Pharmacology for Nurses, 3rd Canadian Edition

Book Preface

When students are asked which subject in their nursing program is the most challenging, pharmacology and pathophysiology always appear near the top of the list. The study of pharmacology demands that students apply knowledge from a wide variety of the natural and applied sciences. The successful prediction of drug action requires a thorough knowledge of anatomy, physiology, chemistry, and pathology, as well as knowledge of the social sciences of psychology and sociology. Current knowledge of drug actions, mechanisms, interactions, and legislation is mandatory for nurses to provide safe and effective care to their clients in all healthcare settings. Lack of proper application of pharmacology can result in immediate and direct harm to the client; therefore, the stakes in learning pharmacotherapeutics in nursing are high.
Pharmacology can be made more understandable if the proper connections are made to knowledge learned in other disciplines; that’s the impetus for starting every unit of the book with a review of the physiology of the related system or a discussion of the principles that inform pharmacotherapy. The vast majority of drugs in clinical practice are prescribed for specific diseases, yet many pharmacology texts fail to recognize the complex interrelationships between pharmacology and pathophysiology. When drugs are learned in isolation from their associated diseases or conditions, students have difficulty connecting pharmacotherapy to therapeutic goals and client wellness. The pathophysiology approach of this text gives the student a clearer picture of the importance of pharmacology to disease, and ultimately to client care. The approach and rationale of this text focus on a holistic perspective to client care, which clearly shows the benefits and limitations of pharmacotherapy in curing, managing symptoms, or preventing illness. Although challenging, the study of pharmacology is truly a fascinating, lifelong journey.

The third Canadian edition continues the tradition of providing a unique Canadian perspective on pharmacotherapeutics, geared towards the education of Canadian undergraduate nursing students and their curriculum. During the editorial process, the text content was thoroughly reviewed and scrutinized by Canadian nurse educators and seasoned Canadian clinical pharmacists. The authors adapted the content of the U.S. edition of the text to fit the Canadian nursing context. The technical review process helped ensure accurate information on Canadian drug names, and their respective doses and routes of administration, including common Canadian Trade names for drugs. The review also highlighted drugs that are exclusively available and approved for use in Canada. Pregnancy categorizations of drugs were updated based on Canadian standards. Tables and illustrations to help students better assimilate pharmacotherapeutic concepts were also added to the respective chapters. We were intentional about adding recommendations for therapeutics driven by Canadian guidelines in the updated chapters. For example, research from Thrombosis Canada led to the addition of a section on direct oral anticoagulants (DOACs) in Chapter 56 . The 2017 Comprehensive Update of the Canadian Cardiovascular Society Guidelines for the Management of Heart Failure were used to add updated content to Chapter 54 . Diabetes Canada clinical practice guidelines were integrated into Chapter 28  to ensure its currency. The Canadian Cardiovascular Society’s dyslipidemia guidelines were used to add the most recent drugs used to treat lipid disorders in Chapter 49 .
We believe that using the aforementioned guidelines ensures the currency and validity of the textbook. Finally, we also updated the NCLEX questions to reflect the current NCLEX test plan and blueprints.

Organization: A Body System and Disease Approach

Pharmacology for Nurses: A Pathophysiological Approach, third Canadian edition, is organized according to body systems (units) and diseases (chapters). This edition of the text has been expanded with new information. We have added more details to new chapters introduced in the second Canadian edition and included NCLEX Success Tips within each chapter to assist the student with making connections to the new NCLEX exam requirement for Canadian registered nurses. This component, that was introduced in the second Canadian edition, was well received and commended by students and faculty. The first chapter in each unit (except in Units 1, 2, and 3) provides a brief discussion of the physiology of the corresponding body system. Each chapter provides complete information on the drug classifications used to treat the diseases discussed in that chapter. Specially designed headings cue students to each classification discussion.
The pathophysiology approach clearly places the drugs in context in terms of how they are used therapeutically. The student is able to easily locate all relevant anatomy, physiology, pathology, and pharmacology in the same chapter in which the drugs are discussed. This approach provides the student with a clear view of the connections between pharmacology, pathophysiology, and the nursing care learned in other clinical courses.

NCLEX Success Tips
The third Canadian edition of Pharmacology for Nurses: A Pathophysiological Approach expands on more chapters to address the rapidly growing needs of students practising in the Canadian healthcare system. Before we started writing the text, we collected feedback from university professors, asking specifically about their experience using other pharmacology texts and their perceptions of an ideal text. These professors shared some of the challenges their students face while taking a pharmacology course. An emerging but immediate need that echoed at a national level was the need to prepare Canadian nursing students to pass the NCLEX exam. Although students can take NCLEX courses after graduation or just before taking the exam, we believe that early introduction of NCLEX format and concepts will give the students ample time to understand and assimilate these concepts. Our textbook is the first nursing pharmacology text to incorporate NCLEX Success Tips.

We experienced challenges while trying to address all stakeholder concerns, as well as student needs, and at the same time keeping the text to a reasonable length. As a result, we reviewed several NCLEX texts and designed tips based on the latest NCLEX exam blueprints. We have presented the new content in a concise and succinct format and have used tables, figures, and illustrations to explain concepts.