Fundamentals of pharmacology : an applied approach for nursing and health

977 Pages·2013·31.39 MB·English

by  Alan Galbraith

FUNDAMENTALS OF
PHARMACOLOGY
AN APPLIED APPROACH FOR
NURSING AND HEALTH
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2
S E C O N D E D I T I O N
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FUNDAMENTALS OF
PHARMACOLOGY:
AN APPLIED APPROACH FOR
NURSING AND HEALTH
ALAN GALBRAITH SHANE BULLOCK ELIZABETH MANIAS
BARRY HUNT ANN RICHARDS
2
S E C O N D E D I T I O N
First published 2007 by Pearson Education Limited
Published 2013 by Routledge
2 Park Square, Milton Park, Abingdon, Oxon OX14 4RN
711 Third Avenue, New York, NY 10017, USA

Routledge is an imprint of the Taylor & Francis Group, an informa business
ISBN: 1741031443 by Alan Galbraith, Shane Bullock and Elizabeth Manias. Copyright © 2004.
Copyright © 2007, Taylor & Francis.
The rights of Alan Galbraith, Shane Bullock, Elizabeth Manias, Barry Hunt and Ann Richards to be
identified as authors of this work have been asserted by them in accordance with the Copyright, Designs
and Patents Act 1988.
All rights reserved. No part of this book may be reprinted or reproduced or utilised in any form or
by any electronic, mechanical, or other means, now known or hereafter invented, including
photocopying and recording, or in any information storage or retrieval system, without permission
in writing from the publishers.

Notices
Knowledge and best practice in this field are constantly changing. As new research and experience
broaden our understanding, changes in research methods, professional practices, or medical
treatment may become necessary.

Practitioners and researchers must always rely on their own experience and knowledge in
evaluating and using any information, methods, compounds, or experiments described herein. In
using such information or methods they should be mindful of their own safety and the safety of
others, including parties for whom they have a professional responsibility.

To the fullest extent of the law, neither the Publisher nor the authors, contributors, or editors,
assume any liability for any injury and/or damage to persons or property as a matter of products
liability, negligence or otherwise, or from any use or operation of any methods, products,
instructions, or ideas contained in the material herein.
ISBN 13: 978-0-13-186901-1 (pbk)
British Library Cataloging-in-Publication Data
A catalogue record for this book is available from the British Library
Library of Congress Cataloging-in-Publication Data
Fundamentals of pharmacology : an applied approach for nursing and health / Alan
Galbraith...[et al.]. — 2nd ed.
p. ; cm.
Includes bibliographical references and index.
ISBN 978-0-13-186901-1
1. Pharmacology. 2. Nursing. I. Galbraith, Alan.
[DNLM]: 1. Pharmacology—Nurses’ Instruction. 2. Pharmaceutical Preparations—
Nurses’ Instruction. QV 4 F981 2007]
RM300.F87 2007
615′.1—dc22
2007012828
Typeset in 10.5/12.5pt Bembo by 35
BRIEF CONTENTS
Guided tour xxxiv
List of figures xxxviii
List of tables xlii
Preface xlv
Acknowledgements xlvii
SECTION I PHARMACOLOGY WITHIN THE SOCIAL CONTEXT 1
CHAPTER 1 An historical perspective 2
CHAPTER 2 Sociocultural aspects 8
SECTION II PHARMACOLOGY WITHIN THE PROFESSIONAL CONTEXT 17
CHAPTER 3 Drug administration and the law 19
CHAPTER 4 Ethical issues 28
CHAPTER 5 The roles and responsibilities of nurses 36
CHAPTER 6 The roles and responsibilities of other health-care professionals 42
SECTION III DRUG ADMINISTRATION AND PROFESSIONAL RESPONSIBILITIES 51
CHAPTER 7 Drug formulations, storage and routes of administration 52
CHAPTER 8 The clinical decision-making process 72
CHAPTER 9 Drug administration strategies and documentation 77
CHAPTER 10 Medication errors 81
CHAPTER 11 Management of common adverse drug reactions 85
SECTION IV GENERAL ASPECTS OF PHARMACOLOGY 105
CHAPTER 12 Drug nomenclature 106
CHAPTER 13 Pharmacokinetics: absorption and distribution 109
CHAPTER 14 Pharmacokinetics: metabolism and excretion 115
CHAPTER 15 Drug interactions 122
CHAPTER 16 Pharmacodynamics 127
CHAPTER 17 Drug development, evaluation and safety 137
CHAPTER 18 Pharmacogenetics 145
CHAPTER 19 Pharmacokinetic factors that modify drug action 152
CHAPTER 20 Paediatric pharmacology and pharmacology in older people 157
SECTION V TOXICOLOGY 169
CHAPTER 21 Poisoning and envenomation 170
CHAPTER 22 Management of clinical overdose 177
CHAPTER 23 Contemporary drugs of abuse 187
CHAPTER 24 Drug abuse in sport 196
SECTION VI AUTONOMIC PHARMACOLOGY 205
CHAPTER 25 General aspects of autonomic pharmacology 206
CHAPTER 26 Adrenergic pharmacology 213
CHAPTER 27 Cholinergic pharmacology 238
SECTION VII CHEMICAL MEDIATORS 261
CHAPTER 28 Introduction to chemical mediators 262
CHAPTER 29 Histamine and antihistamines 265
vi BRIEF CONTENTS
CHAPTER 30 Prostaglandins and serotonin 271
CHAPTER 31 Nitric oxide and the endothelins 281
SECTION VIII MODULATION OF BEHAVIOUR, COGNITION AND MOTOR ACTIVITY 289
CHAPTER 32 General concepts of central nervous system pharmacology 290
CHAPTER 33 Antipsychotic drugs 295
CHAPTER 34 Anxiolytics and hypnotics 305
CHAPTER 35 Antidepressants and mood stabilisers 313
CHAPTER 36 Drugs used in neurodegenerative disorders 328
CHAPTER 37 Antiseizure drugs and muscle relaxants 341
CHAPTER 38 Central nervous system stimulants 355
SECTION IX DRUGS USED TO RELIEVE PAIN AND PRODUCE ANAESTHESIA 363
CHAPTER 39 Narcotic analgesics 364
CHAPTER 40 Non-steroidal anti-inflammatory, antipyretic and analgesic drugs 379
CHAPTER 41 General anaesthesia 393
CHAPTER 42 Local anaesthesia 403
SECTION X MODULATION OF OXYGENATION AND PERFUSION 413
CHAPTER 43 Drugs used to lower blood lipids 414
CHAPTER 44 Antihypertensive drugs 425
CHAPTER 45 Drugs used to promote tissue perfusion 444
CHAPTER 46 Anticoagulants, thrombolytics and antiplatelet drugs 457
CHAPTER 47 Diuretics and other renal drugs 472
CHAPTER 48 Drugs used to treat cardiac insufficiency 482
CHAPTER 49 Fluid and potassium imbalances 503
CHAPTER 50 Antianaemic drugs 518
CHAPTER 51 Drugs used to maintain gas exchange 525
CHAPTER 52 Over-the-counter respiratory medicines 542
SECTION XI MODULATION OF GASTROINTESTINAL FUNCTION 555
CHAPTER 53 Upper gastrointestinal tract drugs 556
CHAPTER 54 Lower gastrointestinal tract drugs 567
CHAPTER 55 Nausea and vomiting 582
SECTION XII MODULATION OF BODY GROWTH, DEVELOPMENT AND METABOLISM 589
CHAPTER 56 Drugs and the pituitary gland 590
CHAPTER 57 The thyroid and the pancreas 601
CHAPTER 58 The adrenal cortex and the gonads 626
CHAPTER 59 Hyperuricaemia and gout 650
CHAPTER 60 Obesity 658
SECTION XIII NUTRITIONAL AND NATURAL THERAPIES 669
CHAPTER 61 Vitamins 670
CHAPTER 62 Minerals 682
CHAPTER 63 Amino acids 690
CHAPTER 64 Enteral and parenteral nutrition 694
CHAPTER 65 Herbal medicines 704
SECTION XIV MODULATION OF CELLULAR GROWTH AND PROLIFERATION 719
CHAPTER 66 Introduction to chemotherapy 721
CHAPTER 67 Sulphonamides and trimethoprim 727
CHAPTER 68 Antibacterial drugs 732
CHAPTER 69 Antituberculotic and antileprotic drugs 751
BRIEF CONTENTS vii
CHAPTER 70 Antiseptics and disinfectants 760
CHAPTER 71 Antiparasitic drugs 768
CHAPTER 72 Antimalarial drugs 777
CHAPTER 73 Antiviral drugs 785
CHAPTER 74 Antifungal drugs 797
CHAPTER 75 Vaccines and immunomodulating drugs 805
CHAPTER 76 Cytotoxic drugs 821
CHAPTER 77 Gene therapies 838
SECTION XV DRUGS USED TOPICALLY 847
CHAPTER 78 Drugs used in diseases of the skin 848
CHAPTER 79 Drugs and the eye 862
APPENDIX A Common prescription terminology 881
APPENDIX B Common US generic drugs names 882
APPENDIX C SI units 883
APPENDIX D Drug calculations 886
APPENDIX E Common symbols used in medication charts 890
APPENDIX F Common word mix-ups 891
APPENDIX G Drug–herb interactions 892
Glossary 894
Index 904
CONTENTS
Guided tour xxxiv
List of figures xxxviii
List of tables xlii
Preface xlv
Acknowledgements xlvii
SECTION I PHARMACOLOGY WITHIN THE SOCIAL CONTEXT 1
CHAPTER 1 An historical perspective 2
Objectives 2
Key terms 2
Drugs and society 3
The ages of pharmacology 3
The age of natural substances 4
The age of synthetic agents 5
The age of biotechnology 6
Summary 7
CHAPTER 2 Sociocultural aspects 8
Objectives 8
Key terms 8
Drug advertising 9
Over-the-counter preparations 10
Common characteristics of over-the-counter preparations 11
Generic versus brand-name preparations 12
Drug therapy in the older person 13
Polypharmacy 13
Nurses and polypharmacy 14
Drug therapy in ethnic groups 14
Summary 16
Further reading 16
Web resources 16
SECTION II PHARMACOLOGY WITHIN THE PROFESSIONAL CONTEXT 17
CHAPTER 3 Drug administration and the law 19
Objectives 19
Key terms 19
The Medicines Act 1968 20
The Misuse of Drugs Act 1971 21
Requisitions 22
Safe custody of drugs 23
Drug addiction 23
Nurses, midwives and health visitors: Standards for the Administration
of Medicines 23
Management of errors and incidents in the administration
of medicines 24
CONTENTS ix
Non-medical prescribing 24
Independent nurse and pharmacist prescribing 24
Supplementary prescribing 26
Patient group directions 26
Summary 26
Questions 27
CHAPTER 4 Ethical issues 28
Objectives 28
Key terms 28
Autonomy 29
Informed and valid consent 29
Rights of refusal 31
Veracity 31
The law and therapeutic privilege 32
Exceptions to veracity 32
Non-maleficence 32
Euthanasia 32
Withholding and withdrawing treatment 33
Beneficence 33
Duty of beneficence 33
Problems with paternalism 34
Conflicts with other principles 34
Justice 34
Allocation of scarce resources 34
Confidentiality 35
Difficulties in maintaining confidentiality 35
Conclusion 35
Summary 35
CHAPTER 5 The roles and responsibilities of nurses 36
Objectives 36
Key terms 36
Patient adherence 37
Patient education 38
Learning principles 38
Teaching principles 38
Patient advocacy 39
The nurse practitioner role 40
Nursing research 40
Summary 41
CHAPTER 6 The roles and responsibilities of other health-care professionals 42
Objectives 42
Key terms 42
The prescriber 43
The pharmacist 43
The physiotherapist 45
The podiatrist 45
The dietician 46
The paramedic 46
The naturopath 46
Summary 47
Case studies 48
Further reading 49
Web resources 50