Look inside the book: Nursing 2025-2026 Drug Handbook

vi How to use Nursing2025–2026 Drug Handbook ®

mix, and store IV medications) and the major potential IV incompatibilities. Action This section succinctly describes each drug’s mechanism of action—that is, how the drug provides its therapeutic effect. For example, although all antihypertensives lower BP, they don’t all do so by the same process. Also in cluded, in table form, are the onset, peak (described in terms of effect or peak blood level), and duration of drug action for each route of administration, if data are available or applicable. Values listed are for patients with normal kidney function, unless otherwise speci fied. The drug’s half-life is also provided when known. Adverse reactions In this section, adverse reactions that are known to occur at a frequency of 1% or greater are listed according to body system. Life-threatening reactions appear in bold italic type. Interactions Within this section, readers can find each drug’s confirmed, clinically significant interac tions (additive effects, potentiated effects, and antagonistic effects) with other drugs, herbs, foods, beverages, and lifestyle behaviors (such as alcohol use, sun exposure, and smoking). Drug interactions are listed under the drug that’s adversely affected. For example, because celecoxib, a nonsteroidal anti-inflammatory drug, interacts with candesartan to decrease the antihypertensive effect of candesartan, this in teraction is listed under candesartan. To check on the possible effects of using two or more drugs simultaneously, refer to the interaction section for each drug. Effects on lab test results This section lists increased and decreased levels, counts, and other values in lab test results that may be caused by the drug’s systemic effects. It also indicates false-positive, false-negative, and otherwise altered lab test results a drug may cause. Contraindications & cautions The “Contraindications & cautions” section outlines any conditions or special circumstances, such as diseases or conditions, in which use of the drug is undesirable or for which the drug

throughout, as warranted, to point out the drug’s safety concerns. For example, a clinical alert logo ( t ) provides important advice about life-threatening effects associated with the drug or its administration; a boxed warning ( Boxed Warning ) represents a specific warning issued by the FDA; and a special icon ( ) indi cates oral drug forms that shouldn’t be crushed or chewed. (See “Anatomy of a monograph” on the inside book cover for a visual guide to the various symbols that may appear within a drug entry.) Available forms This section lists the preparations available for each drug (for example, tablets, capsules, and solutions for injection) and specifies available dosage forms and strengths. Dosage strengths specifically available in Canada are designated with a maple leaf ( • ). Preparations that may be obtained over the counter, without a pre scription, are marked with an open diamond ( ◊ ). Liquid formulations that contain alcohol are indicated with an asterisk (*). Capsules or tablets that shouldn’t be crushed are marked with a “Do Not Crush” symbol ( ). Indications & dosages The “Indications & dosages” section contains general dosage information for adults and children. The dosage instructions reflect current trends in therapeutics and can’t be considered absolute or universal. For each individual pa tient, dosage instructions must be considered in light of the patient’s condition. Indications and dosages that aren’t approved by the FDA are followed by a closed diamond ( ♦ ). Only highly evidence-based off-label uses are included in this edition. Adjust-a-dose content within this section indicates the need for a special dosage adjustment for certain patient populations, such as older adults or those with kidney or liver impairment. In some cases, a dosage adjust ment may apply to all patient populations for all the indications listed; such cases are marked accordingly. Administration Here, readers will find guidelines for safely administering drugs by all applicable routes, including PO, IV, IM, subcut, ophthalmic, in halational, topical, rectal, vaginal, transdermal, and buccal. A special screened background highlights IV administration guidelines (includ ing specific instructions on how to reconstitute,

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