MEDICATION ADMINISTRATION

Drugs affecting the Special Senses and the Reproductive system

Drugs affecting the Repro system…Review of female repro

Male repro…review

Drugs affecting female repro

Contraceptives: May be a synthetic oestrogen or progesterone or a combination of the both

Primary use is contraceptive, but may also be used for menstrual problems and to treat acne in young women

Adverse Affects

Depends on the drug Nausea, vomiting, weight gain Oedema, bloating, Amenorrhea, abnormal bleeding, breast

tenderness, post-pill infertility Decreased libido, headache, dizziness,

anorexia, jaundice, skin pigmentation (chloasma), depression.

Precautions/contraindications

In women with a history of Thrombophlebitis, breast/endometrial

cancer, CVA or heart disease.

Nursing implications

Take at the same time each day; a missed pill should be taken within 12 hours.

If pill missed completely, additional contraceptive should be used for 5-7 days

Yearly cervical smear and professional breast examBSE after each period.First 3 months, dual contraceptivesReport adverse affectsDiscontinue 6 wks prior to elective surgery

Female Hormones

Oestrogen or progesterone used for menopausal syndrome,

primary amenorrhea, breast cancer, ovarian failure and endometriosis.

Oestrogen used to treat prostate problems.

Adverse affects

Depending on drug used GI problems, headache, dizziness,

depression, hypertension, fluid retention, Amenorrhea, breakthrough bleeding,

cervical erosion, thrush, libido changes, Weight gain ,leg cramps, excessive thirst.

Precautions/contraindications

Should be used with care with women who have a history of

Thrombophlebitis, breast Ca, stroke, myocardial infarction

Hypertension, obesity, heavy smokers.

Nursing Implications

Warn re weight gain No smoking Monitor glucose levels Health exam of female, and regular monitoring Clients who have not had a hysterectomy should also be

given progesterone with their oestrogen Monitor fluid retention Monitor hypertension Rotate transidermal patches Vaginal creams should be inserted deep into the vagina

towards the sacrum.

Adverse affects continued

Increased risk of breast cancerHormones via IM – deep into muscle, and

rotate sites.Clients checked for pregnancy first.Eg. Clomid, danazol

Male Hormones(androgens/antiandrgens)

Used for hypogonadism, eunuchoidism, gynaecomastia, prostate Ca.

Androgens may also be used for Breast Ca in females.

Other drugs used to treat erectile dysfunction.

Adverse affects

Tiredness, inability to concentrateReduces libido, depressionImpaired spermatogenesis, gynaecomastia,

impotence, decreased ejaculationFrequent or persistent erections, priapism,

altered lipid levels.

Precautions/contraindications

Should not be used during pregnancy Not used in people with prostate CaPregnancy/lactation

Nursing Implications

Spermatogenesis should be checked before meds are commenced (may take 6-20 months to return to normal after treatment)

Regular prostate examMonitor blood lipid levels and liver

functionPatch sites should be rotated and do not

apply over bony prominences

Pregnancy and Lactation

Generic and trade nameActionDoseUseStabilityCompatibilityAdverse affects

Pregnancy and Lactation

InteractionsPrecautionsNursing implications

Under the above headings, research in the MIMS…the following drugs

Drugs

EpilemHydrallazineMaxalonVentolinPethidineProgesterone

Drugs affecting eye,ear and special senses

Ophthalmic Drugs

Include antibiotics, antifungals,anti virals,steroids,and anesthetics

Mydriatics(dilate the eye)

Cycloplegics( prevent accommodation)

Miotics constrict the pupil

Lubricants for dry eyes

Adverse affects

Include photophobia,burning,stinging, infections,lid edema,allergic reaction,visual probs such as blurring,.

Systemic ….bitter taste,headache, hyper/hypotnsion,tachycardia,dyspnoea,restlessness, confusion,flushing, sweating.

Precautions/contraindications

Mydraitcs contraindicated in narrow angle glaucoma

Miotics should be used with care if intra ocular lens insitu

Take care with steroids and diabetes mellitus as may increase intra ocular pressure or cataract formation

OK with pregnancy and B/F

Nursing implications

Ointments and creams should only be used for that purpose.

Wash hands. Eye drops instilled in middle of lower lid and creams are

instilled in the lower lid from inner canthus to outer canthus.

Check which drop for which eye.. May use different drops for both eyes.

Do not touch eye or lid with the dropper. Write the date of opening..discard 7days if in hosp and 28

if at home.

Implications cont….

Clean eye …saline or water.Check manufacturers instructions.Should not drive if pupils are dilated.Local anesthetic…do not rub and protect

the cornea.Remove contact lenses.Solutions should be clear and kept at room

temp.

Otic drugs

Include analgesics, anesthetics, anti infective, steroids, wax softeners

Adverse affects

Allergic reactions,burning sensation

Precautions

May be used safely in most clients

Nursing implicationsKeep at room tempEnsure ear canal is straightenedWash handsKeep head on the unaffected side for 2-3 minsDo not use steroids if ruptured eardrumRefer to page 218 for trade/generic activity

Drugs affecting the Nose

Include anti-infective,steroids, decongestants,anticholinergics and antihistamines.

Sprays,aerosols,drops, creams jellies,gases and nasal prongs.

Adverse affects

Headache, stinging, excessive drying of the nasal mucosa, ulceration of the nasal mucosa, post-nasal drip, irritation, burning, sinusitis, sneezing.

PrecautionsHypertension and cardiac clients should

take care.

Nursing implications

Avoid contact with the eyes.Blow the nose before instilling.Breathe through mouth while instilling

medications.Shake containers well.wash spray after use.Nasal decongestants should not be used for

longer than 2 weeks.Refer to page 220 for generic/trade activity.

Mouth and throat

Include anti-infective, ulcers,or inflammation.

Lozenge,mouth wash, paints,drops,gels,and lotions.

Adverse affects

Bad taste in mouth, numbness.

Nursing implications If painful ulcers, use analgesic before eating.Remove dentures.Do not drink immediately after instilling.Use mouth wash before and after eating.

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