Nursing Alert

If a significant decrease in the blood pressure (a drop of 20 mm Hg systolic or a systolic below 90 mm Hg) occurs after a dose of an adrenergic blocking drug, the nurse should withhold the drug and notify the primary care provider immediately. A dosage reduction or discontinuation of the drug may be necessary. Some adrenergic blocking drugs (eg, prazosin or terazosin) may cause a first dose effect. A first dose effect occurs when the patient experiences marked hypotension (or postural...

Lithium

Lithium carbonate is rapidly absorbed after oral administration. The most common adverse reactions include tremors, nausea, vomiting, thirst, and polyuria. Toxic reactions may be seen when serum lithium levels are greater than 1.5 mEq L (Table 32-1). Because some of these toxic reactions are potentially serious, lithium blood levels are usually obtained during therapy, and the dosage of lithium is adjusted according to the results. Diarrhea, vomiting, nausea, drowsiness, muscular weakness, lack...

Summary Drug Table Narcotic Antagonists

Complete or partial reversal of opioid effects Narcotic overdose, postoperative narcotic depression Narcotic addiction, alcohol dependence Nausea, vomiting, tachycardia, hypertension, return of postoperative pain, fever, dizziness Abrupt reversal of narcotic depression may result in nausea, vomiting, sweating, increased blood pressure, tachycardia Anxiety, difficulty sleeping, abdominal cramps, nasal congestion, joint and muscle pain, nausea, vomiting, dizziness, irritability Initial dose 0.5...

MAOIs

Orthostatic hypotension is a common adverse reaction seen with the administration of the MAOIs. Other common adverse reactions include dizziness, vertigo, nausea, constipation, dry mouth, diarrhea, headache, and overactivity. One serious adverse reaction associated with the use of the MAOIs is hypertensive crisis (extremely high blood pressure), which may occur when foods containing tyramine (an amino acid present in some foods) are eaten (see Home Care Checklist Avoiding Drug-Food Interactions...

Review Questions

What is the rationale for warming an otic solution that has been refrigerated before instilling the drops into the patient's ear A. The drug becomes thick when refrigerated, and warming liquefies the solution. B. It helps to prevent dizziness on instillation. C. A cold solution can significantly increase the patient's blood pressure. INSTILLING AN OPHTHALMIC PREPARATION Because of shortened hospital stays and increases in the number of ambulatory surgeries for many eye problems, the patient may...

Miscellaneous Sedatives and Hypnotics

Miscellaneous or nonbarbiturate sedatives and hypnotics have essentially the same mode of action as the barbiturates, that is, they depress the CNS. However, SUMMARY DRUG TABLE SEDATIVES AND HYPNOTICS MISCELLANEOUS Disorientation, gastric irritation, nausea, vomiting, delirium, light-headedness, vertigo, hypersensitivity reactions Sedative 250 mg PO TID hypnotic 500 mg-1 g PO Sedation of intubated and mechanically ventilated patients Hypotension, nausea, bradycardia, hypoxia, dizziness,...

Precautions

Administration of these drugs can result in urinary retention. The nurse should give these drugs with great caution to patients with an enlarged prostate because urinary retention may occur. This caution applies to some over-the-counter preparations available for the relief of allergy and cold symptoms and as aids to induce sleep. Some of these products contain atropine, scopo-lamine, or other cholinergic blocking drugs. Although this warning is printed on the container or package, many users...

Barbiturates

All barbiturates have essentially the same mode of action. Depending on the dose given, these drugs are capable of producing central nervous system (CNS) depression and mood alteration ranging from mild excitation to mild sedation, hypnosis (sleep), and deep coma. These drugs also are respiratory depressants the degree of depression SUMMARY DRUG TABLE SEDATIVES AND HYPNOTICS BARBITURATES SUMMARY DRUG TABLE SEDATIVES AND HYPNOTICS BARBITURATES *The term generic indicates the drug is available in...

Ongoing Assessment

If vomiting is severe, the nurse observes the patient for signs and symptoms of electrolyte imbalance. The nurse monitors the blood pressure, pulse, and respiratory rate every 2 to 4 hours or as ordered by the primary health care provider. The nurse carefully measures the intake and output (urine, emesis) until vomiting ceases and the patient is able to take oral fluids in sufficient quantity. The nurse documents in the patient's chart each time the patient has an emesis. The nurse notifies the...

Oxytocin

Oxytocin is an endogenous hormone produced by the posterior pituitary gland (see Chap. 50). This hormone has uterine-stimulating properties, especially on the pregnant uterus. As pregnancy progresses, the sensitivity of the uterus to oxytocin increases, reaching peak sensitivity immediately before the birth of the infant. This sensitivity enables oxytocic drugs to exert their full therapeutic effect on the uterus and produce the desired results. Oxytocin also has antidiuretic and vasopressor...

Summary Drug Table Bronchodilators Continued

The term generic indicates the drug is available in generic form. each breath. A decrease in the amount of air taken into the lungs results in respiratory distress. Use of a bron-chodilating drug opens the bronchi and allows more air to enter the lungs, which in turn, completely or partially relieves respiratory distress.

Actions

Acetylcholine, a natural chemical in the brain, is required for memory and thinking. Individuals with AD slowly lose this chemical, and as the levels of the chemical decrease, the patient experiences problems with memory and thinking. The cholinesterase inhibitors act to increase the level of acetylcholine in the CNS by inhibiting its breakdown and slowing neuronal destruction. However, the disease is progressive, and although these drugs alter the progress of the disease, they do not cure the...

Nitrates

The nitrate antianginal drugs all have the same adverse reactions, although the intensity of some reactions may vary with the drug and the dose. A common adverse reaction seen with these drugs is headache, especially early in therapy. Hypotension, dizziness, vertigo, and weakness may also be associated with headache. Flushing caused by dilatation of small capillaries near the surface of the skin may also be seen. The nitrates are available in various forms eg, sublingual, transmucosal,...

Antiemetic and Antivertigo Drugs

On completion of this chapter, the student will Define the terms nausea, vomiting, antiemetic, and antivertigo. Discuss the general drug actions, uses, adverse reactions, contraindications, precautions, and interactions of antiemetic and antivertigo drugs. Discuss important preadministration and ongoing assessment activities the nurse should perform on the patient receiving an antiemetic or antivertigo drug. List nursing diagnoses particular to a patient receiving an antiemetic or antivertigo...

Summary Drug Table Antineoplastic Drugs Continued

Gonadotropin-Releasing Hormone Analogs Hot flushes, skeletal pain, injection nausea abdominal pain diarrhea constipation decreased serum sodium, magnesium, calcium, and potassium increased blood urea nitrogen visual disturbances ototoxicity tumors, advanced bladder cancer, ovarian tumors neuropathies, nausea, vomiting, anorexia, bone marrow suppression, nephrotoxicity headache, seizures, abdominal pain, mucositis, congestive heart failure, bone marrow depression diarrhea, constipation, bone...

Gerontologic Alert

Older adults are particularly susceptible to a potentially fatal hepatitis when taking isoniazid, especially if they consume alcohol on a regular basis. Two other antitubercular drugs, rifampin and pyrazinamide, can cause liver dysfunction in the older adult. Careful observation and monitoring for signs of liver impairment are necessary eg, increased serum aspartate transaminase, increased serum alanine transferase, increased serum bilirubin, and jaundice . PYRAZINAMIDE. Patients should have...