Question

1. What are the most common adverse effects of drugs used to treat upper respiratory infections in children? What nursing considerations must be implemented when using these drugs in children?

2. What are the most common adverse effects of drugs used to treat upper respiratory infections in adults? What nursing considerations must be implemented when using these drugs in adults?

3. What are the most common adverse effects of drugs used to treat upper respiratory infections in older adults? What nursing considerations must be implemented when using these drugs in older adults?

Answer 1

1. Paediatric

(a) Penicillin

when using penicillin to treat pneumococcal infection, the most common side effect is the development of an allergic reaction.

other adverse reaction:

• skin rashes
• wheezing
• swelling in mouth or throat
• difficulty in swallowing

nursing considerations:

• drugs like amoxicillin, augmentin and penicillin-like antibiotics should be avoided if a child having a penicillin allergy.
• should warn about penicillin allergy in child file.
• long-term use causes superinfection
• use cautiously in neonates to avoid fatal toxicity(gasping syndrome)

(b) amoxicillin

indications: nose and throat infection.

adverse reaction:

• anaemia
• candidiasis
• rash

nursing consideration

• the child may exhibit behavioural changes
• should take in empty stomach
• in case of superinfection withhold medicine

(c) cefaclor(cephalosporins)

indications: pharyngitis and tonsillitis

adverse reactions:

• diarrhoea
• rash
• nausea
• jaundice

nursing consideration

• reduce dosage if creatinine clearance less than 10 mL/minute- may result in Central nervous system toxicity.
• may cause serious interaction with BCG live vaccine and typhoid vaccine

2. Adult

(a)

PENICILLIN

used to treat rheumatic fever and pneumococcal infection in adults

adverse reaction:

• diarrhoea
• oral candidiasis
• anaemia
• seizure
• hypersensitivity
• allergic reaction
• hemolytic anaemia
• neutropenia

nursing consideration

• should use cautiously in renal impaired patients -may increase the severity
• anaphylaxis reaction occurs in an asthmatic patient like urticaria
• should take in empty stomach
• high serum level of penicillin especially in a renal impaired patient may trigger seizures.

(b) AMOXICILLIN

indications: nose and throat infection

adverse reaction

• anaphylaxis
• anaemia
• headache
• rash
• vomiting
• diarrhoea
• tooth discolouration

nursing considerations

• to prevent dehydration due to diarrhoea begin fluid and electrolyte management
• high dose medicine results in false blood glucose test

(c) Older adults

CEFACLOR

indications: pharyngitis and tonsillitis

adverse reaction

• diarrhoea
• vaginitis
• neutropenia

nursing intervention

• monitor closely when using with warfarin
• check for hyperactivity
• monitor creatinine clearance rate
• long-term use results in bacterial or fungal overgrowth

3,

(a)

CEFACLOR

indications: pharyngitis and tonsillitis

adverse reaction:

• jaundice
• diarrhoea
• rash
• anaemia

nursing considerations

• monitor renal function closely when administering to older adults
• check for hypersensitivity
• repeated therapy causes superinfection