Pharmacology Lecture 3

Question 1

Adverse drug Response

Answer 1

only noxious, unintended, and undesired effects that occur at normal drug doses

Question 2

ADR Mild effects

Answer 2

drowsy, itching, nausea, rash

Question 3

ADR Severe effects

Answer 3

respiratory depression, organ injury, anaphylaxis, death

Question 4

ADR Considerations

Answer 4

What increases the risk? illnesses
What impact whom? nurse, pt
How to minimize harm? check and monitor

Question 5

Side effects def

Answer 5

nearly unavoidable secondary drug effect produced at therapeutic doses

Question 6

Toxicity def

Answer 6

any severe ADR, regardless of dose that caused it

Question 7

Allergic reaction def

Answer 7

immune response, the intensity determined by immune system not dosage

Question 8

Idiosyncratic effect def

Answer 8

uncommon drug response resulting from a genetic predisposition

Question 9

Paradoxical effect def

Answer 9

opposite of intended drug response

Question 10

Iatrogenic disease def

Answer 10

occurs as a result of medication care or treatment, including disease produced by drugs

Question 11

Physical dependence def

Answer 11

adapted to drug exposure in such a way that abstinence syndrome will develop if d/c

Question 12

Carcinogenic effect def

Answer 12

ability of certain meds and chemicals to cause concern

Question 13

Teratogenic def

Answer 13

drug induced birth effects

Question 14

Hepatotoxic drugs effect the

Answer 14

liver

Question 15

The liver is the primary site of

Answer 15

metabolism

Question 16

Drugs are the leading cause of

Answer 16

liver failure

Question 17

What increases the risk of liver injury?

Answer 17

combining hepatotoxic drugs

Question 18

Hepatotoxic drug example
(Hint: cholesterol)

Answer 18

Statine

Question 19

What type of drugs are toxic to the heart?

Answer 19

QT drugs

Question 20

QT drugs do what to the body

Answer 20

prolong QT intervals
cause life-threatening dysrhythmias

Question 21

What genders are at higher risk when taking QT drugs?

Answer 21

females

Question 22

Multiple QT drugs are not given _____________

Answer 22

concurrently

Question 23

Kidneys filter

Answer 23

metabolites out of the body
-cumulative exposure cause damage

Question 24

Ototoxic reactions cause
(reason need to catch early)

Answer 24

permanent damage

Question 25

How many approximate drugs are pneumotoxic

Answer 25

600 +

Question 26

How to identify ADR?

Answer 26

underlying diseases polypharmacy unknown

Question 27

Polypharmacy

Answer 27

simultaneous use of multiple drugs to treat a single ailment or condition

Question 28

What questions do you ask to know more about adverse drug reactions?

Answer 28

Symptoms appear shortly after 1st use? Did they go away after d/c? Reappear after reinstititution Illness explain event? Other drug regimen?

Question 29

How do you minimize ADRs?

Answer 29

**early id is key** knowing the major ADRs a drug produces monitor organ functions if toxic individual therapy pt teaching

Question 30

Black box warnings

Answer 30

strongest safety warning a drug can carry and still remain on the market -concise summary of ADR with warnings and precautions --most serious med warning required by FDA

Question 31

Considerations with Black Box Warnings

Answer 31

benefits outweigh the risks safer and equally effective alternative safer but less effective appropriate warning applicable to specific pt ameriorlate the potential of ADR

Question 32

Medication Error

Answer 32

any preventable event that may cause or lead to inappropriate meds used or pt harm -direct harm -indirect harm

Question 33

Med Error causes

Answer 33

**human factors** **communication mistakes** **name confusions** packaging, formulations, and delivery services labeling and references materials

Question 34

What medication error has a 90% fatality rate?

Answer 34

communication mistakes

Question 35

Body composition in relation to drug responses

Answer 35

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

Question 36

Infants has premature

Answer 36

organ systems

Question 37

Older adults have a decline in

Answer 37

organ functions (decline in liver/kidney functions and increase in level of drug in system)

Question 38

Individual Variation Factors in drug responses

Answer 38

tolerance comorbidities diet

Question 39

Tolerance

Answer 39

decrease in responsiveness to a drug as a result of repeated drug administration

Question 40

Comorbidities

Answer 40

taken to manage 1 condition may complicate management of another condition

Question 41

Diet in relation to ADRs

Answer 41

good diets elicit therapeutic responses and reduce harm from ADRs -some foods interact with drugs

Question 42

Kidney disease pathophysiology

Answer 42

due to accumulation of drug toxicity decrease rate of drug exertion

Question 43

Liver disease

Answer 43

drug accumulation of drug toxicity causes decrease rate of drug metabolism

Question 44

Failing to take drugs as prescribed bc of

Answer 44

Patient compliance (manual dexterity or visual activity) Intellectual capacity and psychologic state attitude and belief ability to pay any steps of med errors

Question 45

In drug med errors, Nurses are the

Answer 45

last line of defense

Question 46

Drug therapy in older adults factors

Answer 46

organ function comorbidities polypharmacy noncompliance

Question 47

Pharmacokinetics Changes Absorption

Answer 47

rate slows gastric acidity decreases

Question 48

Pharmacokinetics Changes Distribution

Answer 48

Plasma drug lvl reduced =increase in body fat Plasma drug lvl increased =decrease % lean body mass =decrease in total body water =decrease serum albumin concentration

Question 49

Pharmacokinetics Changes Metabolism

Answer 49

decrease with age - highly variable

Question 50

Pharmacokinetics Changes Excretion

Answer 50

reduce progressively in early adulthood

Question 51

What is the most important cause of ADRs in elderly

Answer 51

decrease progressively in excretion

Question 52

ADR is _____ times more common in the elderly.

Answer 52

7

Question 53

The elderly ADRs account for ____% of hospital admissions.

Answer 53

16

Question 54

The elderly ADRs account for ____% of all med-related deaths.

Answer 54

50 -mostly dose related -mostly avoidable -symptoms nonspecific

Question 55

Important Risk Factors in Elderly

Answer 55

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

Question 56

Goal Treatment

Answer 56

reduce symptoms improve quality of life

Question 57

Assessment of Risk factors

Answer 57

drug history compliance

Question 58

Monitoring of Risk factors

Answer 58

clinical responses plasma drug levels

Question 59

Teaching pts Risk factors of

Answer 59

how to take meds strategies for compliance

Question 60

Nurse advocates for the best medication administration for the pt

Answer 60

simpliest regimen possible easy to open containers large print cost

Question 61

Plasma drug lvl reduced =

Answer 61

increase in body fat

Question 62

Plasma drug lvl increased =

Answer 62

=decrease % lean body mass =decrease in total body water =decrease serum albumin concentration