2 Serious Adverse Drug Reactions
Recognize serious medication reactions, prioritize immediate threats, and follow urgent response and communication steps for allergic reactions, opioid toxicity, severe skin reactions, and possible overdose.
Recognize and prioritize serious reactions
A serious adverse drug reaction requires rapid recognition and a response matched to the immediate threat. Prioritize airway, breathing, and circulation, and do not delay emergency care to finish documentation or a medication round.
Assess first when symptoms suggest a threat to breathing or circulation. Wheezing, lip or tongue swelling, dizziness, fainting, shock signs, seizure, inability to awaken, or rapidly worsening symptoms call for immediate action. A patient with wheezing, lip swelling, and dizziness during an intravenous antibiotic infusion should be assessed before patients reporting mild nausea, constipation, or a mild headache with stable vital signs.
Respond to suspected
Throat tightness, wheezing, falling blood pressure, lip or tongue swelling, and dizziness shortly after a medication may indicate . It can rapidly compromise breathing and circulation, so treat it as an emergency.
Stop the suspected medication, activate emergency help, assess and support airway and breathing, and administer intramuscular epinephrine promptly according to emergency protocol or an authorized order. Do not delay epinephrine while trying an antihistamine first. Follow emergency protocols and the nurse’s scope of practice.
Respond to opioid-related breathing problems
Difficult arousal with slow, shallow breathing after an opioid suggests . This is an emergency rather than a situation for watchful waiting.
Hold further opioid doses, call for emergency assistance, support airway and breathing, and administer when indicated and authorized by protocol or order. Continue close observation because breathing problems can persist or recur.
Escalate severe skin reactions
Fever with a rapidly spreading rash, blisters, skin peeling, or sores in the mouth or involving the eyes can signal a severe drug-related skin reaction, such as or . These reactions can be life-threatening.
Withhold the suspected medication and arrange immediate emergency medical evaluation. Do not reassure the patient that the rash is routine, continue the medication, or simply wait for a later appointment.
Manage a possible medication overdose
A person who may have taken an extra medication dose needs prompt expert guidance even if currently feeling well. Do not wait for symptoms, induce vomiting, or give another dose at the usual time to maintain the schedule.
Promptly notify the appropriate clinician and obtain guidance. Gather the medication name, dose, and time taken, and monitor as directed. In the United States, is available at 1-800-222-1222. Call 911 for collapse, seizure, trouble breathing, or inability to awaken.
Communicate and document after immediate care
For any suspected serious reaction, assess the patient first and summon emergency help as needed. Withhold further doses of the suspected medication pending urgent clinical direction, as appropriate to the reaction and situation.
Communicate the medication, dose, route, timing, symptoms, and vital signs. Begin documentation after immediate care is underway; documentation must not delay emergency treatment.