McKenna's Drug Handbook for Nursing & Midwifery, 7e

1312      Miscellaneous drug categories

Beta blockers: Atypical anaphylaxis. Monitor closely. Neuroleptics and phenothiazine derivative antidepressants: Reduce seizure threshold. Should be discontinued 48 hours prior to and not resumed for 24 hours following procedure. Pethidine: Potential spasms of sphincter of Oddi. Monitor closely. Contraindications Contraindicated in individuals with known hypersensitivity to the preparation or a history of serious hypersensitivity to iodine-containing contrast media; in those with severe cardiovascular insufficiency, thyrotoxicosis, anuria, severe functional disorder of liver or kidneys or monoclonal IgM gammopathy; in children under 14 years old; and in women who are pregnant. care considerations • Closelymonitor individualfordevelopment of anaphylactic reaction. Ensure emergency management equipment is available and in correct working order. • Monitor vital signs and renal function closely following procedure. • Ensure the person is well-hydrated before and after the procedure to avoid contrast- • Ensure safety if the person is light-headed. • Thyroid function testsmay be reduced for up to several weeks. Patient teaching • Advise person to report any adverse effects. • Advise person to take care when standing up or getting out of bed due to potential dizziness. • Caution person that delayed effects may impact on safety when driving or operating machinery. induced nephropathy. • Assess mental status.

metyrapone Metopirone

Pregnancy risk category B2 Use in sport: Permitted Available form Capsules: 250 mg Indications & dosages

➤ Diagnosis of latent ACTH deficiency, assessment of degree of ACTH suppression duringorafterglucocorticoidtherapy,differential diagnosis of adrenocortical hyperfunction in Cushing’ssyndrome— Single-dose test: Adults and children: 30 mg/kg (maximum dose 3 g) PO with yoghurt or milk around midnight prior to test.The blood sample for the assay is taken early the followingmorning (7.30–8.00 am). Multiple-dose test: Adults: 500–750 mg PO q 4 hours for six doses to maximum 3–4.5 g. Children: 15 mg/kg (minimum dose 250 mg) PO q 4 hours for six doses. Urinary steroid levels are measured for 24 hours before and within 24 hours following the test. Action Reverses biosynthesis of cortisol, cortico­ sterone and aldosterone in adrenal cortex. Route Onset Peak Duration PO 2 hrs 24 hrs 24 hrs Adverse reactions CNS: dizziness,headache, light-headedness, sedation. CV: hypertension. Endocrine: adrenal insufficiency. GI: abdominal pain, nausea, vomiting. Haematological: bone marrow failure . Skin: allergic reaction, alopecia, hirsutism, rash.

Reactions may be common , uncommon, life-threatening , or commonandlife-threatening.