Schaum's Outlines Of Pharmacology
Pharmacology
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PharmacologyJAMES KEOGH, R.N.Instructor, New York UniversitySchaum’s Outline SeriesNew YorkChicago San Francisco Lisbon London MadridMexico City Milan New Delhi San Juan SeoulSingapore Sydney Toronto
Copyright 2010 by The McGraw-Hill Companies, Inc. All rights reserved. Except as permitted under the United States Copyright Act of1976, no part of this publication may be reproduced or distributed in any form or by any means, or stored in a database or retrieval system,without the prior written permission of the publisher.ISBN: 978-0-07-162363-6MHID: 0-07-162363-9The material in this eBook also appears in the print version of this title: ISBN: 978-0-07-162362-9, MHID: 0-07-162362-0.All trademarks are trademarks of their respective owners. Rather than put a trademark symbol after every occurrence of a trademarkedname, we use names in an editorial fashion only, and to the benefit of the trademark owner, with no intention of infringement of the trademark. Where such designations appear in this book, they have been printed with initial caps.McGraw-Hill eBooks are available at special quantity discounts to use as premiums and sales promotions, or for use in corporate trainingprograms. To contact a representative please e-mail us at bulksales@mcgraw-hill.com.TERMS OF USEThis is a copyrighted work and The McGraw-Hill Companies, Inc. (“McGraw-Hill”) and its licensors reserve all rights in and to the work.Use of this work is subject to these terms. Except as permitted under the Copyright Act of 1976 and the right to store and retrieve one copyof the work, you may not decompile, disassemble, reverse engineer, reproduce, modify, create derivative works based upon, transmit, distribute, disseminate, sell, publish or sublicense the work or any part of it without McGraw-Hill’s prior consent. You may use the work foryour own noncommercial and personal use; any other use of the work is strictly prohibited. Your right to use the work may be terminatedif you fail to comply with these terms.THE WORK IS PROVIDED “AS IS.” McGRAW-HILL AND ITS LICENSORS MAKE NO GUARANTEES OR WARRANTIES AS TOTHE ACCURACY, ADEQUACY OR COMPLETENESS OF OR RESULTS TO BE OBTAINED FROM USING THE WORK, INCLUDING ANY INFORMATION THAT CAN BE ACCESSED THROUGH THE WORK VIA HYPERLINK OR OTHERWISE, ANDEXPRESSLY DISCLAIM ANY WARRANTY, EXPRESS OR IMPLIED, INCLUDING BUT NOT LIMITED TO IMPLIED WARRANTIES OF MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE. McGraw-Hill and its licensors do not warrant orguarantee that the functions contained in the work will meet your requirements or that its operation will be uninterrupted or error free.Neither McGraw-Hill nor its licensors shall be liable to you or anyone else for any inaccuracy, error or omission, regardless of cause, in thework or for any damages resulting therefrom. McGraw-Hill has no responsibility for the content of any information accessed through thework. Under no circumstances shall McGraw-Hill and/or its licensors be liable for any indirect, incidental, special, punitive, consequentialor similar damages that result from the use of or inability to use the work, even if any of them has been advised of the possibility of suchdamages. This limitation of liability shall apply to any claim or cause whatsoever whether such claim or cause arises in contract, tort orotherwise.
This book is dedicated to Anne, Sandy, Joanne, Amber-Leigh Christine,Shawn and Eric, without whose help and supportthis book couldn’t have been written.
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ContentsCHAPTER 1.What Is Pharmacology?11.1 Definition 1.2 The Roots of Pharmacology 1.3 The Sources of Pharmaceuticals 1.4 Herbals1.5 The United States Pharmacopeia National Formulary 1.6 The 1938 Food, Drug, and Cosmetic Act1.7 The 1952 Durham-Humphrey Amendment to the Food, Drug, and Cosmetic Act 1.8 The 1962Kefauver-Harris Amendment to the Food, Drug, and Cosmetic Act 1.9 The 1970 Comprehensive DrugAbuse Prevention and Control Act 1.10 Medication Names 1.11 Medication Effects 1.12 MedicationSafety 1.13 The Human Trial 1.14 Pregnancy CategoriesCHAPTER 2.Medication Actions and Interactions92.1 Medication Actions 2.2 Multiple Medication Actions 2.3 Strength of Medication Action2.4 Medication Activity 2.5 The Pharmaceutic Phase 2.6 Pharmacokinetics 2.7 Medication Absorption2.8 Absorption Rate 2.9 Bioavailability 2.10 Medication Concentration 2.11 Distribution 2.12 MedicationAccumulation 2.13 Elimination 2.14 The First Pass Effect 2.15 Pharmacodynamics 2.16 Medication TimeResponse 2.17 Receptor Theory 2.18 Agonist and Antagonist 2.19 Categories of Medication Action2.20 Therapeutic Index and Therapeutic Range 2.21 Peak and Trough Levels 2.22 Side Effects2.23 Allergic ReactionsCHAPTER 3.Pharmacology and the Nursing Process203.1 The Nursing Process 3.2 Assessment Related to Drugs 3.3 Patient Information 3.4 Nursing Diagnosis3.5 Planning 3.6 Teaching the Patient about Medication 3.7 Prompt for Feedback 3.8 Medication Plan3.9 Impact of Cultural Influences in Medication Administration 3.10 Culture-Based Communication3.11 Genetic Considerations 3.12 Maternity 3.13 Pediatrics 3.14 Elderly Patients 3.15 AssessingElderly PeopleCHAPTER 4.Substance Abuse294.1 Medication Misuse and Abuse 4.2 Behavioral Patterns of Addiction 4.3 Substance Abuse andHealthcare Professionals 4.4 Detecting Substance Abuse 4.5 Delayed Detection with HealthcareProfessionals 4.6 Testing for Substance Abuse 4.7 Why Substances Are Abused 4.8 Characteristics ofFrequently Abused Medications 4.9 Dependence versus Tolerance 4.10 Pathophysiologic Changes4.11 Commonly Abused Substances 4.12 Assessment for Substance AbuseCHAPTER 5.Principles of Medication Administration395.1 The Process of Medication Administration 5.2 Assessment Required for Specific Medications5.3 Administering Medication 5.4 Preparing the Medication 5.5 Administering the Medication 5.6 UsefulTips When Administering Medication 5.7 Avoiding Medication Errors 5.8 Proper Disposal of Medication5.9 Administering Medication at Home 5.10 Controlling Narcoticsvii
viiiCHAPTER 6.ContentsRoute of Administration466.1 Medication and Routes 6.2 Oral Route 6.3 Sublingual and Buccal Medication Routes 6.4 TransdermalRoute 6.5 Topical Route 6.6 Instillation Route 6.7 Inhalation Route 6.8 Nasogastric and GastrostomyTubes Route 6.9 Suppositories Route 6.10 Parenteral Route 6.11 Intradermal Parenteral Route6.12 Subcutaneous Parenteral Route 6.13 Intramuscular Parenteral Route 6.14 Z-Track InjectionTechnique 6.15 Minimize Pain Parenteral Route 6.16 Intravenous Parenteral RouteCHAPTER 7.Dose Calculations577.1 Medication Measurements 7.2 Converting Metric Units 7.3 Converting Metric Units to Apothecaries’System Units 7.4 Calculating the Desired Dose 7.5 The Formula Method 7.6 Ratio-Proportion7.7 Calculating the IV Flow Rate 7.8 Pediatric Dose Calculation Formula 7.9 Heparin Dose CalculationFormula 7.10 Dopamine Dose Calculation FormulaCHAPTER 8.Herbal Therapy688.1 Understanding Herbal Therapy 8.2 Lack of Uniform Information 8.3 Herbal Therapies and Patients8.4 Forms of Herbal Therapies 8.5 Hazards of Herbal Therapeutics 8.6 Herbal Therapy and the NursingProcess 8.7 Avoiding Common Herbal Therapy Errors 8.8 Common Herbal TherapiesCHAPTER 9.Vitamins and Minerals759.1 Vitamins 9.2 A Well-Balanced Diet 9.3 Recommended Dietary Allowance 9.4 Fat-Soluble Vitamins9.5 Water-Soluble Vitamins 9.6 Vitamins and Assessment 9.7 Vitamins and Vitamin Supplements9.8 Vitamins and Teaching 9.9 MineralsCHAPTER 10. Fluid and Electrolyte Therapy8810.1 Body Fluids 10.2 Electrolytes 10.3 Fluid Movement 10.4 Fluid Concentration 10.5 IntravenousFluids 10.6 Classification of Intravenous Solutions 10.7 Blood and Blood Products 10.8 FluidReplacement 10.9 Replacing Fluid 10.10 Risk of Replacing Fluid 10.11 Potassium 10.12 Hyperkalemia10.13 Responding to Hyperkalemia 10.14 Hypokalemia 10.15 Responding to Hypokalemia 10.16 Sodium10.17 Hypernatremia 10.18 Responding to Hypernatremia 10.19 Hyponatremia 10.20 Respondingto Hyponatremia 10.21 Calcium 10.22 Hypercalcemia 10.23 Responding to Hypercalcemia10.24 Hypocalcemia 10.25 Responding to Hypocalcemia 10.26 Magnesium 10.27 Hypermagnesemia10.28 Responding to Hypermagnesemia 10.29 Hypomagnesemia 10.30 Responding to Hypomagnesemia10.31 Phosphorus 10.32 Hyperphosphatemia 10.33 Responding to Hyperphosphatemia10.34 Hypophosphatemia 10.35 Responding to HypophosphatemiaCHAPTER 11. Nutritional Support Therapies10511.1 Nutrition 11.2 Malnutrition 11.3 Nutritional Support Therapy 11.4 Enteral Nutrition SupportTherapy 11.5 Group of Enteral Feeding Preparations 11.6 Enteral Feeding Preparations 11.7 Ways toAdminister Enteral Feeding Preparations 11.8 Complications of Enteral Feeding 11.9 CalculatingEnteral Feedings 11.10 Administering Enteral Feeding Preparations 11.11 Parenteral Nutrition SupportTherapy 11.12 Risk of Parenteral Nutrition Support Therapy 11.13 Administering Parenteral NutritionSupport TherapyCHAPTER 12. Inflammation and Anti-Inflammatory Medication12.1 The Inflammation Process 12.2 Signs of Inflammation 12.3 Phases of Inflammation 12.4 AntiInflammatory Medication 12.5 Categories of Anti-inflammatory Medication 12.6 Corticosteroids12.7 Nonsteroidal Anti-inflammatory Drugs 12.8 Arthritis Medication 12.9 Gout Medication114
ContentsCHAPTER 13. Infection and Antimicrobialsix12813.1 Microorganisms 13.2 Natural Defense 13.3 Medication for Symptoms 13.4 Antimicrobials13.5 How Antimicrobials Work 13.6 Side Effects of Antimicrobials 13.7 Super Infections 13.8 PreventingAntibiotic-Resistant Bacteria 13.9 Administering Antimicrobial Medication 13.10 Patient Information forAntimicrobial Medication 13.11 Penicillin 13.12 Classification of Penicillin 13.13 Precautions WhenAdministering Penicillin 13.14 Penicillin and Drug–Drug Interactions 13.15 Penicillin and PatientEducation 13.16 Cephalosporin 13.17 Before Administering Cephalosporin 13.18 Generations ofCephalosporins 13.19 Cephalosporin and Drug–Drug Interactions 13.20 Cephalosporin and PatientEducation 13.21 Macrolide Antibiotics 13.22 Administering Macrolide Antibiotics 13.23 Macrolides andDrug–Drug Interactions 13.24 Macrolides and Patient Education 13.25 Lincomycins 13.26 AdministeringLincomycin Antibiotics 13.27 Lincomycins and Drug–Drug Interactions 13.28 Lincomycins and PatientEducation 13.29 Vancomycin 13.30 Administering Vancomycin Antibiotics 13.31 Vancomycin andDrug–Drug Interactions 13.32 Vancomycins and Patient Education 13.33 Aminoglycosides13.34 Administering Aminoglycosides 13.35 Aminoglycosides and Drug–Drug Interactions13.36 Aminoglycosides and Patient Education 13.37 Tetracyclines 13.38 Administering Tetracyclines13.39 Tetraclyclines and Drug–Drug Interactions 13.40 Tetracyclines and Patient Education13.41 Chloramphenicol (Chloromycetin) 13.42 Chloramphenicol and Drug–Drug Interactions13.43 Chloramphenicol and Patient Education 13.44 Fluoroquinolones 13.45 AdministeringFluoroquinolones 13.46 Fluoroquinolones and Drug–Drug Interactions 13.47 Fluoroquinolonesand Patient Education 13.48 Miscellaneous Antibiotics 13.49 Sulfonamides 13.50 AdministeringSulfonamides 13.51 Sulfonamides and Drug–Drug Interactions 13.52 Sulfonamides andPatient EducationCHAPTER 14. Respiratory Diseases and Medication16014.1 Respiration 14.2 Compliance 14.3 Controlling Respiration 14.4 The Tracheobronchial Tube14.5 Respiratory Tract Disorders 14.6 Acute Rhinitis (The Common Cold) 14.7 Home Remedies forAcute Rhinitis 14.8 Medications for Acute Rhinitis 14.9 Sinusitis 14.10 Acute Pharyngitis (Sore Throat)14.11 Acute Tonsillitis 14.12 Acute Laryngitis 14.13 Lower Respiratory Disorders 14.14 Pneumonia14.15 Tuberculosis 14.16 Chronic Bronchitis 14.17 Bronchiectasis 14.18 Emphysema 14.19 AcuteAsthma 14.20 Medications to Treat Chronic Obstructive Pulmonary DiseaseCHAPTER 15. The Neurologic System and Medication18115.1 The Nervous System 15.2 Neurologic Pathways 15.3 Central Nervous System Stimulants15.4 Migraine Headaches 15.5 Treatment for Migraine Headaches 15.6 Central Nervous SystemDepressants 15.7 Sedative-Hypnotics 15.8 Barbiturates 15.9 Anesthetic Agents 15.10 AdministeringGeneral Anesthetic Agents 15.11 Four Stages of Anesthesia 15.12 Topical Anesthetic Agents15.13 Local Anesthesia 15.14 Spinal Anesthesia 15.15 Autonomic Nervous System and AdrenergicBlockers 15.16 The Fight or Flight Response 15.17 Adrenergics and Adrenergic Blockers 15.18 AlphaAdrenergic Blockers 15.19 Beta-Adrenergic Blockers 15.20 Cholinergics 15.21 Anticholinergics15.22 Antiparkinsonism-Anticholinergic Medication 15.23 Skeletal Muscle Relaxants 15.24 ParkinsonismMedication 15.25 Myasthenia Gravis 15.26 Multiple Sclerosis 15.27 Alzheimer’s Disease 15.28 MuscleSpasms 15.29 Epilepsy 15.30 Antipsychotics 15.31 Phenothiazines 15.32 Anxiolytics15.33 AntidepressantsCHAPTER 16. Narcotic Agonists16.1 Pain 16.2 The Gate Control Theory 16.3 Defining Pain 16.4 Assessing Pain 16.5 PainManagement Treatment Plans 16.6 Nonpharmacologic Management of Pain 16.7 PharmacologicManagement of Pain 16.8 Narcotic Analgesics 16.9 Narcotic Agonist-Antagonists 16.10 NarcoticAntagonists231
xContentsCHAPTER 17. Immunologic Agents24117.1 The Immune System 17.2 Human Immunodeficiency Virus and the Immune System 17.3 HumanImmunodeficiency Virus Therapies 17.4 Human Immunodeficiency Virus Medication 17.5 HumanImmunodeficiency Virus Therapy and Pregnancy 17.6 Postexposure Prophylaxis 17.7 Types of Immunity17.8 Vaccines 17.9 Administering Vaccinations 17.10 Patient Education 17.11 ImmunosuppressantMedicationCHAPTER 18. The Gastrointestinal System25418.1 The Gastrointestinal System 18.2 The Esophagus 18.3 The Stomach 18.4 The Intestines18.5 Vomiting and Nausea 18.6 Causes of Vomiting 18.7 Nonpharmacological Treatment of Vomiting18.8 Pharmacological Treatment of Vomiting 18.9 Prescription Antiemetics 18.10 Emetics18.11 Antidiarrhea Medications 18.12 Constipation 18.13 Peptic UlcersCHAPTER 19. Cardiac Circulatory Medications27319.1 The Cardiovascular System 19.2 The Heart 19.3 Coronary Arteries 19.4 Blood Pressure19.5 Circulation 19.6 Blood 19.7 Cardiac Medications 19.8 Glycosides 19.9 Antianginals19.10 Antidysrhythmics 19.11 Heart Failure Medication 19.12 Hypertension 19.13 Blood Pressure andKidneys 19.14 Antihypertensives 19.15 Combining Antihypertensive Drugs 19.16 Angiotensin Antagonists,ACE Inhibitors, and Angiotensin II 19.17 Diuretics 19.18 Types of Diuretics 19.19 Thiazide Diuretics19.20 Loop or High-Ceiling Diuretics 19.21 Osmotic Diuretics 19.22 Carbonic Anhydrase Inhibitors19.23 Potassium-Sparing Diuretics 19.24 Circulatory Medication 19.25 Anticoagulants and Antiplatelets19.26 Thrombolytics 19.27 Antilipemics 19.28 Peripheral Vascular DiseaseCHAPTER 20. Skin Disorders30420.1 The Skin 20.2 Skin Disorders 20.3 Acne Vulgaris 20.4 Psoriasis 20.5 Warts 20.6 Dermatitis20.7 Alopecia 20.8 Burns 20.9 Abrasions and LacerationsCHAPTER 21. Endocrine Medications31421.1 The Endocrine System 21.2 Hormones 21.3 The Pituitary Gland: Growth Hormone 21.4 ThePituitary Gland: Antidiuretic Hormone and Oxytocin 21.5 The Adrenal Gland 21.6 The Thyroid Gland21.7 Hypothyroidism 21.8 Hyperthyroidism 21.9 The Parathyroid Glands 21.10 The Pancreas21.11 Insulin 21.12 Oral Antidiabetics 21.13 Medication That Increases GlucoseCHAPTER 22. Eye and Ear Disorders33122.1 Eye Disorders 22.2 Eye Medication 22.3 Eye Medication: Patient Education 22.4 Ear Disorders22.5 Ear Medication: Patient EducationIndex339
Pharmacology
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CHAPTER 1What Is Pharmacology?1.1 DefinitionPharmacology, derived from two Greek words: Pharmakon (the Greek word for drugs) and logos (the Greek wordfor science). It is the study of the effects of chemicals on living tissues. It focuses particularly on how chemicals help to: Prevent diseases Correct physiology of living tissues Cure or minimize diseasesChemicals that have medicinal properties are referred to as pharmaceuticals. Pharmacology explores the safeand effective use of pharmaceuticals.1.2 The Roots of PharmacologyAncient civilizations discovered that extracts from plants, animals, and minerals had medicinal effects ontissue. These discoveries became the foundation of empirical pharmacology. It was not until the late 1800s thatdevelopments in the sciences of physiology, organic chemistry, and biochemistry provided the scientific approachthat is used in today’s pharmacology.Two separate disciplines developed. These are pharmacy and pharmacology. Pharmacy focuses on preparation and dispensing medication. Pharmacology is a blend of disciplines that collectively enable scientists todevelop new medications that combat diseases. The branches of pharmacology are: Behavioral pharmacology: The study of how medication interacts with human behaviorBiochemical pharmacology: The study of how medication interacts with the chemistry of the bodyCardiovascular pharmacology: The study of how medication interacts with the cardiovascular systemChemotherapy: The study of how medication inhibits growth or kills selected cellsClinical pharmacology: The study of how medication affects the disease process and how medicationsinteract with other medicationsImmunopharmacology: The study of how medication interacts with the body’s immune responseMolecular pharmacology: The study of how medication and hormones interact with cellsNeuropharmacology: The study of how medication interacts with the neurologic systemPharmacokinetics: The study of how medications are absorbed, distributed, and eliminated from the body1
2CHAPTER 1 What Is Pharmacology?1.3 The Sources of PharmaceuticalsPharmaceuticals are derived from one of four sources: Plants: Chemicals that provide medicinal properties are extracted from plants; for example, leavesfrom the foxglove plant are used to produce digitalis, which is used to treat congestive heart failureand cardiac arrhythmias. Animals: Animal byproducts, particularly hormones, are used to supplement human hormones. Forexample, estrogen can be recovered from the urine of a mare and insulin from the pancreas of pigs. Minerals: Trace elements of inorganic crystals are used to supplement minerals in humans. Forexample, iron is used to combat fatigue. Minerals are obtained from animals and plants. Synthetic Derivatives: Scientists are able to develop new medications, such as sulfonamides, bysynthesizing (rearranging) chemical derivatives, resulting in new compounds.1.4 HerbalsHerbals are nonwoody plants whose extracts are used for dietary supplements, but not for medication. Herbalsare described according to their effects on tissue, such as increasing blood flow to the heart. Herbals are not usually described as cures for specific diseases. The Food and Drug Administration does not test or regulate herbals.Therefore there are no purity and strength standards for herbals, which make the effect of an herb unreliable.Herbals are sold over the counter. No prescription is required.Unwanted side effects and undesirable interactions can occur when herbals are taken with prescriptionmedication. For example, Coumadin, which is an anticoagulant, interacts with ginkgo, an herb that inhibitsplatelets, resulting in increased bleeding and stroke.1.5 The United States Pharmacopeia National FormularyThe purity and strength of a medication influence the accuracy and reliability of the dose that is administeredto the patient. Purity is the dilution or mixture of the medication with other materials that give the medicationform so it can be given to the patient. The strength of a medication is its concentration or weight. The dose isthe amount of the medication taken at one time and dosage is the amount taken over a period of time.The United States Pharmacopeia National Formulary is a book that contains strength and purity standardsfor the manufacturing and control of medication. A medication that is listed in the United States PharmacopeiaNation
CHAPTER 10. Fluid and Electrolyte Therapy 88 10.1 Body Fluids 10.2 Electrolytes 10.3 Fluid Movement 10.4 Fluid Concentration 10.5 Intravenous Fluids 10.6 Classification of Intravenous Solutions 10.7 Blood and Blood Products 10.8 Fluid Replacement 10.9 Replacing Fluid 10.10 Risk of Replacing Fluid 10.11 Potassium 10.12 Hyperkalemia
Spanish Grammar. Mr. Schmitt has authored or co-authored the following books, all of which are published by Schaum, McGraw-Hill or Glencoe, McGraw-Hill. SCHAUM Schaum’s Outlines Series German Grammar German Vocabulary Italian Grammar
93 Schaum's Outlines Basic Circuit Analysis John O'Malley 2/ed 94 94 Schaum's Outlines Electronic Devices and Circuits Jimmie J.Cathey 2/ed. 95 95 Schaum's Outlines Electric Circuits Mahmood Nahvi & Joseph A.Edminister4/ed. 96 96 Signal Processing and Linear Systems B.P.Lathi 97 97 Signals and Systems Oppenheim Wilsky2/ed 98 98 VHDL made easy !
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General Pharmacology Drugs acting on Autonomic Nervous System Cardiovascular Pharmacology Drugs acting on GI, respiratory system & CNS Endocrine pharmacology Chemotherapeutic & immunopharmacology Geriatric & Pediatric Pharmacology Lectures/Large Group Discussions Pharmacy: preparat
announcement in class, on the Pharmacology Canvas site, and/or through Outlook. A ‘current’ version of the schedule is posted on the Canvas pharmacology course site (Modules: Pharmacology . pharmacological agents and evolving concepts of therapeutics and assimilate that understanding into practice throughout your professional career.
Practical training is an important aspect of Experimental Pharmacology. This book is collection of specific methods used in understanding of basic principles of experimental pharmacology. In this an attempt has been made to highlight the practical areas of experimental pharmacology with i
Working Group on Clinical Pharmacology in Europe, which was set up in 1986. The Working Group, consisting mainly of university teachers of clinical pharmacology, had broad terms of reference. The Group laid down general principles for the teaching of and training in clinical pharmacology
A1.1.1 Define terms associated with pharmacology. A1.1.2 Describe the history of pharmacology. A1.1.3 Identify sources of drugs and drug information. A1.1.4 Define legal and ethical issues in pharmacology. A1.1.5 Explain the Controlled Substance
