Drug Jaundice

Older adults are particularly susceptible to a potentially fatal hepatitis when taking isoniazd, 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). 

Acetaminophen causes few adverse reactions when used as directed on the label or recommended by the primary health care provider. Adverse reactions associated with the use of acetaminophen usually occur with chronic use or when the recommended dosage is exceeded. Adverse reactions to acetaminophen include skin eruptions, urticaria (hives), hemolytic anemia, pancytopenia (a reduction in all cellular components of the blood), hypoglycemia, jaundice (yellow discoloration of the skin), hepatotoxicily (damage to the liver), and hepatic failure (seen in chronic alcoholics taking the drug). 

If nausea, vomiting, or diarrhea occurs, contact tiie primary health care provider. These drug may also cause flushing, sweating, headache, tiredness, jaundice, skin rash, anorexia, and abdominal distress. Notify tiie primary health care provider if these effects become pronounced. 

These drugs are contraindicated in patients whose diarrhea is associated witii organisms that can harm the intestinal mucosa (Escherichia coli, Salmonella, Shigella) and in patients with pseudomembranous colitis, abdominal pain of unknown origin, and obstructive jaundice The antidiarrheal drugs are contraindicated in children younger than 2 years. 

The nurse observes the patient each day for adverse drug reactions especially signs of fluid and electrolyte imbalance, jaundice (which may indicate hepatotoxicity), and virilization. The primary health care provider must be alerted to any sgns of fluid and electrolyte imbalance or jaundice. 

ASSESSMENT OF THE HOSPITALIZED PATIENT The hospitalized patient receiving a female hormone requires careful monitoring. The nurse takes the vital signs daily or more often, depending on the patient s physical condition and the reason for drug use. The nurse observes the patient for adverse drug reactions, especially those related to the liver (the development of jaundice) or the cardiovascular system (thromboembolism). The nurse weighs the patient weekly or as ordered by the primary health care provider. The nurse... 

The sinusoids transport both portal and arterial blood to the hepatocytes. The systemic blood delivered to the liver contains nutrients, drugs, and ingested toxins. The liver processes the nutrients (carbohydrates, proteins, lipids, vitamins, and minerals) for either immediate use or for storage, while the drugs and toxins are metabolized through a variety of processes known as first-pass metabolism. The liver also processes metabolic waste products for excretion. In cirrhosis, bilirubin (from the enzymatic breakdown of heme) can accumulate this causes jaundice (yellowing of the skin), scleral icterus (yellowing of the sclera), and tea-colored urine (urinary bilirubin excretion). 

Educate the patient on common adverse drug effects and a few of the key signs and symptoms of severe toxicity (i.e., jaundice and abacavir hypersensitivity reaction). Tell them to call their provider immediately if any of those symptoms occur. Make sure they have the correct telephone number for the clinic. 

Newborn jaundice, photochemical treatment of, 79 120 New chemicals, pricing of, 75 641-642 New Chemicals Program (EPA), 9 456 New Drug Application (NDA), 27 574 New drug approval (NDA) process, 78 698-701... 

The activity of glucuronidation is low in the newborn, especially in premature babies (6). This is evident in the jaundice observed in many newborns because the major clearance pathway for bilirubin is glucuronidation. This can also lead to increased toxicity of some drugs in the newborn such as the grey baby syndrome seen in newborns treated with chloramphenicol. 

Among the first three old drugs to be withdrawn from the market during the tenure of the CSD were benziodarone, a vasodilator launched in 1962 and withdrawn in 1964 due to reports of jaundice, pronethalol, a p-blocker introduced in 1963 and withdrawn in 1965 due to animal carcinogenicity and phenox)q)ropazine, an antidepressant introduced in 1961 and withdrawn in 1966 due to its hepatotoxicity. 

Parenteral Anticoagulant-induced prothrombin deficiency hypoprothrombinemia secondary to conditions limiting absorption or synthesis of vitamin K (eg, obstructive jaundice, biliary fistula, sprue, ulcerative colitis, celiac disease, intestinal resection, cystic fibrosis of the pancreas, regional enteritis) drug-induced hypoprothrombinemias due to interference with vitamin K metabolism (eg, antibiotics, salicylates) prophylaxis and therapy of hemorrhagic disease of the newborn. 

Liver function If jaundice develops, consider not readministering the drug. 

Hepatotoxicity Prolonged use of high doses of androgens has been associated with the development of potentially life-threatening peliosis hepatis, hepatic neoplasms, and hepatocellular carcinoma. Cholestatic hepatitis and jaundice occur with fluoxymesterone and methyltestosterone at relatively low doses. Drug-induced jaundice is reversible when the medication is discontinued. 

Clinically significant transaminase elevations have occurred in approximately 1% of patients receiving however, no patient became clinically symptomatic or jaundiced, and values returned to normal when the drug was stopped. 

Hepatic function impairment In patients with preexisting severe liver disease, hepatic encephalopathy (manifested by tremors, confusion, and coma, and increased jaundice) may occur. Because amiloride is not metabolized by the liver, drug accumulation is not anticipated in patients with hepatic dysfunction, but accumulation can occur if hepatorenal syndrome develops. 

Gl dysmotility Esophageal dysmotility and aspiration have been associated with antipsychotic drug use. Use quetiapine, ziprasidone, risperidone, olanzapine, aripiprazole, and others cautiously in patients at risk for aspiration pneumonia. Hypersensitivity reactions Patients who have demonstrated a hypersensitivity reaction (eg, blood dyscrasias, jaundice) with a phenothiazine should not be re-exposed to any phenothiazine unless the potential benefits of treatment outweigh the possible hazards. 

If symptoms of hepatitis accompanied by liver function test abnormalities or jaundice appear, discontinue therapy. If caused by dantrolene and detected early, abnormalities may revert to normal when the drug is discontinued. See Warning Box. 

Pregnancy Category 6 Category D near term. Significant levels may persist in the neonate if these drugs are given near term jaundice, hemolytic anemia, and kernicterus may occur. Do not use at term. 

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