week 3: Ch. 5-6 [adverse effects/errors] Flashcards
What is an adverse drug effect?
Any undesirable effects; could be harmful
Any type of drug/supplement can have an adverse effect
What are side effects?
Predictable
Can occur at a therapeutic drug dose
Less serious than adverse effects
Tolerable
Name ways to prevent adverse drug effects
– Obtain thorough medical history
– Assess patient & diagnostic data
– Prevent medication errors
– Monitor pharmacotherapy carefully
– Know all drugs taken by patient
– Be prepared for unusual drug effects
– Question unusual orders
– Teach clients about adverse effects
FDA’s Adverse Event Reporting System (FAERS)
Voluntary program that encourages providers & consumers to report adverse effects directly to ______________________________
If safety concern, FDA may:
– Conduct additional _______
– Require __________ to labeling information
– Require __________ warning
– Restrict use of drug in specific _____________
– Communicate safety information to providers,
consumers
– __________ product w/ quality/performance
concerns/ Remove from market
Voluntary program that encourages providers & consumers to report adverse effects directly to FDA or manufacturer
- If safety concern, FDA may:
– Conduct additional studies
– Require changes to labeling information
– Require black box warning
– Restrict use of drug in specific populations
– Communicate safety information to providers,
consumers
– Recall product w/ quality/performance
concerns/ Remove from market
All drug allergies are caused by:
hyper response in the immune system
Name the drug classes most likely to cause allergic reactions
– Penicillin and related antibiotics
– Radiologic contrast media with iodine
– Insulin
– NSAIDs
– Sulfonamides
– Cancer chemotherapy agents
– Preservatives
– Certain antiseizure drugs
Idiosyncratic reactions
– Unusual or unexpected responses
– Unrelated to pharmacological action of drug
– Rare
– Unpredictable
– Vary in individual clients
Risk-benefit ratio: a drug has benefits that outweigh:
long-term risk
Carcinogenic drugs
& examples
– Damage______, leading to mutation
– Effects may not be seen for ______
▪Anti______________
▪Immuno__________
▪__________ and hormone antagonists
– Damage DNA, leading to mutation
– Effects may not be seen for years
▪Antineoplastics
▪Immunosuppressants
▪Hormone and hormone antagonists
Teratogens
– Drugs with potential to cause birth defects
– Only used in pregnancy when benefit clearly outweighs risk
– Drugs not tested in pregnant women
– Drug should be identified as safe for use in pregnancy.
Bone marrow toxicity
Serious/ ____________________
Bone marrow important for ______________________________; pancytopenia/aplastic anemia can occur with B.M.T
If recognized, can be reversed
Commonly associated with ________________ drugs
Serious/ life-threatening
Bone marrow important for WBC, RBC, platelets; pancytopenia/aplastic anemia can occur with B.M.T
If recognized, can be reversed
Commonly associated with antineoplastic drugs
Cardiotoxicity
– Common class is _________________________
▪____________________medications
– Prolongation of ___________________________ on ECG
▪Torsade de pointes
>Rare type of ventricular tachycardia that can cause sudden cardiac death
– Common class is anthracyclines
▪Antineoplastic medications
– Prolongation of QT interval on ECG
▪Torsade de pointes
>Rare type of ventricular tachycardia that can cause sudden cardiac death
Dermatologic toxicity
– ________ reactions are common adverse effects.
– Rash with ________________ (itching) common
– Urticaria (hives) may lead to _______________________
– Angioedema & SJS may be fatal.
– _____________________ [skin absorbs extra UV light]
– Skin reactions are common adverse effects.
– Rash with pruritis (itching) common
– Urticaria (hives) may lead to anaphylaxis.
– Angioedema & SJS may be fatal.
– Phototoxicity [skin absorbs extra UV light]
Hepatotoxicity
– _________ detoxifies majority of drugs.
– Hepatotoxicity common adverse effect
– Monitor liver ____________ w/ hepatotoxic drugs
– Signs of liver impairment can be vague.
– Severe liver impairment can cause __________ drug levels.
– Liver detoxifies majority of drugs.
– Hepatotoxicity common adverse effect
– Monitor liver enzymes w/ hepatotoxic drugs
– Signs of liver impairment can be vague.
– Severe liver impairment can cause toxic drug levels.
Nephrotoxicity
– Majority of drugs _________ in kidneys.
– _____________________ exposed to high drug concentrat.
– Recognize signs of risk in client
▪De___________
▪______________ lab values
▪History of renal ____________
– Majority of drugs excreted in kidneys.
– Renal tubules exposed to high drug concentrat.
– Recognize signs of risk in client
▪Dehydration
▪Abnormal lab values
▪History of renal impairment
