Chapter 3- Toxic Effects of Drugs

What is blood dyscrasia?

A drug-induced problem where bone marrow can’t make enough blood cells.

What are signs of blood dyscrasia?

Fatigue, fever, easy bruising, sore throat, pancytopenia.

What are common skin reactions to drugs?

Rash, hives, itching, scaling, or severe skin peeling (like Stevens-Johnson Syndrome).

What should nurses do for skin reactions?

Mild = Skin care + antihistamines. Severe = Stop drug + notify provider.

What causes a drug allergy?

The immune system overreacts to a drug it sees as dangerous.

What are the 4 types of allergic reactions?

1. Type I – Anaphylaxis (IgE)
2. Type II – Cytotoxic (IgG/IgM)
3. Type III – Serum sickness (immune complex)
4. Type IV – Delayed rash/inflammation (T-cells)

What is drug poisoning?

A toxic overdose (accidental or intentional) that may damage organs or be fatal.

What’s the nursing response?

Emergency care, antidotes (if available), ABC support, call poison control.

What is stomatitis?

Inflammation of the mouth caused by a drug.

Nursing care for stomatitis?

Gentle oral care, soft foods, antifungal meds if needed.

What is a superinfection?

A new infection caused by killing off “good” bacteria (often from antibiotics).

Signs and nursing care?

Fever, diarrhea, thrush, vaginal itching → give antifungals, good hygiene, maybe stop drug.

What is a primary drug effect?

Too much of the intended effect (e.g., bleeding from a blood thinner).

What is a secondary effect?

Unrelated side effects (e.g., nausea from antibiotics).

What are CNS drug side effects?

Confusion, drowsiness, hallucinations, seizures.

What should the nurse do?

Ensure safety, monitor mental status, adjust meds if needed.

What are common anticholinergic symptoms?

Dry mouth, constipation, blurry vision, can’t pee or sweat.

Nursing care?

Hydration, oral care, sunglasses, bowel/bladder support.

What is EPS?

Movement issues like tremors, stiffness, jerky motions (from dopamine-blocking drugs).

What’s the fix?

Stop drug, give anticholinergics or Parkinson meds.

What is NMS?

A rare, deadly reaction to antipsychotics → fever, muscle rigidity, confusion.

Nursing action?

EMERGENCY! Stop drug, cool patient, give dantrolene/bromocriptine.

What is a teratogenic drug effect?

Drug causes birth defects or miscarriage.

Nurse’s role?

Educate pregnant patients, report risks, avoid harmful meds.

What causes hypokalemia (low K+)?

Loop diuretics, kidney loss.

What are the signs?

Muscle cramps, irregular pulse, weakness, ileus.

What causes hyperkalemia (high K+)?

K+-sparing diuretics, kidney failure, cell death.

What are the signs?

Weakness, diarrhea, slow heart rate, low urine.

What causes nephrotoxicity?

Drugs like aminoglycosides (gentamicin) harming kidney nephrons.

Signs?

↑ BUN/Creatinine, low urine, fluid retention, rash.

Nursing action?

Stop drug, monitor labs, dialysis if needed.

What causes liver toxicity?

Liver overworked by drug breakdown (e.g., Tylenol overdose).

Signs?

Jaundice, dark pee, pale stool, ↑ liver enzymes.

Nursing care?

Stop drug, rest, monitor labs, supportive care.

What drug causes vision problems?

Chloroquine → retinal damage.

What to do?

Monitor vision, stop drug, assist with safety.

What drugs cause ear damage?

Aminoglycosides, macrolides, aspirin.

Symptoms?

Ringing, dizziness, hearing loss.

Nursing care?

Monitor hearing, prevent falls, notify provider.