{"id":201,"date":"2019-11-12T17:22:48","date_gmt":"2019-11-12T22:22:48","guid":{"rendered":"https:\/\/pressbooks.bccampus.ca\/nursingpharmacology\/chapter\/5-6-antihistamines\/"},"modified":"2022-01-21T18:32:32","modified_gmt":"2022-01-21T23:32:32","slug":"5-6-antihistamines","status":"publish","type":"chapter","link":"https:\/\/pressbooks.bccampus.ca\/nursingpharmacology\/chapter\/5-6-antihistamines\/","title":{"raw":"5.6 Antihistamines","rendered":"5.6 Antihistamines"},"content":{"raw":"<h3>Antihistamines<\/h3>\r\nDiphenhydramine and Cetirizine are two commonly-seen antihistamine drugs. In this chapter we explore Diphenhydramine.\r\n\r\nDiphenhydramine is an example of a first-generation antihistamine. (See Figures 5.6<sup>[footnote]\"<a href=\"https:\/\/www.flickr.com\/photos\/zenbenjamin\/4948476952\" target=\"_blank\" rel=\"noopener noreferrer\">Benadryl Allergy USA<\/a>\" by <a href=\"https:\/\/www.flickr.com\/photos\/zenbenjamin\/\" target=\"_blank\" rel=\"noopener noreferrer\">ZenBenjamin<\/a> is licensed under <a href=\"https:\/\/creativecommons.org\/licenses\/by-nc-sa\/2.0\/\" target=\"_blank\" rel=\"noopener noreferrer\">CC BY-NC-SA 2.0<\/a>[\/footnote]<\/sup> and 5.6a.<sup>[footnote]\"<a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Diphenhydramine_(1).JPG\" target=\"_blank\" rel=\"noopener noreferrer\">diphenhydramine (1)<\/a>\" by <a href=\"https:\/\/commons.wikimedia.org\/wiki\/User:Intropin\" target=\"_blank\" rel=\"noopener noreferrer\">Intropin<\/a> is licensed under<a href=\"https:\/\/creativecommons.org\/licenses\/by-nc-sa\/2.0\/\" target=\"_blank\" rel=\"noopener noreferrer\"> CC BY-NC 2.0[\/footnote]<\/a><\/sup>)\u00a0 Second-generation antihistamines were developed to have fewer side effects. An example of a second-generation antihistamine is cetirizine.\r\n\r\n[caption id=\"attachment_200\" align=\"aligncenter\" width=\"339\"]<img class=\"wp-image-199\" title=\"&quot;Benadryl Allergy USA&quot; by ZenBenjamin is licensed under CC BY-NC-SA 2.0\" src=\"https:\/\/pressbooks.bccampus.ca\/knowinghome\/wp-content\/uploads\/sites\/1167\/2019\/11\/image11-5.png\" alt=\"Photo of an opened package of Benadryl\" width=\"339\" height=\"254\" \/> Figure 5.6 Diphenhydramine is a first-generation antihistamine that is available orally or as an IV medication[\/caption]\r\n\r\n[caption id=\"attachment_200\" align=\"aligncenter\" width=\"259\"]<img class=\"wp-image-200\" title=\"&quot;diphenhydramine (1)&quot; by M is licensed under CC BY-NC 2.0\" src=\"https:\/\/pressbooks.bccampus.ca\/knowinghome\/wp-content\/uploads\/sites\/1167\/2020\/10\/image10-4-225x300.png\" alt=\"Photo of diphenhydramine HCI bottle.\" width=\"259\" height=\"345\" \/> Figure 5.6a Diphenhydramine HCl preparation, single dose vial for IV administration[\/caption]\r\n\r\n<div style=\"clear: both\"><\/div>\r\n<strong>Mechanism of Action<\/strong>\r\n\r\nAntihistamines have the following mechanisms of action: blocks histamine at H1 receptors; inhibits smooth muscle constriction in blood vessels and the respiratory and GI tracts; and decreases capillary permeability, salivation, and tear formation.\r\n\r\n<strong>Indications for Use<\/strong>\r\n\r\nAntihistamines are used for relief of allergy or cold symptoms.\r\n\r\n<strong>Nursing Considerations Across the Lifespan<\/strong>\r\n\r\nThis medication is not safe for children under the age of 2 years without a healthcare provider's order.\r\n\r\n<strong>Adverse\/Side Effects<\/strong>\r\n\r\nFirst-generation medications can cause anticholinergic effects (such as dry mouth, urinary retention, constipation and blurred vision). CNS depression or CNS stimulation with excessive doses can occur, especially in children. Therefore, first-generation antihistamines should be used with caution in the elderly.\r\n\r\nSecond-generation medications may cause headache, nausea, vomiting, dysmenorrhea, and fatigue.<sup>[footnote]Frandsen, G. &amp; Pennington, S. (2018). <em>Abrams\u2019 clinical drug: Rationales for nursing practice <\/em>(11th ed.). Wolters Kluwer.[\/footnote]<\/sup>\r\n\r\n<strong>Client Teaching &amp; Education<\/strong>\r\n\r\nClients should be advised that antihistamines may cause drowsiness, and concurrent use of alcohol or other CNS depressants should be avoided.\u00a0 Clients should take only the recommended amount of medication and not exceed dosing recommendations.\u00a0 Some clients may experience side effects such as dry mouth, and frequent oral hygiene may assist in alleviating discomfort.<sup>[footnote]uCentral from Unbound Medicine. <a href=\"https:\/\/www.unboundmedicine.com\/ucentral\" target=\"_blank\" rel=\"noopener noreferrer\">https:\/\/www.unboundmedicine.com\/ucentral<\/a>[\/footnote]<\/sup>\r\n\r\nNow let's take a closer look at the medication grid for diphenhydramine and cetirizine in Table 5.6.<sup>[footnote]This work is a derivative of <a href=\"https:\/\/www.oercommons.org\/authoring\/54330-pharmacology-notes-nursing-implications-for-clinic\/view\" target=\"_blank\" rel=\"noopener noreferrer\">Pharmacology Notes: Nursing Implications for Clinical Practice<\/a> by <a href=\"https:\/\/www.oercommons.org\/profile\/213497\" target=\"_blank\" rel=\"noopener noreferrer\">Gloria Velarde<\/a> licensed under <a href=\"https:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0\/\" target=\"_blank\" rel=\"noopener noreferrer\">CC BY-NC-SA 4.0<\/a>.[\/footnote],<\/sup> <sup>[footnote]Frandsen, G. &amp; Pennington, S. (2018). <em>Abrams\u2019 clinical drug: Rationales for nursing practice <\/em>(11th ed.). Wolters Kluwer.[\/footnote], [footnote]This work is a derivative of <a href=\"https:\/\/dailymed.nlm.nih.gov\/dailymed\/\" target=\"_blank\" rel=\"noopener noreferrer\">Daily Med<\/a> by <a href=\"https:\/\/www.nlm.nih.gov\/\" target=\"_blank\" rel=\"noopener noreferrer\">U.S. National Library of Medicine<\/a> in the <a href=\"https:\/\/creativecommons.org\/share-your-work\/public-domain\/\" target=\"_blank\" rel=\"noopener noreferrer\">public domain<\/a>. [\/footnote] <\/sup>Medication cards are intended to assist students to learn key points about each medication class.\u00a0 Basic information related to a common generic medication in this class is outlined, including administration considerations, therapeutic effects, and side effects\/adverse effects.\u00a0 Prototype\/generic medication listed in the medication card is also hyperlinked to a free resource from\u00a0 <a href=\"https:\/\/dailymed.nlm.nih.gov\/dailymed\/index.cfm\" target=\"_blank\" rel=\"noopener noreferrer\">Daily Med<\/a>.\u00a0 Because information about medication is constantly changing, nurses should always consult evidence-based resources to review current recommendations before administering specific medication.\r\n\r\nTable 5.6 Diphenhydramine Medication Card [footnote] This work is a derivative of\u00a0 <a href=\"https:\/\/dailymed.nlm.nih.gov\/dailymed\/\" target=\"_blank\" rel=\"noopener\">Daily Med <\/a>by\u00a0<a href=\"https:\/\/www.nlm.nih.gov\/\" target=\"_blank\" rel=\"noopener\">U.S. National Library of Medicine<\/a>\u00a0in the\u00a0<a href=\"https:\/\/creativecommons.org\/share-your-work\/public-domain\/\" target=\"_blank\" rel=\"noopener\">public domain<\/a>.\u00a0[\/footnote]\r\n\r\n<img class=\"alignnone wp-image-1485\" src=\"https:\/\/pressbooks.bccampus.ca\/nursingpharmacology\/wp-content\/uploads\/sites\/1167\/2019\/11\/Gas-Exchange-5.jpg\" alt=\"\" width=\"830\" height=\"1075\" \/>\r\n\r\n&nbsp;","rendered":"<h3>Antihistamines<\/h3>\n<p>Diphenhydramine and Cetirizine are two commonly-seen antihistamine drugs. In this chapter we explore Diphenhydramine.<\/p>\n<p>Diphenhydramine is an example of a first-generation antihistamine. (See Figures 5.6<sup><a class=\"footnote\" title=\"&quot;Benadryl Allergy USA&quot; by ZenBenjamin is licensed under CC BY-NC-SA 2.0\" id=\"return-footnote-201-1\" href=\"#footnote-201-1\" aria-label=\"Footnote 1\"><sup class=\"footnote\">[1]<\/sup><\/a><\/sup> and 5.6a.<sup><a class=\"footnote\" title=\"&quot;diphenhydramine (1)&quot; by Intropin is licensed under CC BY-NC 2.0\" id=\"return-footnote-201-2\" href=\"#footnote-201-2\" aria-label=\"Footnote 2\"><sup class=\"footnote\">[2]<\/sup><\/a><\/a><\/sup>)\u00a0 Second-generation antihistamines were developed to have fewer side effects. An example of a second-generation antihistamine is cetirizine.<\/p>\n<figure id=\"attachment_200\" aria-describedby=\"caption-attachment-200\" style=\"width: 339px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-199\" title=\"&quot;Benadryl Allergy USA&quot; by ZenBenjamin is licensed under CC BY-NC-SA 2.0\" src=\"https:\/\/pressbooks.bccampus.ca\/knowinghome\/wp-content\/uploads\/sites\/1167\/2019\/11\/image11-5.png\" alt=\"Photo of an opened package of Benadryl\" width=\"339\" height=\"254\" srcset=\"https:\/\/pressbooks.bccampus.ca\/nursingpharmacology\/wp-content\/uploads\/sites\/1167\/2019\/11\/image11-5.png 1024w, https:\/\/pressbooks.bccampus.ca\/nursingpharmacology\/wp-content\/uploads\/sites\/1167\/2019\/11\/image11-5-300x225.png 300w, https:\/\/pressbooks.bccampus.ca\/nursingpharmacology\/wp-content\/uploads\/sites\/1167\/2019\/11\/image11-5-768x576.png 768w, https:\/\/pressbooks.bccampus.ca\/nursingpharmacology\/wp-content\/uploads\/sites\/1167\/2019\/11\/image11-5-65x49.png 65w, https:\/\/pressbooks.bccampus.ca\/nursingpharmacology\/wp-content\/uploads\/sites\/1167\/2019\/11\/image11-5-225x169.png 225w, https:\/\/pressbooks.bccampus.ca\/nursingpharmacology\/wp-content\/uploads\/sites\/1167\/2019\/11\/image11-5-350x263.png 350w\" sizes=\"auto, (max-width: 339px) 100vw, 339px\" \/><figcaption id=\"caption-attachment-200\" class=\"wp-caption-text\">Figure 5.6 Diphenhydramine is a first-generation antihistamine that is available orally or as an IV medication<\/figcaption><\/figure>\n<figure id=\"attachment_200\" aria-describedby=\"caption-attachment-200\" style=\"width: 259px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-200\" title=\"&quot;diphenhydramine (1)&quot; by M is licensed under CC BY-NC 2.0\" src=\"https:\/\/pressbooks.bccampus.ca\/knowinghome\/wp-content\/uploads\/sites\/1167\/2020\/10\/image10-4-225x300.png\" alt=\"Photo of diphenhydramine HCI bottle.\" width=\"259\" height=\"345\" srcset=\"https:\/\/pressbooks.bccampus.ca\/nursingpharmacology\/wp-content\/uploads\/sites\/1167\/2020\/10\/image10-4-225x300.png 225w, https:\/\/pressbooks.bccampus.ca\/nursingpharmacology\/wp-content\/uploads\/sites\/1167\/2020\/10\/image10-4-65x87.png 65w, https:\/\/pressbooks.bccampus.ca\/nursingpharmacology\/wp-content\/uploads\/sites\/1167\/2020\/10\/image10-4-350x467.png 350w, https:\/\/pressbooks.bccampus.ca\/nursingpharmacology\/wp-content\/uploads\/sites\/1167\/2020\/10\/image10-4.png 768w\" sizes=\"auto, (max-width: 259px) 100vw, 259px\" \/><figcaption id=\"caption-attachment-200\" class=\"wp-caption-text\">Figure 5.6a Diphenhydramine HCl preparation, single dose vial for IV administration<\/figcaption><\/figure>\n<div style=\"clear: both\"><\/div>\n<p><strong>Mechanism of Action<\/strong><\/p>\n<p>Antihistamines have the following mechanisms of action: blocks histamine at H1 receptors; inhibits smooth muscle constriction in blood vessels and the respiratory and GI tracts; and decreases capillary permeability, salivation, and tear formation.<\/p>\n<p><strong>Indications for Use<\/strong><\/p>\n<p>Antihistamines are used for relief of allergy or cold symptoms.<\/p>\n<p><strong>Nursing Considerations Across the Lifespan<\/strong><\/p>\n<p>This medication is not safe for children under the age of 2 years without a healthcare provider&#8217;s order.<\/p>\n<p><strong>Adverse\/Side Effects<\/strong><\/p>\n<p>First-generation medications can cause anticholinergic effects (such as dry mouth, urinary retention, constipation and blurred vision). CNS depression or CNS stimulation with excessive doses can occur, especially in children. Therefore, first-generation antihistamines should be used with caution in the elderly.<\/p>\n<p>Second-generation medications may cause headache, nausea, vomiting, dysmenorrhea, and fatigue.<sup><a class=\"footnote\" title=\"Frandsen, G. &amp; Pennington, S. (2018). Abrams\u2019 clinical drug: Rationales for nursing practice (11th ed.). Wolters Kluwer.\" id=\"return-footnote-201-3\" href=\"#footnote-201-3\" aria-label=\"Footnote 3\"><sup class=\"footnote\">[3]<\/sup><\/a><\/sup><\/p>\n<p><strong>Client Teaching &amp; Education<\/strong><\/p>\n<p>Clients should be advised that antihistamines may cause drowsiness, and concurrent use of alcohol or other CNS depressants should be avoided.\u00a0 Clients should take only the recommended amount of medication and not exceed dosing recommendations.\u00a0 Some clients may experience side effects such as dry mouth, and frequent oral hygiene may assist in alleviating discomfort.<sup><a class=\"footnote\" title=\"uCentral from Unbound Medicine. https:\/\/www.unboundmedicine.com\/ucentral\" id=\"return-footnote-201-4\" href=\"#footnote-201-4\" aria-label=\"Footnote 4\"><sup class=\"footnote\">[4]<\/sup><\/a><\/sup><\/p>\n<p>Now let&#8217;s take a closer look at the medication grid for diphenhydramine and cetirizine in Table 5.6.<sup><a class=\"footnote\" title=\"This work is a derivative of Pharmacology Notes: Nursing Implications for Clinical Practice by Gloria Velarde licensed under CC BY-NC-SA 4.0.\" id=\"return-footnote-201-5\" href=\"#footnote-201-5\" aria-label=\"Footnote 5\"><sup class=\"footnote\">[5]<\/sup><\/a>,<\/sup> <sup><a class=\"footnote\" title=\"Frandsen, G. &amp; Pennington, S. (2018). Abrams\u2019 clinical drug: Rationales for nursing practice (11th ed.). Wolters Kluwer.\" id=\"return-footnote-201-6\" href=\"#footnote-201-6\" aria-label=\"Footnote 6\"><sup class=\"footnote\">[6]<\/sup><\/a>, <a class=\"footnote\" title=\"This work is a derivative of Daily Med by U.S. National Library of Medicine in the public domain.\" id=\"return-footnote-201-7\" href=\"#footnote-201-7\" aria-label=\"Footnote 7\"><sup class=\"footnote\">[7]<\/sup><\/a> <\/sup>Medication cards are intended to assist students to learn key points about each medication class.\u00a0 Basic information related to a common generic medication in this class is outlined, including administration considerations, therapeutic effects, and side effects\/adverse effects.\u00a0 Prototype\/generic medication listed in the medication card is also hyperlinked to a free resource from\u00a0 <a href=\"https:\/\/dailymed.nlm.nih.gov\/dailymed\/index.cfm\" target=\"_blank\" rel=\"noopener noreferrer\">Daily Med<\/a>.\u00a0 Because information about medication is constantly changing, nurses should always consult evidence-based resources to review current recommendations before administering specific medication.<\/p>\n<p>Table 5.6 Diphenhydramine Medication Card <a class=\"footnote\" title=\"This work is a derivative of\u00a0 Daily Med by\u00a0U.S. National Library of Medicine\u00a0in the\u00a0public domain.\u00a0\" id=\"return-footnote-201-8\" href=\"#footnote-201-8\" aria-label=\"Footnote 8\"><sup class=\"footnote\">[8]<\/sup><\/a><\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone wp-image-1485\" src=\"https:\/\/pressbooks.bccampus.ca\/nursingpharmacology\/wp-content\/uploads\/sites\/1167\/2019\/11\/Gas-Exchange-5.jpg\" alt=\"\" width=\"830\" height=\"1075\" srcset=\"https:\/\/pressbooks.bccampus.ca\/nursingpharmacology\/wp-content\/uploads\/sites\/1167\/2019\/11\/Gas-Exchange-5.jpg 1700w, https:\/\/pressbooks.bccampus.ca\/nursingpharmacology\/wp-content\/uploads\/sites\/1167\/2019\/11\/Gas-Exchange-5-232x300.jpg 232w, https:\/\/pressbooks.bccampus.ca\/nursingpharmacology\/wp-content\/uploads\/sites\/1167\/2019\/11\/Gas-Exchange-5-791x1024.jpg 791w, https:\/\/pressbooks.bccampus.ca\/nursingpharmacology\/wp-content\/uploads\/sites\/1167\/2019\/11\/Gas-Exchange-5-768x994.jpg 768w, https:\/\/pressbooks.bccampus.ca\/nursingpharmacology\/wp-content\/uploads\/sites\/1167\/2019\/11\/Gas-Exchange-5-1187x1536.jpg 1187w, https:\/\/pressbooks.bccampus.ca\/nursingpharmacology\/wp-content\/uploads\/sites\/1167\/2019\/11\/Gas-Exchange-5-1583x2048.jpg 1583w, https:\/\/pressbooks.bccampus.ca\/nursingpharmacology\/wp-content\/uploads\/sites\/1167\/2019\/11\/Gas-Exchange-5-65x84.jpg 65w, https:\/\/pressbooks.bccampus.ca\/nursingpharmacology\/wp-content\/uploads\/sites\/1167\/2019\/11\/Gas-Exchange-5-225x291.jpg 225w, https:\/\/pressbooks.bccampus.ca\/nursingpharmacology\/wp-content\/uploads\/sites\/1167\/2019\/11\/Gas-Exchange-5-350x453.jpg 350w\" sizes=\"auto, (max-width: 830px) 100vw, 830px\" \/><\/p>\n<p>&nbsp;<\/p>\n<div class=\"media-attributions clear\" prefix:cc=\"http:\/\/creativecommons.org\/ns#\" prefix:dc=\"http:\/\/purl.org\/dc\/terms\/\"><h2>Media Attributions<\/h2><ul><li >image11-5       <\/li><li >image10-4       <\/li><li >Gas Exchange 5       <\/li><\/ul><\/div><hr class=\"before-footnotes clear\" \/><div class=\"footnotes\"><ol><li id=\"footnote-201-1\">\"<a href=\"https:\/\/www.flickr.com\/photos\/zenbenjamin\/4948476952\" target=\"_blank\" rel=\"noopener noreferrer\">Benadryl Allergy USA<\/a>\" by <a href=\"https:\/\/www.flickr.com\/photos\/zenbenjamin\/\" target=\"_blank\" rel=\"noopener noreferrer\">ZenBenjamin<\/a> is licensed under <a href=\"https:\/\/creativecommons.org\/licenses\/by-nc-sa\/2.0\/\" target=\"_blank\" rel=\"noopener noreferrer\">CC BY-NC-SA 2.0<\/a> <a href=\"#return-footnote-201-1\" class=\"return-footnote\" aria-label=\"Return to footnote 1\">&crarr;<\/a><\/li><li id=\"footnote-201-2\">\"<a href=\"https:\/\/commons.wikimedia.org\/wiki\/File:Diphenhydramine_(1).JPG\" target=\"_blank\" rel=\"noopener noreferrer\">diphenhydramine (1)<\/a>\" by <a href=\"https:\/\/commons.wikimedia.org\/wiki\/User:Intropin\" target=\"_blank\" rel=\"noopener noreferrer\">Intropin<\/a> is licensed under<a href=\"https:\/\/creativecommons.org\/licenses\/by-nc-sa\/2.0\/\" target=\"_blank\" rel=\"noopener noreferrer\"> CC BY-NC 2.0 <a href=\"#return-footnote-201-2\" class=\"return-footnote\" aria-label=\"Return to footnote 2\">&crarr;<\/a><\/li><li id=\"footnote-201-3\">Frandsen, G. &amp; Pennington, S. (2018). <em>Abrams\u2019 clinical drug: Rationales for nursing practice <\/em>(11th ed.). Wolters Kluwer. <a href=\"#return-footnote-201-3\" class=\"return-footnote\" aria-label=\"Return to footnote 3\">&crarr;<\/a><\/li><li id=\"footnote-201-4\">uCentral from Unbound Medicine. <a href=\"https:\/\/www.unboundmedicine.com\/ucentral\" target=\"_blank\" rel=\"noopener noreferrer\">https:\/\/www.unboundmedicine.com\/ucentral<\/a> <a href=\"#return-footnote-201-4\" class=\"return-footnote\" aria-label=\"Return to footnote 4\">&crarr;<\/a><\/li><li id=\"footnote-201-5\">This work is a derivative of <a href=\"https:\/\/www.oercommons.org\/authoring\/54330-pharmacology-notes-nursing-implications-for-clinic\/view\" target=\"_blank\" rel=\"noopener noreferrer\">Pharmacology Notes: Nursing Implications for Clinical Practice<\/a> by <a href=\"https:\/\/www.oercommons.org\/profile\/213497\" target=\"_blank\" rel=\"noopener noreferrer\">Gloria Velarde<\/a> licensed under <a href=\"https:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0\/\" target=\"_blank\" rel=\"noopener noreferrer\">CC BY-NC-SA 4.0<\/a>. <a href=\"#return-footnote-201-5\" class=\"return-footnote\" aria-label=\"Return to footnote 5\">&crarr;<\/a><\/li><li id=\"footnote-201-6\">Frandsen, G. &amp; Pennington, S. (2018). <em>Abrams\u2019 clinical drug: Rationales for nursing practice <\/em>(11th ed.). Wolters Kluwer. <a href=\"#return-footnote-201-6\" class=\"return-footnote\" aria-label=\"Return to footnote 6\">&crarr;<\/a><\/li><li id=\"footnote-201-7\">This work is a derivative of <a href=\"https:\/\/dailymed.nlm.nih.gov\/dailymed\/\" target=\"_blank\" rel=\"noopener noreferrer\">Daily Med<\/a> by <a href=\"https:\/\/www.nlm.nih.gov\/\" target=\"_blank\" rel=\"noopener noreferrer\">U.S. National Library of Medicine<\/a> in the <a href=\"https:\/\/creativecommons.org\/share-your-work\/public-domain\/\" target=\"_blank\" rel=\"noopener noreferrer\">public domain<\/a>.  <a href=\"#return-footnote-201-7\" class=\"return-footnote\" aria-label=\"Return to footnote 7\">&crarr;<\/a><\/li><li id=\"footnote-201-8\"> This work is a derivative of\u00a0 <a href=\"https:\/\/dailymed.nlm.nih.gov\/dailymed\/\" target=\"_blank\" rel=\"noopener\">Daily Med <\/a>by\u00a0<a href=\"https:\/\/www.nlm.nih.gov\/\" target=\"_blank\" rel=\"noopener\">U.S. National Library of Medicine<\/a>\u00a0in the\u00a0<a href=\"https:\/\/creativecommons.org\/share-your-work\/public-domain\/\" target=\"_blank\" rel=\"noopener\">public domain<\/a>.\u00a0 <a href=\"#return-footnote-201-8\" class=\"return-footnote\" aria-label=\"Return to footnote 8\">&crarr;<\/a><\/li><\/ol><\/div>","protected":false},"author":103,"menu_order":6,"template":"","meta":{"pb_show_title":"on","pb_short_title":"","pb_subtitle":"","pb_authors":["open-resources-for-nursing-open-rn"],"pb_section_license":""},"chapter-type":[48],"contributor":[68],"license":[],"class_list":["post-201","chapter","type-chapter","status-publish","hentry","chapter-type-numberless","contributor-open-resources-for-nursing-open-rn"],"part":182,"_links":{"self":[{"href":"https:\/\/pressbooks.bccampus.ca\/nursingpharmacology\/wp-json\/pressbooks\/v2\/chapters\/201","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/pressbooks.bccampus.ca\/nursingpharmacology\/wp-json\/pressbooks\/v2\/chapters"}],"about":[{"href":"https:\/\/pressbooks.bccampus.ca\/nursingpharmacology\/wp-json\/wp\/v2\/types\/chapter"}],"author":[{"embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/nursingpharmacology\/wp-json\/wp\/v2\/users\/103"}],"version-history":[{"count":17,"href":"https:\/\/pressbooks.bccampus.ca\/nursingpharmacology\/wp-json\/pressbooks\/v2\/chapters\/201\/revisions"}],"predecessor-version":[{"id":2419,"href":"https:\/\/pressbooks.bccampus.ca\/nursingpharmacology\/wp-json\/pressbooks\/v2\/chapters\/201\/revisions\/2419"}],"part":[{"href":"https:\/\/pressbooks.bccampus.ca\/nursingpharmacology\/wp-json\/pressbooks\/v2\/parts\/182"}],"metadata":[{"href":"https:\/\/pressbooks.bccampus.ca\/nursingpharmacology\/wp-json\/pressbooks\/v2\/chapters\/201\/metadata\/"}],"wp:attachment":[{"href":"https:\/\/pressbooks.bccampus.ca\/nursingpharmacology\/wp-json\/wp\/v2\/media?parent=201"}],"wp:term":[{"taxonomy":"chapter-type","embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/nursingpharmacology\/wp-json\/pressbooks\/v2\/chapter-type?post=201"},{"taxonomy":"contributor","embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/nursingpharmacology\/wp-json\/wp\/v2\/contributor?post=201"},{"taxonomy":"license","embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/nursingpharmacology\/wp-json\/wp\/v2\/license?post=201"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}