Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pharm 228 > Adverse Events + Management > Flashcards

Adverse Events + Management Flashcards

1
Q

2 main strategies to reduce injection pain

A

1) minimize anxiety
2) technique considerations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

T or F: always prep needle in pt view so they know its coming

A

F - prep needle out of pt view

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

strategy if injection multiple people in same family

A

start with most anxious person

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Strategies when injecting kids basics

A

distract them
- get parent to restrain kid immediately before giving injection
- don’t give false reassurances

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is better when it comes to pain: fast insert + withdraw or slower + steadier

A

Fast

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

T or F: you can apply light pressure to to area injected after for IM + SC but not ID

A

T

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Non pharm options for kids

A
  • breastfeeding: feed them throughout injection

2+ or younger kids who aren’t breastfeeding: can give sweet tasting solution (2mL of 24-50% sugar solution 1-2 mins before)
—- can give lollipop if older

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

T or F: topical local anesthetics can be applied before injection if needed

A

T- can apply
- don’t apply to damage skin
- may irritate if skin is sensitive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the topical local anesthetic options

A

EMLA: contains 2.5% lidocaine + 2.5% prilocaine
- cream or patch
- onset : 1 hr (lasts 2)

Maxilene: Liposomal lidocaine 4% cream
- onset 20-60mins
- lasts up to 3 hrs

Ametop: tetracaien 4% gel
- onset 30-45mins
lasts 4-6 hrs (cover with occlusive dressing)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What does very common SEs mean (frequency)

A

> 1/10

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Frequency of SE if its common

A

1/10 - 1/100

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Frequency of SE if its uncommon

A

1/100- 1/1000

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Frequency of SE if its rare

A

1/1000 - 1/10000

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Frequency of SE if its very rare

A

< 1/10000

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Which SEs need to be reported to HC

A

severe or unexpected SES

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Passive surveillance of SEs

A

collect from all AES reporting done by HCP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Active SE surveillance

A

proactive, may be performed after serious AEs are detected

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are Ad hoc studies

A

additional surveillance or clinical studies done to characterize specific concerns, assess causal links or determine RFs that make an AE more likely to occur

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

How long after injections does most fainting occur

A

within 15 mins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What should be done if a pt leaves before the 15 min monitoring period post injection is done

A

document

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Why is reporting AEs important

A

to help detect rare events not detect in clinical trials

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

When should AEs be reported

A
  • severe
  • unexpected type or frequency
  • is concern to pt or HCP
  • you don’t need to confirm a causal relationship
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

How do you report AEs / who do you report it do

A
  • report to PH
  • if reaction to non-vaccine injectable product—- report to manufacturer
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What should you do to prepare for AES when doing injections

A
  • have anaphylaxis kit assembled + nearby
  • have snacks + juice
  • have space for patient to lie down
  • must be able to observe pt for 15-30 mins
  • need current CPR + first aid cert
25
Q

What is syncope

A

fainting

26
Q

T or F: 89% of fainting occurs within the first 15 mins post injection

A

T

27
Q

Why does fainting likely occur post injections

A

due to temporary loss of blood to brain

28
Q

SS of syncope

A

pallor, sweating, dizzy, may have rhythmic jerking of limbs when unconscious

29
Q

What are some preventative steps that can be taken when it comes to fainting + injections

A
  • ask about needle anxiety or if had pass rxns
  • ensure in chair with back + armrest
  • don’t inject across a table or desk
  • if high risk of fainting: inject laying down
30
Q

Management strategies if feel like they are going to faint

A

if sitting: have them lean forward with head bw knees

Laying down/ or if at risk of falling when sitting: guide to floor + go into recumbent position (on back with feet slightly elevated)
—— loosen clothing around neck

31
Q

When can breath holding occur

A

can occur in kids if they are upset or crying
——- agitated + then suddenly stop making noise (may show facial flushing or cyanosis)

32
Q

T or F: breath holding with kids is super serious and requires treatment

A

F- no treatment needed

— kids with suddenly resume crying

33
Q

Strategies to help with anxious people

A

support them with regular breathing

distraction

don’t prep needle in front of them

try to get it over with quickly

34
Q

How frequently can local reactions occur with vaccines

A

up to 80%

35
Q

Are local rxns more common with inactive or live vaccines

A

inactive (especially if contain adjuvant)

36
Q

SS of local vaccine rxn

A

pain swelling + redness at site (mild + SL)
- onset: few hours
- duration: 1-2 days

can manage with OTC pain meds

37
Q

What is the difference bw hives vs anaphylaxis reaction

A

swelling or local reaction: just that
- not full allergic reaction

— if have any other body system involved (sneezing, coughing, tearing) + hives: anaphylaxis
————— give E

38
Q

T or F: you can apply ice to help with local rxn to vaccine

A

T

39
Q

Can antihistamines be given to help with itch from local rxn to vaccine?

A

Yes - can give
— but ensure pt has someone to monitor them for the next hour at least (not alone)

  • 2nd gen are better
40
Q

How fast can anaphylaxis reaction occur

A

normally rapidly but can appear up to 30 mins post admin

41
Q

What causes Anaphylactic reaction

A

mediated by IgE —- causes histamine release

  • causes SM of GI and RT to spasm, bronchoconstriction, vasodilation, + increase BV permeability
42
Q

SS of Anaphylactic Rxn

A

Normally includes 1+ body systems

Skin: rash

Respiratory: SM spasms, bronchoconstriction, mucus secretion, airway edema, sneezing

CV: hypotension, syncope, shock

43
Q

How may kids explain anaphylactic rxn

A

throat is tingly or tongue is scratchy

44
Q

Treatment for anaphylactic RX

A
  • call 911
  • assess ABC, mental status, skin + BW
  • get pt into recumbent position with feet up
  • give E: 1:1000 IM into anterolateral aspect of thigh
  • may repeat E admin at 5 min intervals if needed (use different limb)
  • stabilize pt and ensure airway is open, monitor vials
45
Q

Weight based dosing for E

A

0.01mL/kg to max of 0.5mg/dose

46
Q

T or F: 1/4 of anaphylactic reactions have biphasic reaction

A

T- 1/4 have a low reaction occurring within 1-72 hrs of OG rxn

47
Q

What does Epi helps with during Anaphylactic Rxn?

A

martian BP, inhibitor of further rxns

48
Q

SEs of E

A

palpitations, tachycardia, flushing, headache

49
Q

T or F: If not sure someone needs E, don’t give it to them as R> B of use

A

F - if think they need it—- give it to them because leaving anaphylaxis untreated is super serious

50
Q

T or F: there is no absolute CI to E

A

T

51
Q

T or F: Salbutamol use can be considered if bronchoconstriction if anaphylactic rxn is occurring to avoid E use

A

F- can use it but only after giving E

52
Q

Weight based E doses

A

Conc of product: 1mg/mL

2- < 7 yrs (below 25kg) : 0.15mg
7+ - 12 (below 45kg): 0.3mg
> 12: 0.5mg

53
Q

T or F: E auto injectors are made to go through clothing

A

T

54
Q

Are E auto injectors latex free

A

yes

55
Q

Admin instructions for E pen

A

blue to sky + orange to the thigh
- voice assistance

  • pull from outer case
  • pull off red safety guard
  • place the black end against the middle outer thigh + press firmly + hold in place for 5 seconds (will hear click + hiss)
56
Q

Which age/weight group should use junior Epipen

A

those who weigh up to 65lbs or 30kgs
- 0.15 mg dose

57
Q

Who should use regular epipen

A

those who weigh over 30kg
— 0.3mg dose

58
Q

What should all be included in anaphylaxis kit

A

Auto injectors (both types) OR E vials/ampoules
- if using ampoules: need 3 vials of 1:1000 solution, 1 cc with 25g 1” needle, 1 cc with 25g 5/8” needle; 3 25g needles (5/8, 1 and 1.5)

  • E dosing chart
  • alcohol swabs
  • tongue depressors
  • pocket mask
  • watch capable of measuring seconds

Pharm 228 (20 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions