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Metoclopramide & pregnancy

- Metoclopramide is safe to use in pregnancy.
- Has been used for lactation stimulation but is not recommended due to safety and efficacy concerns

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optisulin is safe in pregnancy info from AMH

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Omeprazole is safe to take during pregnancy.You could try eating smaller meals more often, and avoiding fatty and spicy foods. Sitting up straight when you eat will also take the pressure off your stomach.

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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
MOA:

Neutralise hydrochloric acid secreted by gastric parietal cells.

Indications:

Symptomatic relief of dyspepsia, peptic ulcer disease and GORD

Signs & Symptoms:

nausea, constipation, diarrhea, headache

Drug - drug interactions:

Mylanta may react with other medication including (digoxin, iron,  pazopanib, tetracyclaine antibiotics ) preventing them from being fully absorbed by the body.

Nursing considerations/how to prevent, identify/manage risks

Educate the patient to take between meals or at bedtime when symptoms occur or you expect they might occur.

Tablets should be chewed or sucked before swallowing for the best effect.

Antacids can reduce the effect of a number of other medicines taken by mouth. The best way to avoid a problem is to separate taking antacids and other medicines by at least 2 hours.

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Optisulin
MOA: increase the ability to metabolise glucose by increasing cellular glucose uptake,inhibits where glucose is created and lipid metabolism.(long acting)
Indications:
T1DM,
T2DM,
gestational diabetes -
provides a constant basal level

Signs & Symptoms: hypoglycaemia, weight gain, arrythmia, local reactions including redness to subcut site, itching, lipodystrophy, amyloidosis (build up of proteins)

Drug - drug interactions: other diabetes medications and insulin, blood pressure medications, corticosteroids, atypical antipsychotics and alcohol= hypoglycemia

Nursing considerations/how to prevent, identify/manage risks
-regular BGL checks , especially prior to administration.
-to be given once daily to provide a constant basal level
- always give with food,
-do not mix with other insulins,
-rotate sites of injection
-the 2 strengths are NOT interchangable
-safe in preganancy

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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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Novorapid
MOA:
enhances glucose uptake which allows for your body to metabolise glucose (ultra-short acting insulin)
Indications:
mainly type 1 diabetes. but can be used for type 2 diabetes if the it is inadequately controlled by diet, exercise and oral medication.
Signs & Symptoms:
hypoglycaemia, weight gain, local skin irritation, irritation, allergic reactions.
Drug - drug interactions:
none
Nursing considerations/how to prevent, identify/manage risks
close monitoring of BGL, adjust doses, manage risk, ensure correct method, timing, sanitary,  avoid alcohol, education about signs for hypoglycaemia,

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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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Metoclopramide
MOA:
Blocks dopamine-2 receptors in both the chemorecepter trigger zone & GIT. It then blocks the activation of the vomiting centre in the brain.

Indications:
- N&V
- Gastric stasis
- Difficult small intestinal intubation

Signs & Symptoms:
- Drowsiness
- Dizziness
- Headache
- Akathisia

Drug - drug interactions:
- Pakinsons meds - administration with dopamine agonists will reduce the therapeutic effect of the dopamine antagonist
- Suxamethonium - may inhibit suxamethonium metabolism  increasing neuromuscular block and causing respiratory insufficiency. Need to monitor respiratory function.

Nursing considerations/how to prevent, identify/manage risks
- Contraindicated w/ bowel obstruction
- Identify, treat and remove cause of N&V
- Ensure adequate hydration
- Short term use only - max of 5 days
- Prevention w/ antiemetics is better than the cure

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Omeprazole
MOA:
blocking gastric acid production and is from the group of medicines called proton pump inhibitors.
Indications: treat excess stomach acid in conditions such as non-cancerous stomach ulcers, gastroesophageal reflux disease, active duodenal ulcer, Zollinger-Ellison syndrome and erosive esophagitis.
Signs & Symptoms:stomach cramps, bloated feeling, watery and severe diarrhea which may also be bloody sometimes, fever, nausea or vomiting, or unusual tiredness or weakness.
Drug - drug interactions: 1. warfarin: When taken together, omeprazole can cause more warfarin to stick around in your body.
2.digoxin: Omeprazole can interfere with how much digoxin is absorbed into your bloodstream through your stomach. This can result in higher digoxin levels, and potentially more digoxin side effects.
Nursing considerations/how to prevent, identify/manage risks:
1. avoid alcohol and foods that may cause an increase in GI irritation.
2. always take 30 to 60. min before eating.
3. capsules should be swallowed whole
4. instruct patient to report black tarry stool
5. Instruct patient to report bothersome or prolonged side effects, including skin problems (itching, rash) or GI effects (nausea, diarrhea, vomiting, constipation, heartburn, flatulence, abdominal pain).