Chapter 7: Adverse Drug Reactions and Medication Errors Flashcards
adverse drug reactions
any noxious, unintended, and undesired effect that occurs at normal drug doses
adverse drug reactions excludes
excessive dosages
mild reactions
drowsiness, nausea, itching, and rash
severe reactions
potentially fatal
- respiratory depression, neutropenia, helatocellular injury, anaphylazis, and hemmorage
adverse drug reactions are most common in
elderly and very young
side effect
- nearly unavoidable drug effect at therapeutic doses
toxicity
adverse drug reaction caused by excessive dosing
- may occur even with normal dosing in neutropenia and anticancer medications
allergic reaction
- immune respose
- determined primarily by the degree of sensitization of the immune system rather than by drug dosage
what are the most common drugs for allergic reactions
antibiotics (penicillin)
idiosyncratic effect
uncommon drug responses resulting from a genetic predisposition
Example: anaesthetics
paradoxical effect
- opposite of the intended drug response
latrogenic disease
- disease produced by a physician or a disease produced by a drug
iatrogenic disease is also called
drug induced disease
physical dependence
a state in which the body has adapted to drug exposure in such a way that an abstience syndrome will rsult if drug use is discontinued
how does physical dependence develop
during long term use of certain drugs
carcinogenic effect
- only a few
- several drugs to treat cancer are among those with the greatest carcinogenic potential
teratogenic effect
- drug induced birth defects that occurs when women take teratogenic medication during pregnancy
what drug is toxic to the kidneys
Amphotericin B (antifungal)
what drug is toxic to the heart
Doxorubicin (anticancer)
what drugs are toxic to the lungs
Amiodarone (antidysrhythmic)
how many drugs are known as hepatotoxic drugs
more than 50
what drugs should you monitor for liver injury
asparate amminotransferase (AST) and alanine aminotransferase(ALT)
signs of liver injury
jaundice, dark urine, light colored stools, nausea, vomiting, malaise, abdominal discomfort, and loss of appetite
QT interval
measure of the time required for the ventricles to repolarize after each contraction
QT drugs
drugs that prolong the QT interval on electrocardiography (ECG)
use of QT drugs can cause
serious lifetreatening dysrhythmias
- torsades de pointes, ventricular fibrilation
who are the patients at highest risk with QT drugs
women, older adults, patients with bradycardia, congestive heart failure, congenital QT prolongation, low potassium, and low magnesium
drugs that are suspected of causing a previously unknown adverse efffect should be reported to
health canada
boxed warnings are also known as
blackbox warnings
boxed warnings
strongest safety warning a drug can carry and still remain on the market
purpose of boxed warnings
- alert perscribers of potentially severe side effects
- ways to prevent or reduce harm
what are the major causes of morbidity and mortality
medication errors
- knowledge or performace deficits or miscalculation or dosages
fatal medication errors that involve medication administration are mostly due to
- overdose
- wrong drug
- wrong route
who is the last line of defense against medication errors
nurses
ways to reduce medication errors
- educate patients
- double and triple checks
- standarize your procedures
- look up what you are unsure of
- use safety checklists for high alert drugs
- dont use abbreviations
- report errors to make it safer in the future
- medication reconciliation
medication reconciliation
