, Brief Contents
Chapter 28 Drugs for Angina Pectoris and
Unit 1
Myocardial Infarction 379
Core Concepts in Pharmacology 1 Chapter 29 Drugs for Shock 395
Chapter 30 Drugs for Dysrhythmias 407
Chapter 1 Introduction to Pharmacology 2 Chapter 31 Drugs for Coagulation Disorders 423
Chapter 2 Drug Approval and Regulation 11 Chapter 32 Drugs for Hematopoietic Disorders 441
Chapter 3 Principles of Drug Administration 21
Chapter 4 Pharmacokinetics 39
Unit 5
Chapter 5 Pharmacodynamics 51
The Immune System 455
Unit 2
Chapter 33 Drugs for Inflammation and Fever 456
Pharmacology and the Chapter 34 Drugs for Immune System Modulation 471
Drugs for Bacterial Infections 491
Nurse–Patient Relationship 61 Chapter 35
Chapter 36 Drugs for Tubercular, Fungal, Protozoan,
Chapter 6 The Nursing Process and Clinical Judgment and Helminthic Infections 517
Measurement Model in Pharmacology 62 Chapter 37 Drugs for Viral Infections 537
Chapter 7 Medication Errors and Risk Reduction 71 Chapter 38 Drugs for Neoplasia 557
Chapter 8 Drug Administration Throughout
the Lifespan 83 Unit 6
Chapter 9 Individual Variations in Drug Response 95
Chapter 10 The Role of Complementary and The Respiratory System 581
Alternative Therapies in Pharmacology 105
Chapter 39 Drugs for Allergic Rhinitis and the
Chapter 11 Emergency Preparedness and Poisonings 115
Common Cold 582
Chapter 40 Drugs for Asthma and Other
Unit 3 Pulmonary Disorders 597
The Nervous System 127
Unit 7
Chapter 12 Cholinergic Drugs Affecting the Autonomic
Nervous System 128 The Gastrointestinal System 613
Chapter 13 Adrenergic Drugs Affecting the Autonomic
Chapter 41 Drugs for Peptic Ulcer Disease 614
Nervous System 143
Chapter 42 Drugs for Bowel Disorders and Other
Chapter 14 Drugs for Anxiety and Sleep Disorders 155
Gastrointestinal Conditions 629
Chapter 15 Drugs for Mood and Behavioral Disorders 169
Chapter 43 Drugs for Nutritional Disorders 647
Chapter 16 Drugs for Psychoses 189
Chapter 17 Drugs for Seizures 203
Chapter 18 Drugs for Pain Management 221 Unit 8
Drugs for Local and General Anesthesia 243
Chapter 19
Chapter 20 Drugs for Degenerative Diseases of the
The Endocrine System 667
Nervous System 259 Chapter 44 Drugs for Pituitary, Thyroid, and Adrenal
Chapter 21 Drugs for Muscle Spasms and Spasticity 277 Disorders 668
Chapter 22 Substance Use Disorder 289 Chapter 45 Drugs for Diabetes Mellitus 689
Chapter 46 Drugs for Disorders and Conditions of the
Unit 4 Female Reproductive System 705
Chapter 47 Drugs for Disorders and Conditions of the
The Cardiovascular and Male Reproductive System 727
Urinary Systems 301
Unit 9
Chapter 23 Drugs for Lipid Disorders 302
Chapter 24 Diuretic Therapy and Drugs for Chronic The Integumentary System,
Kidney Disease 317 Eyes, and Ears 741
Chapter 25 Drugs for Fluid Balance, Electrolyte, and
Acid–Base Disorders 331 Chapter 48 Drugs for Bone and Joint Disorders 742
Chapter 26 Drugs for Hypertension 345 Chapter 49 Drugs for Skin Disorders 765
Chapter 27 Drugs for Heart Failure 365 Chapter 50 Drugs for Eye and Ear Disorders 783
A01_Adams_7_97097.indd 1 24/03/23 8:34
, Seventh Edition
Pharmacology for
Nurses
A Pathophysiologic Approach
Michael Patrick Adams
Adjunct Professor of Anatomy and Physiology
Hillsborough Community College
Formerly Dean of Health Professions
Pasco-Hernando State College
Leland Norman Holland, Jr.
Professor
Hillsborough Community College
Polk State College
Shanti Ellen Chang
Assistant Professor of Nursing
College of Public Health
George Mason University
A01_Adams_7_97097.indd 3 24/03/23 8:34
, Preface
When students are asked which subject in their nursing Students will love this concise, one-column format that
program is the most challenging, pharmacology always reinforces the clinical judgment measurement model.
appears near the top of the list. The study of pharmacology • NEW! Emerging therapies for the prevention and treat-
demands that students apply knowledge from a wide vari- ment of COVID-19 infections have been added to the
ety of the natural and applied sciences. Successfully pre- antiviral chapter.
dicting drug action requires a thorough knowledge of
• NEW! Coverage of emerging mechanisms in pharma-
anatomy, physiology, chemistry, and pathology as well as
cotherapy are discussed, including use of m-RNA vac-
the social sciences of psychology and sociology. Lack of
cines to teat COVID-19 infections, SGLT2 inhibitors for
adequate pharmacology knowledge can result in immedi-
diabetes, and CGRP inhibitors for migraine.
ate and direct harm to the patient; thus, the stakes in learn-
ing the subject are high. • NEW! Pharmacotherapy of cystic fibrosis, narcolepsy,
Pharmacology cannot be made easy, but it can be and amyotrophic lateral sclerosis has been added.
made understandable when the proper connections are • EXPANDED! Includes more than 120 new drugs,
made to knowledge learned in these other disciplines. The drug classes, indications, and therapies that have been
vast majority of drugs in clinical practice are prescribed for approved since the last edition.
specific diseases, yet many pharmacology textbooks fail to • EXPANDED! Includes new and updated information
recognize the complex interrelationships between pharma- on the importance of biomarkers and pharmacogenet-
cology and pathophysiology. When drugs are learned in ics in the diagnosis and treatment of disease.
isolation from their associated diseases or conditions, stu-
• EXPANDED! All drug tables drugs have been revised
dents have difficulty connecting pharmacotherapy to ther-
to reflect changes in therapeutics.
apeutic goals and patient wellness. The pathophysiology
• UPDATED! Includes new CDC recommendations of
focus of this textbook gives the student a clearer picture of
the prevention of HIV infection following occupational
the importance of pharmacology to disease and, ulti-
exposure, nonoccupational exposure, perinatal expo-
mately, to patient care. The approach and rationale of this
sure, and preexposure prophylaxis.
textbook focus on a holistic perspective to patient care
which clearly shows the benefits and limitations of phar- • UPDATED! The latest black box warnings issued by
macotherapy in curing or preventing illness. In addition to the FDA are included for all appropriate drug proto-
its pathophysiology focus, medication safety and interdis- types.
ciplinary teamwork are consistently emphasized through- • UPDATED! All references have been updated to reflect
out the text. Although difficult and challenging, the study current pharmacotherapeutics.
of pharmacology is truly a fascinating, lifelong journey. • UPDATED! Ten new special features have been
added in topics applying research to nursing practice,
New to This Edition community-oriented practice, lifespan considerations,
and patient safety.
It is amazing how much pharmacology has changed in the
past 4 years. The seventh edition of Pharmacology for
Nurses: A Pathophysiologic Approach has been thoroughly
updated to reflect these changes to current pharmacother-
Organization and Structure—A
apeutics and advances in understanding disease. Pathophysiology Approach
It is not enough for nursing students to memorize names,
• NEW! Pregnancy data for all prototype drugs have
doses, and actions of medications. Not only would this be
been completely updated and expanded to reflect FDA
overwhelming (and boring), but those who wish to enter
requirements implemented since the previous edition.
nursing must develop higher levels of understanding and
• NEW! The clinical judgment measurement model
demonstrate analytical and evaluation skills. The authors
is now discussed and integrated into all appropriate
created this text to assist students in reaching those
medication chapters.
levels.
• NEW! The nursing practice application feature has been Pharmacology for Nurses: A Pathophysiologic Approach
totally transformed into Nursing Clinical Judgement. is organized according to body systems (units) and
ix
A01_Adams_7_97097.indd 9 24/03/23 8:34
Chapter 28 Drugs for Angina Pectoris and
Unit 1
Myocardial Infarction 379
Core Concepts in Pharmacology 1 Chapter 29 Drugs for Shock 395
Chapter 30 Drugs for Dysrhythmias 407
Chapter 1 Introduction to Pharmacology 2 Chapter 31 Drugs for Coagulation Disorders 423
Chapter 2 Drug Approval and Regulation 11 Chapter 32 Drugs for Hematopoietic Disorders 441
Chapter 3 Principles of Drug Administration 21
Chapter 4 Pharmacokinetics 39
Unit 5
Chapter 5 Pharmacodynamics 51
The Immune System 455
Unit 2
Chapter 33 Drugs for Inflammation and Fever 456
Pharmacology and the Chapter 34 Drugs for Immune System Modulation 471
Drugs for Bacterial Infections 491
Nurse–Patient Relationship 61 Chapter 35
Chapter 36 Drugs for Tubercular, Fungal, Protozoan,
Chapter 6 The Nursing Process and Clinical Judgment and Helminthic Infections 517
Measurement Model in Pharmacology 62 Chapter 37 Drugs for Viral Infections 537
Chapter 7 Medication Errors and Risk Reduction 71 Chapter 38 Drugs for Neoplasia 557
Chapter 8 Drug Administration Throughout
the Lifespan 83 Unit 6
Chapter 9 Individual Variations in Drug Response 95
Chapter 10 The Role of Complementary and The Respiratory System 581
Alternative Therapies in Pharmacology 105
Chapter 39 Drugs for Allergic Rhinitis and the
Chapter 11 Emergency Preparedness and Poisonings 115
Common Cold 582
Chapter 40 Drugs for Asthma and Other
Unit 3 Pulmonary Disorders 597
The Nervous System 127
Unit 7
Chapter 12 Cholinergic Drugs Affecting the Autonomic
Nervous System 128 The Gastrointestinal System 613
Chapter 13 Adrenergic Drugs Affecting the Autonomic
Chapter 41 Drugs for Peptic Ulcer Disease 614
Nervous System 143
Chapter 42 Drugs for Bowel Disorders and Other
Chapter 14 Drugs for Anxiety and Sleep Disorders 155
Gastrointestinal Conditions 629
Chapter 15 Drugs for Mood and Behavioral Disorders 169
Chapter 43 Drugs for Nutritional Disorders 647
Chapter 16 Drugs for Psychoses 189
Chapter 17 Drugs for Seizures 203
Chapter 18 Drugs for Pain Management 221 Unit 8
Drugs for Local and General Anesthesia 243
Chapter 19
Chapter 20 Drugs for Degenerative Diseases of the
The Endocrine System 667
Nervous System 259 Chapter 44 Drugs for Pituitary, Thyroid, and Adrenal
Chapter 21 Drugs for Muscle Spasms and Spasticity 277 Disorders 668
Chapter 22 Substance Use Disorder 289 Chapter 45 Drugs for Diabetes Mellitus 689
Chapter 46 Drugs for Disorders and Conditions of the
Unit 4 Female Reproductive System 705
Chapter 47 Drugs for Disorders and Conditions of the
The Cardiovascular and Male Reproductive System 727
Urinary Systems 301
Unit 9
Chapter 23 Drugs for Lipid Disorders 302
Chapter 24 Diuretic Therapy and Drugs for Chronic The Integumentary System,
Kidney Disease 317 Eyes, and Ears 741
Chapter 25 Drugs for Fluid Balance, Electrolyte, and
Acid–Base Disorders 331 Chapter 48 Drugs for Bone and Joint Disorders 742
Chapter 26 Drugs for Hypertension 345 Chapter 49 Drugs for Skin Disorders 765
Chapter 27 Drugs for Heart Failure 365 Chapter 50 Drugs for Eye and Ear Disorders 783
A01_Adams_7_97097.indd 1 24/03/23 8:34
, Seventh Edition
Pharmacology for
Nurses
A Pathophysiologic Approach
Michael Patrick Adams
Adjunct Professor of Anatomy and Physiology
Hillsborough Community College
Formerly Dean of Health Professions
Pasco-Hernando State College
Leland Norman Holland, Jr.
Professor
Hillsborough Community College
Polk State College
Shanti Ellen Chang
Assistant Professor of Nursing
College of Public Health
George Mason University
A01_Adams_7_97097.indd 3 24/03/23 8:34
, Preface
When students are asked which subject in their nursing Students will love this concise, one-column format that
program is the most challenging, pharmacology always reinforces the clinical judgment measurement model.
appears near the top of the list. The study of pharmacology • NEW! Emerging therapies for the prevention and treat-
demands that students apply knowledge from a wide vari- ment of COVID-19 infections have been added to the
ety of the natural and applied sciences. Successfully pre- antiviral chapter.
dicting drug action requires a thorough knowledge of
• NEW! Coverage of emerging mechanisms in pharma-
anatomy, physiology, chemistry, and pathology as well as
cotherapy are discussed, including use of m-RNA vac-
the social sciences of psychology and sociology. Lack of
cines to teat COVID-19 infections, SGLT2 inhibitors for
adequate pharmacology knowledge can result in immedi-
diabetes, and CGRP inhibitors for migraine.
ate and direct harm to the patient; thus, the stakes in learn-
ing the subject are high. • NEW! Pharmacotherapy of cystic fibrosis, narcolepsy,
Pharmacology cannot be made easy, but it can be and amyotrophic lateral sclerosis has been added.
made understandable when the proper connections are • EXPANDED! Includes more than 120 new drugs,
made to knowledge learned in these other disciplines. The drug classes, indications, and therapies that have been
vast majority of drugs in clinical practice are prescribed for approved since the last edition.
specific diseases, yet many pharmacology textbooks fail to • EXPANDED! Includes new and updated information
recognize the complex interrelationships between pharma- on the importance of biomarkers and pharmacogenet-
cology and pathophysiology. When drugs are learned in ics in the diagnosis and treatment of disease.
isolation from their associated diseases or conditions, stu-
• EXPANDED! All drug tables drugs have been revised
dents have difficulty connecting pharmacotherapy to ther-
to reflect changes in therapeutics.
apeutic goals and patient wellness. The pathophysiology
• UPDATED! Includes new CDC recommendations of
focus of this textbook gives the student a clearer picture of
the prevention of HIV infection following occupational
the importance of pharmacology to disease and, ulti-
exposure, nonoccupational exposure, perinatal expo-
mately, to patient care. The approach and rationale of this
sure, and preexposure prophylaxis.
textbook focus on a holistic perspective to patient care
which clearly shows the benefits and limitations of phar- • UPDATED! The latest black box warnings issued by
macotherapy in curing or preventing illness. In addition to the FDA are included for all appropriate drug proto-
its pathophysiology focus, medication safety and interdis- types.
ciplinary teamwork are consistently emphasized through- • UPDATED! All references have been updated to reflect
out the text. Although difficult and challenging, the study current pharmacotherapeutics.
of pharmacology is truly a fascinating, lifelong journey. • UPDATED! Ten new special features have been
added in topics applying research to nursing practice,
New to This Edition community-oriented practice, lifespan considerations,
and patient safety.
It is amazing how much pharmacology has changed in the
past 4 years. The seventh edition of Pharmacology for
Nurses: A Pathophysiologic Approach has been thoroughly
updated to reflect these changes to current pharmacother-
Organization and Structure—A
apeutics and advances in understanding disease. Pathophysiology Approach
It is not enough for nursing students to memorize names,
• NEW! Pregnancy data for all prototype drugs have
doses, and actions of medications. Not only would this be
been completely updated and expanded to reflect FDA
overwhelming (and boring), but those who wish to enter
requirements implemented since the previous edition.
nursing must develop higher levels of understanding and
• NEW! The clinical judgment measurement model
demonstrate analytical and evaluation skills. The authors
is now discussed and integrated into all appropriate
created this text to assist students in reaching those
medication chapters.
levels.
• NEW! The nursing practice application feature has been Pharmacology for Nurses: A Pathophysiologic Approach
totally transformed into Nursing Clinical Judgement. is organized according to body systems (units) and
ix
A01_Adams_7_97097.indd 9 24/03/23 8:34
