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Pharmacology > Adverse Effects > Flashcards

Adverse Effects Flashcards

1
Q

Side Effect

A

Unavoidable secondary drug effect produced at therapeutic doses.

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2
Q

Toxicity

A

Adverse drug reaction caused by excessive dosing

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3
Q

Drug overdose

A

Toxic reaction to excess dose or impaired excretion.

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4
Q

Idiosyncratic Effect

A

Uncommon drug response resulting from a genetic predisposition.

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5
Q

Iatrogenic Disease

A

A disease produced by a provider or drug

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6
Q

Physical Dependence

A

The body has adopted to prolong drug exposure, lead to abstinence syndrome if drug is discontinued. The body is dependent on the drug.

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7
Q

Carcinogenic effect

A

medication or environmental chemicals that can cause cancer.

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8
Q

Teratogenic Effect

A

A drug-induced birth defect

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9
Q

Drug Interaction

A

A drug-drug interaction. How a drug affect the effectiveness or toxicity of another drug. Heroin and narcan

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10
Q

Drug Intolerance

A

Low threshold to the normal pharmacological action of a drug. A low dose of the drug has a big pharmacological effect.

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11
Q

Drug Allergy

A

Immunological mediated reaction to a medication when exposed.

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12
Q

Pseudo Allergic Reaction

A

clinical manifestation similar to an allergic reaction due a histamine release but lack immunological response.
For example Morphine: Giving morphine too quickly via IV can result in hives. Giving IV morphine slowly does not have this reaction.

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13
Q

What are the two types of adverse drug reactions?

A
  • Type A pharmacologic
    -Type B Idiosyncratic
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14
Q

Define and provide an example for pharmacologic adverse drug reaction.

A

An expected primary or secondary pharmacological response. dose dependent.
Example: Primary: blood pressure. Give med to lower BP but BP gets too low.
Secondary: BP drug make you nauseous.

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15
Q

Define and provide an example for Idiosyncratic adverse drug.

A

Unexpected pharmacological response not related to the primary effect of drug. Not dose dependent. Low dose or high dose produce response.
Example: An allergic reaction to penicillin

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16
Q

What are the four types of drug induced blood disorders?

A

1) Hemolytic Anemia
2) Thrombocytopenia
3) Neutropenia
4) Aplastic Anemia

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17
Q

T/F Hemolytic anemia is the increased destruction of red blood cells.

A

T
It can occur inside and outside (organs) the vasculature.
Caused by toxic effect or inherited abnormality or induced immune response.

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18
Q

How is glucose 6 phosphate dehydrogenase deficiency (G-6PD) related to hemoltyic anemia?

A

G-6PD: Enzyme provides reinforcement to the walls of red blood cells against oxidant agents.
glucose 6 phosphate dehydrogenase deficiency: weaken the walls of red blood cells resulting in hemolysis when exposed to oxidant drugs.

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19
Q

T/F glucose 6 phosphate dehydrogenase deficiency is sex-linked in mother to daughter transmission.

A

False: It is sex-linked to mother to son transmission.

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20
Q

What is drug induced thrombocytopenia?

A

Drugs that reduce platelet count below 100,000-150,000/mm3

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21
Q

What range of platelet counts indicate thrombocytopenia?

A

<100,000 - 150-000 mm3

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22
Q

What are mechanisms that contribute to drug induced thrombocytopenia?
a) direct toxic immune suppression or destruction
b) decreased platelet product via thrombopoiesis suppression.
c) all of the above

A

c) all of the above.

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23
Q

Define drug induce neutropenia.

A

Drug induced reduction of white blood cells below the normal range of 2000 cells per mm3.

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24
Q

How might drugs affect hepatocytes in the liver?

A

Hepatocytes are the site of metabolic processing of drugs. The metabolites of some drugs can be toxic to hepatocytes.

25
Q

How might drugs adversely affect the gallbladder?

A

Drugs can affect the gallbladder by impairing secretion of bile or blocking the flow of bile also known as cholestatic lesions.

26
Q

What is centrilobular necrosis?

A

Type of liver disorder.
Caused by the conversion of drug into toxic metabolites. Resulting in the acute death of hepatocytes, can spread.

27
Q

What is steatonecrosis?

A

steato mean fatty tissue.
Steatonecrosis is damage caused to the liver due to accumulation of fatty acid in the liver.
Result from many yrs of drinking.

28
Q

Explain why aspirin is no longer used to treat children?

A

Aspirin is no longer given to children because it can cause Rye’s syndrome in children recovering from a viral infection.

29
Q

Drug XYZ is well known for causing toxic hepatitis in patients. Explain how this occurs.

A

Toxic hepatitis occur when non toxic metabolites binds to proteins and produce an autoimmune response.

30
Q

What is cirrhosis?

A

Long term hepatotoxic reaction caused by untreated hepatitis.

31
Q

Cholestatic Jaundice is caused by:

A

Blockage to the flow of blie or bile duct impairment.

32
Q

For most drugs , the period of greatest risk of drug-induced structural defects during pregnancy is:

A

1st trimester

33
Q

The period of greatest risk of drug-induced fine structure and function defect during pregnancy is:

A

2nd and 3rd trimester

34
Q

Provide an example of a drug that cause tetrogenicity.

A

Thalidomide is an anti-anxiety drug that was given to women. Noticed that when taking during 1st trimester, it caused structural abnormality in new born.

35
Q

You are a PA treating a pregnant patient for UTI. What are some factor you must consider before prescribing a drug?

A

Some drugs are able to cross the placenta via passive diffusion.
—-Lipid soluble and small can cross the placenta.
I would treat this patient with a drug that has a large molecular weight. Allow though water-soluble drug might not pass the placenta. I would not use it because they tend to have a low volume of distribution.

36
Q

What are the different letter grading risk factors?

A

Category A: No risk in 1st trimester or later trimesters (controlled human studies)
Category B: Animal studies showed no risk or showed adverse effects that can be confirmed in humans.
Category C: Some studies indicate risk to fetus. Out weight risk and benefits of giving drug.
Category D: Positive evidence of risk. Give drug if life threatening situation.
Category X: Evidence of fetal abnormalities. Dont give to preg women or suspected preg women.

37
Q

Explain the concept of ion trapping in breast milk.

A

Breast milk is acidic compared to the serum. When lipid soluble (basic) drug passively diffuse into like. They become ionized (water soluble). As a result they are unable to leave the breast milk.

38
Q

What are some functions of the kidneys?

A

Acid-base balance maintenance
H2O + electrolyte homeostasis
excretion

39
Q

What is ototoxicity?

A

It is drug induce deafness due to prolong drug exposure.
the accumulation of drugs can cause:
Reversible: injury or impairment to tissue generation.
Irreversible: Hair cell loss or cell death.

40
Q

What is cross reactivity?

A

Drug A has a similar chemical structure as Drug B (the allergy causing agent). Therefore drug A can produce an allergic reaction as well.

41
Q

What is the function of IgG?

A

-75 percent in serum, involved in secondary immune responses.
-Found in blood, milk, csf, synovial fuild.
-Can cross placenta and act as temp immunity to developing fetus.

42
Q

What is the function of IgM?

A

Triggers the production of IgG in acute infections.

43
Q

What is the function of IgA?

A

IgA if found in the stomach, saliva, tears.
Defends body surface against invading organism.

44
Q

What is the function of IgE?

A

IgE is found in tissues and surface membrane. responsible for hypersensitivity reactions such as anaphylaxis.

45
Q

T/F the function of IgD is unknown.

A

T

46
Q

Drug-Drug interactions can led to

A

one drug can led to the increase or decrease effect of another drug. Consider if the might compete for enzyme.

47
Q

Drug-food interactions can lead to

A

combined it can lead to the increased or decreased effect of drug. Example affects of grapefruit juice on drugs.

48
Q

Drug-lab interactions can lead to:

A

Impacts the results of the lab test.

49
Q

Pharmacodynamic Interactions: drugs, foods etc. Affects what?

A

Affects the pharmacological response or nutrient.

50
Q

Pharmacokinetics interaction: drug food etc. Affects what?

A

Affects the distribution, absorption, metabolism and elimination of drug.

51
Q

What is a subtrate?

A

A drug that is getting metabolised by an enzyme and does not increase or decrease the activities of the enzyme.

52
Q

inhibitors compete with the

A

substrate

53
Q

Metabolised by the enzyme system and decreases the enzyme activity of a different enzyme is called?

A

Inhibitor

54
Q

T/F inhibitors act more rapidly that inductors.

A

T

55
Q

The onset of inhibition and termination of effect is dependent on what?

A

The half life of both the inhibiting drug and the drug whose metabolism is being inhibited.

56
Q

Chronic exposure to drugs can result in greater enzyme production describes what?

A

induction. dose dependent

57
Q

What are two factors that increase enzyme production?

A

increased hepatic blood flow
synthesis of more cytochrome p-450 enzyme

58
Q

T/F time course of induction is dependent on half-life of drugs affected.

A

T

59
Q

T/F a drug may be metabolized by one isoenzyme but inhibited or induce a different enzyme system.

A

T
can stereo selective

Pharmacology (6 decks)

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