Adverse Drug Reactions and Medications

Question 1

Issues related to drug safety

Answer 1

1. Adverse drug reactions (Different from ADEs)
2. Medication Errors

Question 2

Adverse Drug Events

Answer 2

1. harm associated with any dose of a drug

Question 3

Who definition of an ADE

Answer 3

Any unwanted medical occurrence that may present during treatment with a pharmaceutical product, that doesn’t have a casual relationship with the treatment

Question 4

Adverse Drug Reaction

Answer 4

1. can range from annoying to life threatening
2. equated to adverse (side) effects
3. excludes excessive drug doses

Question 5

WHO definition of ADR

Answer 5

1. Any noxious, unintended, or undesired effect occurring with a NORMAL drug dose
2. Subset of ADE

Question 6

Types of ADR

Answer 6

1. toxicity
2. allergic reactions
3. idiosyncratic effect
4. Paradoxical effect
5. Iatrogenic disease
6. Physical dependance
7. Carcinogenic effect
8. Teratogenic effect

Question 7

Medication Errors

Answer 7

Preventable event that may cause or lead to inappropriate medication or Pt. harm

Question 8

Effects of medication errors range from

Answer 8

1. Significant disability
2. Death

Question 9

Why are hospital Medication errors high

Answer 9

each medication order is processed by several people before reaching the pt.
-nurse is the last line of defense for medication errors

Question 10

Types of medication errors

Answer 10

1. Direct dose is too high
2. Direct dose is too low
3. Missed dose
4. Fatal errors

Question 11

What are the fatal medication errors

Answer 11

1. Over dose
2. Wrong drug
3. Wrong route

Question 12

High alert medications

Answer 12

1.Cardiovascular (Androgenic agonists and antagonists)
2. Chemotherapy drugs
3. Hemostasis drugs (warfarin, heparin)
4. Insulins
5. Anesthetics
6. Neuromuscular blocking agents

Question 13

Preventing Medication errors

Answer 13

1. minimize verbal or phone orders
2. List indications
3. Be aware of dangerous abbreviations and symbols
4. Never assume if not specified
5. Don’t try to decipher illegible hand writing
6. No trailing zeros
7. Always leading zeros
8. 7 with a line
9. check med order and 10 rights
10. Learn special admin techniques

Question 14

10 Medication rights

Answer 14

1. Right pt.
2. Right drug
3. right time
4. right route
5. right dose
6. right documentation
7. right reason
8. right pt. education
9. right to refuse
10. right evaluation

Question 15

AHS: Independent Double Check

Answer 15

1. for all med admin
2. use 2 professionals
3. independently check all aspects of drug admin

Question 16

Tips to prevent medication errors

Question 17

Psychosocial factors contributing to drug errors

Answer 17

disruptive behavior among nurses and physicians

Question 18

Reporting and responding to errors

Answer 18

Shared professional responsibility
-follow facility reporting systems
-encourage reporting near misses
-complete documentation

Question 19

Error documentation

Answer 19

-medication error reporting form
-Canadian medication incident reporting + prevention system
-notify pt. of error

Question 20

Medication Reconciliation

Answer 20

update and communicate pt. list of meds at various intervals through health care process

Question 21

Medication reconciliation steps

Answer 21

-Verification
-Clarification
-Reconciliation

Question 22

Verification

Answer 22

(complete hx)

Question 23

Clarification

Answer 23

(professional review of information)

Question 24

Reconciliation

Answer 24

(further investigation into discrepancies and documentation of communication and changes in med orders)