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CNS effects may result from either CNS stimulation (excitement) or CNS depression | *If CNS stimulation is expected,clients may be at risk for seizures and precautions should be taken
*If CNS depression is likely,advise clients not to drive or participate in other activities that can be dangerous. |
Extrapyramidal symptoms (EPS) (abnormal body movents) can include involuntary fine motors tremors,rigidity,uncontrollable restlessness,and acute dystonias (spastic movements and/or muscle rigidity affecting the head,neck,eyes,facial area,and limbs) | *EPS are more often associated with medications affecting the CNS,such as those used to treat mental health disorders.
*Instruct clients to report symptoms to providers. |
Anticholinergic effects are side effects that are a result of muscarinic receptor blockade. Most effects are seen in the eyes,smooth muscle,exocrine glands,and the heart. | *Advise clients to relieve dry mouth by sipping on liquids; manage photophobia by useof sunglasses; and reduce urinary retention by urinating before taking the medication. |
Cardiovascular effects can involve blood vessels and the heart. | For example,antihypertensives can cause orthostatic hypotension.(Low BP based on position change lightheadedness,dizziness)
*Advise clients to change positions slowly,and if feeling light headed or dizzy, to sit or lie down. |
Gastrointestional (GI) effects can results from local irritation of the GI tract.Stimulation of the vomiting center also results in adverse effects. | NSAIDS can cause GI upset. Advise clients to take these medications with food. |
Hematologic effects are relatively common and potentially life-threatening with some groups of medications. | Bone marrow depression/suppression is generally associate with anticancer medications and hemorrhagic disorders with anticoagulants and thrombolytics.Educate clients about signs and symptoms of bleeding(bruising,discolored urine/stool,bleeding gums) |
Hepatoxicity=most meds are metabolized in the liver, the liver is vulnerable to drug-induced injury.Damage to liver cells can impair metabolism of many medications,causing medication accumulation in the body and producing adverse effects. | *when two or more meds that are hepatotxic are combined,the risk for liver damage is increased.
*clients starting a medication known to be hepatotoxic should have baseline liver function tests performed and periodically thereafter. |
Nephrotoxitcity can occur with a # of meds,but is primarily the results of certain antimicrobial agents and NSAIDs.Damage to the kidneys can interfere with meds excretion leading to medication accumalation and adverse effects. | Aminoglycosides can cause renal damage.Monitor serum creatinine and BUN levels of clients an aminoglycoside. |