14 - Adverse drug reactions Flashcards
Patents at higher risk of ADR
younger children - need more tailored dose
Order adults - multiple comorbidities, multiple drugs used
Polypharmacy
Women - lower body weight and ordean size, more fat
Race and genetic polymorphism
How to prevent ADRs
Doctor based strategies
-be careful around high risk drugs
-Stop unnecesary drugs
-if any new symptoms - consider new drug
-avoid treating side effects with more durgs
-Verification - review patietns medications use
Clarificafiton - ensure the medicaitons and doses are approapirate
Reconciliaiton - identify any discrepancies between medication ordered for patients and those on the list
Systematic based strategies
- computerised order entry
- electronic medicaiton record
- smart pumps
Educational programs
Accute allergy list
How to tell if ADR
- always consider possibikity that a drug may be associated with worsening of a patiens condiiton or with a new medical problem
- investigate weather the particular dug is known to cause such a reaction
- rule out alternative explainations
- establish a temproal link between onset of reaction and drug administration
Basically
- know medications
- knowing what causes likely reactions
- look up if uncertain
What to do when you suspect ADR
Withdraw trigger medicaiton
record suspected ADR in the drug chart
Inform the patient, care giver and family doctor
Complete a CARM adverse drug reaction form
How to avoid ADRs
- Do not give drug unless indicated
- Whenever possible use a familiar drug, look out for possible adverse reactions when prescribing new medication
- give clear instructions
- see if patient taking any herbal medicines
- age, renal and hepatic disease may alter drug metabolism, so that smaller doses are required
Definition of adverse drug reaction
a response to a drug which is noxious and unintended, and which occurs at doses normally used in man for prophylaxis, diagnosis or therapy of disease.
