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Module 1 > pharm 3 > Flashcards

pharm 3 Flashcards

1
Q

adverse drug reaction (ADR)

A

-any noxious, unintended, undesired effect that occurs at normal drug doses
-pretty unpredictable

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2
Q

mild ADR effects (4)

A

-drowsiness
-rash
-itching
-nausea

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3
Q

severe ADR effects (4)

A

-respiratory depression
-organ injury
-anaphylaxis
-death

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4
Q

ADR considerations (questions - 3)

A

-what increases the risk?
-what is the impact - for whom?
-how can harm be minimized?

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5
Q

side effect

A

a nearly unavoidable secondary drug effect produced at therapeutic doses

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6
Q

toxicity

A

any severe ADR, regardless of the dose that caused it

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7
Q

allergic reaction

A

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

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8
Q

idiosyncratic effect

A

uncommon drug response resulting from a genetic predisposition
-effect we were not expecting

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9
Q

paradoxical effect

A

the opposite of the intended drug response

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10
Q

iatrogenic disease

A

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

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11
Q

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

carcinogenic effect

A

the ability of certain medications and chemicals to cause cancers

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13
Q

teratogenic effect

A

drug-induced birth defect

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14
Q

organs that can be effected by drugs

A

-liver
-kidneys
-heart
-lungs
-inner ears

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15
Q

organs that can be effected by drugs

A

-liver
-kidneys
-heart
-lungs
-inner ears

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16
Q

liver is the primary site of _______

A

metabolism

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17
Q

_________ are leading cause of liver failure

A

drugs

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18
Q

over 50 commonly given drugs are __________

A

hepatotoxic

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19
Q

some drug metabolites are __________

A

hepatotoxic

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20
Q

giving 1+ hepatotoxic drugs ___________ risk of liver injury

A

increases

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20
Q

giving 1+ hepatotoxic drugs ___________ risk of liver injury

A

increases

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21
Q

DILI

A

drug induced liver injury

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22
Q

prolonged QT

A

some drugs cause space from Q to T to spread out

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23
Q

QT drugs can cause life-threatening ______________

A

dysrhythmias

24
Q

QT drugs are found in ________ drug classes

A

several

25
Q

___________ are at higher risk

A

females

26
Q

multiple QT drugs should/should not be given concurrently

A

should NOT

27
Q

kidney function

A

filtration

28
Q

(kidneys) cumulative exposure can cause _______

A

damage

29
Q

__________ reactions cause permanent damage

A

ototoxic

30
Q

(ears) very important to catch it _______

A

early !!!!!

31
Q

medication that is ototoxic to inner ears

A

furosemide (lasix)

32
Q

pneuomotoxic
how many drugs are pneumotoxic?

A

drugs toxic to lungs
600+

33
Q

poly pharmacy

A

pt taking lots of drugs

34
Q

questions to ask? (5)

A

-did symptoms appears shortly after the drug was first used?
-did symptoms abate when drug was discontinued?
-did symptoms reappear when drug was reinstituted?
-is the illness itself sufficient enough to explain the event?
-are the other drugs in the regimen sufficient enough to explain the event?

35
Q

minimizing ADRs (5)

A

-early identification
-know major ADRs a drug can produce
-monitoring organ function if toxic drugs being given
-individualizing therapy
-pt teaching

36
Q

black box warnings are described as __________ (3)

A

-the strongest safety warning a drug can carry and still remain on the market
-concise summary of the adverse effects of concern
-the most serious medication warning required by FDA

37
Q

considerations when faced with a BBW (5)

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 pt?
-can action be taken to ameliorate the potential for an adverse reaction?

38
Q

medication errors

A

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

39
Q

______ major types of medication errors

A

13

40
Q

causes of medication errors (3)

A

-human factors
-communication mistakes
-name confusion

41
Q

communication mistakes are ____ % of fatal errors

A

90

42
Q

name confusion factors (4)

A

-packaging
-formulations
-delivery services
-labeling and reference materials

43
Q

factors affecting individual response
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

44
Q

factors affecting individual response
age (why?)

A

-infants - immature organ systems
-older adults - decline in organ function

45
Q

factors affecting individual response
pathophysiology
kidney disease

A

reduced rate of drugs EXCRETION - drugs may accumulate to toxic levels (increase, drugs stay in body longer)

46
Q

factors affecting individual response
pathophysiology
liver disease

A

reduces rate of drug METABOLISM - drugs may accumulate to toxic levels (increase, drugs stay in body longer)

47
Q

factors affecting individual response
tolerance

A

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

48
Q

factors affecting individual response
comorbidities and drug interactions

A

drugs taken to manage on condition may complicate management of another conditions
-pt has many issues

49
Q

factors affecting individual response
diet

A

-good diet can elicit therapeutic responses and reduce harm from ADRs
-some foods can interact with drugs and cause ADRs

50
Q

factors affecting individual response
failure to take as prescribed
patient compliance (4)

A

-manual dexterity
-intellectual capacity and physiologic state
-attitude and belief towards drugs
-ability to pay

51
Q

factors affecting individual response
failure to take as prescribed
medication errors

A

-can happen at any step in process
-nurses are last line of defense

52
Q

geriatric concerns (4)

A

-organ function
-comorbidities
-polypharmacy
-noncompliance

53
Q

pharmacokinetic changes : ADME (elderly)
absorption

A

-slows
-gastic acidity decreases

54
Q

pharmacokinetic changes : ADME (elderly)
distribution (4)

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

55
Q

pharmacokinetic changes : ADME (elderly)
metabolism

A

-declines with age
-highly variable

56
Q

pharmacokinetic changes : ADME (elderly)
excretion

A

-decline progressively in early adulthood
-MOST IMPORTANT cause of older adults

57
Q

ADR is ___x more common in older adults

A

7

58
Q

goal of treatment

A

reduce symptoms, improve quality of life

Module 1 (13 decks)

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