Fundamentals of Pharmacology for Midwives provides the reader with a thorough understanding of the essentials of pharmacology associated with childbearing women, and improving safety and care outcomes whilst ensuring the comfort of the mother. It is essential that midwifery students have a knowledge and an understanding of pharmacology, along with an ability to recognise the positive and opposing effects of medicines from conception to birth - including allergies and drug sensitivities, side effects and adverse reactions, contraindications and errors in prescribing, and more.
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Table of Contents
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
