Understanding Pharmacology Essentials for Medication
Safety 2nd Edition
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Chapter 14 Drug Therapy for Thyroid and Adrenal Gland Problems
Overview
Hypothyroidism
Hyperthyroidism
Adrenal Gland Hypofunction
Adrenal Gland Hyperfunction
Get Ready for Practice!
Unit V Drug Therapy for Problems of the Circulatory and Cardiac
Systems
Chapter 15 Drugs That Affect Urine Output
Diuretics
Overactive Bladder
Get Ready for Practice!
Chapter 16 Drug Therapy for Hypertension
Overview
Review of Related Physiology and Pathophysiology
General Issues for Antihypertensive Therapy
Types of Antihypertensive Drugs
Get Ready for Practice!
Chapter 17 Drug Therapy for Heart Failure
Overview
Review of Related Physiology and Pathophysiology
Treatment for Heart Failure
General Issues in Heart Failure Therapy
Types of Drugs Used to Treat Heart Failure
Get Ready for Practice!
Chapter 18 Drug Therapy for Dysrhythmias
Review of Related Physiology and Pathophysiology
General Issues Related to Antidysrhythmic Therapy
Types of Antidysrhythmic Drugs
Drugs for Tachydysrhythmias
Unclassified Antidysrhythmic Drugs
Get Ready for Practice!
Chapter 19 Drug Therapy for High Blood Lipids
Overview
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Review of Related Physiology and Pathophysiology
General Issues for Antihyperlipidemic Therapy
Types of Lipid-Lowering Drugs
Get Ready for Practice!
Chapter 20 Drugs That Affect Blood Clotting
Overview
Review of Related Physiology and Pathophysiology
General Issues for Anticoagulant Therapy
Types of Drugs That Affect Blood Clotting
Get Ready for Practice!
Unit VI Drug Therapy for Respiratory System Problems
Chapter 21 Drug Therapy for Asthma and Other Respiratory Problems
Overview
Review of Related Physiology and Pathophysiology
Types of Drugs for Asthma and COPD
Other Serious Respiratory Disorders
Types of Drug Therapy for Pulmonary Artery Hypertension
Get Ready for Practice!
Unit VII Drug Therapy for Gastrointestinal System Problems
Chapter 22 Drug Therapy for Gastrointestinal Problems
Overview
Nausea and Vomiting
Constipation
Diarrhea
Get Ready for Practice!
Chapter 23 Drug Therapy for Gastric Ulcers and Reflux
Overview
Review of Related Physiology and Pathophysiology
General Issues for Drugs for PUD and GERD
Types of Drugs for PUD and GERD
Other Drugs Used to Treat Ulcers
Get Ready for Practice!
Chapter 24 Drug Therapy with Nutritional Supplements
7
Overview
Review of Related Physiology and Pathophysiology
Get Ready for Practice!
Unit VIII Drug Therapy for Nervous System Problems
Chapter 25 Drug Therapy for Seizures
Overview
Review of Related Physiology and Pathophysiology
Treatment of Seizures
Types of Antiseizure Drugs
Get Ready for Practice!
Chapter 26 Drug Therapy for Alzheimer's and Parkinson's Diseases
Overview
Alzheimer's Disease
Parkinson's Disease
Get Ready for Practice!
Chapter 27 Drug Therapy for Psychiatric Problems
Overview
Depression
Anxiety
Psychosis
Get Ready for Practice!
Chapter 28 Drug Therapy for Insomnia
Insomnia
Get Ready for Practice!
Chapter 29 Drug Therapy for Eye Problems
Overview
Review of Related Physiology and Pathophysiology
General Issues for Local Eye Drug Therapy
Types of Drugs for Glaucoma
Get Ready for Practice!
Unit IX Drug Therapy for Problems of the Musculoskeletal System
Chapter 30 Drug Therapy for Osteoporosis, Arthritis, and Skeletal Muscle Relaxation
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The Musculoskeletal System
Osteoporosis
Arthritis
Muscle Spasms
Get Ready for Practice!
Unit X Drug Therapy for Problems of the Reproductive System
Chapter 31 Drug Therapy for Male Reproductive Problems
Benign Prostatic Hyperplasia
Get Ready for Practice!
Chapter 32 Drug Therapy for Female Reproductive Issues
Menopause
Contraception
Get Ready for Practice!
Appendix A Medication Administration Skills*
Bibliography
Index
The Joint Commission's Official “Do Not Use” List*
9
Copyright
3251 Riverport Lane
St. Louis, Missouri 63043
UNDERSTANDING PHARMACOLOGY: ESSENTIALS FOR MEDICATION SAFETY, SECOND
EDITION ISBN: 978-1-4557-3976-9
Copyright © 2016, by Elsevier Inc. All rights reserved.
No part of this publication may be reproduced or transmitted in any form or by any means,
electronic or mechanical, including photocopying, recording, or any information storage and
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can be found at our website: www.elsevier.com/permissions.
This book and the individual contributions contained in it are protected under copyright by the
Publisher (other than as may be noted herein).
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.
With respect to any drug or pharmaceutical products identified, readers are advised to check the
most current information provided (i) on procedures featured or (ii) by the manufacturer of each
product to be administered, to verify the recommended dose or formula, the method and duration
of administration, and contraindications. It is the responsibility of practitioners, relying on their
own experience and knowledge of their patients, to make diagnoses, to determine dosages and the
best treatment for each individual patient, and to take all appropriate safety precautions.
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.
Previous edition copyrighted 2011.
International Standard Book Number: 978-1-4557-3976-9
Senior Content Strategist: Nancy O'Brien
Content Development Manager: Ellen Wurm-Cutter, Laurie Gower
Content Development Specialist: Heather Rippetoe, Laura Goodrich
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Printed in the United States of America
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Last digit is the print number: 9 8 7 6 5 4 3 2 1
11
Dedication
To David, Emmy, and Violet, who complete my rainbow.
M. Linda Workman
To my mother, the late Routh Annette Jenkins. An extraordinary woman and the inspiration for
my research and the shaping of my career.
Linda LaCharity
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About the Authors
M. Linda Workman, a native of Canada, received her BSN from the University of Cincinnati
College of Nursing and Health. She later earned her MSN and a PhD in Developmental Biology
from the University of Cincinnati. Linda's more than 30 years of academic experience include
teaching at the diploma, associate degree, baccalaureate, and master's levels. Her areas of teaching
expertise include medical-surgical nursing, pharmacology, physiology, and pathophysiology. Linda
has been called the “Mr. Rogers” of nursing education for her ability to creatively present complex
physiologic concepts in a manner that promotes student retention of the information. She has been
recognized nationally for her teaching expertise and has received Excellence in Teaching awards
from Raymond Walters College, the University of Cincinnati, and Case Western Reserve University.
Currently she consults with a variety of nursing programs on teaching and curricular issues and co-
authors a medical-surgical nursing textbook (Ignatavicius and Workman: Medical-Surgical Nursing:
Patient-Centered Collaborative Care) and a genetics textbook.
Linda LaCharity received her BSN from Kent State University's College of Nursing. During her
career in the U.S. Army Nurse Corps, she earned an MN from the University of Washington in
Seattle. Linda earned her PhD from the University of Cincinnati. She worked as a staff nurse and
nurse manager in adult medical-surgical and critical care settings supervising RNs, LPN/LVNs, and
nursing assistant staff. Linda's academic experience includes teaching EMTs and critical care nurses
for the military and across the curriculum at the University of Cincinnati (BSN, MSN, Accelerated
BSN/MSN, and PhD). Her area of teaching expertise in both classroom and patient care settings is
adult health. She was director of the Accelerated Program and an Assistant Professor in the College
of Nursing at the University of Cincinnati in Cincinnati, Ohio. Retired in 2013, she continues to
write textbooks.
13
Reviewers and Advisory Board
REVIEWERS
Chris Bridgers PharmD
Saint Joseph's Hospital
Atlanta, Georgia
Andrew D. Case BSN, MSN
Professor of Human Anatomy, Physiology, and Pharmacology
Southeast Community College
Lincoln, Nebraska
Diane K. Daddario MSN, ACNS-BC, RN, BC, CMSRN
Clinical Nursing Instructor
Pennsylvania College of Technology
Williamsport, Pennsylvania
Michael Dorich PhD, CST, CAHI
Program Director, Surgical Technology
Pittsburgh Technical Institute
Oakdale, Pennsylvania
Gail E. Dunham MSN
Professor of Nursing
Mid Michigan Community College
Harrison, Michigan
Sally Flesch RN, BSN, MA, EdS, PhD
Coordinator, Professor
Practical Nursing Program
Black Hawk College
Moline, Illinois
Cathy Maddry MSN, MA, RN, Alumnus CCRN
Department Head
Heath Occupations
Northwest Louisiana Technical College
Minden Louisiana
Mary E. Stassi RN-BC
Health Occupations Coordinator
St. Charles Community College
Cottleville, Missouri
Claudia Stoffel MSN, RN, CNE
Practical Nursing Program Coordinator
West Kentucky Community and Technical College
Paducah, Kentucky
Audrey Tolouian MSN, BSW, (EdD)
Clinical Instructor, School of Nursing
University of Texas
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El Paso, Texas
Erin Yesenosky MSN
Nursing Instructor
Greater Altoona Career & Technology Center
Altoona, Pennsylvania
ADVISORY BOARD
Nancy Bohnarczyk MA
Adjunct Instructor
College of Mount St. Vincent
New York, New York
Sharyn P. Boyle MSN, RN-BC
Instructor, Associate Degree Nursing
Passaic County Technical Institute
Wayne, New Jersey
Nicola Contreras BN, RN
Faculty
Galen College
San Antonio, Texas
Dolores Cotton MSN, RN
Practical Nursing Coordinator
Meridian Technology Center
Stillwater, Oklahoma
Sharon Gordon MSN, RN, CNOR-E
Practical Nursing Faculty
Lehigh Carbon Community College
Schnecksville, Pennsylvania
Nancy Haughton MSN, RN
Practical Nursing Program Faculty
Chester County Intermediate Unit
Downingtown, Pennsylvania
Shelly Hovis MS, RN
Director, Practical Nursing
Kiamichi Technology Centers
Antlers, Oklahoma
Dawn Johnson RN, MSN, Ed
Practical Nurse Program Director
Great Lakes Institute of Technology
Erie, Pennsylvania
Kristin Madigan RN, MS
Nursing Faculty
Pine Technical and Community College
Pine City, Minnesota
Hana Malik RN, MSN, FNP-BC
Academic Director
Illinois College of Nursing
Lombard, Illinois
Barb Ratliff RN, MSN
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Associate Director of Health Programs
Butler Technology and Career Development Schools
Hamilton, Ohio
Faye Silverman RN, MSN/Ed, PHN, WOCN
Director of Professional Nursing
Kaplan College - North Hollywood Campus
North Hollywood, California
Russlyn A. St. John RN, MSN
Professor and Coordinator, Practical Nursing
Practical Nursing Department
St. Charles Community College
Cottleville, Missouri
Fleur de Liza Tobias-Cuyco BSC, CPhT
Dean, Director of Student Affairs, and Instructor
Preferred College of Nursing
Los Angeles, California
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Preface
The authors of this text are nurses and educators with many decades of clinical and teaching
experience. Our concept of what is needed in a pharmacology textbook is derived from the desire to
create a book that will help students identify the most important content areas for safe drug
administration and patient teaching. With this goal in mind, we developed a unique format based
on four focus areas:
• Why specific drugs are prescribed as therapy for common health problems
• How different drugs work to induce their intended responses
• What critical actions and assessments to perform before and after administering drugs
• Which points are most important to teach patients about their drug therapy
Using these focus areas, we present pharmacology content in a framework that promotes in-
depth learning versus rote memorization, which is truly essential in understanding the principles of
pharmacology and safe drug administration. Interwoven within the textbook are areas that
highlight specific safety issues with regard to medication administration. The impetus for this
inclusion are the recommendations championed by the American Association of Colleges of
Nursing, collectively known as the Quality and Safety Education for Nurses (QSEN) practice
standards. Although this initiative is nursing based, the focus on safety must be a major directive
for all health care professionals involved in the prescribing, preparing, dispensing, and
administering aspects of drug therapy. Specific actions related to safety are noted with “QSEN”
throughout the text.
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Chapter Organization
The textbook has been expanded to accommodate requested information in content areas not
presented in the first edition. These areas now include immunizations and drugs affecting the
immune system, drug therapy for adrenal gland problems, nutritional supplements, drug therapy
for musculoskeletal problems, and drug therapy for common problems of the male and female
reproductive systems. The text has been reorganized into 10 units totaling 32 chapters to streamline
access to specific content areas. Unit I provides an overview of general content important for safe
medication administration. Unit II provides essential mathematical concepts and practice for safe
dosage calculation. Unit III focuses on content that has application to many body systems, such as
inflammation, infection, pain, and cancer. The remaining seven units are divided by the body
system most closely associated with the specific drug therapy. For example, Unit V, Drug Therapy
for Problems of the Circulatory and Cardiac Systems, is further divided into six chapters that
include drug therapy affecting urine output, hypertension, heart failure, dysrhythmias, high blood
lipids, and blood clotting. We believe this content arrangement synchronizes the information for
students when they are studying specific health problems and issues. Although information
regarding normal physiology and pathophysiology is still presented, this information has been
streamlined to promote the pharmacology focus of the text.
Our presentation style for the content of this text is direct, active, and clear. Health care terms and
related physiological mechanisms are explained in clear, straightforward, everyday language to
promote better student understanding and application of the content in the clinical setting.
Photographs and other illustrations have been selected and developed to better explain drug
administration techniques, drug actions, and appropriate health care interventions.
Chapter Objectives presented at the beginning of each chapter focus the student on “need to
know” information, clarifying which issues have the highest priority for safe drug administration.
A list of Key Terms includes phonetic pronunciations, definitions, and page numbers where each
term is first used.
The mathematics review chapters (Chapters 3, 4, and 5) are written in a self-paced, guided-study
format and contain easy-to-understand explanations and examples. Try This! boxes provide more
than 150 practice questions within these chapters, in addition to the end-of-chapter review material.
Answers to these exercises are found at the end of the chapters.
In-text drug tables outline the most common drugs used to treat highlighted disorders and
diseases. Generic and trade names and common dosage ranges for adults and children are included.
Discussion sections on “What To Do Before,” “What To Do After,” and “What to Teach
Patients” about each highlighted drug or drug category emphasize the important aspects of drug
administration, monitoring, follow-up, and patient teaching.
Life Span Considerations sections receive particular attention in most chapters. Differences in
actions, the risks for side effects, precautions, or dosing for pediatric patients, pregnant or
breastfeeding patients, or older adults are presented as appropriate for each drug class.
A Get Ready for Practice! section at the end of each chapter features Key Points, Additional
Learning Resources, Review Questions, and Critical Thinking Activities.
• Key Points emphasize selected need-to-know content from the chapter to help students study for
tests and certification/licensure exams.
• Additional Learning Resources sections refer students to related review material in the
accompanying Study Guide and on the Evolve website at
http://evolve.elsevier.com/Workman/pharmacology/.
• Review Questions correspond item-by-item with the Objectives at the beginning of the chapter.
Drug calculation questions are also included in this section. Answers to the Review Questions are
located on the Evolve site. These review questions are divided by basic and advanced level
concepts.
• Critical Thinking Activities are true-to-practice case studies that present issues and problems
requiring clinical decision making related to individual patients receiving pharmacologic therapy.
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