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RN VATI PHARMACOLOGY ASSESSMENT REMEDIATION
Safety and Infection Control
Accident/Error/Injury Prevention – (2)
Chronic Neurologic Disorders: Contraindications for Pregabalin (Active Learning
Template – Medication, RM Pharm RN 7.0 Chp 13)
Contraindications:
Pregnancy:
Birth defects: can cause skeletal and visceral malformations
Pregnancy Risk Category C: Administer only if the benefits outweigh the
risks
Interactions:
Benzodiazepines, alcohol, and opioids intensify CNS effects
Nursing considerations: Advise the client to avoid medications that affect
the CNS
Medical and Surgical Asepsis: Reducing the Risk of an Allergic Reaction for a Client
Who Has a Latex Allergy (Active Learning Template – Basic Concept, RM FUND
9.0 Ch 10)
Before beginning any task or procedure that requires aseptic technique, health
care team members must check for latex allergies. If the client or any member of
the team has a latex allergy, the team must use latex-free gloves, equipment, and
supplies.
Pharmacological and Parenteral Therapies
Adverse Effects/Contraindications/Side Effects/Interactions – (19)
Airflow Disorders: Adverse Effects of Beta2-Adrenergic Agonists (Active Learning
Template – Medication, RM Pharm RN 7.0 Chp 17)
Tachycardia, angina: Oral agents can cause tachycardia and angina due to
activation of alpha1 receptors in the heart
Nursing considerations:
Advise clients to observe for chest, jaw, or arm pain or palpitations and to
notify the provider if they occur
Instruct clients to check pulse and to report an increase of greater than 20
to 30 beats/min
Advise clients to avoid caffeine
Dosage might need to be reduced
Tremors: Caused by activations of beta2 receptors in skeletal muscle
Nursing considerations:
Tremors usually resolve with continued medication use
Dosage might need to be reduced
Airflow Disorders: Adverse Effects of Ipratropium (Active Learning Template –
Medication, RM Pharm RN 7.0 Chp 17)
Local anticholinergic effects: Dry mouth, hoarseness
Nursing considerations:
Advise clients to sip fluids and suck on sugar-free hard candies to control
dry mouth
Antilipemic Agents: Monitoring Laboratory Values (Active Learning Template –
Medication, RM Pharm RN 7.0 Chp 24)
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HMG-CoA reductase inhibitors (statins); Cholesterol absorption inhibitor; Bile-
acid sequestrants; Nicotinic acids (niacin); Fibrates; Antisense oligonucleotide:
Advise clients about the importance of obtaining baseline cholesterol, HDL,
LDL, and triglyceride levels, as well as liver and kidney function tests, and
monitoring periodically during treatment
Statins, such as atorvastatin, can increase the risk of liver dysfunction and
myopathy
Obtain baseline liver function tests and monitor periodically. Advise
clients to observe for indications of liver damage (anorexia, vomiting,
nausea). The provider should be notified, and the medication will most
likely be discontinued.
For fibrates – with concurrent use, warfarin increases the risk of bleeding
obtain baseline prothrombin time (PT) and INR, and perform periodic
monitoring
Cardiac Glycosides and Heart Failure: Contraindications to the Administration of
Digoxin (Active Learning Template – Medication, RM Pharm RN 7.0 Chp 21)
Pregnancy Risk Category C
Contraindicated in clients who have disturbances in ventricular rhythm, including
ventricular fibrillation, ventricular tachycardia, and second- and third-degree heart
block
Use cautiously in clients who have hypokalemia, partial AV block, advanced heart
failure, and impaired kidney function
Chemotherapy Agents: Priority Assessment During Administration of Paclitaxel
(Active Learning Template – Medication, RM Pharm RN 7.0 Chp 42)
Contraindications/Precautions:
Pregnancy Risk Category D
Contraindicated in clients who have a neutrophil count less than 1,500/mm3.
Use with caution in clients who have myelosuppression.
Nursing Administration:
Assess for indications of neuropathy, including weakness, numbness, tingling,
foot drop, ataxia, and paresthesia. Advise clients to use caution and report
manifestations
Reduce dose for clients who have liver disease
Assess breath sounds for bronchospasm
Monitor for bleeding (bruising) or infection (fever, sore throat)
Monitor CBC and liver enzymes
Give an antiemetic for nausea and vomiting
Advise clients to use good mouth care
Stop chemotherapeutic medications if extravasation occurs
Advise clients to use birth control during treatment
Chemotherapy Agents: Treatment for Adverse Effects of Topotecan (Active Learning
Template – Medication, RM Pharm RN 7.0 Chp 42)
Bone marrow suppression:
Low WBC count or neutropenia, bleeding caused by thrombocytopenia or
low platelet count, and anemia or low RBCs
Can occur 4 to 6 weeks after infusion
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