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CNS effects; GI disturbances; epigastric pain; CV disorders; difficulty in micturition with urinary retention; dyspnoea; hyperglycaemia; sweating; hypersalivation; weakness, tremors; coldness of extremities; hypokalaemia. Gangrene, tissue necrosis and sloughing (extravasation) when used in addition to local anaesthetics. Eye drops: Severe smarting, blurred vision, photophobia; naso-lachrymal ducts obstruction. Oedema, hyperaemia and inflammation of the eyes with repeated administration.

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Epipen
CLASS: Alpha beta adrenergic
MOA:induces increased vascular smooth, pupillary dilator, intestinal sphincter muscle contraction

Indications for use: History of allergic ana phylactic reaction.
pats with h/o generalised allergic reaction

Drug interactions:cardic glycosides, diuretics, irregular heartbeats

Signs & Symptoms: shortness breath, repetitive cough, weak pulse, trouble breathing,/ swallowing

Nursing considerations to prevent, assess or manage risks:
3 mg dose for adults or a smallar.
15 mg dose for children for children.

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The junior version has a green barrel
The adult version a yellow barrel
More information available on how to use :
www.epipen.com

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diet, comorbidities, age, weight, drug–drug interactions, and genetics.

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Doses, Frequency, types of medication (crushed or syrup)
gastric pH and emptying time, intestinal transit time, immaturity of secretion and activity of bile and pancreatic fluid

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absorption, distribution, metabolism and excretion will alter the medication effects in kids

dosing is based on childs age or weight, but may alter depending on each child and their response

taste and ability to take the medications (tablet, liquid etc), kids may not take it properly or the right amount which will reduce effectiveness of the medications

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What factors may result in impaired medication effects in these patients?

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What are you going to give Noah right now for his dyspnoea??

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What are you going to give Noah right now for his dyspnoea??

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Nystatin
CLASS:antifungal
MOA: a polyene macrolide antibiotic that acts by binding to sterols in the plasma membranes of fungi causing the cells to leak, eventually leading to fungal cell death.
Indications for use:
fungal infections of the inside of the mouth and lining of the stomach and intestines.
Drug Interactions:
No known drug interactions
Signs & Symptoms:
nausea
vomiting
diarrhea

Nursing considerations to prevent, assess or manage risks:

Assessment and monitoring
Assess the affected area
-Moist, red patches, papules, pustules, discharge
-Itching, burning, pain
-Laboratory results: skin scrapings
-Monitor for side effects
-Assess understanding of medication self-administration
-Evaluate therapeutic effect

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Ipatropium
CLASS: Anticholinergic
MOA: Promote bronchodilation by inhibiting cholinergic bronchomotor tone. They block muscarinic actions of acetylcholine.
Indications for use: Symptom relief of asthma and COPD
Drug interactions: don't take with drugs with anticholinergic effects as it will increase therapeutic effects as well as risk of adverse effects
Signs & Symptoms: dry mouth, throat irritation, headache, nausea, taste disturbance
Nursing considerations to prevent, assess or manage risks: patient education on how to use, advice to avoid driving if causing dizziness/affecting vision, rinse mouth after use

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Seretide (Salmeterol and Fluticasone propionate)
CLASS: Flucticasone = Inhaled Corticosteroid (ICS) & Salmeterol = Beta-2 agonist
MOA: Fluticasone = Affects protein synthesis of enzymes involved in cell inflammation
Salmeterol = Stimulates b2 receptors in the lungs, relaxing bronchia smooth muscle and leading to bronchodilator
Indications for use: Maintenance treatment of asthma and COPD
Drug interactions:
- Interacts with corticosteroids (prednisolone)
--- hyperglycaemia
--- hypokalaemia
Signs & Symptoms:
- Oral pharyngeal candiasis (yeast fungal infection)
- Soreness in the mouth, tongue and throat
- Increase in heart rate
-
Nursing considerations to prevent, assess or manage risks:
- After using inhaler, rinse mouth with water to avoid systemic absorption and associated side effects
- Ensure no beta blockers are prescribed with the beta agonists
- Is a preventer, not a reliever, therefore salbutamol for fast relief and Seretide as a preventer
- Ensure correct use and technique of inhaler for most effective results

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Salbutamol
CLASS: beta-2 agonist
MOA: Relax bronchial smooth muscle by stimulating beta₂ adrenoreceptors.
Indications for use: relief of asthma and COPD, prevention of exercise-induced bronchoconstriction, management of preterm labour
Drug interactions: beta blockers- antagonise the therapeutic effects and may precipitate asthma, theophylline- potentiate hypokalaemia induced by high doses of beta2 agonists
Signs & Symptoms: tremors, palpitations, headache, hyperglycaemia, tachycardia, muscle cramps, agitation, hyperactivity in children, insomnia
Nursing considerations to prevent, assess or manage risks: ensure the patient has an asthma plan, monitor inhaler technique, monitor for changes in respiration and all vital signs, monitor of salbutamol toxicity,

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Note: Always consider:
Is there anything in the patient's condition/ past history that may increase the risks?

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What would they be for this medication chart?

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Significant risks / drug-drug interactions???

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Significant risks / drug-drug interactions???

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How / why does it occur?
What are they and what signs and symptoms would we see?
What do we as nurses do;
- prevent and/ or manage these?

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Compare and contrast the mode of action of the drug classes

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Compare and contrast the mode of action of the drug classes

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Did you find a simpler way to describe them?
Could you say in your own words what they are?
Did you need to go and look them up again? Do you need to rethink your explanation into your own words?

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Prednisolone
CLASS: Corticosteroids
MOA: Corticosteroids regulate gene expression, which results in glucocorticoid effects which are gluconeogenesis, proteolysis, lipolysis, suppression of inflammation and immune responses, and also mineralocorticoid effects which include hypertension, sodium and water retention, and potassium loss.

Indications for use: inflammatory disease, acute asthma, COPD exacerbation, acute gout, croup, lymphoma, some leukaemias
Prednisolone is a glucocorticoid used to treat adrenocortical insufficiency, inflammatory conditions, and some cancers.Drug interactions:
Signs & Symptoms:

shortness of breath (even with mild exertion), swelling, rapid weight gain;

bruising, thinning skin, or any wound that will not heal;

severe depression, changes in personality, unusual thoughts or behavior;

new or unusual pain in an arm or leg or in your back;

bloody or tarry stools, coughing up blood or vomit that looks like coffee grounds;

severe pain in your upper stomach spreading to your back, nausea and vomiting;

a seizure (convulsions); or

low potassium--leg cramps, constipation, irregular heartbeats, fluttering in your chest, increased thirst or urination, numbness or tingling.

Nursing considerations to prevent, assess or manage risks:

Obtaining comprehensive medical and psychiatric history

Monitoring vital signs and body weight

Assessing for signs of infection

Adhering to established dosage regimen and not changing it without consulting physician

Reporting gastric distress or any sign of peptic ulcer

Deciding whether to discontinue nursing or the drug, considering the importance of the drug to the mother

Not breast feeding while taking the drug without consulting physician