, Table of Contents
Table of Contents 1
Chapter 01- Introduction to Drugs 3
Chapter 02- Drugs and the Body 20
Chapter 03- Toxic Effects of Drugs 37
Chapter 04- The Nursing Process in Drug Therapy and Patient Safety 54
Chapter 05- Dosage Calculations 71
Chapter 06- Challenges to Effective Drug Therapy 86
Chapter 07- Introduction to Cell Physiology 103
Chapter 08- Anti-infective Agents 120
Chapter 09- Antibiotics 138
Chapter 10- Antiviral Agents 155
Chapter 11- Antifungal Agents 172
Chapter 12- Antiprotozoal Agents 188
Chapter 13- Anthelmintic Agents 204
Chapter 14- Antineoplastic Agents 220
Chapter 15- Introduction to the Immune Response and Inflammation 237
Chapter 16- Anti-inflammatory, Antiarthritis, and Related Agents 254
Chapter 17- Immune Modulators 270
Chapter 18- Vaccines and Sera 287
Chapter 19- Introduction to Nerves and the Nervous System 304
Chapter 20- Anxiolytic and Hypnotic Agents 320
Chapter 21- Antidepressant Agents 337
Chapter 22- Psychotherapeutic Agents 354
Chapter 23- Antiseizure Agents 371
Chapter 24- Antiparkinsonism Agents 388
Chapter 25- Muscle Relaxants 404
Chapter 26- Narcotics, Narcotic Antagonists, and Antimigraine Agents 420
Chapter 27- General and Local Anesthetic Agents 436
Chapter 28- Neuromuscular Junction Blocking Agents 453
Chapter 29- Introduction to the Autonomic Nervous System 470
Chapter 30- Adrenergic Agonists 487
Chapter 31- Adrenergic Antagonists 503
Chapter 32- Cholinergic Agonists 520
Chapter 33- Anticholinergic Agents 536
Chapter 34- Introduction to the Endocrine System 553
Chapter 35- Hypothalamic and Pituitary Agents 569
Chapter 36- Adrenocortical Agents 585
Chapter 37- Thyroid and Parathyroid Agents 602
Chapter 38- Agents to Control Blood Glucose Levels 619
Chapter 39- Introduction to the Reproductive System 636
Chapter 40- Drugs Affecting the Female Reproductive System 653
Chapter 41- Drugs Affecting the Male Reproductive System 669
Chapter 42- Introduction to the Cardiovascular System 685
Chapter 43- Drugs Affecting Blood Pressure 702
Chapter 44- Agents for Treating Heart Failure 719
Chapter 45- Antiarrhythmic Agents 735
Chapter 46- Antianginal Agents 752
Chapter 47- Lipid-Lowering Agents 768
Chapter 48- Drugs Affecting Blood Coagulation 785
Chapter 49- Drugs Used to Treat Anemias 801
Chapter 50- Introduction to the Renal System 817
,Chapter 51- Diuretic Agents 833
Chapter 52- Drugs Affecting the Urinary Tract and the Bladder 849
Chapter 53- Introduction to the Respiratory System 866
Chapter 54- Drugs Acting on the Upper Respiratory Tract 883
Chapter 55- Drugs Acting on the Lower Respiratory Tract 900
Chapter 56- Introduction to the Gastrointestinal System 917
Chapter 57- Drugs Affecting Gastrointestinal Secretions 933
Chapter 58- Drugs Affecting Gastrointestinal Motility 949
Chapter 59- Antiemetic Agents 965
,Chapter 01- Introduction to Drugs
A nurse working in radiology administers iodine to a patient who is having a computed tomography(CT)
scan. The nurse working on the oncology unit administers chemotherapy to patients who have
cancer. At the Public Health Department, a nurse administers a measles-mumps-rubella (MMR)
vaccine to a 14-month-old child as a routine immunization. Which branch of pharmacology best
describes the actions of all three nurses?
Pharmacoeconomics
Pharmacotherapeutics
Pharmacodynamics
Pharmacokinetics
Ans: B
Feedback:
Pharmacology is the study of the biologic effects of chemicals. Nurses are involved with clinical
pharmacology or pharmacotherapeutics, which is a branch of pharmacology that deals with the uses of
drugs to treat, prevent, and diagnose disease. The radiology nurse is administering a drug to help
diagnose a disease. The oncology nurse is administering a drug to help treat a disease.
Pharmacoeconomics includes any costs involved in drug therapy. Pharmacodynamics involves how a
drug affects the body and pharmacokinetics is how the body acts on the body.
A physician has ordered intramuscular (IM) injections of morphine, a narcotic, every 4 hours as neededfor
pain in a motor vehicle accident victim. The nurse is aware this drug has a high abuse potential.
Under what category would morphine be classified?
Schedule I
Schedule II
Schedule III
Schedule IV
Ans: B
Feedback:
Narcotics with a high abuse potential are classified as Schedule II drugs because of severe dependence
, liability. fSchedule fI fdrugs fhave fhigh fabuse fpotential fand fno faccepted fmedical fuse. fSchedule
fIII fdrugs f have fa flesser fabuse fpotential fthan fII fand fan faccepted fmedical fuse. fSchedule fIV
fdrugs fhave flow fabuse f potential f and f limited f dependence f liability.
When finvolved fin fphase fIII fdrug fevaluation fstudies, fwhat fresponsibilities fwould fthe fnurse
fhave? f Working f with f animals f who fare f given f experimental f drugs
Choosing fappropriate fpatients fto fbe finvolved fin fthe fdrug
fstudy f Monitoring fand f observing f patients f closely f for fadverse
f effects fConducting fresearch fto f determine f effectiveness fof fthe
fdrugAns: f C
Feedback:
Phase fIII fstudies finvolve fuse fof fa fdrug fin fa fvast fclinical fpopulation fin fwhich fpatients fare
fasked fto frecord fany f symptoms f they f experience f while ftaking f the f drugs. f Nurses f may f be
fresponsible f for f helping f collect fand fanalyze fthe finformation fto fbe fshared fwith fthe fFood fand
fDrug fAdministration f(FDA) fbut fwould fnot f conduct f research f independently f because f nurses
f do f not f prescribe f medications. f Use f of f animals f in f drug f testing fis f done fin fthe f preclinical
ftrials. fSelect f patients fwho fare finvolved fin f phase f II f studies fto f participate f in f studies f where
fthe f participants f have f the f disease fthe f drug f is f intended f to f treat. f These f patients fare
f monitored fclosely ffor fdrug faction fand fadverse feffects. fPhase f I fstudies f involve f healthy fhuman
fvolunteers f who f are f usually f paid ffor f their f participation. f Nurses f may f observe f for fadverse
f effects fand f toxicity.
What fconcept fis fconsidered fwhen fgeneric fdrugs fare fsubstituted ffor fbrand fname fdrugs?
fBioavailability
Critical fconcentration
fDistribution
Half-life
f Ans: A
Feedback:
Bioavailability fis fthe fportion fof fa fdose fof fa fdrug fthat freaches fthe fsystemic fcirculation fand fis
favailable fto fact fon fbody fcells. fBinders fused fin fa fgeneric fdrug f may fnot fbe fthe fsame fas
fthose fused fin fthe fbrand fname f drug. f Therefore, f the f way f the f body f breaks f down f and f uses
fthe f drug f may f differ, f which f may f eliminate fa f generic f drug f substitution. f Critical
f concentration f is fthe famount f of f a f drug f that f is f needed f to f cause fa f therapeutic f effect fand
fshould f not f differ f between f generic fand fbrand f name f medications. f Distribution fis f the fphase fof
fpharmacokinetics, fwhich finvolves fthe fmovement fof fa fdrug fto fthe fbody’s ftissues fand fis fthe
, same fin fgeneric fand fbrand fname fdrugs. fA fdrug’s fhalf-life fis fthe ftime fit ftakes ffor fthe famount fof
fdrug fto f decrease fto f half fthe f peak flevel, f which fshould f not fchange f when fsubstituting f a f generic
f medication.
A fnurse fis fassessing fthe fpatient’s fhome fmedication fuse. fAfter flistening fto fthe fpatient flist fcurrent
f medications, fthe f nurse fasks f what f priority f question?
Do fyou ftake fany f generic f medications?
Are fany f of fthese f medications f orphan f drugs?
Are fthese fmedications fsafe fto ftake fduring
fpregnancy? f Do f you f take fany f over-the-counter
f medications?
Ans: D
Feedback:
It fis fimportant ffor fthe fnurse fto fspecifically fquestion fuse f of fover-the-counter f medications
f because f patients f may f not fconsider fthem fimportant. f The f patient fis funlikely fto f know fthe f meaning
fof forphan f drugs f unless f they f too f are f health f care f providers. f Safety f during f pregnancy, f use f of fa
f generic f medication, f or f classification fof f orphan f drugs f are f things f the f patient f would f be f unable
fto fanswer f but f could f be f found f in f reference f books fif f the f nurse f wishes f to f research f them.
After fcompleting fa fcourse fon fpharmacology ffor fnurses, fwhat fwill fthe fnurse fknow?
fEverything f necessary f for f safe fand f effective f medication f administration
Current fpharmacologic ftherapy; fthe fnurse fwill fnot frequire fongoing feducation ffor
f5 fyears. fGeneral fdrug finformation; fthe f nurse fcan fconsult fa fdrug f guide f for fspecific
fdrug finformation. f The f drug factions f that f are fassociated f with f each f classification f of
f medicationAns: C
Feedback:
After fcompleting fa fpharmacology fcourse fnurses fwill fhave fgeneral fdrug finformation fneeded ffor
fsafe fand f effective f medication fadministration fbut fwill fneed fto fconsult fa fdrug fguide ffor fspecific
fdrug finformation f before f administering fany f medication. f Pharmacology f is f constantly f changing,
f with f new f drugs f entering f the f market fand f new f uses f for f existing f drugs f identified. f Continuing
f education f in f pharmacology f is f essential fto f safe f practice. f Nurses ftend f to f become f familiar f with
fthe f medications f they f administer f most f often, fbut fthere fwill falways fbe fa fneed fto fresearch fnew
fdrugs fand falso fthose fthe fnurse fis fnot ffamiliar fwith f because f no f nurse f knows f all f medications.
, A fnurse fis finstructing fa fpregnant fpatient fconcerning fthe fpotential frisk fto fher ffetus ffrom fa
fPregnancy f Category f B f drug. f What f would f the f nurse finform f the f patient?
Adequate fstudies fin f pregnant f women f have f demonstrated f there f is f no f risk fto fthe ffetus.
Animal fstudies fhave fnot fdemonstrated fa frisk fto fthe ffetus, fbut fthere fhave fbeen fno fadequate fstudiesin
f pregnant f women.
Animal fstudies fhave fshown fan fadverse feffect fon fthe ffetus, fbut fthere fare fno fadequate fstudies
finpregnant f women.
There fis fevidence fof fhuman ffetal frisk, fbut fthe fpotential fbenefits ffrom fuse fof fthe fdrug fmay
fbeacceptable f despite f potential frisks.
Ans: B
Feedback:
Category fB findicates fthat fanimal fstudies fhave fnot fdemonstrated fa frisk fto fthe ffetus. fHowever,
fthere fhave f not fbeen fadequate fstudies fin fpregnant fwomen fto fdemonstrate frisk fto fa ffetus fduring
fthe ffirst ftrimester fof f pregnancy f and f no f evidence f of frisk f in f later ftrimesters. f Category f A
findicates f that f adequate fstudies f in f pregnant f women f have f not f demonstrated fa frisk fto fthe
ffetus fin fthe ffirst ftrimester f or fin flater ftrimesters.
Category fC findicates fthat fanimal fstudies fhave fshown fan fadverse feffect fon fthe ffetus, fbut
f no fadequate fstudies fin f humans. fCategory fD freveals fevidence fof f human f fetal frisk, fbut fthe
fpotential fbenefits ffrom fthe f use f of f the f drugs f in f pregnant f women f may f outweigh f potential
frisks.
Discharge fplanning ffor fpatients fleaving fthe fhospital fshould finclude finstructions fon fthe fuse fof fover-
the- fcounter f(OTC) fdrugs. fWhich fcomment fby fthe fpatient fwould fdemonstrate fa fgood
funderstanding f of fOTC f drugs?
OTC f drugs fare fsafe fand fdo f not f cause fadverse f effects fif f taken f properly.
OTC fdrugs fhave fbeen faround ffor fyears fand fhave fnot fbeen ftested fby fthe fFood fand fDrug
f Administration f(FDA).
OTC fdrugs fare fdifferent ffrom fany fdrugs favailable fby fprescription fand fcost
fless. f OTC f drugs f could fcause f serious f harm fif f not ftaken faccording f to
f directions.
Ans: D
Feedback:
It fis fimportant fto ffollow fpackage fdirections f because fOTCs fare fmedications fthat fcan fcause
fserious f harm f if f not f taken f properly. f OTCs f are f drugs f that f have f been f determined f to f be
fsafe f when f taken f as f directed; f however, fall fdrugs f can fproduce fadverse feffects feven f when