1|Page
Davis's Canadian Drug Guide for Nurses (Summary)
,2|Page
Contents
Chapter 1: How to Use This Guide ......................................................................................... 12
1.1 Purpose of the Guide ..................................................................................................... 12
1.2 Organization of the Guide ............................................................................................. 12
1.3 Format of Drug Monographs......................................................................................... 12
1.4 Symbols and Highlights ................................................................................................ 13
1.5 Evidence and Sources ................................................................................................... 14
.............................................................................................................. 14
1.6 Using the Guide in Clinical Practice ............................................................................ 14
1.7 Safety First: The Nurse’s Role ...................................................................................... 15
Chapter 2: Evidence-Based Pharmacotherapeutics What Nurses Need to Know ........... 15
2.1 The Meaning of Evidence-Based Pharmacotherapeutics ......................................... 15
2.2 Key Principles of Pharmacotherapeutics .................................................................... 15
2.3 The Role of Evidence in Clinical Decision-Making .................................................... 16
2.4 From Research to the Bedside: The Nurse’s Process............................................... 16
2.5 The Nurse’s Scope of Pharmacotherapeutic Responsibility .................................... 17
2.6 The Importance of Continuing Education ................................................................... 17
2.7 Integrating Evidence with Compassionate Care ........................................................ 18
Chapter 3: Genetics and Drug Response — Pharmacogenomics in Nursing Practice... 18
3.1 Introduction ..................................................................................................................... 18
3.2 The Genetic Basis of Drug Response .......................................................................... 18
3.3 Nursing Implications of Pharmacogenomics ............................................................. 19
3.4 Ethical and Legal Considerations ................................................................................ 19
3.5 Current and Emerging Applications ............................................................................ 19
3.6 Summary ......................................................................................................................... 20
Chapter 4: Medication Safety — Errors, Near Misses, and System-Based Prevention... 20
4.1 Introduction ..................................................................................................................... 20
4.2 Understanding Medication Errors ................................................................................ 20
4.3 Near Misses and Error Reporting ................................................................................. 21
4.4 The “Five Rights” and Beyond ..................................................................................... 21
4.5 Human and System Factors .......................................................................................... 21
4.6 Technological Innovations in Safety............................................................................ 22
4.7 The Nurse’s Role in Prevention .................................................................................... 22
,3|Page
4.8 Building a Culture of Safety .......................................................................................... 23
4.9 Summary ......................................................................................................................... 23
Chapter 5: Recognising and Managing Adverse Drug Reactions (ADRs) ........................ 23
5.1 Introduction ..................................................................................................................... 23
5.2 Classification of ADRs ................................................................................................... 23
5.3 Risk Factors for ADRs ................................................................................................... 24
5.4 Clinical Recognition of ADRs ....................................................................................... 24
5.5 Management of ADRs .................................................................................................... 24
5.6 Reporting and Pharmacovigilance ............................................................................... 25
5.7 Patient Education and Follow-Up ................................................................................. 25
5.8 Summary ......................................................................................................................... 26
Chapter 6: Risk-Mitigation Systems — Regulatory Frameworks and High-Alert
Medications............................................................................................................................... 26
6.1 Introduction ..................................................................................................................... 26
6.2 Regulatory Oversight in Canada .................................................................................. 26
6.3 Institutional Risk-Management Systems ..................................................................... 26
6.4 High-Alert Medications .................................................................................................. 27
6.5 Risk-Mitigation Strategies ............................................................................................. 27
6.6 Root-Cause Analysis (RCA) and Continuous Improvement ..................................... 28
6.7 Ethical and Legal Accountability.................................................................................. 28
6.8 Summary ......................................................................................................................... 28
Chapter 7: Special Dosing Considerations — Paediatrics, Geriatrics, Pregnancy, and
Organ Impairment .................................................................................................................... 28
7.1 Introduction ..................................................................................................................... 28
7.2 Paediatric Considerations ............................................................................................. 29
7.3 Geriatric Considerations ............................................................................................... 29
7.4 Pregnancy and Lactation .............................................................................................. 30
7.5 Renal and Hepatic Impairment ..................................................................................... 30
7.6 Obesity and Other Special Populations ...................................................................... 31
7.7 Summary ......................................................................................................................... 31
Chapter 8: The Cytochrome P450 System and Drug Interactions — What Nurses Should
Understand ............................................................................................................................... 31
8.1 Introduction ..................................................................................................................... 31
8.2 Overview of the CYP450 System .................................................................................. 31
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8.3 Drug–Drug Interactions ................................................................................................. 32
8.4 Drug–Food Interactions ................................................................................................. 32
8.5 Genetic Variability and the CYP450 System ............................................................... 32
8.6 Environmental and Lifestyle Influences ...................................................................... 33
8.7 Monitoring and Clinical Decision-Making ................................................................... 33
8.8 Summary ......................................................................................................................... 33
Chapter 9: Patient and Family Education — Teaching Safe Medication Use ................... 33
9.1 Introduction ..................................................................................................................... 33
9.2 The Role of the Nurse as Educator .............................................................................. 34
9.3 Core Teaching Topics for Safe Medication Use ......................................................... 34
9.4 Culturally Competent Communication ........................................................................ 34
9.5 Strategies for Promoting Adherence ........................................................................... 35
9.6 Education Across the Lifespan .................................................................................... 35
9.7 Evaluation of Learning................................................................................................... 35
9.8 Summary ......................................................................................................................... 36
Chapter 10: Drug Administration by Route and Technique ................................................ 36
10.1 Introduction................................................................................................................... 36
10.2 Oral Route (PO)............................................................................................................. 36
10.3 Sublingual and Buccal Routes ................................................................................... 36
10.4 Parenteral Routes (Intradermal, Subcutaneous, Intramuscular, Intravenous) ..... 37
10.5 Topical and Transdermal Routes ............................................................................... 37
10.6 Inhalation Route ........................................................................................................... 37
10.7 Rectal and Vaginal Routes .......................................................................................... 38
10.8 Ophthalmic and Otic Administration ......................................................................... 38
10.9 Nasal and Nebulized Routes ....................................................................................... 38
10.10 Intrathecal, Epidural, and Intraosseous Routes ..................................................... 38
10.11 Safety Precautions ..................................................................................................... 38
10.12 Summary ..................................................................................................................... 39
Chapter 11: Adverse Drug Reactions and Toxicology ........................................................ 39
11.1 Introduction................................................................................................................... 39
11.2 Classification of Adverse Drug Reactions ................................................................ 39
11.3 Common Adverse Drug Reactions............................................................................. 40
11.4 Nursing Responsibilities in ADR Management ........................................................ 40
Davis's Canadian Drug Guide for Nurses (Summary)
,2|Page
Contents
Chapter 1: How to Use This Guide ......................................................................................... 12
1.1 Purpose of the Guide ..................................................................................................... 12
1.2 Organization of the Guide ............................................................................................. 12
1.3 Format of Drug Monographs......................................................................................... 12
1.4 Symbols and Highlights ................................................................................................ 13
1.5 Evidence and Sources ................................................................................................... 14
.............................................................................................................. 14
1.6 Using the Guide in Clinical Practice ............................................................................ 14
1.7 Safety First: The Nurse’s Role ...................................................................................... 15
Chapter 2: Evidence-Based Pharmacotherapeutics What Nurses Need to Know ........... 15
2.1 The Meaning of Evidence-Based Pharmacotherapeutics ......................................... 15
2.2 Key Principles of Pharmacotherapeutics .................................................................... 15
2.3 The Role of Evidence in Clinical Decision-Making .................................................... 16
2.4 From Research to the Bedside: The Nurse’s Process............................................... 16
2.5 The Nurse’s Scope of Pharmacotherapeutic Responsibility .................................... 17
2.6 The Importance of Continuing Education ................................................................... 17
2.7 Integrating Evidence with Compassionate Care ........................................................ 18
Chapter 3: Genetics and Drug Response — Pharmacogenomics in Nursing Practice... 18
3.1 Introduction ..................................................................................................................... 18
3.2 The Genetic Basis of Drug Response .......................................................................... 18
3.3 Nursing Implications of Pharmacogenomics ............................................................. 19
3.4 Ethical and Legal Considerations ................................................................................ 19
3.5 Current and Emerging Applications ............................................................................ 19
3.6 Summary ......................................................................................................................... 20
Chapter 4: Medication Safety — Errors, Near Misses, and System-Based Prevention... 20
4.1 Introduction ..................................................................................................................... 20
4.2 Understanding Medication Errors ................................................................................ 20
4.3 Near Misses and Error Reporting ................................................................................. 21
4.4 The “Five Rights” and Beyond ..................................................................................... 21
4.5 Human and System Factors .......................................................................................... 21
4.6 Technological Innovations in Safety............................................................................ 22
4.7 The Nurse’s Role in Prevention .................................................................................... 22
,3|Page
4.8 Building a Culture of Safety .......................................................................................... 23
4.9 Summary ......................................................................................................................... 23
Chapter 5: Recognising and Managing Adverse Drug Reactions (ADRs) ........................ 23
5.1 Introduction ..................................................................................................................... 23
5.2 Classification of ADRs ................................................................................................... 23
5.3 Risk Factors for ADRs ................................................................................................... 24
5.4 Clinical Recognition of ADRs ....................................................................................... 24
5.5 Management of ADRs .................................................................................................... 24
5.6 Reporting and Pharmacovigilance ............................................................................... 25
5.7 Patient Education and Follow-Up ................................................................................. 25
5.8 Summary ......................................................................................................................... 26
Chapter 6: Risk-Mitigation Systems — Regulatory Frameworks and High-Alert
Medications............................................................................................................................... 26
6.1 Introduction ..................................................................................................................... 26
6.2 Regulatory Oversight in Canada .................................................................................. 26
6.3 Institutional Risk-Management Systems ..................................................................... 26
6.4 High-Alert Medications .................................................................................................. 27
6.5 Risk-Mitigation Strategies ............................................................................................. 27
6.6 Root-Cause Analysis (RCA) and Continuous Improvement ..................................... 28
6.7 Ethical and Legal Accountability.................................................................................. 28
6.8 Summary ......................................................................................................................... 28
Chapter 7: Special Dosing Considerations — Paediatrics, Geriatrics, Pregnancy, and
Organ Impairment .................................................................................................................... 28
7.1 Introduction ..................................................................................................................... 28
7.2 Paediatric Considerations ............................................................................................. 29
7.3 Geriatric Considerations ............................................................................................... 29
7.4 Pregnancy and Lactation .............................................................................................. 30
7.5 Renal and Hepatic Impairment ..................................................................................... 30
7.6 Obesity and Other Special Populations ...................................................................... 31
7.7 Summary ......................................................................................................................... 31
Chapter 8: The Cytochrome P450 System and Drug Interactions — What Nurses Should
Understand ............................................................................................................................... 31
8.1 Introduction ..................................................................................................................... 31
8.2 Overview of the CYP450 System .................................................................................. 31
, 4|Page
8.3 Drug–Drug Interactions ................................................................................................. 32
8.4 Drug–Food Interactions ................................................................................................. 32
8.5 Genetic Variability and the CYP450 System ............................................................... 32
8.6 Environmental and Lifestyle Influences ...................................................................... 33
8.7 Monitoring and Clinical Decision-Making ................................................................... 33
8.8 Summary ......................................................................................................................... 33
Chapter 9: Patient and Family Education — Teaching Safe Medication Use ................... 33
9.1 Introduction ..................................................................................................................... 33
9.2 The Role of the Nurse as Educator .............................................................................. 34
9.3 Core Teaching Topics for Safe Medication Use ......................................................... 34
9.4 Culturally Competent Communication ........................................................................ 34
9.5 Strategies for Promoting Adherence ........................................................................... 35
9.6 Education Across the Lifespan .................................................................................... 35
9.7 Evaluation of Learning................................................................................................... 35
9.8 Summary ......................................................................................................................... 36
Chapter 10: Drug Administration by Route and Technique ................................................ 36
10.1 Introduction................................................................................................................... 36
10.2 Oral Route (PO)............................................................................................................. 36
10.3 Sublingual and Buccal Routes ................................................................................... 36
10.4 Parenteral Routes (Intradermal, Subcutaneous, Intramuscular, Intravenous) ..... 37
10.5 Topical and Transdermal Routes ............................................................................... 37
10.6 Inhalation Route ........................................................................................................... 37
10.7 Rectal and Vaginal Routes .......................................................................................... 38
10.8 Ophthalmic and Otic Administration ......................................................................... 38
10.9 Nasal and Nebulized Routes ....................................................................................... 38
10.10 Intrathecal, Epidural, and Intraosseous Routes ..................................................... 38
10.11 Safety Precautions ..................................................................................................... 38
10.12 Summary ..................................................................................................................... 39
Chapter 11: Adverse Drug Reactions and Toxicology ........................................................ 39
11.1 Introduction................................................................................................................... 39
11.2 Classification of Adverse Drug Reactions ................................................................ 39
11.3 Common Adverse Drug Reactions............................................................................. 40
11.4 Nursing Responsibilities in ADR Management ........................................................ 40
