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Perfect for this student nurse!“Seriously, I love this book. It has already helped me ace 2 assignments! Definitely a must-have for student nurses.”—Amy L., Online Student Reviewer
SAFETY FIRST WITH ‘CURE & CARE’!
Davis’s Drug Guide for Nurses®, Eighteenth Edition delivers everything you need to administer medications safely across the lifespan—643 well-organized monographs encompassing hundreds of generic drugs and thousands of trade names. Its nursing-focused Cure & Care’ approach explains what the drug does and describes what the nurse does and how the nursing process relates to the pharmacotherapeutics.
BONUS! FREE DIGITAL ACCESS
An access code inside new, printed texts unlocks your one-year, FREE 1-year subscription to DrugGuide.com, Davis’s Drug Guide Online, powered by Unbound Medicine, information on more than 5,000 trade names and generic drugs, as well as audio pronunciations and color photographs, all updated regularly.
LIFE-SAVING GUIDANCE AT A GLANCE
- In-depth coverage of patient safety, red tab for high-alert medications, red, capitalized letters for life-threatening side effects, and REMS (Risk Evaluation and Mitigation Strategies) icon
- Special considerations for patient populations
- Icon highlighting pharmacogenomic content
- IV administration coverage
- Patient and family teaching guidance
- Canadian-specific content identified with a maple leaf icon
FREE ONLINE LEARNING, CARE PLANNING & PATIENT EDUCATION TOOLS
- Audio Pronunciation Library of 1,200+ drug names
- Tutorials with self-tests, Preventing Medication Errors and Psychotropic Drugs
- Calculators for body mass index (BMI), metric conversions, IV drip rates, dosage/KG and Fahrenheit/Celsius.
- Interactive Case Studies, each followed by a series of questions
- Eight audio podcasts covering must-know information, concepts, and considerations for safe drug administration
- Video clips illustrating the safe administration of medications
HOW TO USE DAVIS’S DRUG GUIDE FOR NURSES
Davis’s Drug Guide for Nurses provides comprehensive, up-to-date drug information in wellorganized, nursing-focused monographs. It also includes extensive supplemental material in 14 appendices, thoroughly addresses the issue of safe medication administration, and educates the reader about 50 different therapeutic classes of drugs. In this 18th edition, we have continued the tradition of focusing on safe medication administration by including Medication Safety Tools and even more information about health care’s most vulnerable patients: children, the elderly, pregnant women, and breast feeding mothers. Look for more Pedi, Geri, OB, Lactation, and Rep headings in the monographs. We have also included a BEERS label at the top of applicable drug monographs for those medications listed in the Beers Criteria developed by the American Geriatrics Society. These medications are considered to be potentially inappropriate for use in older adults because they are associated with more risk than beneft in this patient population. In addition, we’ve included information relevant to Canadian students and nurses. You’ll fnd an appendix comparing Canadian and U.S. pharmaceutical practices, more Canada-only combination drugs in the Combination Drugs appendix, and additional Canadian brand names in the drug monographs. To help you fnd this information quickly, we’ve also added a maple leaf icon ( ) in the index next to each Canadian entry. We have added pharmacogenomic information throughout numerous monographs to guide the nurse in selecting and monitoring various drug therapies. To help you fnd this information quickly, we’ve added a double helix icon ( ) to denote this information as it applies to specifc drugs. Use this book to enhance your competence in implementing and evaluating medication therapies. The following sections describe the organization of Davis’s Drug Guide for Nurses and explain how to quickly fnd the information you need.
Safe Medication Use Articles
“Medication Errors: Improving Practices and Patient Safety,” “Detecting and Managing Adverse Drug Reactions,” “Overview of Risk Evaluation and Mitigation Systems (REMS),” “Special Dosing Considerations,” and “Educating Patients About Safe Medication Use” comprise the safe medication use articles and provide an overview of the medication safety issues that confront practitioners and patients. Leading off this series, the medication errors article familiarizes you with the systems issues and clinical situations repeatedly implicated in medication errors and suggests practical means to avoid them. It also teaches you about high alert medications, which have a greater potential to cause patient harm than other medications. “Detecting and Managing Adverse Drug Reactions” explains the different types of adverse reactions and provides guidance on how to detect and manage them. “Risk Evaluation and Mitigation Strategies (REMS)” explains strategies developed by the pharmaceutical industry and required by the Food and Drug Administration (FDA) to minimize adverse drug reactions from potentially dangerous drugs. We have highlighted the drugs that currently have approved REMS programs associated with their use by adding a REMS label at the top of applicable drug monographs. “Special Dosing Considerations” identifes the patient populations, such as neonates and patients with renal impairment, who require careful dose adjustments to ensure optimal therapeutic outcomes. “Educating Patients About Medication Use” reviews the most important teaching points for nurses to discuss with their patients and their families. In addition to these safety articles, other critical information is highlighted in red throughout the drug monographs. This allows the reader to quickly identify important information and to see how nursing practice, including assessment, implementation, and patient teaching, relates to it.
Classifications Profile
Medications in the same therapeutic class often share similar mechanisms of action, assessment guidelines, precautions, and interactions. The Classifcations Profle provides summaries of the major therapeutic classifcations used in Davis’s Drug Guide for Nurses. It also provides patient teaching information common to all agents within the class and a list of drugs within each class.
Medication Safety Tools
Updated for this edition is a section with tables and charts that nurses can use for a quick but thorough reference to information that will help them avoid making medication errors. It includes lists of drugs that are associated with adverse reactions and falls in the elderly; proper dosing for pediatric intravenous medications; confused drug names; FDA-approved Tall Man letters and more.
Drug Monographs
Drug monographs are organized in the following manner:
High Alert Status: Some medications, such as chemotherapeutic agents, anticoagulants, and insulins, have a greater potential for harm than others. These medications have been identifed by the Institute for Safe Medication Practices as high alert drugs. Davis’s Drug Guide for Nurses includes a high alert tab in the upper right corner of the monograph header in appropriate medications to alert the nurse to the medication’s risk. The term “high alert” is used in other parts of the monograph as well, to help the nurse administer these medications safely. See the article “Medication Errors: Improving Practices and Patient Safety” for a complete list of high alert medications in Davis’s Drug Guide for Nurses. Refer to www.ISMP.org for all solutions, groups, and individual high alert drugs.
Generic/Brand Name: The generic name appears frst, with a pronunciation key, followed by an alphabetical list of trade names. Canadian trade names are preceded by a maple leaf ( ). Many brand names have been discontinued by the manufacturer requiring nurses to know the generic names of drugs. Brand names that have been discontinued have a slash through them (Decadron). Common names, abbreviations, and selected foreign names are also included.
Classification: The therapeutic classifcation, which categorizes drugs by the disease state they are used to treat, appears frst, followed by the pharmacologic classifcation, which is based on the drug’s mechanism of action.
Controlled Substance Schedule: All drugs regulated by federal law are placed into one of fve schedules, based on the drug’s medicinal value, harmfulness, and potential for abuse or addiction. Schedule I drugs, the most dangerous and having no medicinal value, are not included in Davis’s Drug Guide for Nurses. (See Appendix H for a description of the Schedule of Controlled Substances.)
Pregnancy Category: The FDA recently recommended discontinuation of the Pregnancy Category system (A, B, C, D, and X) since this categorization may not appropriately communicate the risk that a drug may have during pregnancy or breast feeding. Based on this guidance, the Pregnancy Categories have been removed from each of the drug monographs. These pregnancy letter categories have been replaced in drug prescribing information and Patient/Family Teaching with a narrative summary that describes the potential risk of using the drug during pregnancy and breast feeding, as well as the potential impairment of fertility in women and men of reproductive potential. The drug monographs have been enhanced with this detailed information in these patient populations and highlighted by a Rep tag to call the user’s attention to reproductive information.
Indications: Medications are approved by the FDA for specifc disease states. This section identifes the diseases or conditions for which the drug is commonly used and includes signifcant unlabeled uses as well.
Action: This section contains a concise description of how the drug produces the desired therapeutic effect.
Pharmacokinetics: Pharmacokinetics refers to the way the body processes a medication by absorption, distribution, metabolism, and excretion. This section also includes information on the drug’s half-life.
Absorption: Absorption describes the process that follows drug administration and its subsequent delivery to systemic circulation. If only a small fraction is absorbed following oral administration (diminished bioavailability), then the oral dose must be much greater than the parenteral dose. Absorption into systemic circulation also follows other routes of administration such as topical, transdermal, intramuscular, subcutaneous, rectal, and ophthalmic routes. Drugs administered intravenously are 100% bioavailable.
Distribution: This section comments on the drug’s distribution in body tissues and fuids. Distribution becomes important in choosing one drug over another, as in selecting an antibiotic that will penetrate the central nervous system to treat meningitis or in avoiding drugs that cross the placenta or concentrate in breast milk. Information on protein binding is included for drugs that are 95% bound to plasma proteins, which has implications for drug-drug interactions.
Metabolism and Excretion: Drugs are primarily eliminated from the body either by hepatic conversion to active or inactive compounds (metabolism or biotransformation) and subsequent excretion by the kidneys, or by renal elimination of unchanged drug. Therefore, drug metabolism and excretion information is important in determining dosage regimens and intervals for patients with impaired renal or hepatic function. The creatinine clearance (CCr) helps quantify renal function and guides dosage adjustments. Formulas to estimate CCr are included in Appendix E.
Half-Life: The half-life of a drug is the amount of time it takes for the drug concentration to decrease by 50% and roughly correlates with the drug’s duration of action. Half-lives are given for drugs assuming the patient has normal renal or hepatic function. Conditions that alter the half-life are noted.
Time/Action Profile: The time/action profle table provides the drug’s onset of action, peak effect, and duration of activity. This information can aid in planning administration schedules and allows the reader to appreciate differences in choosing one route over another.
Contraindications and Precautions: Situations in which drug use should be avoided are listed as contraindications. In general, most drugs are contraindicated in pregnancy or lactation, unless the potential benefts outweigh the possible risks to the mother or baby (e.g., anticonvulsants, antihypertensives, and antiretrovirals). Contraindications may be absolute (i.e., the drug in question should be avoided completely) or relative, in which certain clinical situations may allow cautious use of the drug. The precautions portion includes disease states or clinical situations in which drug use involves particular risks or in which dose modifcation may be necessary. Extreme cautions are noted separately to draw attention to conditions under which use of the drug results in serious, potentially life-threatening consequences…
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