Preface

Robert J. Kizior, BS, RPh, Keith J. Hodgson, RN, BSN, CCRN

Nurses are faced with the ever-challenging responsibility of ensuring safe and effective drug therapy for their patients. Not surprisingly, the greatest challenge for nurses is keeping up with the overwhelming amount of new drug information, including the latest FDA-approved drugs and changes to already approved drugs, such as new uses, dosage forms, warnings, and much more. Nurses must integrate this information into their patient care quickly and in an informed manner.

Saunders Nursing Drug Handbook 2018 is designed as an easy-to-use source of current drug information to help the busy nurse meet these challenges. What separates this book from others is that it guides the nurse through patient care to better practice and better care.

This handbook contains the following:

1. An IV compatibility chart. This handy chart is bound into the handbook to prevent accidental loss.

2. The Drug Classifications section. The action and uses for some of the most common clinical and pharmacotherapeutic classes are presented. Unique to this handbook, each class provides an at-a-glance table that compares all the generic drugs within the classification according to product availability, dosages, side effects, and other characteristics. Its half-page color tab ensures you can’t miss it!

3. An alphabetical listing of drug entries by generic name. Blue letter thumb tabs help you page through this section quickly. Information on medications that contain a Black Box Alert is an added feature of the drug entries. This alert identifies those medications for which the FDA has issued a warning that the drugs may cause serious adverse effects. Tall Man lettering, with emphasis on certain syllables to avoid confusing similar sounding/looking medications, is shown in slim blue capitalized letters (e.g., *acetaZOLAMIDE). High Alert drugs with a blue icon Image are considered dangerous by The Joint Commission and the Institute for Safe Medication Practices (ISMP) because if they are administered incorrectly, they may cause life-threatening or permanent harm to the patient. The entire High Alert generic drug entry sits on a blue-shaded background so that it’s easy to spot! To make scanning pages easier, each new entry begins with a shaded box containing the generic name, pronunciation, trade name(s), fixed combination(s), and classification(s).

4. A comprehensive reference section. Appendixes include vital information on calculation of doses; controlled drugs; chronic wound care; drugs of abuse; equianalgesic dosing; herbals: common natural medicines; lifespan, cultural aspects, and pharmacogenomics of drug therapy; normal laboratory values; cytochrome P450 enzymes; poison antidotes; preventing medication errors; parenteral fluid administration; and Common Terminology Criteria for Adverse Events (CTCAE).

5. Drugs by Disorder. You’ll find Drugs by Disorder in the front of the book for easy reference. It lists common disorders and the drugs most often used for treatment.

6. The index. The comprehensive index is located at the back of the book on light blue pages. Undoubtedly the best tool to help you navigate the handbook, the comprehensive index is organized by showing generic drug names in bold, trade names in regular type, classifications in italics, and the page number of the main drug entry listed first and in bold.

A DETAILED GUIDE TO THE SAUNDERS NURSING DRUG HANDBOOK

An intensive review by consultants and reviewers helped us to revise the Saunders Nursing Drug Handbook so that it is most useful in both educational and clinical practice. The main objective of the handbook is to provide essential drug information in a user-friendly format. The bulk of the handbook contains an alphabetical listing of drug entries by generic name.

To maintain the portability of this handbook and meet the challenge of keeping content current, we have also included additional information for some medications on the Evolve® Internet site. Users can also choose from 100 monographs for the most commonly used medications and customize and print drug cards. Evolve® also includes drug alerts (e.g., medications removed from the market) and drug updates (e.g., new drugs, updates on existing entries). Information is periodically added, allowing the nurse to keep abreast of current drug information.

We have incorporated the IV Incompatibilities/Compatibilities Image heading. The drugs listed in this section are compatible or incompatible with the generic drug when administered directly by IV push, via a Y-site, or via IV piggyback. We have highlighted the intravenous drug administration and handling information with a special heading iconImage and have broken it down by Reconstitution, Rate of Administration, and Storage.

We present entries in an order that follows the logical thought process the nurse undergoes whenever a drug is ordered for a patient:

• What is the drug?

• How is the drug classified?

• What does the drug do?

• What is the drug used for?

• Under what conditions should you not use the drug?

• How do you administer the drug?

• How do you store the drug?

• What is the dose of the drug?

• What should you monitor the patient for once he or she has received the drug?

• What do you assess the patient for?

• What interventions should you perform?

• What should you teach the patient?

The following are included within the drug entries:

Generic Name, Pronunciation, Trade Names. Each entry begins with the generic name and pronunciation, followed by the U.S. and Canadian trade names. Exclusively Canadian trade names are followed by a blue maple leaf Image. Trade names that were most prescribed in the year 2015 are underlined in this section.

Black Box Alert. This feature highlights drugs that carry a significant risk of serious or life-threatening adverse effects. Black Box Alerts are ordered by the FDA.

Do Not Confuse With. Drug names that sound similar to the generic and/or trade names are listed under this heading to help you avoid potential medication errors.

Fixed-Combination Drugs. Where appropriate, fixed-combinations, or drugs made up of two or more generic medications, are listed with the generic drug.

Pharmacotherapeutic and Clinical Classification Names. Each entry includes both the pharmacotherapeutic and clinical classifications for the generic drug.

Action/Therapeutic Effect. This section describes how the drug is predicted to behave, with the expected therapeutic effect(s) under a separate heading.

Pharmacokinetics. This section includes the absorption, distribution, metabolism, excretion, and half-life of the medication. The half-life is bolded in blue for easy access.

Uses/Off-Label. The listing of uses for each drug includes both the FDA uses and the off-label uses. The off-label heading is shown in bold blue for emphasis.

Precautions. This heading incorporates a discussion about when the generic drug is contraindicated or should be used with caution. The cautions warn the nurse of specific situations in which a drug should be closely monitored.

Lifespan Considerations Image. This section includes lactation data and age-specific information concerning children and elderly people.

Interactions. This heading enumerates drug, food, and herbal interactions with the generic drug. As the number of medications a patient receives increases, awareness of drug interactions becomes more important. Also included is information about therapeutic and toxic blood levels in addition to the altered lab values that show what effects the drug may have on lab results.

Product Availability. Each drug monograph gives the form and availability of the drug. The icon Image identifies noncrushable drug forms.

Administration/Handling. Instructions for administration are given for each route of administration (e.g., IV, IM, PO, rectal). Special handling, such as refrigeration, is also included where applicable. The routes in this section are always presented in the order IV, IM, SQ, and PO, with subsequent routes in alphabetical order (e.g., Ophthalmic, Otic, Topical). IV administration Image is broken down by reconstitution, rate of administration (how fast the IV should be given), and storage (including how long the medication is stable once reconstituted).

IV Incompatibilities/IV Compatibilities Image. These sections give the nurse the most comprehensive compatibility information possible when administering medications by direct IV push, via a Y-site, or via IV piggyback.

Indications/Routes/Dosage. Each entry provides specific dosing guidelines for adults, elderly, children, and patients with renal and/or hepatic impairment. Dose modification for toxicity has been added where applicable. Dosages are clearly indicated for each approved indication and route.

Side Effects. Side effects are defined as those responses that are usually predictable with the drug, are not life-threatening, and may or may not require discontinuation of the drug. Unique to this handbook, side effects are grouped by frequency listed from highest occurrence percentage to lowest so that the nurse can focus on patient care without wading through myriad signs and symptoms of side effects.

Adverse Effects/Toxic Reactions. Adverse effects and toxic reactions are very serious and often life-threatening undesirable responses that require prompt intervention from a health care provider.

Nursing Considerations. Nursing considerations are organized as care is organized. That is:

Saunders Nursing Drug Handbook is an easy-to-use source of current drug information for nurses, students, and other health care providers. It is our hope that this handbook will help you provide quality care to your patients.

We welcome any comments you may have that would help us to improve future editions of the handbook. Please contact us via the publisher at http://evolve.elsevier.com/SaundersNDH.