Pharmacology A Patient-Centered Nursing Process Approach NINTH EDITION Linda E. McCuistion, PhD, MSN NCLEX® Live Review Presenter, Mandeville, Louisiana Kathleen Vuljoin-DiMaggio, RN, MSN Assistant Professor of Nursing, University of Holy Cross New Orleans, New Orleans, Louisiana Mary B. Winton, PhD, RN, ACANP-BC Assistant Professor, Tarleton State University, Stephenville, Texas Jennifer J. Yeager, PhD, RN, AGNP Assistant Professor and Director of the Graduate Nursing Program, Tarleton State University, Stephenville, Texas 2 Table of Contents Cover image Title page Copyright Dedication Meet the Authors In Recognition Contributors Reviewers Preface Acknowledgments Unit I. Introduction to Pharmacology Introduction 1. Drug Development and Ethical Considerations Core Ethical Principles Objectives and Phases of Pharmaceutical Research American Nurses Association Code of Ethics Drug Standards and Legislation Nurse Practice Acts Canadian Drug Regulation Initiatives to Combat Drug Counterfeiting Drug Names Over-the-Counter Drugs Drug Resources Critical Thinking Case Study 3 2. Pharmacokinetics, Pharmacodynamics, and Pharmacogenetics Pharmacokinetics Pharmacodynamics Pharmacogenetics Drug Interactions Drug-Nutrient Interactions Drug-Laboratory Interactions Drug-Induced Photosensitivity Critical Thinking Case Study 3. Cultural Considerations Ethnomedicine Ethnopharmacology Pharmacogenetics Transcultural Nursing The Giger and Davidhizar Transcultural Assessment Model Critical Thinking Case Study 4. Complementary and Alternative Therapies Dietary Supplement Health and Education Act Of 1994 Current Good Manufacturing Practices Commonly Used Herbal Remedies Potential Hazards of Herbs Tips for Consumers and Health Care Providers Herbal Resources Critical Thinking Case Study 5. Pediatric Considerations Pharmacokinetics Pharmacodynamics Nursing Implications Considerations for the Adolescent Patient Nursing Process: Family-Centered Collaborative Care Critical Thinking Case Study 6. Geriatric Considerations Physiologic Changes Pharmacokinetics Pharmacodynamics Nursing Implications: Older Adult Drug Dosing and Monitoring Health Teaching with the Older Adult Critical Thinking Case Study 4 7. Drugs in Substance Use Disorder Substance Use Disorder Special Needs of Patients with Substance Use Disorder The Nurse with Substance Use Disorder Critical Thinking Case Study Unit II. Pharmacotherapy and Drug Administration Introduction 8. The Nursing Process and Patient-Centered Care Nursing Process: Patient-Centered Collaborative Care Critical Thinking Case Study 9. Safety and Quality “Five-Plus-Five” Rights of Medication Administration Nurses’ Rights when Administering Medication Culture of Safety Safety Risks with Medication Administration High-Alert Medications Look-Alike and Sound-Alike Drug Names Other Factors in the Prevention of Medication Errors Resources for Preventing Errors in Medication Administration Pregnancy Categories and Subsections Guidelines for Medication Administration Critical Thinking Case Study 10. Drug Administration Self-Administration of Medication Forms and Routes of Drug Administration Nursing Implications for Administration of Parenteral Medications Developmental Needs of Pediatric Patients Technological Advances Critical Thinking Case Study 11. Drug Calculations Overview Section 11A. Systems of Measurement With Conversion Factors Section 11B. Calculation Methods—Enteral and Parenteral Drug Dosages Section 11C. Calculating Dosages—Drugs That Require Reconstitution Section 11D. Calculation Methods—Insulin Dosages Section 11E. Calculation Methods—Intravenous Flow Rates 5 Unit III. Maintenance of Homeostasis Introduction 12. Fluid Volume and Electrolytes Homeostasis Fluid Replacement Electrolytes Critical Thinking Case Study 13. Vitamin and Mineral Replacement Vitamins Minerals Critical Thinking Case Study 14. Nutritional Support Different Types of Nutritional Support Critical Thinking Case Study Unit IV. Autonomic Nervous System Drugs Introduction Sympathetic Nervous System Parasympathetic Nervous System 15. Adrenergic Agonists and Antagonists Adrenergic Agonists Central-Acting Alpha Agonists Adrenergic Antagonists (Adrenergic Blockers) Critical Thinking Case Study 16. Cholinergic Agonists and Antagonists Cholinergic Agonists Cholinergic Antagonists Critical Thinking Case Study Unit V. Central and Peripheral Nervous System Drugs Introduction 17. Stimulants Pathophysiology Amphetamines 6 Anorexiants and Analeptics Critical Thinking Case Study 18. Depressants Types and Stages of Sleep Nonpharmacologic Methods Sedative-Hypnotics Anesthetics Critical Thinking Case Study 19. Antiseizure Drugs International Classification of Seizures Antiseizure Drugs Critical Thinking Case Study 20. Drugs for Parkinson’s Disease and Alzheimer Disease Parkinson’s Disease Alzheimer Disease Critical Thinking Case Study 21. Drugs for Neuromuscular Disorders and Muscle Spasms Myasthenia Gravis Multiple Sclerosis Skeletal Muscle Relaxants Critical Thinking Case Study Unit VI. Mental and Behavioral Health Drugs Introduction 22. Antipsychotics and Anxiolytics Psychosis Antipsychotic Agents Anxiolytics Critical Thinking Case Study 23. Antidepressants and Mood Stabilizers Depression Antidepressant Agents Mood Stabilizers Critical Thinking Case Study Unit VII. Pain and Inflammation Management Drugs 7 Introduction 24. Antiinflammatories Pathophysiology Antiinflammatory Agents Nonsteroidal Antiinflammatory Drugs Corticosteroids Disease-Modifying Antirheumatic Drugs Antigout Drugs Critical Thinking Case Study 25. Analgesics Pathophysiology Nonopioid Analgesics Opioid Analgesics Adjuvant Therapy Treatment for Opioid-Addicted Individuals Opioid Agonist-Antagonists Opioid Antagonists Headaches: Migraine and Cluster Critical Thinking Case Study Unit VIII. Antimicrobial Drugs Introduction 26. Antibacterials Pathophysiology Antibacterial Drugs Section 26A. Penicillins and Cephalosporins Section 26B. Macrolides, Oxazolidinones, Lincosamides, Glycopeptides, Ketolides, Tetracyclines, and Glycylcyclines Section 26C. Aminoglycosides, Fluoroquinolones, and Lipopeptides Section 26D. Sulfonamides and Nitroimidazoles 27. Antituberculars, Antifungals, and Antivirals Tuberculosis Antitubercular Drugs Special Populations Fungus Antifungal Drugs Viruses Non-HIV Antivirals Critical Thinking Case Study 8 28. Antimalarials, Anthelmintics, and Peptides Antimalarial Drugs Anthelmintic Drugs Peptides Critical Thinking Case Study Unit IX. Immunologic Drugs Introduction Immune System Structure Immune System Function 29. HIV- and AIDS-Related Drugs HIV Infection: Pathophysiology HIV Life Cycle HIV Transmission Laboratory Testing Classification Indications for Antiretroviral Therapy Antiretroviral Drugs Immune Reconstitution Inflammatory Syndrome The Nurse’s Role in Antiretroviral Therapy Opportunistic Infections Antiretroviral Therapy in Pregnancy Occupational HIV Exposure and Postexposure Prophylaxis Critical Thinking Case Study 30. Transplant Drugs Organ Transplantation Promoting Adherence Critical Thinking Case Study 31. Vaccines Immunity Vaccines Vaccine-Preventable Diseases Vaccination Recommendations Immunization Before International Travel Vaccine Safety: Reporting Diseases and Adverse Reactions Varicella Vaccine Future Developments in Vaccines Critical Thinking Case Study 9 Unit X. Antineoplastics and Biologic Response Modifiers Introduction The Cell Cycle Growth Rate Anticancer Therapy 32. Anticancer Drugs Genetic, Inflammatory, Infective, Environmental, and Dietary Influences Cell Cycle–Nonspecific and Cell Cycle–Specific Anticancer Drugs Cancer Chemotherapy Alkylating Drugs Antimetabolites Antitumor Antibiotics Plant Alkaloids Immunomodulators Targeted Therapies Liposomal Chemotherapy Hormones and Hormonal Agonists and Antagonists Biologic Response Modifiers Miscellaneous Chemotherapy Agents Critical Thinking Case Study 33. Targeted Therapies to Treat Cancer Pathophysiology Targeted Therapy Drugs Critical Thinking Case Study 34. Biologic Response Modifiers Interferons Colony-Stimulating Factors Interleukin 2 Critical Thinking Case Study Unit XI. Respiratory Drugs Introduction Lung Compliance Control of Respiration Bronchial Smooth Muscle 35. Upper Respiratory Disorders 10