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Pharmacology > Adverse Drug Rections Quiz 3 > Flashcards

Adverse Drug Rections Quiz 3 Flashcards

1
Q

Mild ADR effects

A

Drowsiness
Itchiness
Nausea
Rash

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2
Q

Severe ADR effects

A

Respiratory depression ( trouble breathing )
Organ injury ( mainly kidney and liver )
Anaphylaxis ( severe allergic reaction )
Death

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3
Q

What increases the risk of ADR (adverse drug reactions)

A

ppl that are very young and very old

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4
Q

What is the impact - for whom is the impact?

A

everyone is impacted

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5
Q

Side effect definition

A

nearly unavoidable secondary drug effect produced at the therapeutic doses

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6
Q

Toxicity means

A

any severe ADR, regardless of the dose that caused it

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7
Q

Allergic reaction means

A

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

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8
Q

Idiosyncratic effect means

A

effect thats not expected

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9
Q

Paradoxical effect means

A

the opposite of the intended drug response

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10
Q

Iatrogenic Disease is caused by

A

the result of medical care or treatment ( surgery ), including disease produced by drugs

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11
Q

Physical dependence means

A

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

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12
Q

Teratogenic Effect means

A

drug induced birth defect

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13
Q

Carcinogenic Effect means

A

the ability of certain medications and chemicals to cause cancers

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14
Q

What organs are usually affected by organ toxicity?

A

liver
kidneys
heart
lungs
inner ears

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15
Q

Hepatotoxic Drugs (Liver)

A

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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16
Q

what does DILI mean

A

drug induced liver injury

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17
Q

Atorvin statin is used for _______ and can cause ______

A

high cholesterol
liver failure

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18
Q

QT Drugs ( the ekg heart thing )

A

used for prolong QT interval
can cause life threatening dysrhythmias
QT drugs found in several drug classes
females are higher risk
multiple QT drugs shouldn’t be given concurrently ( at the same time )

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19
Q

QT intervals

A

some medications are not appropriate for patients with prolonged QT interval

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20
Q

Nephrotoxic ( Kidneys )

A

toxicity in the kidneys
filter metabolites out of body
cumulative ( add it all together ) exposure can cause damage

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21
Q

Ototoxic ( Ears )

A

ototoxic reactions cause permanent damage
very important to catch it early

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22
Q

common drug for ototoxic

A

furosemined ( Lasix ) - can cause deafness

23
Q

Hepatoxic ( Lungs )

A

over 600 drugs are pneumotoxic

24
Q

Identifying Problem that could cause Adverse Drug Reactions

A

Underlying illness
Polypharmacy ( pt takes many drugs, immunocomprimised )
Unknown

25
Q

Questions to Ask

A

Did symptoms appear shortly after the drug was first used?

Did symptoms abate ( go away ) when the drug was discontinued?

Did symptoms reappear when the drug was reinstituted?

Is the illness itself sufficient to explain the event? ( how to check - labs )

Are other drugs in the regimen sufficient to explain the event?

26
Q

Which are ways to minimize ADR’s

  • early identification
  • know major ADRs that a drug can produce
  • monitoring organ function if toxic drugs are given
  • individualized therapy
  • patient teaching
A

early identification
know major ADRs that a drug can produce
monitoring organ function if toxic drugs are given
individualized therapy
patient teaching

27
Q

What are black box warnings

A

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

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

the most serious medication warning required by the FDA
( PAY VERY CLOSE ATTENTION )

28
Q

Which are considerations when faced with a BBW?

  • Does the potential benefit of treatment outweigh the risk?
  • Are there safer ( and equally effective ) alternatives?
  • Would a safer but less effective alternative be appropriate?
  • Is the boxed warning applicable to this specific patient?
  • Can action be taken to AMELIORATE the potential for adverse reaction?
A

Does the potential benefit of treatment outweigh the risk?

Are there safer ( and equally effective ) alternatives?

Would a safer but less effective alternative be appropriate?

Is the boxed warning applicable to this specific patient?

Can action be taken to AMELIORATE ( help make it better ) the potential for adverse reaction?

29
Q

Medication Errors mean

A

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

patients can make a medication error too

30
Q

Which are causes of medication errors?

A. Human factors
B. Communication mistakes
C. Name confusion
D. Packaging, formulations, and delivery services
E. Labeling and reference materials
G. All of the above

A

Human factors
Communication mistakes = 90% of fatal errors
Name confusion
Packaging, formulations, and delivery services
Labeling and reference materials

31
Q

Which are factors affecting individual responses to drugs?

  • body composition
  • Age
  • Infants
  • Pathophysiology
  • Tolerance
  • Comorbidities
  • Diet
  • Patient Compliance
  • Medication Errors
A

Body compositions
Age
Pathophysiology
Tolerance
Comorbidities
Diet
Patient Compliance
Medication Errors

32
Q

What is body composition?

A

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

33
Q

Which age demographic affect individual response?

A

Infants
- immature organ systems

Older Adults
- decline in organ function

34
Q

What pathophysiology factors affecting individual response to drugs?

A

Kidney Disease
- reduces rate of drug EXCRETION ( drugs may accumulate to toxic levels )

Liver Disease
- reduces rate of drug METABOLISM ( drugs may accumulate to toxic levels )

35
Q

Decline in liver or kidney function = Increase of level of drug in system

T/F

A

TRUE

36
Q

How does Tolerance affect individual response?

A

Decreased responsiveness to a drug as a result of repeated drug administration

37
Q

How does Comorbidities and Drug Interactions affect individual response to drugs?

A

Drugs taken to manage one condition may complicate management of another condition ( other things going on )

38
Q

How does Diet affect individual response?

A

Good diet can elicit therapeutic responses and reduce harm ADRs
Some food can interact with drugs and cause ADRs

39
Q

How does Patient Compliance affect individual response?

A

Manual dexterity & visual acuity
Intellectual capacity & psychologic stage
Attitude and belief toward drugs
Ability to pay

40
Q

How does Medication Errors affect individual response?

A

Can happen at any step in the process

NURSES ARE THE LAST LINE OF DEFENSE

40
Q

Drug therapy concerns for geriatrics??

A

Organ function
Comorbidities
Polypharmacy
Noncompliance

(the older the person the more meds)

40
Q

Pharmacokinetic changes: Absorption ( Elderly )

A

rate of absorption slows
( slows down a whole lot )

gastric acidity declines

40
Q

Pharmacokinetic changes: Distribution ( 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 )

40
Q

Pharmacokinetic Changes: Metabolism ( Elderly )

A

tends to decline with age

Highly variable

40
Q

Pharmacokinetic Changes: Excretion ( Elderly )

A

Begins to decline progressively in early adulthood

MOST IMPORTANT CAUSE OF ADRs IN OLDER ADULTS

HIGH LEVELS OF DRUGS IN SYSTEM

40
Q

ADRs 7 times more common in older adults

T/F

A

TRUE

40
Q

ADR in elderly

  • account for 16% of hospital admissions of older adults
  • 50% of all medication-relate deaths

T/F

A

TRUE

40
Q

ADR in elderly

  • mostly dose related
  • symptoms tend to be nonspecific
  • older adults less likely to share alcohol or recreational drug use ( shame )
  • ADRs are mostly avoidable

T/F

A

TRUE

40
Q

Important Risk Factors ( Elderly ) Include

  • Reduced renal function: drug accumulation
  • Polypharmacy
  • Greater severity of illness
  • Low therapeutic index drugs
  • Increased individual variation
  • Inadequate supervision of long-term therapy
  • Poor adherence
  • Metabolism of drug
A

Reduced renal function: drug accumulation
Polypharmacy
Greater severity of illness
Low therapeutic index drugs
Increased individual variation
Inadequate supervision of long-term therapy
Poor adherence

40
Q

The goal of treatment is to reduce the symptoms and improve quality of life

T/F

A

TRUE

40
Q

Assessment pt consists of what

A

Drug history
Compliance

40
Q

Monitoring pt consists of what

A

Clinical responses
Plasma drug levels

40
Q

Patient education consists of what

A

How to take medications
Stratagies for compliance
Simplest regimen possible

40
Q

Patient advocacy consists of what

A

Easy to open containers
Large print
Cost

Pharmacology (7 decks)

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