Chapter 7: Adverse Drug Reactions and Medication Errors

Question 1

Adverse Drug Reactions (ADR)

Answer 1

Any noxious, unintended, and undesired effect that occurs at normal drug doses. Adverse reactions can range in intensity.
Patients at increased risk of adverse drug events include the very young, older adults, the very ill, and those taking multiple drugs.

Question 2

Mild reactions

Answer 2

Drowsiness, nausea, itching, and rash.

Question 3

Severe reactions

Answer 3

Potential fatal conditions such as neutropenia, hepatocellular injury, cardiac dysrhythmias, anaphylaxis, and hemorrhage.

Question 4

Side Effect

Answer 4

A nearly unavoidable secondary drug effect produced at therapeutic doses.

Question 5

Toxicity

Answer 5

The degree of detrimental physiologic effects caused by excessive drug dosing.

Question 6

Allergic Reaction

Answer 6

Triggered immune response

Question 7

Idiosyncratic Effect

Answer 7

An uncommon drug response resulting from a genetic predisposition.

Question 8

Paradoxical Effect

Answer 8

Is the opposite of the intended drug response.

Question 9

Iatrogenic Disease

Answer 9

A disease produced by drugs.

Question 10

Physical Dependence

Answer 10

State in which the body has become used to the effect of the drug and will experience withdrawal symptoms without the drug.

Question 11

Carcinogenic Effect

Answer 11

Drug-induced cancers.

Question 12

Teratogenic Effect

Answer 12

Drug-induced birth defect.

Question 13

Organ-Specific Toxicity

Answer 13

Common injury include:
Kidney - by amphotericin B (an antifungal drug)
Heart - by doxorubicin (an anticancer drug
Lungs - by amiodarone (an antidysrhythmic drug)
Inner ear - by aminoglycoside antibiotics (eg, gentamicin)

Question 14

Hepatotoxic Drugs

Answer 14

Drugs metabolized by the liver can be converted to toxic products and injure liver cells.
Drugs are the most common cause of acute liver failure, and hepatotoxicity is the most common reason for removing drugs from the market.

Question 15

QT Interval Drugs

Answer 15

Drugs that prolong the QT interval pose a risk of torsades de pointes, a dysrhythmia that can progress to fatal ventricular fibrillation. The QT interval is a measure of the time required for the ventricles to repolarize after each contraction.

Question 16

Medication Guides (MedGuides)

Answer 16

FDA-approved documents created to educate patients about how to minimize harm from potentially dangerous drugs

Question 17

Boxed Warnings (black box warning)

Answer 17

The black box warning indicates the serious adverse effects of the drug that have been reported.

Question 18

Risk Evaluation and Mitigation Strategies (REMS)

Answer 18

A plan to minimize drug-induced harm.

Question 19

Medication Error

Answer 19

Any preventable event that may cause or lead to inappropriate use or harm.

Question 20

Ways to Reduce Medication Errors

Answer 20

1. Replacing handwritten medication orders with a computerized order entry.
2. Using bar-code systems.
3. Incorporating medication reconciliation.
4. Banned abbreviations, symbols, and dose designations.
   5.

Question 21

Medication Reconciliation

Answer 21

Medication reconciliation is the process of comparing a list of all medications that a patient is currently taking with a list of new medications that are about to be provided
3 Steps are:
Verification
Clarification
Reconciliation

Question 22

3 most common types of fatal medication errors

Answer 22

giving an overdose, giving the wrong drug, and using the wrong route.

Question 23

3 most common causes of fatal medication errors

Answer 23

human factors
miscommunication
similarities in drug names.

Question 24

atorvastatin [Lipitor]

Answer 24

A lipid-lowering drug, is a commonly prescribed example of a hepatotoxic drug.

Question 25

AST

Answer 25

liver enzyme that is helpful for monitoring liver function (hepatotoxicity)

Question 26

BUN

Answer 26

Measure of kidney function.

Question 27

INR

Answer 27

Comparative rating of prothrombin time ratios that is used to monitor patients taking the anticoagulant agent warfarin.

Question 28

CRP

Answer 28

Elevated in inflammatory and neoplastic disease, myocardial infarction, and the third trimester of pregnancy. It is used as a cardiac risk marker.

Question 29

The nurse checks 6 elements rx

Answer 29

Pt name, rx date, drug name, drug dose, administration route, and prescriber’s signature.
Information about allergies due to drug reaction should be requested during the initial assessments. The expiration date of the drug is not included on the prescription.

Question 30

Effects of drugs

Answer 30

Drowsiness and nausea are examples of drug side effects. A side effect is formally defined as a nearly unavoidable secondary drug effect produced at therapeutic doses. Coma and severe hypoglycemia are examples of drug toxicity. Mild itching is most often an example of an allergic reaction.