Fundamentals of Pharmacology for Midwives

Ian Peate, OBE, FRCN, Senior Lecturer Roehampton University; Visiting Professor of Nursing, St George’s University of London and Kingston University London; Visiting Professor, Northumbria University; Visiting Senior Clinical Fellow, University of Hertfordshire, and Editor-in-Chief of the British Journal of Nursing.Cathy Hamilton, RGN, RM, PgDip, PGCert, MSc, is a Principal Lecturer and Lead Midwife for Education, University of Hertfordshire.

• Contributors xixPreface xxiAcknowledgements xxiiiHow to Use Your Textbook and the Companion Website xiiiPart I Essentials of pharmacology 1Chapter 1 Introduction to pharmacology 3Jenny BrewsterAim 3Introduction 3Pharmacology 4Nursing and Midwifery Council (NMC) 4Medicines optimisation 6Embryology 6The use of medicines in pregnancy 7Pre- existing conditions 9Occupational exposure 10Drugs used in labour 10Breast feeding 11Conclusion 12Glossary 12Test yourself 12References 12Further reading 14Chapter 2 How to use pharmaceutical and prescribing reference guides 15Kirsty Fishburn and Andrea HiltonAim 15Introduction 16British National Formulary and British National Formulary for Children 16Drug tariff 20Electronic medicines compendium (eMC) 20Medicines and Healthcare products Regulatory Agency 21National Institute for Health and Care Excellence 22UK teratology information service 23Conclusion 24Glossary 24Test yourself 25References 25Chapter 3 Legal and ethical issues 27Hema TurnerAim 27Introduction 27The law 28Ethical principles 32Consent for treatment: adults 34Research 37Conclusion 38Test yourself 39References 39Chapter 4 Medicines management 42Rebecca MurrayAim 42Introduction 42Medicines management and optimisation 43Medicines regulations 44The ‘rights’ of medicines administration 45Medication errors 48Self- administration of medicines 48Storage and disposal of medicines 48Student midwives 49Conclusion 49Glossary 50Test yourself 50References 50Further reading 51Part 2 Introduction to pharmacology 53Chapter 5 Pharmacodynamics and pharmacokinetics 55Barry Hill and Claire LeaderAim 55Introduction 55Regulatory bodies 56Teratogenesis and Fetotoxicity 56Pharmacokinetics 57Pharmacodynamics 67Conclusion 75Test yourself 75References 75Chapter 6 Formulations 77Sinéad McKee and Cathy HamiltonAim 77Introduction 77Oral route of administration 78Topical route of administration 81Transdermal route of administration 83Inhalation route of administration 85Injection route of administration 86Conclusion 88Glossary 89Test yourself 89References 89Further reading 91Chapter 7 Adverse drug reaction 92Cathy HamiltonAim 92Introduction 92Classification of ADR 93Recognising an ADR 94Predisposing factors for ADRs 94Physical signs and symptoms of ADR 96Management of a suspected ADR 96Reporting ADRs 98Conclusion 100Glossary 101Test yourself 101References 101Chapter 8 Analgesics 103Iñaki MansillaAim 103Introduction 103Physiological changes in pregnancy and the puerperium that may require pain management 104Pain transmission during pregnancy, labour and puerperium 105Pain management 106Non- pharmacological approach to analgesia 113Pharmacological approach to analgesia 113Pharmacological analgesia provided by an anaesthetist and monitored by midwives 115Postnatal analgesia 116Conclusion 117Glossary 117Test yourself 117References 117Chapter 9 Antibiotics and antibacterials 121Amanda WatermanAim 121Introduction 121Terminology and differences between micro- organisms 122Antibiotic resistance and the global impact 123Antibacterial stewardship programme 123Bacteria 124Prescribing 133Conclusion 138Glossary 139Test yourself 139References 140Further reading 143Part 3 Medications used during pregnancy and childbirth 145Chapter 10 Medications used in labour 147Chin SwainAim 147Introduction 147Uterotonic drugs 148Epidural 156Spinal anaesthesia 158Documentation 159Conclusion 159Find out more 159Glossary 160Test yourself 161References 161Chapter 11 Medications and the cardiovascular system 163Carl ClareAim 163Introduction 163Cardiac disease and pregnancy 164Antiarrhythmic drugs 165Antihypertensive drugs 172Fibrinolytics 173Cardiomyopathy 175Hyperlipidaemia 178Breast feeding 178Conclusion 178Find out more 178Glossary 179Test yourself 179References 180Further reading 180Chapter 12 Medications and the renal system 181Sam BassettAim 181Introduction 182Anatomy and physiology of the renal tract 182Physiological changes to the renal system during pregnancy 183Common renal conditions in pregnancy 184Specific conditions and their management 191Conclusion 199Find out more 199Glossary 199Test yourself 200References 200Chapter 13 Medications and diabetes 202Carl Clare and Celia WildemanAim 202Introduction 202Physiology 203Pathophysiology 205Signs and symptoms 205Diagnosis and investigations 206Treatment of diabetes 208Care of the woman during pregnancy in the presence of pre- existing diabetes 212Blood glucose monitoring in diabetes 214Diabetic emergencies 217Diabetes and birth 218Conclusion 219Find out more 219Glossary 219Test yourself 220References 220Further reading 221Chapter 14 Medications and respiration 222Helen McIntyreAim 222Introduction 222Asthma 223Chronic obstructive pulmonary disease 225Tuberculosis 229Influenza 232Pneumonia and COVID- 19 232Pulmonary embolism 234Cystic fibrosis 235Human immunodeficiency virus 236Find out more 236Glossary 236Test yourself 237References 237Chapter 15 Medications and the gastrointestinal system 239Debbie GurneyAim 239Introduction 239Nausea and vomiting in pregnancy 240Heartburn 243Constipation 247Irritable bowel syndrome 249Diarrhoea 250Anorectal conditions 250Conclusion 252Find out more 253Glossary 253Test yourself 254References 254Further reading 255Chapter 16 Medications and nutritional supplementation 256Cathy AshwinAim 256Introduction 257Assessing the needs of the woman 257Folic acid 257Iron 259Vitamin D and calcium 262Vitamin B12 262Vitamin A 263Vitamin B6 264Vitamin E 264Vitamin K 265Zinc 266Magnesium 266Herbal and integrative supplementation and therapies 266Factors affecting adequate vitamin and mineral intake during pregnancy 268Conclusion 268Find out more 268Glossary 269Test yourself 269References 270Further reading 271Chapter 17 Medications and the nervous system 272Cathy HamiltonAim 272Introduction 273Headache and migraine 273Epilepsy 275Conclusion 284Find out more 285Glossary 285Test yourself 285References 285Chapter 18 Medications and mental health 288Emmanuel NdisangAim 288Introduction 288Medications and mental health presentations 289Psychotropic medication in the perinatal period 292Psychotropic medications and lactation 297Conclusion 298Glossary 299Test yourself 299References 299Further reading 301Chapter 19 Medications and the immune system 302Janet G. Migliozzi and Cathy HamiltonAim 302Introduction 302Immunity 303Vaccines 304Conclusion 314Find out more 314Glossary 315Test yourself 315References 316Chapter 20 Medications and breast feeding 318Deborah Sharp and Zoi VardavakiAim 318Introduction 319Transfer of medication in breast milk 319Maternal diseases and medication in the breast- feeding mother 323Over- the- counter medicines 326Midwife’s role 326Breast feeding and medications information 327Conclusion 327Find out more 327Glossary 328Test yourself 328References 328Further reading 329Chapter 21 Medications and sexually transmitted infections 330Celia WildemanAim 330Introduction 331Bacteria 331Viruses 332Parasites 332Chlamydia trachomatis (chlamydia) 334Gonorrhoea 338Syphilis 341Hepatitis B virus 342Human papillomavirus 343Human immunodeficiency virus (HIV) 344Trichomonas vaginalis (TV) 345Conclusion 346Glossary 346Test yourself 347References 347Further reading 348Chapter 22 Medications and recreational drug use 349Laura Abbott and Karen MillsAim 349Introduction 349Role of midwives working with women who use drugs 350Drugs of misuse 350Absorption, distribution, metabolism and excretion (ADME) of drugs 355Understanding the role drugs play in the lives of women 355Drug use, pregnancy and risks 357Breast feeding and drug use 358Conclusion 359Find out more 360Glossary 360Test yourself 360References 361Further reading 363Chapter 23 Medications used in emergency midwifery situations 364Jayne E. MarshallAim 364Principles of managing maternity emergencies 365Communication 365Professional responsibility in emergency situations 367Maternal collapse 368Thrombosis and thromboembolism 371Drug toxicity/overdose 373Major haemorrhage/hypovolaemia 374Pre- eclampsia and eclampsia 379Sepsis 383Cardiac arrest 383Perimortem caesarean section (resuscitative hysterotomy) 384Conclusion 387Find out more 387Glossary 387Test yourself 387References 388Further reading 389Chapter 24 Medications used in contraception 390Emma Dawson- GoodeyAim 390Introduction 390Pharmacokinetic and pharmacodynamic interactions 392Combined hormonal contraception 393Progesterone- oral pill 396Progesterone injection 397Progesterone implant 398Intrauterine contraceptive (IUC) 399Emergency contraception 400Conclusion 401Find out more 402Glossary 402Test yourself 403References 403Further reading 403Index 405