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Toxic Effects of Drugs
Adverse Drug Reaction
- Definition
- Adverse effects are undesired effects that may be unpleasant or even dangerous
- Reasons adverse drug reactions occur:
- The drug may have other effects on the body besides the therapeutic effect
- The patient is sensitive to the drug given
- The drug’s action on the body causes other responses
- The patient is taking too much or too little of the drug
Types of Adverse Reactions
- Primary actions
- Overdose: extension of the desired effect
- Secondary actions
- Undesired effects produced in addition to the pharmacologic effect
- Hypersensitivity reactions
- Excessive response to the primary or secondary effect of the drug
Types of Drug Allergies
- Anaphylactic reaction
- Cytotoxic reaction
- Serum sickness reaction
- Delayed allergic reaction
Variety of Adverse Effects Associated With Drug Use
Types of Drugs Allergies
Drug-Induced Tissue & Organ Damage
Drug-Induced Tissue and Organ Damage
Dermatologic Reactions
- Rash/hives
- Assessment
- Abnormalities in the skin, red areas, blisters
- Interventions
- May need to discontinue the medication
- Stomatitis
- Assessment
- Inflammation of the mucous membranes
- Interventions
Drug-Induced Tissue and Organ Damage
- Superinfections: destruction of the body’s normal flora
- Assessment
- Fever, diarrhea, and vaginal discharge
- Interventions
- Supportive care (mouth/skin care), give antifungal medications, stop drug responsible for the infection
- Blood dyscrasia: bone marrow suppression
- Assessment
- Fever, chills, and weakness
- Interventions
- Monitor blood counts and protective isolation
Toxicity
- Liver
- Assessment
- Fever, nausea, jaundice, change in color of urine or stool, and elevated liver enzymes
- Interventions
- Kidney
- Assessment
- Change in urinary pattern or elevated BUN and creatinine
- Interventions
- Notify physician, stop medication, or decrease dosage
Poisoning
- Poisoning occurs when an overdose of a drug damages multiple body systems
- Damage to multiple systems can lead to a fatal reaction
Altered Glucose Metabolism
- Hypoglycemia
- Assessment finding: low serum blood glucose level
- Intervention: restore glucose to the body (D50)
- Hyperglycemia
- Assessment finding: high serum glucose level
- Intervention: administer medications to decrease glucose level (insulin)
Electrolyte Imbalances
- Hypokalemia
- Assessment finding: decrease in serum potassium level
- Interventions: replace serum potassium (IV or oral supplement) and monitor serum level of potassium
- Hyperkalemia
- Assessment finding: increase in serum potassium level
- Interventions: decrease the serum potassium concentration (using sodium polystyrene sulfonate), monitor serum level of potassium, and monitor cardiac rhythm
Sensory Effects
- Ocular toxicity
- Assessment finding: visual changes
- Interventions: monitor for visual changes when giving medication known to cause ocular damage; discontinue medication after notifying physician
- Auditory damage
- Assessment finding: damage to the eighth cranial nerve
- Interventions: monitor for hearing loss; discontinue medication after notifying physician
Neurologic Effects
- General central nervous system (CNS) effects
- Assessment: altered level of consciousness
- Intervention: prevent injury
- Atropine-like (anticholinergic) effects
- Assessment: dry mouth, urinary retention, and blurred vision
- Interventions: sugarless lozenges to keep mouth moist; advise the patient to void before administration of the medication
- Parkinson-like syndrome
- Assessment: muscle tremors and changes in gait
- Intervention: discontinue medication
- Neuroleptic malignant syndrome
- Assessment: extrapyramidal symptoms
- Intervention: discontinue medication
Teratogenicity
- Drugs may harm the developing fetus or embryo
- Prevent teratogenicity through teaching
- Advise pregnant women that any medication may adversely affect the baby
- Weigh the actual benefits against the potential risks
- Advise pregnant women that they should not take medications without checking with their health care provider first
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Tags
adverse drug reaction, adverse drug reactions, blood counts, blood dyscrasia, bone marrow suppression, drug allergies, effects of drugs, fever chills, mouth care, normal flora, organ damage, pharmacologic effect, protective isolation, secondary actions, serum sickness, supportive care, therapeutic effect, types of drugs, undesired effects, vaginal discharge