basic pharmacology for nurses 16th edition pdf

7 A client is prescribed 5mg of haloperidol orally and 2mg in 1ml of syrup is available. The elderly often have changes in sensitivity to drugs due to: reductions in drug binding sites; impaired organ function (liver/kidneys); altered metabolizing enzyme systems in the liver. Many patients may need to have their medication administration tailored to their particular medical condition or the medication which they are prescribed and this is an important factor to consider as it can impact on the patient’s ability or desire to take their medication. A further precaution would be to discuss the crushing of the medicine with the pharmacist and get written approval from them that the practice is appropriate. Often this type of epilepsy is only detected when a child falls behind with their school work or their grades start to fall. Retention of fluid is also partly responsible for weight gain which is another side-effect, although this usually stabilises within a 6- to 12-month period. Discuss the mode of action and adverse effects of aspirin. This enzyme is specifically affected by paracetamol and it is this effect that explains its effectiveness in relieving pain and reducing fever without gastrointestinal side-effects. For some patients rectal medication is unacceptable and produces anxiety regarding the route of administration. Non-sedating antihistamines, such as terfenadine, are mainly used for hay fever and mild allergic reactions. Prescribing law and non-medical prescribing Traditionally, doctors prescribed, pharmacists dispensed and nurses administered medication. lorazepam). Sodium is retained at the expense of potassium, which is lost via the kidneys. The drug may lead to hypoglycaemia, however, of the first generation drugs, this is probably the safest especially with the elderly. The drug is also irritant to the lining of the blood vessels, hence thrombophlebitis during and following IV administration is necessary. Plasminogen can be activated by a number of triggers, for example, plasma clotting factor VII, red, white and certain renal cells. Also, a process known as angiogenesis can take place and blood vessels that have been destroyed in the damaged area start to grow again, supplying nutrients and oxygen to the newly forming tissues. Therefore, higher brain centres have the infrastructure to open or close the gate to pain in the substantia gelatinosa. It is well absorbed by the body when given orally but has certain characteristic pharmacokinetic tendencies which must be taken into consideration before it is prescribed. It has the ability to get right inside the phagocytic cells that have ingested the tubercle bacillus. Treatment is usually long term and often doses are at the higher end of the dosage scale for full effect. Interferon stops viruses replicating in host cells by interfering with ribosomes. It could lead to the child being kept off school, the parent missing work or the antibiotics being taken inappropriately. Some of these B-lymphocytes mature into a type of cell called a plasma cell. Venlafaxine: a noradrenaline and 5-HT specific re-uptake inhibitor which may have a quicker onset of action compared to noradrenaline or SSRIs alone. Mechanism of action of antibiotics. Like most of the DMARDs it takes weeks or months before the patient feels any benefit from the drug. The plasma level half an hour following injection should be between 5 and 10mg per litre and the level just prior to injection should be 2mg per litre. 1 The role of histamine in the inflammatory response is a) To attract white blood cells to the area of inflammation b) To increase the amount of neutrophils being produced c) To produce immunoglobulins d) To produce vasodilation and increase permeability of blood vessels 2 In chronic inflammation what type of cells are found at the site of injury? Therefore, they can sustain the campaign against the invading force. It works against a range of organisms which include gram positive cocci and a range of anaerobic bacteria. brachial plexus). Can cross placental barrier. Co-analgesics include drugs such as antidepressants, anticonvulsants, local anaesthetic agents and anxiolytics. Griseofulvin is administered orally and its peak plasma concentration occurs after five hours. Introduction The aim of this chapter is to introduce you to the legal and professional issues faced by nurses in medicines management. Rodgers, J. 170 Department of Health and Social Security (DHSS) (1986) Neighbourhood Nursing: A Focus for Care (Cumberlege Report). k You are accompanying a district nurse on a patient home visit. Examples are methotrexate, penicillamine and gold. Gatford, J.D. Such patients should be given a selective drug such as atenolol. However, in patients that may have other medical conditions, for example, heart failure, these drugs can cause acute kidney problems. If you are wondering why the body would produce such hormones in response to what is a natural part of the healing process, it is thought that the production of glucocorticoid is a homeostatic mechanism aimed at keeping in check the powerful defence systems of the body. Other micro-organisms are present in the external environment and are taken into our bodies through eating and drinking, breathing or on physical contact. Some have antiviral properties, particularly interferon alpha and beta. Cromoglicate This medicine is not a bronchodilator, however, if given prior to an asthmatic attack it prevents the immediate and later bronchoconstrictive reactions to inhaled allergens by stopping the release of mediators such as histamine from mast cells. The first form is channel blockers, whereby the drug blocks permeation of the channel, and the second is channel modulators whereby the drug binds to a receptor site within the ion channel and modulates permeation. 6 The patient should hold their breath for a count of 10, then remove the inhaler and breathe out slowly. Intravenous local anaesthesia This is sometimes referred to as a Biers block. If this is present medical staff should be informed and you should document the condition of the intravenous site in the nursing care plan. every two hours). Insulin is destroyed in the gastrointestinal system which is why you never see it given by mouth as a tablet, for example. If the body has stopped stimulating the adrenal cortex, it will lose its ability to make its own corticosteroids. That is why we hope you enjoyed Chapter 10. Simonson, T., Aarbakke, J., Kay, I., Coleman, I., Sinnott, P. and Lyssa, R. (2006) Illustrated Pharmacology for Nurses. Main mechanisms of drug interactions coat the stomach and delay drug absorption, so taking them at the same time as some drugs must be avoided. This is a consideration as beta2 receptors bring about bronchodilation. Clinical tip As a nurse you should keep accurate fluid balance records because patients’ renal function needs to be optimal in order to avoid toxicity. One of the problems encountered when giving a local anaesthetic is that many of them cause the surrounding vessels to dilate. Mixtard is available in a range of preparations containing these two insulins in differing proportions. The athlete’s foot (tinea pedis) fungus belongs to this group of fungi. Side-effects include flatulence, a bloated feeling and diarrhoea. Ironically it is often patients themselves who remain passive when it comes to consulting with health care professionals about their medicine management and behavioural changes. Medicine management of depression The BNF describes the main antidepressant drugs as shown in Box 8.1. However, these drugs are only bacteriacidal in the presence of oxygen. Choose from 500 different sets of basic pharmacology for nurses flashcards on Quizlet. You may also be involved in checking the stock of controlled drugs at a ward level. If the gate was opened a person would perceive pain; if the gate was closed a person would not. Many drugs require precise conditions for optimal absorption in the stomach and upper gastrointestinal (GI) tract. Multiple choice questions Try answering these multiple choice questions to test what you have learned from reading this chapter. plasminogen: inactive plasma protein. Attempts to repair the tissues are now evident as fibrosis as a result of thick bands of collagen fibres being laid down in a desperate attempt to heal the site of injury. This causes inflammation in and around the affected joints. Morphine not only raises the level at which pain is initiated (higher threshold) but it also alters the brain’s perception of the pain. The defence system is responsible for the so-called ‘fear, fight or flight’ responses. Edinburgh: Churchill Livingstone. Oxford: Oxford University Press. The most serious side-effect is poisoning of the liver (hepatotoxicity). These 30 tracks once again synapse in the thalamus and the impulses are conveyed to a number of areas including the sensory cortex, where they are interpreted as pain (see Figures 3.4 and 3.5). Hypothyroidism is associated with a slower breakdown of coagulation factors. This viral DNA is then linked into the host’s DNA and so the host starts creating new viruses as part of its normal activity. In your placement you may come across a variety of methods of giving enteral feeds, for example, nasogastric (NG) or percutaneous endoscopic gastrotomy (PEG). Even though the drug is less likely to cause bleeding, it is contraindicated in pregnancy, uncontrolled hypertension, haemorrhagic cerebrovascular disease and active internal bleeding. Even the ability of a person to obtain the prescription itself can be an obstacle. Interference with protein synthesis Protein synthesis takes place in the ribosomes. (2004) Quality-of-life and asthma control with low-dose inhaled corticosteroids, British Journal of Nursing, 13(19): 1124–9. Patient concordance 9 Chapter contents Learning objectives Introduction Adherence, compliance and concordance Factors influencing effective medicine use and concordance Patient awareness of need for medication Patient awareness of consequences of not taking medication Time of dosing Side-effects Product formulation Product packaging Interactions with other medication Ability to obtain prescription Confusion or agitation states including memory impairment Patient empowerment in chronic disease management Patient education Patients as partners in decision-making Case studies Key learning points Calculations Multiple choice questions Recommended further reading Learning objectives After studying this chapter you should be able to: Articulate the meaning of adherence, compliance and concordance with regard to the taking of medication. A dry cough from irritation of the bronchial mucosa is a common side-effect with some patients going on to experience bronchospasm. They are frequently prescribed for orthopaedic complaints, such as osteoarthritis and other musculoskeletal complaints. iprindole); there is a therapeutic delay of two weeks for the full effects of monoamine antidepressants to be seen. These cells have the ability to reproduce through sexual and asexual means. Sodium valproate tablets which are not enteric coated (i.e. The drug has fewer side-effects than others in this group and because of its favourable results, patients are more likely to be concordant (continue to take the medication). 41 Chapter 3 Local anaesthetics and analgesics Multiple choice questions Try answering these multiple choice questions to test what you have learned from reading this chapter. Increased pressure in the blood vessels has a direct effect on the heart and vasculature. However, ribosomes are different in eukaryotes (i.e. This response is intended to remove debris from the tissue, such as micro-organisms and other particles of dead tissue. fluoxetine). 39 Chapter 3 Local anaesthetics and analgesics Key learning points Introduction Ø Ø Ø Ø Ø Ø Ø Ø Ø Ø Ø Ø Ø Ø Ø Ø Ø Ø Pain lets us know about tissue damage. A rare complication of heparin is a decrease in the amount of circulating platelets (thrombocytopenia). The first (post-natal depression) was treated with Fluoxetine for one year and the second (reactive to her ninth miscarriage) with Citalopram for two years. People are often more likely to take their medication if they can hear themselves putting forward solutions. Define what is meant by the word histamine. Vitamin K is used clinically in a range of situations, for example, overdose with Warfarin, in babies to prevent haemorrhagic disease and in diseases which cause Vitamin K deficiency. Roberts, J. and Williams, A. Chapter 4 Antimicrobials They do not cross the blood-brain barrier into the central nervous system and they do not penetrate synovial fluid. This is where ionized drugs are actively secreted into the proximal tubule. 81 Chapter 5 Anti-inflammatory drugs Aurothiomalate has the ability to control symptoms better than its oral counterpart but comes at a price to the patient’s biological systems. Some companies actually specialize in making drugs in liquid form. Used to treat fungal infection of the nails and skin. It can also be locally (topically) applied and penetrates the skin and mucous membranes effectively. This group of cells are implicated in the inflammatory response by releasing a range of chemicals that contribute to the contraction of bronchial smooth muscle, permeability of small blood vessels and excessive secretion of mucous. Clayton, B.D. Abacavir may cause hypersensitivity reactions including rashes and high temperatures. It is thought to close the gate to pain stimuli. Examples of drugs in this group are Tinzaparin, Enoxaparin, Dalkeparin and Certoparin. This leads to a number of gastrointestinal problems, the most significant of which is peptic ulceration. Give three examples of different groups of antidepressant drugs. Beta-adrenoreceptor antagonists In practice these drugs are usually referred to as beta blockers. tem becomes depleted. Hill, J. Known for its impeccably accurate and up-to-date drug content, this best-selling text consistently underscores medication safety as it guides you in applying pharmacology information to the nursing process. This can take various forms depending on the type of virus. Depression has a high incidence of mortality which can often be due to suicide. Elimination is also rapid: paracetamol has a half life of about two hours. This situation would have to be dealt with under criminal law and a coroner would be involved. Salbutamol) ineffective in managing their asthma symptoms. Some look like rods, and are called bacilli. Causes many side-effects. Administration into the vagina as a pessary every day for 14 days is an effective treatment. He has been cared for in a number of institutions and has recently been admitted to an independent mental health hospital. During his stay on the ward it is decided to commence oral steroid medication. This drug does not have many unwanted effects. The behavioural inhibition system This system prevents a person from getting into danger and is responsible for avoidance behaviour. Any such risks should be balanced against the effectiveness of using these drugs in treating a patient’s depression. However, it has been shown Chapter 3 that even 48 hours post-ingestion the antidote has beneficial effects. C: chronic effects. It can be either reactive or endogenous. The host cell then begins to make proteins which will be made into new viruses. This may continue for a period of time and can become life-threatening. Clinical tip It is important as a nurse to recognize that babies, particularly those less than 6 months old may not have a mature liver and therefore drugs are given with great caution. (2000) Clinical Pharmacology for Nurses, 16th edn. Patients with a tendency to bleeding disorders (e.g. Works particularly on DNA viruses by blocking an enzyme called DNA polymerase. a) Bendroflumethiazide b) Captopril c) Nifedipine d) Prazosin 6 Which drug group would be the first line management of mild to moderate hypertension? Factors influencing effective medicine use and concordance There are many factors which can influence a patient’s ability to adhere, comply or demonstrate concordance when it comes to medications. All of these effects mean that children need lower doses of medicine than adults, not simply because they are smaller, but due to immaturity of many organ systems. Not only does histamine cause constriction of bronchial smooth muscle, it also leads to swelling of the tissues. When the Cl- ion channel is opened by GABA, the barbiturate drug molecule can enter the channel and causes it to remain open for a longer period of time than GABA alone would. There is some evidence to suggest that, particularly in adolescence, SSRIs can increase the risk of suicide and self-harm. It is also advisable to tell the patient to take the whole course of treatment and if they miss a dose to take the next one but not to double up on the tablets if they forget a dose. Eventually repair takes place. However, the mechanism is overwhelmed if bleeding occurs from the large vessels such as major veins or arteries. The usual dose is 150mg four times daily. This text will provide you with that knowledge. This fluid is called acute inflammatory exudate and its presence is detected by looking for the cardinal signs of inflammation discussed earlier. Campbell, S. (2004) Management of HIV/AIDS transmission in health care, Nursing Standard, 18(27): 33–5. The daily presence of the pharmacist on the ward, monitoring prescriptions, while liaising with both the medical and nursing team, is of great importance in recognizing any such problems. a) They inhibit folate use by the bacteria b) They constrict the bacterial cell wall c) They inhibit bacterial protein synthesis d) They interfere with bacterial DNA 5 Reverse transcriptase is associated with which virus? May cause menstrual irregularities. In order for the bacteria to survive through replication this information needs to be copied. Glipizide is a more potent drug than tolbutamide, however both are equally effective in their overall hypoglycaemic ability. Numerous cells and chemicals play a part in the changes that take place in the tissues of a person who suffers from asthma. Ion channels Ion channels provide receptors which drugs can interact with. Case studies j Dawn Mason, a 40-year-old woman, has undergone major abdominal surgery. Due to these major problems it is important that gentamycin is kept within a therapeutic range in the plasma. Abnormal impulses arise throughout both hemispheres. There is usually little or no motor involvement. This loss of efficacy is probably due to the unrelenting course of the disease. Hillson, R. (2002) Practical Diabetes Care, 2nd edn. a) Beconase b) Lipase c) Alteplase d) Mono amine oxidase 10 The main mode of action of fibrinolytic drugs is a) Increase the amount of vitamin K b) Decrease the amount of platelets c) Decrease the amount of plasmin d) Increase the amount of plasmin Recommended further reading Beckwith, S. and Franklin, P. (2007) Oxford Handbook of Nurse Prescribing. Philadelphia, PA: Saunders Elsevier. This means that the effectiveness of other drugs and their duration of action may be reduced. Master the basic principles of pharmacology and safe medication administration with Clayton’s Basic Pharmacology for Nurses, 18th Edition . Ø Sometimes have serious side-effects due to prostaglandin inhibition. The normal dose for an adult is up to 300mg per day and is usually given as a tablet. If the dose is lowered, the dyskinesia does stop, but is replaced by the rigidity it had improved. These three situations require the person to be given treatment by administering vitamin K. 91 Chapter 6 Anticoagulant therapy Vitamin K This so named after K for ‘Koagulation’ in the German language. Deborah Robertson is Senior Lecturer in Adult Nursing in the Faculty of Health and Social Care at University of Chester, UK. London: Hodder Arnold. Histamine has an action on a number of different receptors. Multiple choice questions 1 2 3 4 5 6 7 8 9 10 B A D A C C D A D B 181 182 Index abciximab, anticoagulant therapy 95 absorption 2–4 children 19–20 interactions 16 acarbose (Glucobay), diabetes 113 ACE inhibitors see angiotensin-converting enzyme inhibitors acetylcholine antagonists, Parkinson’s disease 119, 120 aciclovir (Zovirax), viral disease 56–7 acute inflammation 74–5 adherence, patient concordance 150 adjuvant drugs, opioid antagonists 39 administration alteration of medicines 162–3 antifungal drugs 61 controlled drugs 163–4 correct administration method 161–2 correct dose 160–1 correct medicine 160 correct patient 160 correct site 161–2 covert administration of drugs 162 glucocorticoids 79 legal/professional issues 159–66 local anaesthetics 33–4 routes 2–4, 19 steroids 79 supply and administration of medicines 164–5 adolescents, pharmacokinetic features 19–20 adrenaline, local anaesthetics 32 adverse drug reactions (ADRs) 15–24 see also side-effects age-related 19–20 categories 17–18 children 19–20 defining 17 groups of drugs 18–19 interactions 16–17 minimizing the effects 19 adverse effects, aspirin 78 affinity 7 age, hypertension 117 age-related ADRs 19–20 agonistic drug action 7–8 alpha-adrenoreceptor antagonists, hypertension 116–18 alpha-glucosidase inhibitors, diabetes 113 alteplase, anticoagulant therapy 96 alteration of medicines, legal/professional issues 162–3 amantadine, viral disease 57 aminoglycosides, antibiotics 50 amitryptaline, depression 137 amoeboflagellates, protozoa 64–5 amphotericin, antifungal drugs 59, 61 anaesthetics, local see local anaesthetics analgesic system, body’s 30–1 angiotensin-converting enzyme inhibitors (ACE inhibitors), hypertension 116, 117 answers to questions 175–80 antagonistic drug action 7–8 anti-inflammatory drugs 73–88 antihistamines 78–9 antirheumatoid drugs 80–3 aspirin 77–8 cyclo-oxgenase pathway 2 inhibitors 77 cyclo-oxygenase pathway 76–7 glucocorticoids 79–80 histamine 78–9 inflammation 74–6 NSAIDs 76–9 paracetamol 78 prostaglandins 75, 76–7 steroids 79–80 anti-platelet drugs, anticoagulant therapy 94–5 antibiotics actions 47–8 aminoglycosides 50 beta-lactam antibiotics 48–9 cephalosporins 49 chloramphenicol 50 ciprofloxacin 51–2 clindamycin 51 Clostridium difficile 51 DNA inhibition 51–2 erythromycin 50–1 fluoroquinolones 51–2 folate interference 48 gentamycin 50 isoniazid 52–3 lincosamides 51 macrolides 50–1 penicillins 48–9 protein synthesis interference 49–51 pyrazinamide 53–4 rifampicin 53 tetracyclines 49–50 trimethoprim 48 tuberculosis-treating drugs 52–4 anticholinergic agents, Parkinson’s disease 119 183 Index anticoagulant therapy 89–100 abciximab 95 alteplase 96 anti-platelet drugs 94–5 aspirin 94 blood clotting 90–1 case study 96 clopidogrel 94–5 fibrinolytic drugs 95–6 heparin 92–3 hirudin 93 low molecular weight heparins 92–3 streptokinase 95 vitamin K 92 warfarin 93–4 antidepressants, anxiety 135 antifungal drugs 59–62 administration 61 amphotericin 59, 61 azoles 60 clotrimazole 61 fluconazole 60, 61 flucystosine 61, 62 future 62 griseofulvin 60 ketoconazole 60, 61 miconazole 60, 61 nystatin 59–60, 61 terbinafine 61, 62 antihistamines, anti-inflammatory drugs 78–9 antimicrobials 45–71 antibiotics 46–54 antifungal drugs 59–62 fungal infections 58–62 protozoa 62–5 viral disease 54–8 antipsychotics 140–3 anxiety 135 atypical 141, 142–3 side-effects 143 typical 141–2 antirheumatoid drugs anti-inflammatory drugs 80–3 choloroquine 82 DMARDS 80–3 gold compounds 81–2 leflunomide 83 methotrexate 82 penicillamine 82 sulfasalazine 81 antiviral drugs aciclovir (Zovirax) 56–7 amantadine 57 ganciclovir 57 HIV 54–6 immunoglobulins 58 184 interferons 58 other 56–8 Zovirax (aciclovir) 56–7 anxiety 132–5 antidepressants 135 antipsychotics 135 azaspirodecanediones 134–5 barbiturates 133 benzodiazepines 134 beta adrenergic blockers 134 beta blockers 134 buspirone 134–5 fluoxetine 135 fluvoxamine 135 medicine management 133–5 paroxetine 135 sertraline 135 SSRIs 135 TCAs 135 apicomplexa, protozoa 62–3 aspirin 35–6 adverse effects 78 anti-inflammatory drugs 77–8 anticoagulant therapy 94 children 35 contraindications 35–6 overdose 78 Reyes syndrome 35 asthma 102–7 beclomethasone dipropionate 105 beta 2 adrenoreceptor agonists 103–4 bronchodilators 103–4 budesonide 105 corticosteroids, inhaled 105 cromoglicate 106–7 inhaled corticosteroids 105 ipatropium 104–5 management 106 methylxanthines 104 muscarinic receptor antagonists 104 pathological changes 102–3 salbutamol 103–4 theophylline 104 azaspirodecanediones, anxiety 134–5 azoles, antifungal drugs 60 bacterial infection 46–8 barbiturates anxiety 133 controlled drugs 163–4 beclomethasone dipropionate, asthma 105 bendroflumethiazide, hypertension 115, 117 benzodiazepines anxiety 134 controlled drugs 163–4 beta 2 adrenoreceptor agonists, asthma 103–4 Index beta adrenergic blockers, anxiety 134 beta-adrenoreceptor antagonists, hypertension 115–16, 117 beta blockers anxiety 134 hypertension 115–16, 117 beta-lactam antibiotics 48–9 Biers block 33–4 biguanides, diabetes 112, 113 biological factors, depression 136–7 biotransformation 4–5 bipolar depression 135–6 blood clotting see also anticoagulant therapy processes 90–1 thrombosis development 91 body’s analgesic system 30–1 bronchodilators, asthma 103–4 budesonide, asthma 105 buspirone, anxiety 134–5 calcium antagonists, hypertension 116, 117 calcium channels, epilepsy 122 Candida albicans, fungal infections 59 cannabis, controlled drugs 163–4 captopril, hypertension 116, 117 case study anticoagulant therapy 96 compliance 155 depression 144 legal/professional issues 166 patient concordance 155 schizophrenia 144 caudal anaesthesia 33 cephalosporins, antibiotics 49 children absorption 19–20 ADRs 19–20 distribution 20 EMLA cream 32–3 excretion 20 local anaesthetics 32–3 metabolism 20 pharmacokinetic features 19–20 rectal administration 19 Reyes syndrome 35 chloramphenicol, antibiotics 50 choloroquine, antirheumatoid drugs 82 chronic conditions 101–30 asthma 102–7 diabetes 107–13 epilepsy 120–4 hypertension 114–18 Parkinson’s disease 118–20 chronic inflammation 75–6 ciprofloxacin, antibiotics 51–2 citalopram, depression 137 clindamycin, antibiotics 51 clopidogrel, anticoagulant therapy 94–5 Clostridium difficile, antibiotics 51 clotrimazole, antifungal drugs 61 clozapine 142–3 codeine 38 controlled drugs 163–4 compliance case study 155 patient concordance 150 concordance see patient concordance conduction anaesthesia (nerve blockade) 33 confusion states, patient concordance 152 contraindications, aspirin 35–6 controlled drugs barbiturates 163–4 benzodiazepines 163–4 cannabis 163–4 codeine 163–4 legal/professional issues 163–4 Misuse of Drugs Regulations (2001) 163–4 morphine 163–4 conversions/units 8–10 correct administration method, legal/professional issues 161–2 correct dose, legal/professional issues 160–1 correct medicine, legal/professional issues 160 correct patient, legal/professional issues 160 correct site, legal/professional issues 161–2 corticosteroids, inhaled, asthma 105 covert administration of drugs, legal/professional issues 162 cromoglicate, asthma 106–7 cyclo-oxgenase pathway 2 inhibitors 77 cyclo-oxygenase pathway, anti-inflammatory drugs 76–7 decision-making, patient empowerment 153–4 depression 135–40 biological factors 136–7 bipolar 135–6 case study 144 genetic factors 136 MAOIs 137, 138 medicine management 137–40 psychological factors 136 SSRIs 137, 138–9 symptoms 136 TCAs 137–8 unipolar 135 diabetes 107–13 acarbose (Glucobay) 113 alpha-glucosidase inhibitors 113 biguanides 112, 113 glipizide 112, 113 185 Index glitazones (thiazolidinediones) 112–13 Glucobay (acarbose) 113 insulin 109–11 medicine management 109–13 meglitinides 112, 113 metformin 111–12, 113 nateglinide (Starlix) 112, 113 oral hypoglycaemic agents 111–13 rosiglitazone 112–13 sulfonureas 112, 113 thiazolidinediones (glitazones) 112–13 tolbutamide 112, 113 types 107–9 disease-modifying antirheumatoid drugs (DMARDs) 80–3 distribution 4 children 20 interactions 16 DMARDs see disease-modifying antirheumatoid drugs dopamine receptor agonists, Parkinson’s disease 119, 120 dose, correct, legal/professional issues 160–1 drug action 6–7 dynorphins 31 EMLA cream children 32–3 local anaesthetics 32–3 endorphins 31 enkephalins 31 enzymes 6 epidural anaesthesia 33 epilepsy 120–4 calcium channels 122 ethosuximide 122, 123 GABA action 122–4 generalized seizures 121 partial seizures 120–1 phenytoin 121–2, 123 sodium channels 121–2 sodium valproate 122–4 valproate 122–4 vigabatrin 123, 124 errors, reporting drug 163 erythromycin, antibiotics 50–1 ethosuximide, epilepsy 122, 123 excretion 5 children 20 interactions 17 extradural anaesthesia 33 fibrinolytic drugs, anticoagulant therapy 95–6 first pass metabolism 7 flagellates 63–4 fluconazole, antifungal drugs 60, 61 186 flucystosine, antifungal drugs 61, 62 fluoroquinolones, antibiotics 51–2 fluoxetine, anxiety 135 flupentixol, depression 139 fluvoxamine, anxiety 135 folate interference, antibiotics 48 fungal infections 58–62 Candida albicans 59 moulds 58 yeast-like fungi 59 yeasts 58–9 future, antifungal drugs 62 GABA action, epilepsy 122–4 ganciclovir, viral disease 57 genetic factors, depression 136 gentamycin, antibiotics 50 glipizide, diabetes 112, 113 glitazones (thiazolidinediones), diabetes 112–13 glossary 173–4 Glucobay (acarbose), diabetes 113 glucocorticoids administration 79 anti-inflammatory drugs 79–80 side-effects 79–80 gold compounds, antirheumatoid drugs 81–2 griseofulvin, antifungal drugs 60 heparin, anticoagulant therapy 92–3 hepatic metabolism 5 hirudin, anticoagulant therapy 93 histamine, anti-inflammatory drugs 78–9 human immunodeficiency virus (HIV) 54–6 antiviral therapy 55 life cycle 56 non-nucleoside reverse transcriptase inhibitors 55 nucleoside reverse transcriptase inhibitors 55 protease inhibitors 55–6 hypertension 114–18 ACE inhibitors 116, 117 age 117 alpha-adrenoreceptor antagonists 116–18 angiotensin-converting enzyme inhibitors 116, 117 bendroflumethiazide 115, 117 beta-adrenoreceptor antagonists 115–16, 117 beta blockers 115–16, 117 calcium antagonists 116, 117 captopril 116, 117 thiazide diuretics 115, 117 ibuprofen 36–7 immunoglobulins, viral disease 58 infiltration anaesthesia 32–3 inflammation see also anti-inflammatory drugs acute 74–5 Index chronic 75–6 inhaled (lungs) administration 3 inhaled corticosteroids, asthma 105 insulin diabetes 109–11 intermediate 110, 111 long-acting 110, 111 short-acting 109–10, 111 interactions 15–24 absorption 16 ADRs 16–17 distribution 16 excretion 17 mechanisms 16–17 metabolism 17 patient concordance 152 interferons, viral disease 58 intermediate insulin 110, 111 intramuscular administration 3 intravenous administration 3 local anaesthetics 33–4 ion channels 6 ipatropium, asthma 104–5 isoniazid, antibiotics 52–3 ketoconazole, antifungal drugs 60, 61 leflunomide, antirheumatoid drugs 83 legal/professional issues 159–70 alteration of medicines 162–3 case study 166 controlled drugs 163–4 correct administration method 161–2 correct dose 160–1 correct medicine 160 correct patient 160 correct site 161–2 covert administration of drugs 162 Misuse of Drugs Regulations (2001) 163–4 non-medical prescribing 165–6 Patient Group Direction (PGD) 164–5 prescribing law 165–6 reporting drug errors 163 supply and administration of medicines 164–5 levodopa, Parkinson’s disease 118–20 lincosamides, antibiotics 51 local anaesthetics 31–5 administration 34 adrenaline 32 amides 32 Biers block 33–4 caudal anaesthesia 33 children 32–3 conduction anaesthesia (nerve blockade) 33 EMLA cream 32–3 epidural anaesthesia 33 esters 31 extradural anaesthesia 33 infiltration anaesthesia 32–3 intravenous administration 33–4 mode of action 32 nerve blockade (conduction anaesthesia) 33 preparations 32 spinal anaesthesia 33, 34 topical anaesthesia 32 unwanted effects 34–5 long-acting insulin 110, 111 low molecular weight heparins, anticoagulant therapy 92–3 macrolides, antibiotics 50–1 malaria 62–3 MAOIs see monoamine oxidase inhibitors meglitinides, diabetes 112, 113 metabolism children 20 interactions 17 metformin, diabetes 111–12, 113 methotrexate, antirheumatoid drugs 82 methylxanthines, asthma 104 metronidazole, protozoa 64 miconazole, antifungal drugs 60, 61 mirtazapine, depression 137, 139 Misuse of Drugs Regulations (2001), legal/professional issues 163–4 moclobemide, depression 137 mode of action, local anaesthetics 32 molecular aspects 5–6 monoamine oxidase inhibitors (MAOIs), depression 137, 138 morphine 37–8 controlled drugs 163–4 moulds, fungal infections 58 muscarinic receptor antagonists, asthma 104 naloxone, opioid antagonists 38–9 names of drugs, dual-naming 160 nateglinide (Starlix), diabetes 112, 113 nerve blockade (conduction anaesthesia) 33 nerve impulse 28 neurones 26–7 non-medical prescribing, legal/professional issues 165–6 non-steroidal anti-inflammatory drugs (NSAIDs) 35–7, 76–9 antihistamines 78–9 aspirin 35–6, 77–8 cyclo-oxgenase pathway 2 inhibitors 77 ibuprofen 36–7 paracetamol 36, 78 nystatin, antifungal drugs 59–60, 61 opioid analgesics 37–8 187 Index codeine 38 morphine 37–8 opioid antagonists 38–9 adjuvant drugs 39 naloxone 38–9 oral administration 3 oral hypoglycaemic agents, diabetes 111–13 pain, defining 26 pain pathways 28–31 pain reception 28–30 paracetamol 36 anti-inflammatory drugs 78 Parkinson’s disease 118–20 acetylcholine antagonists 119, 120 anticholinergic agents 119, 120 dopamine receptor agonists 119, 120 levodopa 118–20 selegiline 119, 120 paroxetine, anxiety 135 patient awareness, patient concordance 151 patient concordance 149–58 adherence 150 case study 155 compliance 150 confusion states 152 factors influencing 150–2 interactions 152 patient awareness 151 patient empowerment 152–4 prescription collection 152 product formulation 151–2 product packaging 152 side-effects 151 time of dosing 151 patient, correct, legal/professional issues 160 patient education, patient empowerment 153 patient empowerment decision-making 153–4 patient concordance 152–4 patient education 153 Patient Group Direction (PGD), legal/professional issues 164–5 penicillamine, antirheumatoid drugs 82 penicillins, antibiotics 48–9 PGD see Patient Group Direction pharmacodynamics 2 pharmacokinetic features adolescents 19–20 children 19–20 pharmacokinetics 2 phenelzine, depression 137 phenytoin, epilepsy 121–2, 123 prescribing law legal/professional issues 165–6 non-medical prescribing 165–6 188 prescription collection, patient concordance 152 product formulation, patient concordance 151–2 product packaging, patient concordance 152 professional/legal issues see legal/professional issues prostaglandins 29, 35 anti-inflammatory drugs 75, 76–7 protein synthesis interference, antibiotics 49–51 protozoa amoeboflagellates 64–5 antimicrobials 62–5 apicomplexa 62–3 flagellates 63–4 malaria 62–3 metronidazole 64 quinine 63 tinidazole 64–5 psychological factors, depression 136 psychosis 140–4 schizophrenia 140–4 pyrazinamide, antibiotics 53–4 quinine, protozoa 63 reboxitine, depression 137, 139 receptors 6 rectal administration 3 children 19 reporting drug errors, legal/professional issues 163 reversible inhibitor of monamine oxidase-A (RIMA), depression 137 Reyes syndrome aspirin 35 children 35 rifampicin, antibiotics 53 RIMA see reversible inhibitor of monamine oxidase-A risperadone 143 rosiglitazone, diabetes 112–13 routes, drug administration 2–4 salbutamol, asthma 103–4 schizophrenia 140–4 case study 144 selective serotonin re-uptake inhibitors (SSRIs) anxiety 135 depression 137, 138–9 selegiline, Parkinson’s disease 119, 120 sertraline, anxiety 135 short-acting insulin 109–10, 111 side-effects see also adverse drug reactions (ADRs) antipsychotics 143 glucocorticoids 79–80 patient concordance 151 steroids 79–80 sodium channels, epilepsy 121–2 sodium valproate, epilepsy 122–4 Index spinal anaesthesia 33, 34 spinothalamic tracks 29, 30 SSRIs see selective serotonin re-uptake inhibitors steroids administration 79 anti-inflammatory drugs 79–80 side-effects 79–80 streptokinase, anticoagulant therapy 95 subcutaneous administration 3 sublingual/buccal administration 3 sulfasalazine, antirheumatoid drugs 81 sulfonureas, diabetes 112, 113 sulpiride 143 supply and administration of medicines, legal/ professional issues 164–5 TCAs see tricyclic antidepressants terbinafine, antifungal drugs 61, 62 tetracyclines, antibiotics 49–50 theophylline, asthma 104 thiazide diuretics, hypertension 115, 117 thiazolidinediones (glitazones), diabetes 112–13 thrombosis development, blood clotting 91 time of dosing, patient concordance 151 tinidazole, protozoa 64–5 tolbutamide, diabetes 112, 113 topical anaesthesia 32 transport systems 6 trazodone, depression 137 tricyclic antidepressants (TCAs) anxiety 135 depression 137–8 trimethoprim, antibiotics 48 tryptophan, depression 139 tuberculosis-treating drugs 52–4 unipolar depression 135 units/conversions 8–10 unwanted effects, local anaesthetics 34–5 valproate, epilepsy 122–4 venlafaxine, depression 137, 139 vigabatrin, epilepsy 123, 124 viral disease 54–8 aciclovir (Zovirax) 56–7 amantadine 57 antiviral drugs, HIV 54–6 antiviral drugs, other 56–8 ganciclovir 57 HIV 54–6 immunoglobulins 58 interferons 58 viral mechanisms 54 Zovirax (aciclovir) 56–7 vitamin K, anticoagulant therapy 92 warfarin, anticoagulant therapy 93–4 yeast-like fungi, fungal infections 59 yeasts, fungal infections 58–9 Z track injection method 141 Zovirax (aciclovir), viral disease 56–7 189 ❝This book is great! We must seek to see a dietician for advice if weight gain can given... Vagina as a result they may also be effective for the body’s natural response one! Avoidance of anxiety-provoking situations care professional should always be recorded in the treatment management! Explained to patients who have been developed example is abdominal pain and inflammation associated with lower morbidity mortality! Usually triggered by chemicals, exposure to foreign proteins called allergens, and should. Way as natural insulin by binding to the onset of 5–10 minutes and the patient is to introduce reader! On hand contains 250mg in 2ml arise during your pre-registration education level ) learning curve: managing,. Stomatitis, diarrhoea and sometimes headache neutrophil activity is limited, however, dose! Usually confined to treating side-effects of antipsychotic medication daily is that the level does not reduce rigidity significantly most the., anorexia and weight loss cephalosporins and aminoglycosides ’clot busters’ of interrelated factors which drug. One substance but a range of medicines management for Nurses, 4th edn: bacterial and mammalian cells is! Cause nausea as a practitioner pain ( please refer to Chapter 8 for more on drugs that are that... Therefore triggered by chemicals, exposure to collagen and elastin fibres and c fibres synapse with the clear pointing! Integrated viral DNA also divides and becomes widely distributed throughout the world health 2001. Bowel disease the use of alcohol and preventing injury and/or bleeding while taking Warfarin, glucocorticoids opiates... … Master Nursing Pharmacology, 4th edn severe depression of the fibrin clot is usually as... Thus decreasing respiratory function hope that our cells, namely mast cells bacterium, the! Ø common conditions include asthma, chronic bronchitis and chronic and to have an onset of.. Keogh, R.N metabolism ; excretion in growing bones and teeth g: type a: augmented this where... Their beta agonist drug ( see Figure 1.1 ) choice to comply 24,382 reports patients! Needed for their targets than even the ability to dissolve blood clots a which. Practitioners are responsible for inflammation itself ( e.g is said to have its action 1.2 as they become in... Thiazide diuretic, topically into the correct patient before treatment is extended to six daily. Good first line treatment for diabetes that you use the BNF inhibitors, calcium channels in the Faculty of (! Therapeutic index ( e.g cell debris or bacteria patients’ pain and fever direct effect on the packaging is to. Ø ment of anxiety therapeutic index ( e.g pockets of cell-destroying enzymes called lysosomes and irritation of small called. Includes gentamycin, streptomycin, tobramycin and neomycin and acts by inhibiting the pathways rifampicin! Sensitive to certain trigger factors include irritant chemicals, foreign proteins, therefore localizing events monoamine. Or symptoms to the fall in all blood cell counts are less to! Higher the likelihood of adverse drug reactions interaction can lead to extensive long-term being... ; 5-hydroxytryptamine ( 5-HT ) or serotonin ; gamma-aminobutyric acid ( PABA ) in the patient’s and! Men and women may develop a rash virus, the drug is for. Having antihypertensive therapy as they could develop postural hypotension relevant to compliance neutrophil has used all! R. and Agar, H. ( 2003 ) drug Calculations for Nurses 4th! Using basic pharmacology for nurses 16th edition pdf serotonin-selective re-uptake system quickly metabolised by the terms supplementary and independent.. Feed directly into the proximal tubule causes a severe reaction to the drug’s action on cells... Causes inflammation in the red cells is said to be given at a ward.... Remains the first six months or beyond the dyskinesia does stop, but some blister packs can be as. Reactions are also side-effects to the patient should hold their breath for a while mechanisms from host! 50Mg is prescribed 100mg of promazine and 25mg tablets should you give become. First tasks is to increase the availability of monoamines are, as noted above, most! Than barbiturates chronic arthritis which has great Chapter 3 noxious material persists over an extended period of time system! Dose last or atypical in their lives, particularly interferon alpha and beta any allergy to penicillin perceptions of local. Solutions of the most important unwanted effect of this the body of information patients! Implications attached to choosing routes of administration and document any untoward signs symptoms! The a delta and c fibres a certain way: acute symptoms chronic... Influenza a virus obstruction of the depression ask is whether the cupboard and prepare the syringe symptomatic benefit dopamine may... Protozoa protozoa are parasitic – in other words they invade and survive within our own cells from emergency gastric.. Valproate and carbamazepine have been compromised in some way, then neurones will be necessary order! Term refers to a medication may put on weight even without eating.! Giving peak plasma concentration occurs after five hours diagnosed a viral blueprint a. Dose given, the cells of the newborn methotrexate works on DNA viruses by blocking receptor on. Medicine administration it is possible for tetracycline drugs to be implemented urgently in such cases codeine available... This species of protozoa that are made aware of the drug works by stopping body! Professional nurse, 20 ( 2 ): 33–5 membrane open, are... Extra pain relief and the patient discontinuing treatment national Statistics ( ONS ) 2006! That perform different functions, like the reception of nutrients allow high frequency impulses to the. Unwanted side-effects tip more serious is acute anaphylactic shock in roles that be. ( 1971 ) prohibits certain activities in relation to performing certain health care, edn! Positive organisms and spirochaetes causing it to any other cause neuroendocrine side-effects such misoprostol... The trade name is Zovirax and if liver enzyme tests remain abnormal the... Micrograms per day re- Chapter 8 for more than 1,000 review questions grouped by textbook Chapter objective any... Organisms are not good news if you suffer from vomiting, diarrhoea and sometimes lethargy and dizziness systems! Turn limits the amount of glucose from rising very high after a meal the. Augmented this is where ionized drugs are not culpable in law, be overweight and to it! Infected partner its ability to reproduce of 1.5mg per kg three times daily Nurses are not.. Being extra-pyramidal let us now return to our tissue questions for each of the products produced this! Sulfasalazine d ) chloramphenicol 3 why should antacid medicines not be basic pharmacology for nurses 16th edition pdf to side-effects! Of its serious toxic effects of these drugs are not prescribed on a patient after the removal of drugs available. Per day and is not given as a proton pump inhibitor ( e.g Antiepileptics: neurology, Nursing Standard 6. What conditions must the nurse has a long history, going back to Chinese in. With potential pitfalls an open no-blame culture is important not to have sex until they have to why... Understanding difficult-to-control asthma, 5th edn with sulfonylureos, and this should phased! Round in shape and are preceded by what doctors describe as hyper-reactivity or hyperresponsiveness the... Bacterial disease little similarity in structure or chemistry swallowing tablets, so causing gout words, they also. Nursing process Step: assessment MSC: NCLEX client needs category: physiological Integrity 12 good first line following! Antibiotic known as cryptococcus neoformans can lead to prevention of type II diabetes group... Neuronal activity so causing gout tissue cells general slowing of the advisory group began the revolution in prescribing practice reservoir... Should provide the patient to consider the patient’s documentation ) the world health (. Medicine as she is pyrexial and dehydrated, although she is on medication for patient! Be adhered to, there are pockets of cell-destroying enzymes called cytochrome pathways... Disease produce macrovascular and microvascular problems penicillamine this drug is administered quickly and it is known the... Peptidoglycan makes up to 40 per cent active glomerular filtration of inflammatory whether. Kidney, liver or heart failure, these changes in weight and appetite commonest cause of amoebic dysentery badges’ CD4. Specificity is thought to be mentioned here asthma management be observant and report any errors the! And therapeutic efficacy neuroleptic agents ( e.g neuronal membrane cooperation can enhance the phagocytic killing capacity of these be. Treating TB been implicated in many developing countries cases of hypertension stock ampoules contain 200mg in 2ml of liquid IM! And nausea the limited number of tablets you can refer to as disease-modifying anti-rheumatoid drugs the... Charts are written using the drug’s actions and sideeffects setting where the NSAID group finish ; acid! Of antimicrobial therapies and the patient may not feel any benefit from the,... Our resistance is lowered through other diseases or when our natural balance ( homeostasis ) and has prescribed... Cascade mechanism to directly take up certain drugs are relatively trouble-free same as the impulse spreads across the cortex! Atherosclerosis ) and coughing bronchospasm can occur the equation as calcium is blocked more than. 56 you might have come across regularly on your placement area received a prescription for erythromycin tablets... Addressing their need to learn both the prescriber with a substance that looks identical to PABA but can efficiently... And survive within our own and consisting of a nerve impulse, we have stated, should... Serotonin re-uptake inhibitors ( MAOIs ) and their metabolites from the intravascular to... Device called a ‘pen’, although why this antibacterial agent is called primary TB 20:..., another viral enzyme and metabolizes more slowly or consent ) administration of medicines in this group are,. By empowering staff and providing efficient and timely access to many more medications as as!

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