Table Of ContentMedicines
Management for
Nurses
at a Glance
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Medicines
Management
for Nurses
at a Glance
Simon Young
Academic Subject Manager – Medicines
Management and Prescribing
Faculty of Life Sciences and Education
University of South Wales
Ben Pitcher
Senior Lecturer
Faculty of Life Sciences and Education
University of South Wales
Series editor: Ian Peate
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Library of Congress Cataloging-in-Publication Data
Young, Simon, 1971- , author.
Medicines management for nurses at a glance / Simon Young, Ben Pitcher.
p. ; cm. – (At a glance series)
Includes index.
ISBN 978-1-118-84072-6 (paperback)
I. Pitcher, Ben, 1979-, author. II. Title. III. Series: At a glance series (Oxford, England)
[DNLM: 1. Drug Therapy–nursing–Great Britain. 2. Drug Prescriptions–nursing–
Great Britain. 3. Drug Therapy–methods–Great Britain. 4. Nurse C linicians–Great
Britain. WY 100 FA1]
RT68
615.1'4–dc23
2015033805
A catalogue record for this book is available from the British Library.
Wiley also publishes its books in a variety of electronic formats. Some content that appears
in print may not be available in electronic books.
Cover image: GettyImages-478860007/sturti
Set in 9.5/11.5pt Minion Pro by Aptara, India
1 2016
Contents
Preface vii
About the companion website ix
Part 1 Introduction to Pharmacology and Medicines
Management 1
1 Why is managing medicines important in nursing? 2
2 Keeping up to date with medicines management 4
3 What is a medicine? 6
4 Medicines nomenclature: what’s in a name? 8
5 Numeracy and medicines management 10
6 Clinical pharmacokinetics I 12
7 Clinical pharmacokinetics II 14
8 Routes of administration I 16
9 Routes of administration II 18
10 Pharmacodynamics I 20
11 Pharmacodynamics II 22
Part 2 Managing medicines 25
12 Dyspepsia 26
13 Acute diarrhoea and constipation 28
14 Chronic bowel disease 30
15 Nausea and vomiting 32
16 Anti-anginals 34
17 Anti-arrhythmics 36
18 Heart failure 38
19 Hypertension 40
20 Diuretics 42
21 Respiratory conditions I 44
22 Respiratory conditions II 46
23 Opioid analgesics 48
24 Anxiolytics and hypnotics 50
25 Antipsychotics 52
26 Depression 54
27 Epilepsy 56
28 Alcohol: detoxification 58
29 Alcohol: maintaining abstinence 60
30 Smoking cessation 62
31 Fighting infection 64
32 Antibiotics 66
33 Diabetes: insulin 68
v
34 Diabetes: antiglycaemics 70
35 Thyroid conditions 72
36 Oral contraception 74
37 Anticoagulants 76
38 Antiplatelet drugs 78
39 Musculoskeletal disorders 80
40 Non-steroidal anti-inflammatory drugs and non-opioid
analgesics 82
41 Topical agents and emollients 84
42 Topical steroids 86
Part 3 Safe and effective medicines management 89
43 Medicines management in pregnancy and
breastfeeding 90
44 Medicines management in children 92
45 Medicines management in elderly people 94
46 Medicines management in people with hepatic and renal
impairment 96
47 Drug interactions 98
48 Adverse drug reactions 100
49 Pharmacovigilance 102
50 Classification of medicines 104
Index 107
vi
Preface
The main aims of this publication are twofold: to introduce topics we wanted to cover didn’t make the cut. The presence or
pre-registration nursing students to the principles of man- absence of a topic does not reflect upon the importance of that
aging medicines and to aid more experienced nurses (and topic. The topics selected afforded us, as authors, an opportunity
other healthcare professionals) to develop a better sense of the to encourage readers to consider applying principles learned to
breadth and depth of medicines management. other areas of medicines management.
In order that standards of teaching and learning and curricu- The charts seen in the therapeutic topics sections are varia-
lum delivery are equitably set across all universities, the Nurs- tions of the ‘prescription charts’ seen in hospitals or Medicines
ing and Midwifery Council (NMC) oversees the accreditation of Administration Record Sheets seen in care home settings. The
nursing curricula. Despite this, there will be varying emphasis on lessons learned from these topics apply to managing those medi-
the importance of each of the many subject areas that make up cines across all areas of practice (e.g. in community-based set-
the knowledge base of nursing. The nurse’s knowledge of phar- tings). The charts enabled us to share some practical knowledge
macology will vary significantly for a variety of reasons. Many with regards medicines to administration and management that
nurses will not have formally studied pharmacological science in add value and authenticity to the text.
their training and we hope this book will offer a gateway to phar- Throughout the book we have used the terms ‘nurse’ and
macological knowledge, which is key to managing medicines. ‘healthcare professional’. We acknowledge that the term ‘nurse’
Many pharmacology texts consider the subject in great depth could be replaced by the term ‘midwife’ but for brevity we have
and offer insight into the development of basic pharmacologi- used the term ‘nurse’. In, addition we have used the term ‘patient’
cal science through to complex evidence-based clinical phar- most often to refer to the person who is taking the medication.
macology. This book attempts to look directly at pharmacology, We appreciate that terminology varies from practice area to prac-
and its impact on clinical practice and on managing medicines tice area and acknowledge that ‘patients’ are people - just like us.
safely and efficaciously. It often refers to the important cardinal We use the term ‘patient’ not to define the person but to define
resources of medicines management such as the British National the responsibility the healthcare professional has for their care.
Formulary (BNF), the NMC standards and the summary of This book, it is hoped, will contribute to a better understanding
product characteristics (SPC) of the medicine. These resources of medicines and the people who take them. We hope that in
should be read alongside this text to gain further perspective some way it will also contribute something positive to managing
on the use of medicines in modern health care. The text does medicines and to the people who take them.
not aim to replace these resources but we hope it will assist in Finally, Ben and I would like to offer our thanks to those who
understanding their importance and offer critical consideration have supported us in putting this book together. First, we would
of their use. In addition the book, while accurate and up to date, like to thank the team at Wiley, especially Karen and James, for
does not replace guidelines, protocols and other evidence-based their dedication, patience and support. Second, we would like
texts. Professional judgement and up to date knowledge should to thank all the patients, students and healthcare professionals
always be applied in making clinical decisions directly affecting who have inspired us as practising healthcare professionals and
the health and well-being of patients. educators. The last and most important thanks go to our families.
The book covers a range of topics and is not designed for one Special thanks go to our wives, Jess and Tash, who offered us so
branch or field of nursing practice. A range of fundamental med- much support through the entire process. An additional thanks
icines management principles and therapeutic topics are con- to our inspirational offspring: Jack, Jacob, Lily, Luke and Lydia –
sidered and explored. For example, chapters tackling substance this book would not have been possible without you.
misuse should be relevant to most areas of practice but will be
more applicable and practically useful to some specific branches Ben Pitcher and
of nursing. The size of the ‘… at a glance’ books means that some Simon Young
vii
