Adverse reactions

Adverse reactions explains how a medicine produces its effect at receptors, enzymes, ion channels or other body targets. Nursing care links the expected action to measurable patient outcomes and early recognition of exaggerated or unwanted effects.

In Diploma in Nursing (Extension) - DNE 114: Mental Health Nursing(II) Pharmacology (III), study this topic by asking three questions: what does the medicine or drug group do, what patient factors change its safety, and what must the nurse monitor before and after administration?

• Agonists activate receptors and produce a response.
• Antagonists block receptors and reduce or prevent a response.
• Dose-response thinking helps predict therapeutic benefit and toxicity.
• Autonomic medicines can affect heart rate, blood pressure, secretions, bronchi, bladder and pupil size.

• Measure baseline observations that relate to the drug action, such as pulse, blood pressure, respiratory rate or mental state.
• Check contraindications before medicines that alter autonomic or central nervous system function.
• Evaluate whether the expected response occurs within the correct time frame.

• Use the medication rights and pause when the order, patient condition or available medicine does not match.
• Check high-risk medicines, unfamiliar doses and calculations with a competent colleague or prescriber according to local policy.
• Monitor the patient at the time the medicine is expected to begin working, not only at the end of the shift.
• Document the medicine, dose, route, time, relevant observations, patient education and response.

Escalate immediately if the patient develops breathing difficulty, collapse, severe allergic features, uncontrolled bleeding, marked confusion, convulsions or any rapidly worsening condition.

• Assessment: identify why the medicine or drug group is needed, the patient's baseline condition, allergies, current medicines and risk factors.
• Planning: set a clear expected outcome, such as reduced pain, controlled blood pressure, improved infection signs or absence of adverse effects.
• Implementation: administer safely, explain the medicine in simple language and follow facility policy for high-alert medicines.
• Evaluation: compare the patient's response with the expected effect and report poor response, toxicity or serious adverse reactions.

In pharmacodynamics, the nursing process prevents medicine administration from becoming a mechanical task. It keeps the focus on whether the patient is safer and improving.

• Use generic medicine names where possible and confirm brand names carefully because different brands may contain the same active ingredient.
• Consider stock availability, affordability, storage conditions and referral options when planning patient education.
• Follow facility protocols for controlled medicines, cold-chain items, antibiotics, injections and emergency medicines.
• Report medicine incidents and near misses honestly so the system can become safer.

• Revise adverse reactions by linking the drug group, expected effect, adverse effects and nursing checks.
• Confirm baseline observations, contraindications, interactions and monitoring needs before administration.
• Connect patient teaching to safe self-administration, adherence, storage and follow-up.
• Escalate when the medicine should be held, the dose looks unsafe or the patient deteriorates.

• Assess current mental state, suicide risk, substance use, physical observations, allergies and current medicines before administration.
• Monitor sedation, falls risk, movement changes, mood worsening, sleep, appetite, adherence and signs of toxicity or withdrawal.
• Teach the patient and family that many psychiatric medicines need consistent use and follow-up before full benefit is seen.
• Document consent or refusal, medicine given, response, side effects, education and any safety concerns.