,
,Pharmacology for Nurses
SENIOR CONTRIBUTING AUTHORS
TINA BARBOUR-TAYLOR, UNIVERSITY OF WEST FLORIDA
LEAH MUELLER (SABATO), MIDDLE TENNESSEE STATE UNIVERSITY
DONNA PARIS, TEXAS TECH UNIVERSITY HEALTH SCIENCES CENTER
SCHOOL OF NURSING
DORIE WEAVER, FRANCIS MARION UNIVERSITY
,OpenStax
Rice University
6100 Main Street MS-375
Houston, Texas 77005
To learn more about OpenStax, visit https://openstax.org.
Individual print copies and bulk orders can be purchased through our website.
©2024 Rice University. Textbook content produced by OpenStax is licensed under a Creative Commons
Attribution 4.0 International License (CC BY 4.0). Under this license, any user of this textbook or the textbook
contents herein must provide proper attribution as follows:
- If you redistribute this textbook in a digital format (including but not limited to PDF and HTML), then you
must retain on every page the following attribution:
“Access for free at openstax.org.”
- If you redistribute this textbook in a print format, then you must include on every physical page the
following attribution:
“Access for free at openstax.org.”
- If you redistribute part of this textbook, then you must retain in every digital format page view (including
but not limited to PDF and HTML) and on every physical printed page the following attribution:
“Access for free at openstax.org.”
- If you use this textbook as a bibliographic reference, please include
https://openstax.org/details/books/pharmacology in your citation.
For questions regarding this licensing, please contact .
Trademarks
The OpenStax name, OpenStax logo, OpenStax book covers, OpenStax CNX name, OpenStax CNX logo,
OpenStax Tutor name, Openstax Tutor logo, Connexions name, Connexions logo, Rice University name, and
Rice University logo are not subject to the license and may not be reproduced without the prior and express
written consent of Rice University.
HARDCOVER BOOK ISBN-13 978-1-711472-79-9
B&W PAPERBACK BOOK ISBN-13 978-1-711472-78-2
DIGITAL VERSION ISBN-13 978-1-961584-37-2
ORIGINAL PUBLICATION YEAR 2024
1 2 3 4 5 6 7 8 9 10 RS 24
,OPENSTAX
OpenStax provides free, peer-reviewed, openly licensed textbooks for introductory college and Advanced
Placement® courses and low-cost, personalized courseware that helps students learn. A nonprofit ed tech
initiative based at Rice University, we’re committed to helping students access the tools they need to complete
their courses and meet their educational goals.
RICE UNIVERSITY
OpenStax is an initiative of Rice University. As a leading research university with a distinctive commitment to
undergraduate education, Rice University aspires to path-breaking research, unsurpassed teaching, and
contributions to the betterment of our world. It seeks to fulfill this mission by cultivating a diverse community
of learning and discovery that produces leaders across the spectrum of human endeavor.
PHILANTHROPIC SUPPORT
OpenStax is grateful for the generous philanthropic partners who advance our mission to improve educational
access and learning for everyone. To see the impact of our supporter community and our most updated list of
partners, please visit openstax.org/foundation.
Arnold Ventures Burt and Deedee McMurtry
Chan Zuckerberg Initiative Michelson 20MM Foundation
Chegg, Inc. National Science Foundation
Arthur and Carlyse Ciocca Charitable Foundation The Open Society Foundations
Digital Promise Jumee Yhu and David E. Park III
Ann and John Doerr Brian D. Patterson USA-International Foundation
Bill & Melinda Gates Foundation The Bill and Stephanie Sick Fund
Girard Foundation Steven L. Smith & Diana T. Go
Google Inc. Stand Together
The William and Flora Hewlett Foundation Robin and Sandy Stuart Foundation
The Hewlett-Packard Company The Stuart Family Foundation
Intel Inc. Tammy and Guillermo Treviño
Rusty and John Jaggers Valhalla Charitable Foundation
The Calvin K. Kazanjian Economics Foundation White Star Education Foundation
Charles Koch Foundation Schmidt Futures
Leon Lowenstein Foundation, Inc. William Marsh Rice University
The Maxfield Foundation
, Study where you want, what
you want, when you want.
When you access your book in our web view, you can use our new online
highlighting and note-taking features to create your own study guides.
Our books are free and flexible, forever.
Get started at openstax.org/details/books/pharmacology
Access. The future of education.
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,Contents
Preface 1
UNIT 1 INTRODUCTION TO PHARMACOLOGY FOR
NURSES
CHAPTER 1
Introduction to Pharmacology 7
Introduction 7
1.1 Pharmacology, Interdisciplinary Teams, and Nursing Practice 7
1.2 Drug Sources, Forms, and Names 10
1.3 Drug Classifications and Prototypes 21
1.4 Special Considerations 23
Chapter Summary 29
Key Terms 29
Review Questions 30
CHAPTER 2
Drug Administration 33
Introduction 33
2.1 Drug Administration and the Nursing Process 33
2.2 Pharmacokinetics and Pharmacodynamics 43
2.3 Drug Administration Routes, Preparation, and Administration 51
2.4 Dosage Calculations 72
Chapter Summary 84
Key Terms 84
Review Questions 85
CHAPTER 3
Ethics, Legal Considerations, and Safety 89
Introduction 89
3.1 Legal Considerations 89
3.2 Drug Errors and Prevention 94
3.3 Documentation and Informatics 102
Chapter Summary 108
Key Terms 108
Review Questions 108
UNIT 2 HOMEOSTASIS
CHAPTER 4
Introduction to Homeostasis 111
Introduction 111
4.1 What Is Homeostasis? 111
,4.2 Osmolality 115
4.3 Maintaining Homeostasis 116
4.4 Negative Feedback Loop 117
Chapter Summary 120
Key Terms 120
Review Questions 121
CHAPTER 5
Fluids and Electrolytes, Vitamins, Minerals, and Alternative
Therapies 123
Introduction 123
5.1 Fluid Volume 123
5.2 Electrolytes 127
5.3 Intravenous Fluid Therapy, Total Parenteral Nutrition, and Blood Products 135
5.4 Vitamins, Minerals, and Complementary and Alternative Therapies 140
Chapter Summary 148
Key Terms 148
Review Questions 149
UNIT 3 IMMUNE SYSTEM
CHAPTER 6
Introduction to the Immune System and the Inflammatory
Response 151
Introduction 151
6.1 Introduction to Immunity 151
6.2 Vaccine-Preventable Diseases, Vaccines, and Immunizations 154
6.3 Immunosuppressants, Biologics, Monoclonal Antibodies, and Biosimilar Drugs 162
6.4 Introduction to the Inflammatory Response and Anti-inflammatory Drugs 170
Chapter Summary 183
Key Terms 183
Review Questions 184
CHAPTER 7
Anti-infective Drugs 187
Introduction 187
7.1 Introduction to Bacterial, Viral/COVID-19, and Fungal Infections 187
7.2 Antibiotic, Antiviral/Anti–COVID-19, and Antifungal Drugs 189
7.3 Introduction to HIV, AIDS, and Antiretrovirals 204
7.4 Introduction to Sexually Transmitted Infections and Drugs to Treat Them 210
7.5 Introduction to Tuberculosis and Antitubercular Drugs 215
7.6 Antiparasitic and Anthelminthic Drugs 220
Chapter Summary 224
Key Terms 224
Review Questions 224
Access for free at openstax.org
,CHAPTER 8
Introduction to Cancer Therapy and Cancer Drugs 227
Introduction 227
8.1 Introduction to Cancer and Phases of Cancer Therapy 228
8.2 Chemotherapeutic Drugs 230
8.3 Hormonal Therapy 250
8.4 Biologic Response Modifiers 253
Chapter Summary 257
Key Terms 257
Review Questions 257
UNIT 4 NERVOUS SYSTEM AND DRUGS FOR
MENTAL WELL-BEING
CHAPTER 9
Introduction to the Nervous System 261
Introduction 261
9.1 Introduction to the Nervous System 262
9.2 Structure and Function of the Nervous System 263
9.3 Characteristics of Drugs to Treat Nervous System Disorders 266
Chapter Summary 270
Key Terms 270
Review Questions 270
CHAPTER 10
Drugs to Treat Myasthenia Gravis and Alzheimer’s Disease
273
Introduction 273
10.1 Introduction to Myasthenia Gravis 275
10.2 Cholinergic Drugs 277
10.3 Introduction to Alzheimer’s Disease 282
10.4 Alzheimer’s Drugs 284
Chapter Summary 291
Key Terms 291
Review Questions 291
CHAPTER 11
Drugs to Treat Parkinson’s Disease and Multiple Sclerosis 295
Introduction 295
11.1 Introduction to Parkinson’s Disease 295
11.2 Anti-Parkinsonian Drugs 299
11.3 Introduction to Multiple Sclerosis 322
11.4 Drugs Used in the Treatment of Multiple Sclerosis 325
Chapter Summary 344
Key Terms 344
Review Questions 345
, CHAPTER 12
Anticonvulsant Drugs and Drugs to Treat Epilepsy, Migraine
Headaches, and Intracranial Emergencies 347
Introduction 347
12.1 Epilepsy and Anticonvulsant Drugs 348
12.2 Migraine Headaches and Migraine Headache Drugs 366
12.3 Intracranial Emergencies and Intracranial Emergency Drugs 373
Chapter Summary 379
Key Terms 379
Review Questions 380
CHAPTER 13
Psychopharmacologic Drugs 383
Introduction 383
13.1 Antidepressants 384
13.2 Antipsychotics 396
13.3 Mood Stabilizers 405
13.4 Anxiolytics and Sedative-Hypnotics 408
13.5 CNS Stimulants and Nonstimulants 416
Chapter Summary 424
Key Terms 424
Review Questions 425
CHAPTER 14
Pain Response Drugs 427
Introduction 427
14.1 Introduction to Pain 427
14.2 Nonopioid Analgesics 430
14.3 Opioid Agonists and Antagonists 435
Chapter Summary 444
Key Terms 444
Review Questions 444
CHAPTER 15
Substance Use Disorder Treatment Drugs 447
Introduction 447
15.1 Introduction to Substance Use Disorders 447
15.2 Opioid Use Disorder Drugs 451
15.3 Alcohol Use Disorder Drugs 457
15.4 Nicotine Use Disorder Drugs 461
Chapter Summary 467
Key Terms 467
Review Questions 467
Access for free at openstax.org
,Pharmacology for Nurses
SENIOR CONTRIBUTING AUTHORS
TINA BARBOUR-TAYLOR, UNIVERSITY OF WEST FLORIDA
LEAH MUELLER (SABATO), MIDDLE TENNESSEE STATE UNIVERSITY
DONNA PARIS, TEXAS TECH UNIVERSITY HEALTH SCIENCES CENTER
SCHOOL OF NURSING
DORIE WEAVER, FRANCIS MARION UNIVERSITY
,OpenStax
Rice University
6100 Main Street MS-375
Houston, Texas 77005
To learn more about OpenStax, visit https://openstax.org.
Individual print copies and bulk orders can be purchased through our website.
©2024 Rice University. Textbook content produced by OpenStax is licensed under a Creative Commons
Attribution 4.0 International License (CC BY 4.0). Under this license, any user of this textbook or the textbook
contents herein must provide proper attribution as follows:
- If you redistribute this textbook in a digital format (including but not limited to PDF and HTML), then you
must retain on every page the following attribution:
“Access for free at openstax.org.”
- If you redistribute this textbook in a print format, then you must include on every physical page the
following attribution:
“Access for free at openstax.org.”
- If you redistribute part of this textbook, then you must retain in every digital format page view (including
but not limited to PDF and HTML) and on every physical printed page the following attribution:
“Access for free at openstax.org.”
- If you use this textbook as a bibliographic reference, please include
https://openstax.org/details/books/pharmacology in your citation.
For questions regarding this licensing, please contact .
Trademarks
The OpenStax name, OpenStax logo, OpenStax book covers, OpenStax CNX name, OpenStax CNX logo,
OpenStax Tutor name, Openstax Tutor logo, Connexions name, Connexions logo, Rice University name, and
Rice University logo are not subject to the license and may not be reproduced without the prior and express
written consent of Rice University.
HARDCOVER BOOK ISBN-13 978-1-711472-79-9
B&W PAPERBACK BOOK ISBN-13 978-1-711472-78-2
DIGITAL VERSION ISBN-13 978-1-961584-37-2
ORIGINAL PUBLICATION YEAR 2024
1 2 3 4 5 6 7 8 9 10 RS 24
,OPENSTAX
OpenStax provides free, peer-reviewed, openly licensed textbooks for introductory college and Advanced
Placement® courses and low-cost, personalized courseware that helps students learn. A nonprofit ed tech
initiative based at Rice University, we’re committed to helping students access the tools they need to complete
their courses and meet their educational goals.
RICE UNIVERSITY
OpenStax is an initiative of Rice University. As a leading research university with a distinctive commitment to
undergraduate education, Rice University aspires to path-breaking research, unsurpassed teaching, and
contributions to the betterment of our world. It seeks to fulfill this mission by cultivating a diverse community
of learning and discovery that produces leaders across the spectrum of human endeavor.
PHILANTHROPIC SUPPORT
OpenStax is grateful for the generous philanthropic partners who advance our mission to improve educational
access and learning for everyone. To see the impact of our supporter community and our most updated list of
partners, please visit openstax.org/foundation.
Arnold Ventures Burt and Deedee McMurtry
Chan Zuckerberg Initiative Michelson 20MM Foundation
Chegg, Inc. National Science Foundation
Arthur and Carlyse Ciocca Charitable Foundation The Open Society Foundations
Digital Promise Jumee Yhu and David E. Park III
Ann and John Doerr Brian D. Patterson USA-International Foundation
Bill & Melinda Gates Foundation The Bill and Stephanie Sick Fund
Girard Foundation Steven L. Smith & Diana T. Go
Google Inc. Stand Together
The William and Flora Hewlett Foundation Robin and Sandy Stuart Foundation
The Hewlett-Packard Company The Stuart Family Foundation
Intel Inc. Tammy and Guillermo Treviño
Rusty and John Jaggers Valhalla Charitable Foundation
The Calvin K. Kazanjian Economics Foundation White Star Education Foundation
Charles Koch Foundation Schmidt Futures
Leon Lowenstein Foundation, Inc. William Marsh Rice University
The Maxfield Foundation
, Study where you want, what
you want, when you want.
When you access your book in our web view, you can use our new online
highlighting and note-taking features to create your own study guides.
Our books are free and flexible, forever.
Get started at openstax.org/details/books/pharmacology
Access. The future of education.
openstax.org
,Contents
Preface 1
UNIT 1 INTRODUCTION TO PHARMACOLOGY FOR
NURSES
CHAPTER 1
Introduction to Pharmacology 7
Introduction 7
1.1 Pharmacology, Interdisciplinary Teams, and Nursing Practice 7
1.2 Drug Sources, Forms, and Names 10
1.3 Drug Classifications and Prototypes 21
1.4 Special Considerations 23
Chapter Summary 29
Key Terms 29
Review Questions 30
CHAPTER 2
Drug Administration 33
Introduction 33
2.1 Drug Administration and the Nursing Process 33
2.2 Pharmacokinetics and Pharmacodynamics 43
2.3 Drug Administration Routes, Preparation, and Administration 51
2.4 Dosage Calculations 72
Chapter Summary 84
Key Terms 84
Review Questions 85
CHAPTER 3
Ethics, Legal Considerations, and Safety 89
Introduction 89
3.1 Legal Considerations 89
3.2 Drug Errors and Prevention 94
3.3 Documentation and Informatics 102
Chapter Summary 108
Key Terms 108
Review Questions 108
UNIT 2 HOMEOSTASIS
CHAPTER 4
Introduction to Homeostasis 111
Introduction 111
4.1 What Is Homeostasis? 111
,4.2 Osmolality 115
4.3 Maintaining Homeostasis 116
4.4 Negative Feedback Loop 117
Chapter Summary 120
Key Terms 120
Review Questions 121
CHAPTER 5
Fluids and Electrolytes, Vitamins, Minerals, and Alternative
Therapies 123
Introduction 123
5.1 Fluid Volume 123
5.2 Electrolytes 127
5.3 Intravenous Fluid Therapy, Total Parenteral Nutrition, and Blood Products 135
5.4 Vitamins, Minerals, and Complementary and Alternative Therapies 140
Chapter Summary 148
Key Terms 148
Review Questions 149
UNIT 3 IMMUNE SYSTEM
CHAPTER 6
Introduction to the Immune System and the Inflammatory
Response 151
Introduction 151
6.1 Introduction to Immunity 151
6.2 Vaccine-Preventable Diseases, Vaccines, and Immunizations 154
6.3 Immunosuppressants, Biologics, Monoclonal Antibodies, and Biosimilar Drugs 162
6.4 Introduction to the Inflammatory Response and Anti-inflammatory Drugs 170
Chapter Summary 183
Key Terms 183
Review Questions 184
CHAPTER 7
Anti-infective Drugs 187
Introduction 187
7.1 Introduction to Bacterial, Viral/COVID-19, and Fungal Infections 187
7.2 Antibiotic, Antiviral/Anti–COVID-19, and Antifungal Drugs 189
7.3 Introduction to HIV, AIDS, and Antiretrovirals 204
7.4 Introduction to Sexually Transmitted Infections and Drugs to Treat Them 210
7.5 Introduction to Tuberculosis and Antitubercular Drugs 215
7.6 Antiparasitic and Anthelminthic Drugs 220
Chapter Summary 224
Key Terms 224
Review Questions 224
Access for free at openstax.org
,CHAPTER 8
Introduction to Cancer Therapy and Cancer Drugs 227
Introduction 227
8.1 Introduction to Cancer and Phases of Cancer Therapy 228
8.2 Chemotherapeutic Drugs 230
8.3 Hormonal Therapy 250
8.4 Biologic Response Modifiers 253
Chapter Summary 257
Key Terms 257
Review Questions 257
UNIT 4 NERVOUS SYSTEM AND DRUGS FOR
MENTAL WELL-BEING
CHAPTER 9
Introduction to the Nervous System 261
Introduction 261
9.1 Introduction to the Nervous System 262
9.2 Structure and Function of the Nervous System 263
9.3 Characteristics of Drugs to Treat Nervous System Disorders 266
Chapter Summary 270
Key Terms 270
Review Questions 270
CHAPTER 10
Drugs to Treat Myasthenia Gravis and Alzheimer’s Disease
273
Introduction 273
10.1 Introduction to Myasthenia Gravis 275
10.2 Cholinergic Drugs 277
10.3 Introduction to Alzheimer’s Disease 282
10.4 Alzheimer’s Drugs 284
Chapter Summary 291
Key Terms 291
Review Questions 291
CHAPTER 11
Drugs to Treat Parkinson’s Disease and Multiple Sclerosis 295
Introduction 295
11.1 Introduction to Parkinson’s Disease 295
11.2 Anti-Parkinsonian Drugs 299
11.3 Introduction to Multiple Sclerosis 322
11.4 Drugs Used in the Treatment of Multiple Sclerosis 325
Chapter Summary 344
Key Terms 344
Review Questions 345
, CHAPTER 12
Anticonvulsant Drugs and Drugs to Treat Epilepsy, Migraine
Headaches, and Intracranial Emergencies 347
Introduction 347
12.1 Epilepsy and Anticonvulsant Drugs 348
12.2 Migraine Headaches and Migraine Headache Drugs 366
12.3 Intracranial Emergencies and Intracranial Emergency Drugs 373
Chapter Summary 379
Key Terms 379
Review Questions 380
CHAPTER 13
Psychopharmacologic Drugs 383
Introduction 383
13.1 Antidepressants 384
13.2 Antipsychotics 396
13.3 Mood Stabilizers 405
13.4 Anxiolytics and Sedative-Hypnotics 408
13.5 CNS Stimulants and Nonstimulants 416
Chapter Summary 424
Key Terms 424
Review Questions 425
CHAPTER 14
Pain Response Drugs 427
Introduction 427
14.1 Introduction to Pain 427
14.2 Nonopioid Analgesics 430
14.3 Opioid Agonists and Antagonists 435
Chapter Summary 444
Key Terms 444
Review Questions 444
CHAPTER 15
Substance Use Disorder Treatment Drugs 447
Introduction 447
15.1 Introduction to Substance Use Disorders 447
15.2 Opioid Use Disorder Drugs 451
15.3 Alcohol Use Disorder Drugs 457
15.4 Nicotine Use Disorder Drugs 461
Chapter Summary 467
Key Terms 467
Review Questions 467
Access for free at openstax.org
