Chapter 7: Adverse Drug Reactions and Medication Errors

Question 1

Adverse Drug Reactions (ADR)

Answer 1

An ADR, as defined by the World Health Organization, is any noxious, unintended, and undesired effect that occurs at normal drug doses.

Question 2

Side Effect:

Answer 2

A side effect is formally defined as a nearly unavoidable secondary drug effect produced at therapeutic doses.

Question 3

Side Effect intensity is dependent on what

Answer 3

Side effects are generally predictable, and their intensity is dose dependent.

Question 4

Toxicity: formal definition

Answer 4

The formal definition of toxicity is the degree of detrimental physiologic effects caused by excessive drug dosing.

Question 5

Toxicity everyday definition

Answer 5

in everyday language the term toxicity has come to mean any severe ADR, regardless of the dose that caused it.

Question 6

Allergic Reaction:

Answer 6

An allergic reaction is an immune response

Question 7

Intensity of allergic reaction and dosage size:

Answer 7

the intensity of allergic reactions is largely independent of dosage.

Question 8

Idiosyncratic Effect:

Answer 8

An idiosyncratic effect is defined as an uncommon drug response resulting from a genetic predisposition.

Question 9

Paradoxical Effect:

Answer 9

A paradoxical effect is when an effect is the opposite of the intended drug response.

Question 10

Example of Paradoxal effect:

Answer 10

A common example is the insomnia and excitement that may occur when some children and older adults are given benzodiazepines for sedation.

Question 11

Iatrogenic Disease:

Answer 11

An iatrogenic disease is a disease that occurs as the result of medical care or treatment.

Question 12

Physical Dependence:

Answer 12

Physical dependence is a state in which the body has adapted to drug exposure in such a way that an abstinence syndrome will result if drug use is discontinued.

Question 13

Carcinogenic Effect:

Answer 13

The term carcinogenic effect refers to the ability of certain medications and environmental chemicals to cause cancers.

Question 14

Teratogenic Effect:

Answer 14

A teratogenic effect is a drug-induced birth defect.

Question 15

Teratogens

Answer 15

Medicines and other chemicals capable of causing birth defects are called teratogens.

Question 16

Important sites of drug toxicity:

Answer 16

1. Liver
2. Kidney
3. Bone Marrow

Question 17

For drugs that are toxic to the liver, the patient should be monitored

Answer 17

the patient should be monitored for signs and symptoms of liver damage (jaundice, dark urine, light-colored stools, nausea, vomiting, malaise, abdominal discomfort, loss of appetite),

Question 18

For drugs that are toxic to the kidneys, what is needed for the patient?

Answer 18

For drugs that are toxic to the kidneys, the patient should undergo routine urinalysis and measurement of serum creatinine or creatinine clearance levels.

Question 19

For drugs that are toxic to bone marrow, what is needed for patient?

Answer 19

For drugs that are toxic to bone marrow, periodic complete blood cell counts are required.

Question 20

Among fatal medication errors involving drug administration, the most common types are:

Answer 20

Among fatal medication errors involving drug administration, the most common types are giving an overdose (36.4%), giving the wrong drug (16.2%), and using the wrong route (9.5%).

Question 21

Among fatal medication errors, the Institute of Medicine (IOM) identifies three categories that account for 90% of all errors.

Answer 21

1. human factors,
2. communication mistakes, and
3. name confusion