NURS222 Lecture Notes - Lecture 4: Multiple Drug Resistance, Drug Resistance, Notifiable Disease
18 Dec 2018
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Severe adr"s - all patients will experience infusion reaction and renal damage to varying degrees *** Symptoms usually start within 1-3 hours - try to pre-treat on drugs to prevent adrs. High incidence of phlebitis - change peripheral sites often; pre-treat iv site with heparin. Highly nephrotoxic - reversible except if dose goes over 4 grams, but depends on residual impairment: monitor renal funciton, give extra fluids, monitor i&o, and other nephrotoxic drugs, monitor hematocrit and rbc. Doesn"t cross into csf - inject into spinal cord to get it into cns so that it can take of the infection in the brain. Think toxic - toxic to kidney, liver, and blood; monitor lft"s, electrolytes, renal labs; monitor for multiple organ failure, interactions with drugs; risk of cardiac failure: polyenes - nystatin=mycostatin. Comes in lozenge or can be in drink to swish it down esophagus. Can be used prophylactically for patients going through radiation.
