Loyola Univ., New Orleans, LA. Annual, pocket quick reference contains data on thousands of drugs, a free companion web site, new pediatric and geriatric dosages, new appendices, and more. This edition includes a diskette with the most commonly prescribed drugs.
"synopsis" may belong to another edition of this title.
BILLIE ANN WILSON is currently Professor and Director of the Department of Nursing at Loyola University in New Orleans, Louisiana. Prior to entering nursing, she taught natural and physical sciences at the secondary and collegiate levels. She holds a Bachelor of Science in Biology from Boston College, a Master of Science in Biology from Purdue University, a Bachelor of Science in Nursing from Northwestern State University of Louisiana, a Master of Nursing from Louisiana State University Medical Center, and a PhD in Curriculum and Instruction from the University of New Orleans.
MARGARET T. SHANNON is currently Professor and Dean of the Division of Nursing at Our Lady of Holy Cross College, New Orleans, Louisiana. Her educational preparation includes a Bachelor of Science in Chemistry and a Master of Science in Chemistry, both from Saint Louis University; a Master of Arts in Teaching Biology from Saint Mary's College, a Bachelor of Science in Nursing from Northwestern State University of Louisiana, a Master of Nursing from Louisiana State University Medical Center, and a PhD in Curriculum and Instruction from the University of New Orleans. Prior to entering nursing, she taught physical science, natural science, and mathematics at the secondary and collegiate levels.
CAROLYN L. STANG is currently a drug information specialist in Chicago, Illinois. She has worked in hospital and community pharmacies, home health care, and the pharmaceutical industry. Dr. Stang has been a freelance medical writer and an assistant professor at Rutgers University College of Pharmacy. She holds a Bachelor of Science in Pharmacy from the University of Tennessee, Memphis, and completed a fellowship in Family Medicine at the Medical University of South Carolina, Charleston.
Current- * Contains thousands of druge—including those recently approved by the FDA.
* Provides afree Companion Website prenhall/drugguides that offers new drug updates, inks to drug manufacturers and the FDA, administration techniques, common herbal remedies, a review of pharmacology, and much more.
* Includes a free diskette with the most commonly prescribed drugs. Comprehensive- * Provides new pediatric and geriatric dosages where appropriate.
* Features new appendixes with new drugs & FDA warnings, ocular medications, low-molecular weight heparins, and nasal & oral corticosteroids.
* Presents unique appendixes with comprehensive fixed drug combinations and signs & symptoms glossary.
Accessible- * Lists all drugs alphabetically by generic drug names, with an index that includes both generic and trade names.
* Highlights important IV dosage and administration information.
* Provides quick access to drug interactions, side effects, and patient & family teaching.
PREFACE
Nursing Drug Guide 2001 is a current and reliable reference designed to provide the information needed to make appropriate decisions regarding drug administration. New to this edition are user-friendly charts of ocular medications, low-molecular weight heparins, and oral and nasal corticosteroids (Appendix A). Also new to this edition, pediatric and geriatric dosages as well as adult dosages are listed in the Route and Dosage section for each drug.
This text contains a valuable administration tool, a list of oral drug dosage forms that should not be crushed. This "do-not-crush" list is found in Appendix D. Appendix G contains a list of 36 new drug monographs which are posted on the website for the book. (See back for directions on how to access.) The 2001 edition of the Nursing Drug Guide also includes 36 new FDA-approved drugs, and a disk (inside the front cover) that may be used to print monographs of commonly dispensed drugs.
In the Administration section of each drug monograph, complete and comprehensive information for IV drugs includes directions for reconstitution, dilution, methods of administration, and rate of injection or infusion. Thus, this Guide eliminates the need for additional resources for IV drug administration. Also important for IV drug administration, and listed in individual drug monographs, is Y-site compatibility. A chart of Y-site compatibility for IV drugs is conveniently located after the index.
The Nursing Implications section of each drug monograph is formatted in an easy-to-use manner so that all pertinent information needed by nurses is listed under three headings: Administration, Assessment & Drug Effects, and Patient & Family Education. Under these headings, the reader can quickly and easily identify needed information and incorporate it into the appropriate steps of the nursing process. Therapeutic effectiveness of the drug can be determined by monitoring improvement in the condition for which the drug is prescribed, and by using the Assessment and Drug Effects section of the Nursing Implications.
The authors recognize that the decision-making process related to drug administration is a cyclical one. For example, assessments are made both prior to and after drug administration. Thus, nursing diagnoses and interventions may change as a result of an achieved therapeutic effect, therapeutic failure, manifestation of an adverse effect, or demonstration of a learning need. The authors believe that users of this reference will find that the clear and logical design of the drug monographs facilitates decision-making and supports the nursing process.
The disk at the front of this Nursing Drug Guide 2001 runs on Windows-based computers. It is designed to assist nurses in providing drug information and nursing implications for patients in hospitals, clinics, and all community settings. Monographs of the most commonly prescribed and dispensed drugs and prototype drugs are available on the disk and may be printed for convenient use by students and nurses. Appropriate information can be retrieved for patients.
The authors wish to acknowledge Joanne Bullard, RN, MN, at Our Lady of Holy Cross College, and Debora Panepinto for their assistance in the preparation of this book. Most of all, we wish to express our appreciation to our past and present students who have provided the inspiration for this work. It is for these individuals and all who strive for excellence in patient care that this work was undertaken.
Billie Ann Wilson, APRN, PhD
Margaret T. Shannon, APRN, PhD
Carolyn L. Stang, PharmD HOW TO USE THIS BOOK
In this Guide, all drugs are listed alphabetically according to generic names. Each drug is, however, indexed by both its generic and trade names. Trade names followed by a maple leaf indicate that the drug is available only in Canada. If a drug is not listed in the alphabetical section, it may be a combination drug, which by definition is made up of more than one generic component. These mbination drugs are found by their trade names in the index and in a separate Appendix F, Prescription Combination Drugs, which lists the generic components and the amount of each generic drug. THERAPEUTIC EFFECTIVENESS
Therapeutic effectiveness of the drug can be determined by monitoring improvement in the condition for which the drug is prescribed, and by using the Assessment and Drug Effects section of the Nursing Implications.
The information needed for safe and effective drug administration is given for each drug in the alphabetical listing. The reader should review all the information provided. Occasionally, the reader will be referred to the Glossary, Appendix G. This glossary of key terms, clinical conditions, and associated signs and symptoms provides valuable information regarding common assessment findings related to therapeutic effectiveness or ineffectiveness of specific drugs.
Drugs have multiple uses or indications; therefore, it is important to know why a drug is being prescribed for a client. Therapeutic effectiveness of the drug may be determined by monitoring for improvement in the condition for which the drug is prescribed.
While some advanced practice nurses and other health professionals now have prescriptive privileges, physician is used throughout this book to designate the prescribes of medications.
For each drug, the following information is provided where pertinent:
CLASSIFICATION: The classifications used in this book are based on the classification scheme used by the American Hospital Formulary Service (AHFS), which classifies drugs by pharmacologic and therapeutic category. This enables the nurse to identify different classes of drugs that have similar therapeutic implications or that primarily affect the same physiologic system. In general, all drugs in a class will have similar actions, uses, side effects, and nursing implications. Therefore, we have selected certain drugs representative of a class—prototype drugs—and have discussed them in more detail than the other drugs in that class. In addition, throughout the generic listing the names of prototype drugs are highlighted in color-tinted boxes. In-depth information on those drugs not extensively discussed may be obtained by referring to the prototype drug. When a drug belongs to a class that has a designated prototype, that prototype is identified directly below the drug classification. The table on pages xiii to xviii outlines the classification scheme and lists the drug considered representative for each class.
PREGNANCY CATEGORY: Drugs may be described as category A, B, C, D, or X according to risk–benefit ratio for the mother and fetus, with A being the lowest and X the highest risk. If the FDA pregnancy category is known, it will be indicated. Refer to Appendix C, FDA Pregnancy Categories, for a more complete description of pregnancy categories.
SCHEDULE: In the United States, controlled substances, such as narcotics, are classified as belonging to one of five schedules (I to V) according to abuse potential, with I having the highest and V the lowest potential for abuse. Refer to Appendix B for a more complete description of each schedule.
ACTIONS/PHARMACODYNAMICS: This entry describes the mechanism by which the specific drug produces physiologic and biochemical changes at the cell, tissue, or organ level.
USES: The therapeutic applications of each drug are described in terms of normal (labeled) use and unlabeled use. An unlabeled use is literally one that does not appear on the drug label or in the manufacturer's literature on the use of the drug. The unlabeled use is, nevertheless, an accepted use for the drug supported by the medical literature.
ROUTE & DOSAGE: Route is specified as SC, IM, IV, PO, PR, nasal, ophthalmic, vaginal, topical, aural, intradermal, or intrathecal; doses are listed separately for adult, geriatric, child, and infant for those with reduced renal function (creatinine clearance), and according to use. This information is highlighted with shading for quick reference.
PHARMACOKINETICS: This section lists information about onset, peak, and duration of drug action. It also lists the mechanisms of metabolism and elimination when known.
CONTRAINDICATIONS & PRECAUTIONS: Many drugs are contraindicated and therefore should not be used in specific pathophysiologic conditions, during pregnancy, or with particular drugs or food. In other cases, the drug should be used with great caution because of a greater than average risk of untoward effects.
ADVERSE/SIDE EFFECTS: Virtually all drugs have adverse or side effects that may be bothersome to some individuals but not to others. In this entry, adverse/side effects are listed according to systems or organs with the most common printed in italics and those that are life-threatening underlined.
DIAGNOSTIC TEST INTERFERENCES: This entry describes the effect of the drug on various diagnostic tests and alerts the nurse to possible misinterpretations of test results.
DRUG INTERACTIONS: Individual drugs, drug classes, and foods that interact with the drug under discussion are listed. Drugs may interact to inhibit or enhance one another; thus, drug interactions may improve the therapeutic response, lead to therapeutic failure, or produce specific untoward reactions. Only drugs that have been shown to cause clinically significant interactions with the drug under discussion are listed.
INCOMPATIBILITIES: Solutions and drug additives physically incompatible with the drug under discussion are listed. Therefore, these solutions and drug additives should not be mixed in solution with the drug. The table on the inside back cover contains information related to the compatibility of drugs that are administered by intravenous Y-site. Additional drugs that should not be administered together are listed in the monographs.
NURSING IMPLICATIONS: Nursing implications are listed under three headings: Administration, Assessment & Drug Effects, and Patient & Family Education. Before administering a drug, the nurse should read all three sections to determine (1) the appropriate administration techniques, (2) the assessments that should be made before and after administration of the drug and indicators of drug effectiveness, and
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