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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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Pregnant and breast feeding patients and medications

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Pregnant and breast feeding patients and medications

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1. What steps should the nurse take prior to administering medicines to a pregnant or breastfeeding patient?

Look up the prescribed medications to see if they are safe to administer.
Remember there may be an additional resource that you may want to access

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Mylanta/Omeprazole
Class:
Mylanta- antacids
Omeprazole- proton pump inhibitors

MOA:
Mylanta- neutralise hydrochloric acid secreted by gastric parietal cells
Omeprazole-bind to the hydrogen/potassium ATPase enzyme system, inhibiting both stimulated and basal acid secretion

Indications for use:
Mylanta- dyspepsia, peptic ulcer disease, GORD
Omeprazole- peptic ulcer disease, GORD, zollinger, H.pylori eradication, treatment and prevention of peptic ulcer and erosion associated with NSAIDs

Nursing considerations:
Mylanta- can reduce effects of medication taken orally, should be given over more than 2hrs
Omeprazole- avoid alcohol and foods that may cause an increase in GI irritation

Drug - drug interactions:
Mylanta- none
Omeprazole- none

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Metoclopramide
Class: Antiemetic

MOA: blocks the dopamine-2 receptors in the chemoreceptor trigger zone and GIT

Indications for use: nausea, vomiting, pregnancy, post operative, surgical procedures, radiation

Nursing considerations: Use short term only, can be used for lactation stimulation but not recommended

Drug - drug interactions: as its a dopamine antagonist don't use with dopamine agonists as it will reduce the therapeutic effect.

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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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Gliclazide
Class: Sulfonylurea

MOA: Increase pancreatic insulin secretion; may decrease insulin resistance

Indications for use: Type 2 diabetes

adverse effect:
- hypoglycaemia (common)
- nausea, diarrhoea, metallic taste, headache, rash (infrequent)

Nursing considerations:
• May cause aplastic anemias, hypoglycaemia, photosensitivity, dizziness, drowsiness, headache, diarrhoea
• Monitor CBC, assess for allergy to sulfonamides
• Beta blockers may increase signs of hypoglycemia
• Instruct patient on how to check blood sugars and
• Instruct patient on importance of carrying source of sugar in case of
hypoglycemia

Drug - drug interactions:
The use of nonsteroidal anti-inflammatory drugs, some azole antifungals, sulfonamides, probenecid, monoamine oxidase inhibitors, beta-blockers, quinolones, and salicylates can potentiate hypoglycemia in the presence of glipizide.

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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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Novorapid
Class: Insulin (short-acting)

MOA:
- Increases or restores ability to metabolise glucose by enhancing cellular glucose uptake
- It inhibits endogenous glucose outputs and lipolysis

Indications for use:
- T1DM
- Inadequately controlled T2DM

Nursing considerations:
- Close BGL monitoring
- Adjusting doses
- Managing risks

Drug - drug interactions:
- Beta-blockers
- ACE-inhibitors
- Anabolic steroids

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Optisulin

Class:
Insulin

MOA:
Increases or restores the ability to metabolise glucose by enhancing cellular glucose uptake

Indications for use:
Diabetes Mellitus (Type I and type II, gestational)

Nursing considerations:
- Rotate injection sites to avoid damage to muscle and prevent subcutaneous atrophy.
- Regular monitoring of BGL.
- Consider patient's food consumption and dietary habits.
- Patient education surrounding dietary intake
- Keep in room temp for 1-2 hours prior to injection
- Regularly given same time every day
- If dose forgotten, check BGL prior to giving dose

Risks/Adverse Effects:
- Hypoglycaemia (loss of consciousness, seizures, disorientation)
- Weight gain
- Local reaction at site of injection
- Allergic reaction (skin rashes, sweating, shortness of breath)

Drug - drug interactions:
- Some betblockers can increase BGLs, lowering the effect of insulin. This can cause hypoglycaemia. Betablockers can also mask the symptoms of hypoglycaemia.
- Sertraline: SSRIs may disrupt glucose homeostasis and result in unpredictable effects during co-administration with insulin.