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 patientâs 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 patientsâ 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 athleteâs 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 brainâs perception of the pain. The defence system is responsible for the so-called âfear, fight or flightâ 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 hostâs 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): 1124â9. 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 Ã Ã Ã Ã Ã Ã Ã Ã Ã Ã Ã Ã Ã Ã Ã Ã Ã Ã 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 patientâs 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 patientâs 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 patientâs 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): 33â5. 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 . Ã 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 âKoagulationâ 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 2â4 children 19â20 interactions 16 acarbose (Glucobay), diabetes 113 ACE inhibitors see angiotensin-converting enzyme inhibitors acetylcholine antagonists, Parkinsonâs disease 119, 120 aciclovir (Zovirax), viral disease 56â7 acute inflammation 74â5 adherence, patient concordance 150 adjuvant drugs, opioid antagonists 39 administration alteration of medicines 162â3 antifungal drugs 61 controlled drugs 163â4 correct administration method 161â2 correct dose 160â1 correct medicine 160 correct patient 160 correct site 161â2 covert administration of drugs 162 glucocorticoids 79 legal/professional issues 159â66 local anaesthetics 33â4 routes 2â4, 19 steroids 79 supply and administration of medicines 164â5 adolescents, pharmacokinetic features 19â20 adrenaline, local anaesthetics 32 adverse drug reactions (ADRs) 15â24 see also side-effects age-related 19â20 categories 17â18 children 19â20 defining 17 groups of drugs 18â19 interactions 16â17 minimizing the effects 19 adverse effects, aspirin 78 affinity 7 age, hypertension 117 age-related ADRs 19â20 agonistic drug action 7â8 alpha-adrenoreceptor antagonists, hypertension 116â18 alpha-glucosidase inhibitors, diabetes 113 alteplase, anticoagulant therapy 96 alteration of medicines, legal/professional issues 162â3 amantadine, viral disease 57 aminoglycosides, antibiotics 50 amitryptaline, depression 137 amoeboflagellates, protozoa 64â5 amphotericin, antifungal drugs 59, 61 anaesthetics, local see local anaesthetics analgesic system, bodyâs 30â1 angiotensin-converting enzyme inhibitors (ACE inhibitors), hypertension 116, 117 answers to questions 175â80 antagonistic drug action 7â8 anti-inflammatory drugs 73â88 antihistamines 78â9 antirheumatoid drugs 80â3 aspirin 77â8 cyclo-oxgenase pathway 2 inhibitors 77 cyclo-oxygenase pathway 76â7 glucocorticoids 79â80 histamine 78â9 inflammation 74â6 NSAIDs 76â9 paracetamol 78 prostaglandins 75, 76â7 steroids 79â80 anti-platelet drugs, anticoagulant therapy 94â5 antibiotics actions 47â8 aminoglycosides 50 beta-lactam antibiotics 48â9 cephalosporins 49 chloramphenicol 50 ciprofloxacin 51â2 clindamycin 51 Clostridium difficile 51 DNA inhibition 51â2 erythromycin 50â1 fluoroquinolones 51â2 folate interference 48 gentamycin 50 isoniazid 52â3 lincosamides 51 macrolides 50â1 penicillins 48â9 protein synthesis interference 49â51 pyrazinamide 53â4 rifampicin 53 tetracyclines 49â50 trimethoprim 48 tuberculosis-treating drugs 52â4 anticholinergic agents, Parkinsonâs disease 119 183 Index anticoagulant therapy 89â100 abciximab 95 alteplase 96 anti-platelet drugs 94â5 aspirin 94 blood clotting 90â1 case study 96 clopidogrel 94â5 fibrinolytic drugs 95â6 heparin 92â3 hirudin 93 low molecular weight heparins 92â3 streptokinase 95 vitamin K 92 warfarin 93â4 antidepressants, anxiety 135 antifungal drugs 59â62 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 59â60, 61 terbinafine 61, 62 antihistamines, anti-inflammatory drugs 78â9 antimicrobials 45â71 antibiotics 46â54 antifungal drugs 59â62 fungal infections 58â62 protozoa 62â5 viral disease 54â8 antipsychotics 140â3 anxiety 135 atypical 141, 142â3 side-effects 143 typical 141â2 antirheumatoid drugs anti-inflammatory drugs 80â3 choloroquine 82 DMARDS 80â3 gold compounds 81â2 leflunomide 83 methotrexate 82 penicillamine 82 sulfasalazine 81 antiviral drugs aciclovir (Zovirax) 56â7 amantadine 57 ganciclovir 57 HIV 54â6 immunoglobulins 58 184 interferons 58 other 56â8 Zovirax (aciclovir) 56â7 anxiety 132â5 antidepressants 135 antipsychotics 135 azaspirodecanediones 134â5 barbiturates 133 benzodiazepines 134 beta adrenergic blockers 134 beta blockers 134 buspirone 134â5 fluoxetine 135 fluvoxamine 135 medicine management 133â5 paroxetine 135 sertraline 135 SSRIs 135 TCAs 135 apicomplexa, protozoa 62â3 aspirin 35â6 adverse effects 78 anti-inflammatory drugs 77â8 anticoagulant therapy 94 children 35 contraindications 35â6 overdose 78 Reyes syndrome 35 asthma 102â7 beclomethasone dipropionate 105 beta 2 adrenoreceptor agonists 103â4 bronchodilators 103â4 budesonide 105 corticosteroids, inhaled 105 cromoglicate 106â7 inhaled corticosteroids 105 ipatropium 104â5 management 106 methylxanthines 104 muscarinic receptor antagonists 104 pathological changes 102â3 salbutamol 103â4 theophylline 104 azaspirodecanediones, anxiety 134â5 azoles, antifungal drugs 60 bacterial infection 46â8 barbiturates anxiety 133 controlled drugs 163â4 beclomethasone dipropionate, asthma 105 bendroflumethiazide, hypertension 115, 117 benzodiazepines anxiety 134 controlled drugs 163â4 beta 2 adrenoreceptor agonists, asthma 103â4 Index beta adrenergic blockers, anxiety 134 beta-adrenoreceptor antagonists, hypertension 115â16, 117 beta blockers anxiety 134 hypertension 115â16, 117 beta-lactam antibiotics 48â9 Biers block 33â4 biguanides, diabetes 112, 113 biological factors, depression 136â7 biotransformation 4â5 bipolar depression 135â6 blood clotting see also anticoagulant therapy processes 90â1 thrombosis development 91 bodyâs analgesic system 30â1 bronchodilators, asthma 103â4 budesonide, asthma 105 buspirone, anxiety 134â5 calcium antagonists, hypertension 116, 117 calcium channels, epilepsy 122 Candida albicans, fungal infections 59 cannabis, controlled drugs 163â4 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 19â20 ADRs 19â20 distribution 20 EMLA cream 32â3 excretion 20 local anaesthetics 32â3 metabolism 20 pharmacokinetic features 19â20 rectal administration 19 Reyes syndrome 35 chloramphenicol, antibiotics 50 choloroquine, antirheumatoid drugs 82 chronic conditions 101â30 asthma 102â7 diabetes 107â13 epilepsy 120â4 hypertension 114â18 Parkinsonâs disease 118â20 chronic inflammation 75â6 ciprofloxacin, antibiotics 51â2 citalopram, depression 137 clindamycin, antibiotics 51 clopidogrel, anticoagulant therapy 94â5 Clostridium difficile, antibiotics 51 clotrimazole, antifungal drugs 61 clozapine 142â3 codeine 38 controlled drugs 163â4 compliance case study 155 patient concordance 150 concordance see patient concordance conduction anaesthesia (nerve blockade) 33 confusion states, patient concordance 152 contraindications, aspirin 35â6 controlled drugs barbiturates 163â4 benzodiazepines 163â4 cannabis 163â4 codeine 163â4 legal/professional issues 163â4 Misuse of Drugs Regulations (2001) 163â4 morphine 163â4 conversions/units 8â10 correct administration method, legal/professional issues 161â2 correct dose, legal/professional issues 160â1 correct medicine, legal/professional issues 160 correct patient, legal/professional issues 160 correct site, legal/professional issues 161â2 corticosteroids, inhaled, asthma 105 covert administration of drugs, legal/professional issues 162 cromoglicate, asthma 106â7 cyclo-oxgenase pathway 2 inhibitors 77 cyclo-oxygenase pathway, anti-inflammatory drugs 76â7 decision-making, patient empowerment 153â4 depression 135â40 biological factors 136â7 bipolar 135â6 case study 144 genetic factors 136 MAOIs 137, 138 medicine management 137â40 psychological factors 136 SSRIs 137, 138â9 symptoms 136 TCAs 137â8 unipolar 135 diabetes 107â13 acarbose (Glucobay) 113 alpha-glucosidase inhibitors 113 biguanides 112, 113 glipizide 112, 113 185 Index glitazones (thiazolidinediones) 112â13 Glucobay (acarbose) 113 insulin 109â11 medicine management 109â13 meglitinides 112, 113 metformin 111â12, 113 nateglinide (Starlix) 112, 113 oral hypoglycaemic agents 111â13 rosiglitazone 112â13 sulfonureas 112, 113 thiazolidinediones (glitazones) 112â13 tolbutamide 112, 113 types 107â9 disease-modifying antirheumatoid drugs (DMARDs) 80â3 distribution 4 children 20 interactions 16 DMARDs see disease-modifying antirheumatoid drugs dopamine receptor agonists, Parkinsonâs disease 119, 120 dose, correct, legal/professional issues 160â1 drug action 6â7 dynorphins 31 EMLA cream children 32â3 local anaesthetics 32â3 endorphins 31 enkephalins 31 enzymes 6 epidural anaesthesia 33 epilepsy 120â4 calcium channels 122 ethosuximide 122, 123 GABA action 122â4 generalized seizures 121 partial seizures 120â1 phenytoin 121â2, 123 sodium channels 121â2 sodium valproate 122â4 valproate 122â4 vigabatrin 123, 124 errors, reporting drug 163 erythromycin, antibiotics 50â1 ethosuximide, epilepsy 122, 123 excretion 5 children 20 interactions 17 extradural anaesthesia 33 fibrinolytic drugs, anticoagulant therapy 95â6 first pass metabolism 7 flagellates 63â4 fluconazole, antifungal drugs 60, 61 186 flucystosine, antifungal drugs 61, 62 fluoroquinolones, antibiotics 51â2 fluoxetine, anxiety 135 flupentixol, depression 139 fluvoxamine, anxiety 135 folate interference, antibiotics 48 fungal infections 58â62 Candida albicans 59 moulds 58 yeast-like fungi 59 yeasts 58â9 future, antifungal drugs 62 GABA action, epilepsy 122â4 ganciclovir, viral disease 57 genetic factors, depression 136 gentamycin, antibiotics 50 glipizide, diabetes 112, 113 glitazones (thiazolidinediones), diabetes 112â13 glossary 173â4 Glucobay (acarbose), diabetes 113 glucocorticoids administration 79 anti-inflammatory drugs 79â80 side-effects 79â80 gold compounds, antirheumatoid drugs 81â2 griseofulvin, antifungal drugs 60 heparin, anticoagulant therapy 92â3 hepatic metabolism 5 hirudin, anticoagulant therapy 93 histamine, anti-inflammatory drugs 78â9 human immunodeficiency virus (HIV) 54â6 antiviral therapy 55 life cycle 56 non-nucleoside reverse transcriptase inhibitors 55 nucleoside reverse transcriptase inhibitors 55 protease inhibitors 55â6 hypertension 114â18 ACE inhibitors 116, 117 age 117 alpha-adrenoreceptor antagonists 116â18 angiotensin-converting enzyme inhibitors 116, 117 bendroflumethiazide 115, 117 beta-adrenoreceptor antagonists 115â16, 117 beta blockers 115â16, 117 calcium antagonists 116, 117 captopril 116, 117 thiazide diuretics 115, 117 ibuprofen 36â7 immunoglobulins, viral disease 58 infiltration anaesthesia 32â3 inflammation see also anti-inflammatory drugs acute 74â5 Index chronic 75â6 inhaled (lungs) administration 3 inhaled corticosteroids, asthma 105 insulin diabetes 109â11 intermediate 110, 111 long-acting 110, 111 short-acting 109â10, 111 interactions 15â24 absorption 16 ADRs 16â17 distribution 16 excretion 17 mechanisms 16â17 metabolism 17 patient concordance 152 interferons, viral disease 58 intermediate insulin 110, 111 intramuscular administration 3 intravenous administration 3 local anaesthetics 33â4 ion channels 6 ipatropium, asthma 104â5 isoniazid, antibiotics 52â3 ketoconazole, antifungal drugs 60, 61 leflunomide, antirheumatoid drugs 83 legal/professional issues 159â70 alteration of medicines 162â3 case study 166 controlled drugs 163â4 correct administration method 161â2 correct dose 160â1 correct medicine 160 correct patient 160 correct site 161â2 covert administration of drugs 162 Misuse of Drugs Regulations (2001) 163â4 non-medical prescribing 165â6 Patient Group Direction (PGD) 164â5 prescribing law 165â6 reporting drug errors 163 supply and administration of medicines 164â5 levodopa, Parkinsonâs disease 118â20 lincosamides, antibiotics 51 local anaesthetics 31â5 administration 34 adrenaline 32 amides 32 Biers block 33â4 caudal anaesthesia 33 children 32â3 conduction anaesthesia (nerve blockade) 33 EMLA cream 32â3 epidural anaesthesia 33 esters 31 extradural anaesthesia 33 infiltration anaesthesia 32â3 intravenous administration 33â4 mode of action 32 nerve blockade (conduction anaesthesia) 33 preparations 32 spinal anaesthesia 33, 34 topical anaesthesia 32 unwanted effects 34â5 long-acting insulin 110, 111 low molecular weight heparins, anticoagulant therapy 92â3 macrolides, antibiotics 50â1 malaria 62â3 MAOIs see monoamine oxidase inhibitors meglitinides, diabetes 112, 113 metabolism children 20 interactions 17 metformin, diabetes 111â12, 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 163â4 moclobemide, depression 137 mode of action, local anaesthetics 32 molecular aspects 5â6 monoamine oxidase inhibitors (MAOIs), depression 137, 138 morphine 37â8 controlled drugs 163â4 moulds, fungal infections 58 muscarinic receptor antagonists, asthma 104 naloxone, opioid antagonists 38â9 names of drugs, dual-naming 160 nateglinide (Starlix), diabetes 112, 113 nerve blockade (conduction anaesthesia) 33 nerve impulse 28 neurones 26â7 non-medical prescribing, legal/professional issues 165â6 non-steroidal anti-inflammatory drugs (NSAIDs) 35â7, 76â9 antihistamines 78â9 aspirin 35â6, 77â8 cyclo-oxgenase pathway 2 inhibitors 77 ibuprofen 36â7 paracetamol 36, 78 nystatin, antifungal drugs 59â60, 61 opioid analgesics 37â8 187 Index codeine 38 morphine 37â8 opioid antagonists 38â9 adjuvant drugs 39 naloxone 38â9 oral administration 3 oral hypoglycaemic agents, diabetes 111â13 pain, defining 26 pain pathways 28â31 pain reception 28â30 paracetamol 36 anti-inflammatory drugs 78 Parkinsonâs disease 118â20 acetylcholine antagonists 119, 120 anticholinergic agents 119, 120 dopamine receptor agonists 119, 120 levodopa 118â20 selegiline 119, 120 paroxetine, anxiety 135 patient awareness, patient concordance 151 patient concordance 149â58 adherence 150 case study 155 compliance 150 confusion states 152 factors influencing 150â2 interactions 152 patient awareness 151 patient empowerment 152â4 prescription collection 152 product formulation 151â2 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 153â4 patient concordance 152â4 patient education 153 Patient Group Direction (PGD), legal/professional issues 164â5 penicillamine, antirheumatoid drugs 82 penicillins, antibiotics 48â9 PGD see Patient Group Direction pharmacodynamics 2 pharmacokinetic features adolescents 19â20 children 19â20 pharmacokinetics 2 phenelzine, depression 137 phenytoin, epilepsy 121â2, 123 prescribing law legal/professional issues 165â6 non-medical prescribing 165â6 188 prescription collection, patient concordance 152 product formulation, patient concordance 151â2 product packaging, patient concordance 152 professional/legal issues see legal/professional issues prostaglandins 29, 35 anti-inflammatory drugs 75, 76â7 protein synthesis interference, antibiotics 49â51 protozoa amoeboflagellates 64â5 antimicrobials 62â5 apicomplexa 62â3 flagellates 63â4 malaria 62â3 metronidazole 64 quinine 63 tinidazole 64â5 psychological factors, depression 136 psychosis 140â4 schizophrenia 140â4 pyrazinamide, antibiotics 53â4 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 112â13 routes, drug administration 2â4 salbutamol, asthma 103â4 schizophrenia 140â4 case study 144 selective serotonin re-uptake inhibitors (SSRIs) anxiety 135 depression 137, 138â9 selegiline, Parkinsonâs disease 119, 120 sertraline, anxiety 135 short-acting insulin 109â10, 111 side-effects see also adverse drug reactions (ADRs) antipsychotics 143 glucocorticoids 79â80 patient concordance 151 steroids 79â80 sodium channels, epilepsy 121â2 sodium valproate, epilepsy 122â4 Index spinal anaesthesia 33, 34 spinothalamic tracks 29, 30 SSRIs see selective serotonin re-uptake inhibitors steroids administration 79 anti-inflammatory drugs 79â80 side-effects 79â80 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 164â5 TCAs see tricyclic antidepressants terbinafine, antifungal drugs 61, 62 tetracyclines, antibiotics 49â50 theophylline, asthma 104 thiazide diuretics, hypertension 115, 117 thiazolidinediones (glitazones), diabetes 112â13 thrombosis development, blood clotting 91 time of dosing, patient concordance 151 tinidazole, protozoa 64â5 tolbutamide, diabetes 112, 113 topical anaesthesia 32 transport systems 6 trazodone, depression 137 tricyclic antidepressants (TCAs) anxiety 135 depression 137â8 trimethoprim, antibiotics 48 tryptophan, depression 139 tuberculosis-treating drugs 52â4 unipolar depression 135 units/conversions 8â10 unwanted effects, local anaesthetics 34â5 valproate, epilepsy 122â4 venlafaxine, depression 137, 139 vigabatrin, epilepsy 123, 124 viral disease 54â8 aciclovir (Zovirax) 56â7 amantadine 57 antiviral drugs, HIV 54â6 antiviral drugs, other 56â8 ganciclovir 57 HIV 54â6 immunoglobulins 58 interferons 58 viral mechanisms 54 Zovirax (aciclovir) 56â7 vitamin K, anticoagulant therapy 92 warfarin, anticoagulant therapy 93â4 yeast-like fungi, fungal infections 59 yeasts, fungal infections 58â9 Z track injection method 141 Zovirax (aciclovir), viral disease 56â7 189 âThis book is great! 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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 patientâs 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 badgesâ CD4. 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