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Understanding Pharmacology

Essentials for Medication Safety

2 EDITION

M. Linda Workman, PhD, RN,

FAAN

Linda LaCharity, PhD, RN

Table of Contents

Cover image

Title page

Copyright

Dedication

About the Authors

Reviewers and Advisory Board

Preface
Chapter Organization

Learner-Friendly Instructional Design

Teaching and Learning Package

Acknowledgments

Special Features
Unit I General Aspects of Pharmacology

Chapter 1 Drug Regulation, Actions, and Responses

Drug Therapy

Ways in Which Drugs Affect the Body (Pharmacodynamics)

How the Body Uses and Changes Drugs (Pharmacokinetics)

Life Span Considerations

Drug Interactions

Get Ready for Practice!

Chapter 2 Safely Preparing and Giving Drugs

Overview

The Eight Rights of Safe Drug Administration

Types and Interpretation of Drug Orders

Drug Errors

Principles of Administering Drugs

Giving Enteral Drugs

Giving Parenteral Drugs

Giving Percutaneous Drugs

Get Ready for Practice!

Unit II Mathematics for Pharmacology and Dosage

Calculation
Chapter 3 Mathematics Review and Introduction to Dosage
Calculation
Why Do Health Professionals Need Mathematics?

Math Check

Getting Started

Talking About Numbers: A Whole Number Versus a Part of a Number

Solving Dosage and Calculation Problems

Get Ready for Practice!

Chapter 4 Medical Systems of Weights and Measures

Overview

Math Check

Measuring Systems Temperature: Fahrenheit and Celsius

Apothecary System for Drug Measurements

Household System for Liquid and Dry Measurements

Two-Step Drug Dosage Calculations

Get Ready for Practice!

Chapter 5 Dosage Calculation of Intravenous Solutions and Drugs

Overview

Get Ready for Practice!

Unit III Pharmacology for Multisystem Application

Chapter 6 Anti-Inflammatory Drugs
Review of Related Physiology and Pathophysiology

Types of Anti-Inflammatory Drugs

Get Ready for Practice!

Chapter 7 Drugs for Pain Control

Pain

Review of Related Physiology and Pathophysiology

General Issues Related to Analgesic Drug Therapy

Opioids (Narcotics)

Nonopioid Pain-Control Drugs

Get Ready for Practice!

Chapter 8 Anti-Infectives: Antibacterial Drugs

Review of Related Physiology and Pathophysiology

Antibacterial Therapy

General Issues in Antibacterial Therapy

Types of Antibacterial Drugs

Antibacterial Drug Resistance

Get Ready for Practice!

Chapter 9 Anti-Infectives: Antiviral Drugs

Viral Infection

Retroviral Infection
 Get Ready for Practice!

Chapter 10 Anti-Infectives: Antitubercular and Antifungal Drugs

Tuberculosis

Fungal Infections

Get Ready for Practice!

Chapter 11 Drugs That Affect the Immune System

Overview of the Immune System and Immunity

Immunosuppressive Therapy

Get Ready for Practice!

Chapter 12 Anticancer Drugs

Review of Related Physiology and Pathophysiology

Types of Cancer Treatment

Get Ready for Practice!

Unit IV Drug Therapy for Endocrine Problems

Chapter 13 Drug Therapy for Diabetes

Overview

Review of Related Physiology and Pathophysiology

Types of Drugs for Diabetes

Get Ready for Practice!

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

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

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
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*

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

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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
Publishing Services Manager: Jeff Patterson
Senior Project Manager: Jodi M. Willard
Design Direction: Renee Duenow

Printed in the United States of America

Last digit is the print number: 9 8 7 6 5 4 3 2 1

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
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.
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
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

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