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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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What factors may result in impaired medication effects in these patients?
Children exhibit different pharmacokinetics and pharmacodynamics because of their immature renal and hepatic function, different body composition, altered protein binding and dissimilar receptor patterns. rEduced gastric acidity, gastric emptying slower as peristalsis is impaired, child has thin skin effecting skin absorption, total body fat count is less, reduced production of enzymes due to immature renal, blood brain barrier, high metabolic rate causing increased absorption

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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: Anti-fungal
MOA: Binds to ergosterol in fungal cell membranes altering their permeability and allowing leakage of intracellular components.
Indications for use: "thrush"
- Oropharyngeal candidiasis
- Treatment and suppression of intestinal candidiasis
- Vulvovaginal candidiasis

Drug interactions:
- Certain probiotics
Signs & Symptoms:
- nausea
- vomiting
- diarrhoea
Nursing considerations to prevent, assess or manage risks:
- Discontinue medication administration if rash or sensitivity occurs.

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Ipatropium
CLASS: Anticholinergic
MOA: Antagonises the action of acetylcholine in the parasympathetic nervous system, block the parasympathetic nervous system response, resulting in long-acting bronchodilation when inhaled.
Indications for use: Asthma, COPD
Drug interactions:
Signs & Symptoms: Dry mouth, throat irritation.
Nursing considerations to prevent, assess or manage risks: educate patient to keep away from eyes and make sure they inform nurse or doctor of any eye discomfort. Rinse mouth after dose to reduce discomfort for patient

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Prednisolone
CLASS: Corticosteroid
MOA: Local Anti inflammatory action
Indications for use: Used for anti-inflammatory and immunosuppressant effects for conditions such as autoimmune or inflammatory disease, acute asthma, COPD exacerbation, acute gout, croup
Drug interactions: Haloperidol
Signs & Symptoms:
increased appetite, mood changes, insomnia, GIT issues, fluid retention, hyperglycaemia, hypertension, osteoporosis
Nursing considerations to prevent, assess or manage risks: Monitor BGL's, Give in morning preferably, monitor fluid retention, monitor BP, monitor dosage charted daily.

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Seretide
CLASS: Corticorsteoid and Beta 2 agonist

MOA: Seretide contains Salmeterol and Fluticasone Propinate which have differing MOA's.
Salmeterol protects against symptoms as it is a histamine, decreasing inflammation in the lungs.
Fluticasone Propionate improves lung function and is a prevents exacerbations of the condition.

Indications for use:
Maintenance treatment of asthma

Maintenance treatment of COPD

Drug interactions:
- NSAIDs
- Warfarin
- ketoconazole
- Beta blocker

Signs & Symptoms:
Beta2 Agonist -
- tremor
- headache
- heart palpitations
Corticosteroids -
- dysphonia
- bruising
- candidiasis

Nursing considerations to prevent, assess or manage risks:
- it is a preventative measure, do not use for acute symptoms of asthma
- use with a spacer and rinse mouth out with water afterwards

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Salbutamol
CLASS: short acting Beta2 agonists

MOA: stimulates Beta2 adrenergic receptors, this leads to activation of adenyl cyclic AMP, and this relaxes smooth muscles. release of cyclic AMP prevents other bronchoconstrictors medications like histamine.

Indications for use: to relieve symptoms of asthma and chronic obstruction pulmonary disease (COPD) such as coughing, wheezing, and feeling breathless.

Drug interactions: amiofampridine, aminophyline, aminodarone, amisdulpride, amphotericin B

Signs & Symptoms: trembling, particularly in the hands, nervous tension, headache, suddenly noticeable heartbeats (palpitations), muscle cramps.

Nursing considerations to prevent, assess or manage risks:
1. assess lung sounds, PR and BP before drug administration and during peak of medication.
2. observe fore paradoxical spasm and withhold medication and notify physician if condition occurs.
3. administer PO medications with meals to minimize gastric irritation.

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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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Epipen
CLASS:Alpha and b adrenergic agonists
MOA: Through its action on alpha-1 receptors, epinephrine induces increased vascular smooth muscle contraction, pupillary dilator muscle contraction, and intestinal sphincter muscle contraction.
Drug interactions: With vasodilators, antihypertensive, diuretics, monoamine oxidase inhibitors(with these all, epinephrine antagonises pressor effects).
Indication: hypersensitivity reactions including anaphylaxis, hypotension due to septic shock, ventricular fibrillation, pulseless ventricular tachycardia, systole etc.

Signs & Symptoms:Nervousness, sweating, naseus, vomiting, dizziness, anxiety, shakiness, pale skin

Nursing considerations to prevent, assess or manage risks:
Assesment

1.  History: Allergy or hypersensitivity to epinephrine
2. Physical: Weight; skin color, normal urine output; urinalysis, renal function tests, blood and urine glucose, serum electrolytes, thyroid function tests, ECG

Warning
1.Use extreme caution when calculating and preparing
doses.
2.Protect drug solutions from light, extreme heat, and freezing.
3. Shake the suspension for injection well before withdrawing the dose.
4.Keep a rapidly acting alpha-adrenergic blocker (phentolamine) or a vasodilator (a nitrate) readily available in case of excessive hypertensive reaction.

5.Do not exceed recommended dosage; adverse effects or loss of effectiveness may result.

Teaching
1.You may experience these side effects: Dizziness, drowsiness, fatigue, apprehension (use caution if driving or performing tasks that require alertness); anxiety, emotional changes.
2.Report chest pain, dizziness, insomnia, weakness, tremor or irregular heart beat (respiratory inhalant, nasal solution), difficulty breathing

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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?