C H A P T E R 3
Toxic effects of drugs
39
against the potential risks. All pregnant women should
be advised not to self-medicate during the pregnancy.
Emotional and physical support is needed to assist the
woman in dealing with the possibility of fetal death or
birth defects.
Box 3.1 summarises all of the adverse effects that
have been described throughout this chapter.
Iatrogenicity
The terms
iatrogenesis
and
iatrogenic artifact
refer to
inadvertent adverse effects or complications caused
by, or as a result of, medical treatment or advice. In
addition to harmful consequences of actions by doctors,
iatrogenesis can also refer to actions by other health
care professionals, such as psychologists, therapists,
pharmacists, nurses, dentists, midwives and others.
Iatrogenesis is not restricted to conventional medicine,
as iatrogenesis can also result from complementary and
alternative medicine treatments. Causes of iatrogenesis
include chance, medical error, negligence, social control,
anxiety or annoyance related to medical procedures,
and the adverse effects or interactions of medications.
CHAPTER SUMMARY
■■
No drug does only what is desired of it. All drugs
have adverse effects associated with them.
■■
Adverse drug effects can range from allergic reactions
to tissue and cellular damage. The nurse or midwife,
as the healthcare provider associated with drug
administration, needs to assess each situation for
potential adverse effects and intervene appropriately
to minimise those effects.
■■
Adverse effects can be extensions of the primary
action of a drug or secondary effects that are not
necessarily desirable, but are unavoidable.
■■
Allergic reactions can occur when a person’s body
makes antibodies to a drug or drug-protein complex.
If the person is exposed to that drug at another time,
an immune response may occur. Allergic reactions
can be of various types. The exact response should be
noted to avoid future confusion in care provision.
■■
Tissue damage can include skin problems, mucous
membrane inflammation, blood dyscrasia,
superinfections, liver or renal toxicity, poisoning,
hypoglycaemia or hyperglycaemia, electrolyte
disturbances, various central nervous system
problems (ocular damage, auditory damage, atropine-
like effects, Parkinson-like syndrome, neuroleptic
malignant syndrome) and teratogenicity.
Knowing your strengths and weaknesses helps you to
study more effectively. Take a PrepU Practice Quiz
to find out how you measure up!
ONLINE RESOURCES
An extensive range of additional resources to enhance teaching
and learning and to facilitate understanding of this chapter may
be found online at the text’s accompanying website, located on
thePoint at
These include Watch and
Learn videos, Concepts in Action animations, journal articles,
review questions, case studies, discussion topics and quizzes.
WEBLINKS
Healthcare providers and students may want to consult
the following Internet source:
Guidelines.pdf
World Health Organization (2005) World Alliance
for Patient Safety—WHO Draft Guidelines for
Adverse Event Reporting and Learning Systems—from
information to action.
BIBLIOGRAPHY
Dempsey, J., Hillege, S. & Hill, R. (2014).
Fundamentals of
Nursing and Midwifery: A Person-centred Approach to Care
(2nd Australian and New Zealand edn). Sydney: Lippincott
Williams & Wilkins.
• Extension of primary
action
• Occurrence of
secondary action
• Allergic reactions
Anaphylactic reactions
Cytotoxic reactions
Serum sickness
reactions
Delayed allergic
reactions
• Tissue and organ
damage
Dermatological
reactions
Stomatitis
Superinfections
Blood dyscrasia
• Toxicity
Liver injury
Renal injury
Poisoning
• Alterations in glucose
metabolism
Hypoglycaemia
Hyperglycaemia
• Electrolyte imbalances
Hypokalaemia
Hyperkalaemia
• Sensory effects
Ocular toxicity
Auditory damage
• Neurological effects
General CNS effects
Atropine-like
(anticholinergic) effects
Parkinson-like
syndrome
Neuroleptic malignant
syndrome (NMS)
• Teratogenicity
• Iatrogenicity
■■
BOX 3.1
Summary of adverse drug effects
