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8/9/2019 Toxic Effects of Drugs
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TOXIC EFFECTS OF
DRUGS
8/9/2019 Toxic Effects of Drugs
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ADVERSE EFFECTS
> Drug may have other efects aside rom thetherapeutic efect
• Patient is sensitive to the given drug
• Drug’s action is on the body causes otherresponses that are unpleasant orundesirable
• Patient is taking too much or too little o thedrug
• Patient is taking too much or too little o thedrug
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ADVERSE EFFECTS
A. PRIAR! A"#I$%&
-. &imple drug overdose' patient sufers rom
efects o an e(tension o the desired efect
o the drug). &*"$%DAR! A"#I$%&
+ %ot necessarily desirable but unavoidable
". -!P*R&*%&I#II#!
+ *(cessively responsive to either the primaryor secondary efects o the drug
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DRUG ALLERGY Allergy
type
Assessment Interventio
nsAnaphylactic reaction
+ Involve antibody
that reacts /ith
speci0c sites in the
body to cause the
release o chemicals1histamine2 that can
lead to respiratory
distress and even
respiratory arrest
-ives3 rash3 D$)3
increased )P3 dilated
pupils3 diaphoresis3
4panic5 eeling3
increased -R3
respiratory arrest
%otiy prescriber3
*pinephrine 16.7 ml23
assage the site+speed
up
"ytoto(ic reactions+ Involves antibodies
that circulate in the
blood and attack the
antigens 1drug2 on
cell sites
Decreased hematocrit3decreased 8)"3
decreased plt' elevated
liver and renal
unctions
%otiy prescriber3Discontinue drug3
Prevent inection3
"onserve energy
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DRUG ALLERGY Allergy type Assessment Interventions
&erum sickness
reaction
+ Involves
antibodies that
circulate in the
blood and cause
damage to varioustissues by
depositing in the
blood vessel'
Itchy rash3 ever3
s/ollen lymph nodes3
s/ollen painul 9oints3
edema on the ace
and limbs
%otiy prescriber3Discontinue drug3
Provide comortmeasure
Delayed allergic
reaction+ $ccurs several
hours ater
e(posure and
involves
antibodies that are
Rash3 hives3 s/ollen
9oints
%otiy prescriber3Discontinue drug3 &kincare
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DRUG-IDUCED TISSUE AD ORGADA!AGE
A.Dermatological reactions
• Adverse reactions involving the skin
•&imple rash to dermatitis
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DRUG-IDUCED AD TISSUE AD ORGADA!AGE
A.:. Rashes3 hives
Assessment;
#hese can be seen. &evere reactionsmay include e(oliative dermatitis3 ever3
enlarged lymph nodes3 enlarged liverand erythema
Interventions;
In mild cases3 or /hen bene0ts out/eighthe discomort o the skin lesion3 provideskin care
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DRUG-IDUCED AD TISSUE AD ORGADA!AGE
A.=. &tomatitis
+ inammation o the mucous membranescan occur because o the direct to(icreaction to the drug
Assessment;&/ollen gums3 inamed gums 1gingivitis23
s/ollen and red tongue 1glositis23 di?culty
s/allo/ing3 bad breath3 painInterventions;
Provide re@uent mouth care3 small re@uentmeals3 dental consultation3 antiungal
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DRUG-IDUCED AD TISSUE AD ORGADA!AGE
). &uperinections
Assessment;
ever3 diarrhea3 glossitis3 mucousmembrane lesions3 vaginal discharge
Interventions;
&upportive measures
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DRUG-IDUCED AD TISSUE AD ORGADA!AGE
". )lood Dyscrasias
• )one marro/ suppression caused by drugefects
• Drugs that can cause cell death
Assessment; ever3 chills3 sore throat3 /eakness3back pain3 decreased hematocrit3 lo/ platelet3lo/ 8)"3 reduction o the elements o the ")"
Interventions; onitor blood counts. Providecomort measures. Discontinue i /ith
bleeding.
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DRUG-IDUCED AD TISSUE AD ORGADA!AGE
#o(icity
D.:. Biver in9ury
Assessment; ever3 malaise3 nausea3vomiting3 9aundice3 changes in color ourineCstools3 abdominal pain elevatedliver unctions3 elevated bilirubin level
Interventions; Discontinue drug. %otiyprescriber. &upportive care.
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DRUG-IDUCED AD TISSUE AD ORGADA!AGE
#o(icity
D.:. Biver in9ury
Assessment; ever3 malaise3 nausea3vomiting3 9aundice3 changes in color ourineCstools3 abdominal pain elevatedliver unctions3 elevated bilirubin level
Interventions; Discontinue drug. %otiyprescriber. &upportive care.
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DRUG-IDUCED AD TISSUE AD ORGADA!AGE
D.=. Renal in9ury
Assessment;
*levated )%3 elevated creatinine3decreased hematocrit3 electrolyte
imbalances3 atigue3 malaise3 edema
Interventions;
%otiy prescriber. Discontinue drug. $fersupportive care 1dietCuid restrictions3electrolyte therapy3 rest periods2. In
severe cases+dialysis
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DRUG-IDUCED AD TISSUE AD ORGADA!AGE
*. Poisoning
• $ccurs /hen an overdose o a drugdamages multiple body systemsleading to the atal reactions
ALTERATIOS I GLUCOSE
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ALTERATIOS I GLUCOSE!ETA"OLIS!
A. -ypoglycemia
Assessment;
atigue3 dro/siness3 hunger3 an(iety3headache3 cold and clammy skin3shaking and lack o coordination
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ALTERATIOS I GLUCOSE!ETA"OLIS!
). -yperglycemia
+&ome drugs stimulate the breakdo/n oglycogen or alter metabolism in such a /ayto cause high serum glucose levels
1hyperglycemia2Assessment;
atigue3 increased urination3 increased thirst3deep respirations3 restlessness3 increased
hunger3 nausea3 hot or ushed skin3 ruityodor
Interventions;
Insulin therapy
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I!"ALACES
A. -ypokalemia
Assessment;
Bo/ serum potassium levels
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I!"ALACES
). -yperkalemia
Assessment;
>F.6 m*@CB3 /eakness3 cramps3diarrhea3 numbness and tingling3 slo/-R3 lo/ )P3 lo/ $3 D$)
Interventions;
Decrease serum E. institute saetymeasures. onitor cardiac efects.
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SESORY EFFECTSA. $cular to(icity
1#he blood vessels in the retina are verytiny and are called 4end arteries52
Assessment;
)lurring o vision3 color+blindness3corneal damage3 blindness
Interventions;
onitor vision. "onsult prescriber.Discontinue drug. &upportive measures.
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SESORY EFFECTS). Auditory damage
Assessment;
DiGGiness3 ringing in the ears3 loss obalance3 loss o hearing
Interventions;
onitor perceptual loss. Provideprotective measures. "onsult /ith theprescriber. Discontinue the drug.&upportive
TERATOGEICITY
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TERATOGEICITY CATEGORIES
#regn$n%yC$tegory
A
Adequate and well-controlled human studies have failed todemonstrate a risk to the fetus in the first trimester ofpregnancy (and there is no evidence of risk in latertrimesters).
#regn$n%yC$tegory
"
Animal reproduction studies have failed to demonstrate a riskto the fetus and there are no adequate and well-controlledstudies in pregnant women OR Animal studies have shownan adverse effect !ut adequate and well-controlled studies in
pregnant women have failed to demonstrate a risk to the fetusin any trimester.
#regn$n%y
C$tegoryC
Animal reproduction studies have shown an adverse effect onthe fetus and there are no adequate and well-controlledstudies in humans !ut potential !enefits may warrant use of
the drug in pregnant women despite potential risks.