a patient,are caused by the drug itselfor caused by changes in the expression of the disease.Such knowledge is cru- cial in making treatment decisions, and is one of the main differences between skilled and unskilled medical staff.As a nurse you are close to the patients during your work and are in a unique position to make valuable observations.Illustrated Pharmacology for Nursesis a tool to help you com- bine these observations with your knowledge and skills in order to care for the patient effectively. Illustrated Pharmacology for Nurses proved a great success when it was first published in 1997 in Norway.In the years that followed the book has been loved by nurse students (and medical students) all over Scandinavia after translation into Danish and Swedish. This edition brings its unique approach to English-speaking students.We hope that you enjoy it. Good luck in learning and understanding the fascinating subject of pharmacology! Terje Simonsen November 2005 This page intentionally left blank acknowledgements I would like to thank all the staff at Hodder,in particular Clare Patterson, who have made the publication of this book possible.I would also like to thank Jan,Matthew and Amy. IK

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