Chapter 3 Flashcards
role of nurse regarding drug toxicity (3)
Recognize adverse effects
Patient and family teaching
Responding to adverse effects - some can be countered with specific precautions, comfort measures
2 types of side effects
Primary action - extension of desired effect - too much
Secondary action - effects in addition to desired effect
define hypersensitivity
Excessive response to a drug
hypersensitivity usually r/t
underlying condition
define drug allergies
Occur when body forms antibodies to drug causing an immune response to it
define cross-sensitivity + example
some drugs are similar enough to produce a reaction to both
cephalosporin and penicillin
if a patient says they have a drug allergy, ask them…
what their response to drug is
4 types of allergy
anaphylaxis
cytotoxic
serum sickness
delayed reaction
explain anaphylaxis
Antibodies release histamines that cause mucous membrane swelling, constriction of airways
s/s anaphylaxis
Hives, rash may be present at beginning
Increased BP, HR, panic, respiratory arrest
admin _____ for anaphylaxis
epinephrine
explain cytotoxic allergy
Antibodies attack antigens on cell sites, causing cell death
s/s cytotoxic allergy
CBC (complete blood count) shows damage to blood cells, elevated liver enzymes, decreased renal function
treatment for cytotoxic is ____
supportive; relief of symptoms
explain serum sickness
Antibodies cause damage to tissues
when may serum sickness occur
a week or more after exposure
s/s serum sickness
Itchy rash, high fever, swollen lymph nodes, painful joints, edema of face and limbs
admin ______ for serum sickness
antiinflammatory drugs - steriods
explain delayed reaction allergy
Antibodies are bound to specific WBCs
s/s delayed reaction
Rash, hives, swollen joints
admin ______ for delayed reaction
antihistamines, steroids
7 types of tissue/organ damage from drugs
dermatological superinfections blood dyscrasias toxicity electrolyte imbalances sensory damage neural damage
examples of dermatological damage
rash
exfoliative dermatitis
Stevens-Johnson syndrome
explain superinfections + example
Disruption of normal flora & overgrowth - Thrush
explain blood dyscrasia
Bone marrow suppression due to drugs that cause cell death - often associated with chemo
s/s of blood dyscrasia
anemia
leukopenia
thrombocytopenia
pancytopenia
protect blood dyscrasia patients from (2) and support…
infections
bleeding
bone marrow recovery
2 types of drug toxicity (organs)
liver
kidney
s/s liver injury
Fever, malaise, n/v, jaundice, darkening of urine, abdominal pain, elevated liver enzymes
s/s renal injury
Elevated BUN (blood urea nitrogen), elevated creatinine, edema, electrolyte imbalances, decreased urinary output
hypoglycemia cause ex
antidiabetic meds
hyperglycemia cause ex
drugs that stimulate glycogenolysis
steroids
hypokalemia cause ex
loop diuretics
hyperkalemia cause ex
k-sparing diuretics
s/s hypoglycemia
Fatigue, drowsiness, hunger, anxiety, h/a (headache), cold & clammy skin, tremors, tachycardia, confusion, unconsciousness
s/s hyperglycemia
Polyuria, polydipsia, polyphagia, deep respirations (Kussmaul respirations), flushed skin, fruity breath
hypokalemia = K
<3.5
K > ___ is hyper
5
s/s hypokalemia
weakness, numbness, tingling, muscle cramps, n/v/d, irregular heart rate
s/s hyperkalemia
weakness, muscle cramps, numbness, tingling, bradycardia
s/s eye damage
Blurred vision, vision changes, corneal damage, blindness
ex drug that can cause retinal damage
Hydrocychloroquine
s/s hearing damage
Dizziness, tinnitus, loss of balance, loss of hearing
ex drug that can cause hearing damage
antibiotics
s/s neural effects
Confusion, delirium, insomnia, drowsiness, hyper or hyporeflexia, respiratory depression, loss of consciousness
block effects of ACh in parasympathetic NS
anticholinergic effects
dopamine levels affected
parkinson-like syndrome
anesthesia drugs may cause…
Neuropleptic malignant syndrome
s/s anticholinergic effects
Dry mouth, constipation, urinary hesitancy, urinary retention, impotence, palpitations, tachycardia, decreased sweating
s/s parkinson-like syndrome
Akinesia, muscular tremors, drooling, rigidity, akalthisia (restlessness)
s/s neuropleptic malignant syndrome
Slow reflexes, high fever, HTN, tachycardia - may be fatal
