Fundamentals of Pharmacology for Midwives

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