4
P A R T 1
Introduction to nursing pharmacology
sufferers. It is only available in Australia through the
Australian Government’s Special Access Scheme.
Ingestion of a plant-derived food can sometimes lead
to a drug effect. For instance, the body converts natural
liquorice to a false aldosterone—a hormone found in the
body—resulting in fluid retention and hypokalaemia or
low serum potassium levels if large amounts of liquorice
are eaten. However, people seldom think of liquorice as
a drug.
Finally, plants have become the main component of
the growing alternative therapy movement. Chapter 6
discusses the alternative therapy movement and its
impact on today’s drug regimens.
Animal products
Animal products are used to replace human chemicals
that fail to be produced because of disease or genetic
problems. Until recently, insulin for treating diabetes
was obtained exclusively from the pancreas of cows and
692 Hormonal drugs
Reactions may be
common
, uncommon,
life-threatening
, or
COMMONAN
REATENING.
sitagliptin
Januvia
Pregnancy risk category B3
Use in sport: Permitted
AVAILABLE FORMS
Tablets:
25 mg, 50 mg, 100 mg
INDICATIONS & DOSAGES
➤
Management of diabetesmellitus type 2—
Adults over 18 years:
100 mg PO once
daily.
Adjust-a-dose:
Adults with moderate
PO once daily.
ACTION
Enhances glycaemic control in type 2 dia-
betes by improving beta-cell receptiveness
to glucose, stimulating insulin synthesis and
release and lowering glucagon secretion
leading to reduced production of glucose
in the liver.
Route
Onset
Peak
Duration
PO
Unknown
1–4 hrs
24 hrs
ADVERSE REACTIONS
CNS:
headache.
ENT:
nasopharyngitis.
GI:
abdominal pain, diarrhoea, nausea,
vomiting,
pancreatitis.
Haematological:
neutrophilia.
Musculoskeletal:
rhabdomyolysis.
Metabolic:
hypoglycaemia.
Renal:
acute renal failure.
Skin:
generalised exfoliative dermatitis,
rash, urticaria,
Stevens-Johnson syndrome.
Other:
hypersensitivity reactions such as
anaphylaxis,angio-oedema,
rash, urticaria
and other skin conditions.
INTERACTIONS
Drug-drug.
Digoxin:
May slightly increase
plasma digoxin levels.
Sulfonylurea:
Increased risk of hypoglycae-
mia.
CONTRAINDICATIONS
Contraindicated in individuals hypersensi-
tive to the drug or any of the ingredients.
CARE CONSIDERATIONS
• Monitor blood glucose levels closely.
• Monitor white cell counts regularly.
• Whenused in conjunctionwith a sulfonyl-
urea, dosage of the sulfonylurea may need
reducing to avoid hypoglycaemia.
PATIENT TEACHING
• Advise person that drug may be taken
with or without food.
• Advise person to continue taking the
medication even if feeling well.
• Advise individual to report persistent,
severe abdominal pain to doctor immedi-
ately.
vildagliptin
Galvus
Pregnancy risk category B3
Use in sport: Permitted
AVAILABLE FORMS
Tablets:
50 mg
INDICATIONS & DOSAGES
➤
Management of type 2 diabetesmellitus in
dual combination—
Adults:
In dual combination with metfor-
min, 50 mg PO in the morning or 50 mg
PO b.i.d.
In dual combination with a sulfonylurea, 50
mg PO once daily in the morning.
Adjust-a-dose:
Avoid if creatinine clear-
ance is below 50 mL/minute. Avoid in per-
son with hepatic impairment.
ACTION
Enhances glycaemic control in type 2 dia-
betes by improving beta-cell receptiveness
to glucose, stimulating insulin synthesis and
DH_7E_Ch_53.indd 692
30/01/14 2:40 PM
FIGURE 1.1
Example of a drug monograph from
McKenna’s Drug Handbook for
Nursing and Midwifery
(7th edn).
