The nurse is caring for a patient who has been getting morphine sulfate regularly every 4 hours for the last 2 weeks.The patient has a history of renal failure and liver disease.While on rounds,the nurse finds the patient is lethargic with a respiratory rate of 6 breaths per minute.The nurse expects that the physician will order naloxone (Narcan)to counter the ______________ of the morphine.

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Toxic effects develop after prolonged intake of a medication,when a medication accumulates in the blood as the result of decreased clearance by the liver and/or kidneys (because of impaired metabolism or excretion),or when too high a dose is given.Respiratory depression is a known effect of opioid toxicity.
In an idiosyncratic reaction,a patient overreacts or underreacts to a medication or has a reaction different from normal.This type of reaction is unpredictable. Allergic reactions are unpredictable responses to a medication.Exposure to an initial dose of a medication causes a patient to become sensitized immunologically.The medication acts as an antigen,which causes antibodies to be produced.Side effects are predictable and often unavoidable secondary effects produced at a usual therapeutic drug dose.For example,some antihypertensive medications cause impotence in male patients.The difference between a side effect and a toxic effect is the amount of medication in the bloodstream.

The Nurse Is Caring for a Patient Who Has Been