Adverse drug reactions administration

MANAGEMENT OF ADVERSE DRUG REACTIONS Administration of butorphanol, a partial agonist and antagonist of the mu receptor, was able to prevent morphine-induced pruritus without increasing effects of opiate withdrawal including nausea and vomiting [59 ]. 

Monitoring and Managing Adverse Drug Reactions Treatment of minor hypersensitivity reactions may include administration of an antihistamine such as Benadryl (for a rash or itching). Major hypersensitivity reactions, such as bronchospasm, laryngospasm,... 

The expected outcomes for the patient depend on the reason for administration but may include an optimal response to therapy (infectious process controlled), management of adverse drug reactions, and an understanding of and compliance with the prescribed treatment regimen. 

Monitoring and Managing Adverse Drug Reactions A variety of adverse reactions can be seen with the administration of the fluoroquinolones or aminoglycosides. The nurse observes die patient, especially during the first 48 hours of tiierapy. It is important to report the occurrence of any adverse reaction to the primary health care provider before die next dose of the drug is duei If a serious adverse reaction such as a hypersensitivity reaction, respiratory difficulty, severe diarrhea, or a decided drop in blood pressure occurs, the nurse contacts die primary health care provider immediately. 

D Risk for Impaired Skin Integrity related to initial infection, adverse drug reactions, IV administration of the antiviral drug... 

As part of the ongoing assessment during the administration of naloxone, the nurse monitors the blood pressure, pulse, and respiratory rate at frequent intervals, usually every 5 minutes, until the patient responds. After the patient has shown response to the drug, the nurse monitors vital signs every 5 to 15 minutes. The nurse should notify tlie primary healdi care provider if any adverse drug reactions occur because additional medical treatment may be needed. The nurse monitors die respiratory rate, rhydun, and depdi pulse blood pressure and level of consciousness until the effects of die narcotics wear off. 

Educating the Patient and Family When Hie patient is hospitalized, the nurse explains all treatments and possible adverse effects to file patient before file initiation of therapy. The primary health care provider usually discusses the proposed treatment and possible adverse drug reactions with the patient and family members. The nurse briefly reviews these explanations immediately before parenteral administration of a drug. 

Approximately 10% of new chemical entities (NCEs) show serious adverse drug reactions (ADRs) after market launch. Such events usually result in new black box warnings by the US Food and Drug Administration (FDA), label change or market withdrawal. The most common causes for these actions are hepatic toxicity, hematologic toxicity and cardiovascular toxicity [2], Reasons for such ADRs, which are identified only after NCEs are launched on the market, include the narrow spectrum of clinical disorders and participating patient profiles in clinical studies as well as the fact that serious ADRs are often rare and that the number of patient exposures required to identify such occurrences sometimes may range over a few millions [3],... 

There is considerable confusion in the use of terminology in this area. Edwards and Aronson proposed the following definition. An adverse drug reaction is an appreciably harmful or unpleasant reaction, resulting from an intervention related to the use of a medicinal product, which predicts hazard from future administration and warrants prevention... 

Serum chemistry markers play an important role in hepatotoxicity evaluation in human and animal safety studies. The classic markers of hepatotoxicity are alanine aminotransferase (ALT), aspartate aminotrasnferase (AST) and alkaline phosphatase (ALP) [124—127]. Drug-induced hepatotoxicity can be difficult to assess in some circumstances. Hepatotoxic responses can be intrinsic (predictable, dose-related) or idiosyncratic (unpredictable, non-dose-related). ALT, AST and ALP are generally not useful for predicting idiosyncratic responses. The administration of some drugs, such as isoniazid, can lead to a high incidence of ALT elevation, but are tolerated by most patients without severe hepatotoxicity. Adverse drug reactions can be masked... 

The Food and Drug Administration (FDA) maintains a computerized human teratogen Information system as part of Its adverse drug reaction reporting... 

According to the Food and Drug Administration, an adverse drug reaction rate of 1 % is frequent or common. 

Soldatos et al. (1986) reported on serious adverse drug reactions in all five psychiatric inpatients during a clinical trial of 0.5 mg triazolam and placebo. The patients and nurses were blind in the study, but not the physician with medical responsibility for the patients. The study consisted of 1 week of placebo baseline, 2 weeks of triazolam administration, and 1 week of withdrawal on placebo. All five patients developed severe reactions to triazolam. Case 1 developed anxiety and hallucinations on the last two days of triazolam administration and the first withdrawal day. Case 2 had a sudden increase in anxiety and became irritable, uncooperative, and depressed. She became withdrawn and cried, and showed considerable impairment of memory and orientation. On withdrawal of triazolam, she became more incoherent, expressing paranoid ideas of persecution that persisted about a week. She required Haldol to control her delusions. Case 3 developed severe insomnia during withdrawal and reported considerable anxiety and irritability along with an uncontrollable fear of death, which persisted to the next day when she additionally manifested a marked degree of memory impairment. Case 4, by... 

Kennedy, D. L., McGinnis, T. (1993, September). Monitoring adverse drug reactions The FDA s new MedWatch program. Rockville, MD Food and Drug Administration. 

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