"Davis's Drug Guide for Nurses," 18th Edition by April Hazard Vallerand and Cynthia A. Sanoski is an essential resource that provides comprehensive, accessible information on the safe administration of drugs for nursing students and practicing nurses. This guide is designed to support nurses in medication management by giving clear and thorough drug information, covering over 5,000 medications. The 18th edition includes updates on new drugs, as well as revised content on existing drugs, incorporating the latest evidence-based guidelines to ensure safe patient care.
Key Structure and Features
The guide is structured to provide quick, actionable information in a clinical setting, with entries that follow a consistent format. Each drug entry typically includes:
• Generic and Trade Names: Helps nurses identify the drug accurately.
• Classifications: Includes both therapeutic and pharmacologic classifications, allowing nurses to understand the primary purpose and function of each drug.
• Action: Describes the drug’s mechanism of action, explaining how it affects the body at a cellular or systemic level.
• Therapeutic Effects and Uses: Lists the specific conditions or symptoms for which the drug is prescribed.
• Pharmacokinetics: Provides information on absorption, distribution, metabolism, and excretion, helping nurses understand how the drug behaves within the body.
• Contraindications and Precautions: Identifies patient conditions or factors that require caution, such as pregnancy, comorbidities, or drug allergies.
• Adverse Reactions and Side Effects: Highlights both common and severe side effects, enabling
nurses to monitor and respond to any adverse reactions effectively.
• Interactions: Lists potential drug-drug and drugfood interactions, which are essential for planning safe and effective medication regimens.
• Dosages and Administration: Details dosage ranges for adults, children, and special populations, alongside methods of administration.
• Patient and Family Teaching: Provides guidance for educating patients and caregivers about the medication’s purpose, how to take it properly, and what side effects to watch for.
• Nursing Implications and Considerations: Offers specific advice on patient assessment, monitoring, and interventions related to each drug.
Part 1: Introduction to Safe Medication Administration
The introductory section of the guide focuses on essential principles for medication administration:
• Nursing Responsibilities: Stresses the nurse's role in safely managing medication, from verifying correct dosages to monitoring patient responses.
• Legal and Ethical Considerations: Reviews the nurse's responsibility to maintain patient safety, consent, and autonomy.
• Strategies for Reducing Medication Errors: This includes best practices such as the “Five Rights” of medication administration (right patient, right drug, right dose, right route, and right time), and guidance on interpreting drug orders accurately. This section is fundamental for developing the knowledge needed to understand the broader context of drug administration and lays the foundation for nurses to be vigilant in minimizing medication errors.
Part 2: Individual Drug Entries
The bulk of the guide consists of detailed entries for individual drugs. Each entry provides an in-depth look at the characteristics and clinical application of the drug.
Example Drug Entry: Metoprolol (Beta-blocker)
• Mechanism: Describes how metoprolol works to reduce blood pressure by blocking beta receptors in the heart, decreasing heart rate.
• Indications: Lists specific conditions such as hypertension, angina, and heart failure.
• Side Effects: Highlights common reactions like fatigue, dizziness, and gastrointestinal disturbances, as well as rare but severe reactions like bronchospasm.
• Nursing Implications: Advises on monitoring blood pressure and heart rate, and assessing for signs of worsening heart failure.
• Patient Education: Instructs nurses on advising patients to take the medication consistently and avoid sudden discontinuation.
Drug Entry: Insulin
• Types of Insulin: Differentiates between rapid, short, intermediate, and long-acting insulins, each with distinct onset, peak, and duration times.
• Dosing and Administration: Provides detailed information on subcutaneous injection techniques and timing relative to meals.
• Hypoglycemia Prevention: Emphasizes monitoring blood glucose levels and recognizing early signs of hypoglycemia.
• Patient Teaching: Instructs nurses to educate patients about dietary management and blood glucose monitoring. Each entry is designed to be clear, comprehensive, and applicable in a clinical setting, enabling nurses to make quick decisions in patient care.
Part 3: Special Drug Considerations for Different Populations
The guide includes specific sections and symbols highlighting considerations for unique populations:
• Pediatrics: Many drugs have different effects and dosage requirements in children. Pediatric dosing guidelines are provided when applicable, with special attention to age-related pharmacokinetics.
• Geriatrics: Aging can affect drug metabolism and increase susceptibility to side effects, so the guide provides geriatric-specific dosing and monitoring advice.
• Pregnancy and Lactation: Drugs are categorized based on safety during pregnancy and breastfeeding, and potential risks to the fetus or nursing infant are highlighted.
• Renal and Hepatic Impairment: The guide provides altered dosing guidelines for patients with renal or liver conditions, recognizing how impaired organ function can impact drug metabolism and excretion.
Part 4: Nursing Implications and Patient Care
The guide emphasizes a holistic approach to patient care by including nursing implications for each drug, covering:
• Pre-Administration Assessment: Encourages nurses to assess baseline health conditions, such
as vital signs, blood tests, and symptoms, before administering medications.
• Ongoing Monitoring: Specific advice on observing the patient’s response to the drug, managing side effects, and identifying signs of toxicity.
• Post-Administration Care: Instructions for postadministration monitoring to ensure the drug’s effectiveness and minimize adverse effects. This approach reinforces a proactive stance, helping nurses recognize and address potential complications early.
Part 5: Drug Interactions and Safety Alerts
The guide includes a comprehensive section on drug interactions, emphasizing the importance of:
• Avoiding Harmful Combinations: Identifying dangerous drug interactions, such as those that may lead to cardiac issues or respiratory distress.
• Safety Alerts: Highlighting "High Alert" drugs that require extra care due to the severity of possible adverse effects.
• OTC and Herbal Interactions: Noting potential interactions between prescription medications and over-the-counter or herbal products, which patients may not disclose.
This focus on interaction and safety alerts is vital in hospital and outpatient settings, where polypharmacy is common.
Part 6: Patient and Family Teaching
Patient education is a critical component, and the guide includes advice for communicating with patients:
• Medication Purpose: Teaching patients the reason for taking the medication.
• Dosage and Timing: Instructions on maintaining a consistent dosing schedule, especially for chronic medications.
• Managing Side Effects: Guidance on recognizing and managing common side effects, and knowing when to seek medical help.
• Lifestyle Adjustments: Encouraging lifestyle changes to enhance medication effectiveness, such as dietary adjustments or exercise.
Nurses are encouraged to simplify complex information to improve adherence and minimize risks associated with misunderstanding or misuse.
Additional Tools and Resources
The 18th edition also includes appendices and online resources:
• Appendices: Quick-reference tables for laboratory values, vital signs, and other diagnostic criteria, supporting clinical decision-making.
• Interactive Online Resources: A companion website offers quizzes, drug calculators, and interactive exercises for additional learning and skill reinforcement.
• Common Abbreviations and Symbols: An appendix of standard medical abbreviations and symbols helps nurses quickly interpret drug orders and instructions.
"Davis's Drug Guide for Nurses," 18th Edition remains an invaluable tool for safe and effective drug administration in nursing practice. It equips nurses with critical information on a wide range of medications, provides practical nursing implications, and emphasizes patient education. The guide’s clear layout, extensive details, and focus on patient safety make it an essential reference for nurses aiming to provide high-quality, informed care in diverse healthcare settings. The updates in this edition reflect advancements in pharmacology and changes in evidence-based practice, ensuring that nurses have the latest information at their fingertips.