This is the second edition of the Open RN Nursing Pharmacology OER textbook. This free online textbook is an open educational resource with CC-BY 4.0 licensing that has been developed for prelicensure nursing students.

This edition has been updated according to the 2023 NCLEX-PN and NCLEX-RN Test Plans, and additional NCLEX Next Generation-style learning activities have been added to each chapter. It is aligned with the Wisconsin Technical College System (WTCS) statewide nursing curriculum for the Nursing Pharmacology course (543-103). View a list of updates in the second edition here.

This book introduces the principles of pharmacology and discusses classes of medications and their effects on the body. Emphasis is on the use of the nursing process to safely administer medications. This book is not intended to be used as a drug reference book. However, links are provided for prototype medications for each medication class to DailyMed, a trustworthy U.S. National Library of Medicine website, that contains detailed information about drugs marketed in the United States.

The Open RN project is supported by a $2.5 million grant from the Department of Education and is licensed under a Creative Commons Attribution 4.0 International License. However, these contents do not necessarily represent the policy of the Department of Education, and you should not assume endorsement by the federal government. More information about the Open RN project can be found at cvtc.edu/OpenRN.

The first edition of Open RN Nursing Pharmacology won an Award for Excellence from OE Global in 2020. For more information about the award, visit the 2020 OE Awards for Excellence site.

Contents

• Preface
• Standards and Conceptual Approach
• Chapter 1 Pharmacokinetics & Pharmacodynamics
  • 1.1. PHARMACOKINETICS & PHARMACODYNAMICS INTRODUCTION
  • 1.2. PHARMACOKINETICS
  • 1.3. ABSORPTION
  • 1.4. DISTRIBUTION
  • 1.5. METABOLISM
  • 1.6. EXCRETION
  • 1.7. PHARMACODYNAMICS
  • 1.8. TYPES OF MEDICATIONS
  • 1.9. EFFICACY, DOSE-RESPONSE, ONSET, PEAK, AND DURATION
  • 1.10. THERAPEUTIC LEVELS
  • 1.11. EVALUATING EFFECTS
  • 1.12. LEARNING ACTIVITIES
  • I. GLOSSARY
• Chapter 2 Legal/Ethical
  • 2.1. LEGAL/ETHICAL INTRODUCTION
  • 2.2. ETHICAL AND PROFESSIONAL FOUNDATIONS OF SAFE MEDICATION ADMINISTRATION BY NURSES
  • 2.3. LEGAL FOUNDATIONS AND NATIONAL GUIDELINES FOR SAFE MEDICATION ADMINISTRATION
  • 2.4. CULTURAL AND SOCIAL DETERMINANTS RELATED TO MEDICATION ADMINISTRATION
  • 2.5. PREVENTING MEDICATION ERRORS
  • 2.6. LEARNING ACTIVITIES
  • II. GLOSSARY
• Chapter 3 Antimicrobials
  • 3.1. ANTIMICROBIALS INTRODUCTION
  • 3.2. BASIC CONCEPTS OF ANTIMICROBIAL THERAPY
  • 3.3. ANTIMICROBIAL ADMINISTRATION CONSIDERATIONS
  • 3.4. APPLYING THE NURSING PROCESS TO ADMINISTERING ANTIMICROBIALS
  • 3.5. PENICILLIN
  • 3.6. CEPHALOSPORINS
  • 3.7. CARBAPENEMS
  • 3.8. MONOBACTAMS
  • 3.9. SULFONAMIDES
  • 3.10. FLUOROQUINOLONES
  • 3.11. MACROLIDES
  • 3.12. AMINOGLYCOSIDES
  • 3.13. TETRACYCLINES
  • 3.14. ANTIVIRALS
  • 3.15. ANTIFUNGALS
  • 3.16. ANTIMALARIALS
  • 3.17. ANTIPROTOZOALS
  • 3.18. ANTIHELMINTICS
  • 3.19. ANTITUBERCULARS
  • 3.20. MISCELLANEOUS ANTIBACTERIALS: GLYCOPEPTIDES
  • 3.21. LEARNING ACTIVITIES
  • III. GLOSSARY
• Chapter 4 Autonomic Nervous System
  • 4.1. AUTONOMIC NERVOUS SYSTEM INTRODUCTION
  • 4.2. BASIC CONCEPTS OF THE AUTONOMIC NERVOUS SYSTEM
  • 4.3. APPLYING THE NURSING PROCESS TO ANS MEDICATIONS
  • 4.4. ANS MEDICATION CLASSES
  • 4.5. NICOTINE RECEPTOR AGONISTS
  • 4.6. MUSCARINIC RECEPTOR AGONISTS
  • 4.7. MUSCARINIC ANTAGONISTS
  • 4.8. ALPHA-1 AGONISTS
  • 4.9. ALPHA-1 ANTAGONISTS
  • 4.10. ALPHA-2 AGONISTS
  • 4.11. BETA-1 AGONISTS
  • 4.12. BETA-1 ANTAGONISTS
  • 4.13. BETA-2 AGONISTS
  • 4.14. BETA-2 ANTAGONISTS
  • 4.15. ALPHA- AND BETA-RECEPTOR AGONISTS (CATECHOLAMINES)
  • 4.16. ACETYLCHOLINESTERASE INHIBITORS
  • 4.17. LEARNING ACTIVITIES
  • IV. GLOSSARY
• Chapter 5 Respiratory System
  • 5.1. RESPIRATORY INTRODUCTION
  • 5.2. BASIC CONCEPTS OF THE RESPIRATORY SYSTEM
  • 5.3. COMMON RESPIRATORY DISORDERS
  • 5.4. APPLYING THE NURSING PROCESS TO ADMINISTERING RESPIRATORY MEDICATIONS
  • 5.5. RESPIRATORY MEDICATION CLASSES
  • 5.6. ANTIHISTAMINES
  • 5.7. DECONGESTANTS
  • 5.8. ANTITUSSIVES
  • 5.9. EXPECTORANTS
  • 5.10. BETA-2 AGONISTS
  • 5.11. ANTICHOLINERGICS
  • 5.12. CORTICOSTERIODS
  • 5.13. LEUKOTRIENE RECEPTOR ANTAGONISTS
  • 5.14. XANTHINE DERIVATIVES
  • 5.15. LEARNING ACTIVITIES
  • V. GLOSSARY
• Chapter 6 Cardiovascular & Renal Systems
  • 6.1. CARDIOVASCULAR AND RENAL SYSTEM INTRODUCTION
  • 6.2. BASIC CONCEPTS OF THE CARDIOVASCULAR AND RENAL SYSTEMS
  • 6.3. COMMON CARDIOVASCULAR DISORDERS
  • 6.4. APPLYING THE NURSING PROCESS TO ADMINISTERING CARDIOVASCULAR AND RENAL MEDICATIONS
  • 6.5. CARDIOVASCULAR AND RENAL SYSTEM MEDICATIONS
  • 6.6. ANTIARRHYTHMICS
  • 6.7. CARDIAC GLYCOSIDES
  • 6.8. ANTIANGINAL – NITRATES
  • 6.9. DIURETICS
  • 6.10. ANTIHYPERTENSIVES
  • 6.11. ANTILIPEMICS
  • 6.12. BLOOD COAGULATION MODIFIERS
  • 6.13. ERECTILE AGENTS
  • 6.14. LEARNING ACTIVITIES
  • VI. GLOSSARY
• Chapter 7 Gastrointestinal System
  • 7.1. GASTROINTESTINAL INTRODUCTION
  • 7.2. BASICS CONCEPTS OF THE GASTROINTESTINAL SYSTEM
  • 7.3. ANTIULCER MEDICATIONS
  • 7.4. ANTIDIARRHEAL MEDICATIONS AND LAXATIVES
  • 7.5. ANTIEMETICS
  • 7.6. LEARNING ACTIVITIES
  • VII. GLOSSARY
• Chapter 8 Central Nervous System
  • 8.1. CENTRAL NERVOUS SYSTEM INTRODUCTION
  • 8.2. BASIC CONCEPTS OF THE CENTRAL NERVOUS SYSTEM
  • 8.3. DISORDERS OF THE CNS SYSTEM
  • 8.4. APPLYING THE NURSING PROCESS TO ADMINISTERING CNS MEDICATIONS
  • 8.5. CNS DEPRESSANTS
  • 8.6. CNS STIMULANTS
  • 8.7. ANTIDEPRESSANTS
  • 8.8. ANTIMANIAS
  • 8.9. ANTIPSYCHOTICS
  • 8.10. ANTICONVULSANTS
  • 8.11. ANTI-PARKINSON’S MEDICATIONS
  • 8.12. LEARNING ACTIVITIES
  • VIII. GLOSSARY
• Chapter 9 Endocrine System
  • 9.1. ENDOCRINE INTRODUCTION
  • 9.2. BASIC CONCEPTS OF THE ENDOCRINE SYSTEM
  • 9.3. CORTICOSTERIODS
  • 9.4. ANTIDIABETICS
  • 9.5. THYROID MEDICATIONS
  • 9.6. HORMONAL CONTRACEPTIVES
  • 9.7. LEARNING ACTIVITIES
  • IX. GLOSSARY
• Chapter 10 Analgesics & Musculoskeletal System
  • 10.1. ANALGESICS AND MUSCULOSKELETAL INTRODUCTION
  • 10.2. BASIC CONCEPTS OF ANALGESICS AND THE MUSCULOSKELETAL SYSTEM
  • 10.3. ACUTE PAIN, CHRONIC PAIN, AND MUSCULOSKELETAL DISORDERS
  • 10.4. APPLYING THE NURSING PROCESS TO PAIN MANAGEMENT
  • 10.5. ANALGESIC AND MUSCULOSKELETAL MEDICATIONS
  • 10.6. NONOPIOID ANALGESICS
  • 10.7. OPIOID ANALGESICS AND ANTAGONISTS
  • 10.8. ADJUVANT ANALGESICS
  • 10.9. ANTIGOUT MEDICATIONS
  • 10.10. ANTIMIGRAINE MEDICATIONS
  • 10.11. ANESTHETICS
  • 10.12. LEARNING ACTIVITIES
  • X. GLOSSARY
• Appendix A – Additional Information Related to the NCLEX Test Plan
• Answer Key