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im1 > Pharm Quiz 3 > Flashcards

Pharm Quiz 3 Flashcards

1
Q

What are adverse drug reactions?

A

any noxious, unintended, undesired effect that occurs @ normal drug doses

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2
Q

What are mild ADR effects?

A

drowsiness
itching
nausea
rash

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3
Q

what are severe ADR effects

A

respiratory depression
organ injury
anaphylaxis
death

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4
Q

what are ADR considerations?

A

What increases risks
what is the impact - for whom
how can harm be minimized

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5
Q

What is a side effect?

A

a nearly unavoidable secondary drug effect produced @ therapeutic doses

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6
Q

What is toxicity?

A

any sever ADR, regardless of the dose that caused it

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7
Q

What is an allergic reaction

A

immune response, the intensity of which is determined by immune system, not dosage

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8
Q

What is idiosyncratic effect?

A

uncommon response resulting from a genetic predisposition

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9
Q

What is paradoxical effect

A

the opposite pf the intended drug response

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10
Q

What is iatrogenic disease

A

occurs as the result of medical care or treatment, including disease produced by drugs

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11
Q

What is physical dependence?

A

body has adapted to drug exposure in such a way that abstinence syndrome will develop if discontinued

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12
Q

What is carcinogenic effect?

A

the ability of certain meds & chemicals to cause cancers

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13
Q

What is teratogenic effect?

A

drug-induced birth deffect

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14
Q

Hepatotoxic Drugs: What are the components

A

liver is primary site of metabolism
drugs are leading cause of liver failure
over 50 commonly given drugs are hepatotoxic
some drug metabolites are hepatotoxic
combining hepatotoxic drugs increases risk of liver injury

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15
Q

What is DILIY

A

drug induced liver injury

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16
Q

What are QT drugs?

A

prolong the QT interval

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17
Q

What life-threatening thing can a QT drug cause?

A

dysrhythmias

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18
Q

Are QT drugs found in several classes

A

yes

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19
Q

Who is at a higher risk under QT meds

A

females

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20
Q

QT drugs: What should not be given cocurrently

A

multiple QT drugs

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21
Q

What do the kidneys do?

A

filter metabolites out of body

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22
Q

What can cumulative exposure do to the kidneys?

A

can cause damage to the kidneys

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23
Q

What reaction can cause permanent damage to the ears?

A

ototoxic

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24
Q

What does this damage in the ears

A

can cause hearing loss so it’s very important to catch early

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25
Q

How many drugs are pneumotoxic to the lungs?

A

over 600

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26
Q

How do we look for adverse drug reactions?

A

underlying illness
polypharmacy
unknown

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27
Q

What questions should we ask when we notice an adverse effect?

A

Did symps appear shortly after the drug was first used?
Did symps abate when the drug was discontinued?
Did symps reappear when the drug was reinstituted?
Is the illness itself sufficient to explain the event?
Are other drugs in the regimen sufficient to explain the event?

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28
Q

What are ways to minimize ADRs?

A

Early id is key
Know major ADRs that a drug can produce
Monitoring of organ function if toxic drugs are being given
Individualizing therapy
Pt teaching

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29
Q

What are black box warnings?

A

strongest safety warning a drug can carry & still remain on the market

29
Q

What are black box warnings?

A

strongest safety warning a drug can carry & still remain on the market

30
Q

What info do black box warnings contain?

A

concise summary of the adverse effects of concern - (warnings & precautions)

31
Q

Which med warning is the most serious by the FDA?

A

Black box warning

32
Q

What should we consider before giving a black box med to a pt?

A

does the potential benefit of treatment outweigh the risk?
are there safer (& equally effective) alternatives?
would a safer but less effective alternative be appropriate?
is the boxed warning applicable to this specific pt?
can action be taken to ameliorate the potential for an adverse reaction?

33
Q

What is the definition of medication errors?

A

any preventable event that may cause or lead to inappropriate medication use or pt harm while the medication is in the control of the healthcare professional, pt, or consumer”

34
Q

How many types of med error are there?

A

13 types

35
Q

What factors cause med errors?

A

human factors
communication mistakes = 90% of fatal errors
Name confusion
Packaging, formulations, & delivery services
Labeling & reference material

36
Q

What are the factors affecting individual response?

A

Body composition
Age
Pathophysiology
Tolerance
Comorbidities & drug interactions
Diet

37
Q

How does body composition affect individual response?

A

If the same dose of a drug is given to a big person & a small person, the drug concentration will be higher in the smaller person

38
Q

Why does age affect individual response (infants)?

A

immature organ systmes

39
Q

Why does age effect individual response (older adults)?

A

decline in organ function

40
Q

How does pathophysiology affect the individual response? (kidney disease)

A

reduces rate of drug excretion - drugs may accumulate to toxic levels

41
Q

How does pathophysiology affect the individual response (liver disease)?

A

Reduces rate of drug metabolism - drugs may accumulate to toxic levels

42
Q

If there are more drugs in the system what happens to the liver & kidneys

A

decline in function of liver & kidneys

43
Q

How does tolerance affect individual response?

A

decreased responsiveness to a drug as a result of repeated drug admin

44
Q

How do comorbidites & drug interactions affect individual response?

A

drugs taken to manage one condition may complicate management of another condtion

45
Q

How does diet affect individual response?

A

good diet can elicit therapeutic responses & reduce harm from ADRs
some foods can interact w/ drugs & cause ADRs

46
Q

What can cause failures in taking drugs?

A

Pt compliance
Medication errors

47
Q

How does pt compliance affect the pt taking drugs?

A

manual dexterity & visual acuity
intellectual capacity & psychological state
attitude & belief toward drugs
Can happen at any step in the process

48
Q

Who is the last line of defense for med errors

A

nurse

49
Q

What are geriatric concerns when given meds?

A

organ function
comorbities
polypharmacy
noncompliance

50
Q

What are Pharmacokinetic Changes: ADME (Elderly)?

A

Absorption
Distribution
Metabolism
Excretion

50
Q

What are Pharmacokinetic Changes: ADME (Elderly)?

A

Absorption
Distribution
Metabolism
Excretion

51
Q

What changes absorption in the elderly?

A

rate of absorption slows
gastric acidity declines

52
Q

What changes in distribution occurs in the elderly?

A

increased body fat % - plasma drug levels reduced
decreased % lean body mass - plasma drug levels increased
decreased total body water - plasma drug levels increased
Decreased serum albumin concentration - plasma drug levels increased

53
Q

What changes in metabolism occur in the elderly?

A

tends to decline w/ age
which is highly variable

54
Q

What changes in excretion occur in the elderly?

A

begins to decline progressively in early adulthood
the most important cause of ADRs in older adults

55
Q

ADRs are how many times more likely in older adults?

A

7 times

56
Q

ADRs account for what percentage of hospital admissions in older adults?

A

16% of hospital admissions

57
Q

ADRs account for how many percentage of deaths related to medication?

A

50%

58
Q

What are mostly dose related?

A

ADRs

58
Q

What are mostly dose related?

A

ADRs

59
Q

What are mostly dose related?

A

ADRs

60
Q

Are symptoms specific or nonspecific for ADRs in the elderly?

A

they are mostly dose related

60
Q

Are symptoms specific or nonspecific for ADRs in the elderly?

A

nonspecific

61
Q

Are older adults likely to share alcohol or recreational drug use?

A

not very likely

62
Q

Are ADRs mostly avoidable

A

yes

63
Q

What are the important risk factors we should know for the elderly?

A

reduced renal function - drug accumulation
polypharmacy
greater severity of illness
low therapeutic index of drugs
increase individual variation
inadequate supervision of long-term therapy
poor adherence

64
Q

What are the goals of treatment?

A

reduce symps
improve QOL

65
Q

What should we determine when assessing pt’s?

A

drug history
compliance

66
Q

What should we be looking for when we monitor a pt we have given meds to?

A

clinical responses
plasma of drug levels

67
Q

What should we teach when giving a pt meds?

A

how to take meds
Strats for complience

68
Q

How should we advocate for our pt when they are taking meds?

A

simpilest regimen possible
Easy to open containers
large print
cost

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