Dispensing III Flashcards
Response to a drug which is noxious and unintended and which occurs at doses normally used in man for prophylaxis, diagnosis, or therapy of disease or for the modification of physiologic function
ADVERSE DRUG REACTION
Asians and Eskimos
(Fast or Slow Acetylators)
Fast
Caucasians and Egyptians
(Fast or Slow Acetylators)
Slow
Most common type of ADR
AUGMENTED
Dose Dependent
Predictable
Common
Reproducible
TYPE A: AUGMENTED
most severe type of ADR
TYPE B: BIZZARE
-Not dose related
-Unpredictable
-Rare
-Unknown mechanism -Serious and fatal
TYPE B: BIZZARE
a disease that causes a fast rise in body temperature, resulting to severe muscle contraction and muscle breakdown
Malignant Hyperthermia
is due to hemolysis or abnormal breakdownof RBC
Hemolytic Anemia
is a immune-mediated
hypersensitivity complex involving the skin and mucous membrane; loss of up to 10% of outer layer of skin or necrolysis
Steven Johnsons Syndrome
genetically determined rxns or unsual effects
Idiosyncratic
related to immune responses to environmental antigens, resulting to symptomatic rxns
Hypersensitivity rxn
Allergic reaction that is provoke by reexposure to specific type of antigen or allergen (pollen)
TYPE 1: ANAPHYLACTIC/IMMEDIATE
- The antibodies produced bind to antigen on the patient’s own cell surfaces (leukocytes and erythrocytes) that will produce
compliment-mediated lysis
TYPE 2: CYTOTOXIC
- Leads to small immune complexes, which are not effectively
cleared, causing tissue damage and inflammation
TYPE 3: IMMUNE COMPLEX
A reaction that takes 2 to 3 days to developed
TYPE 4: DELAYED OR CELL MEDIATED
acute generalized reactions that occur when a previously sensitized person reexposed to a particle antigen
Anaphylactic reaction
Clinical manifestations of this reaction include hemolytic anemia, thrombocytopenia, and granulocytopenia
CYTOTOXIC REACTIONS
- Reaction result from the formation of antibody complexes in serum, which often deposit in blood vessel walls, resulting in activation of complement and endothelial cell injury
TYPE 3: IMMUNE COMPLEX
Dose Related
Time Dependent
Duration (↑) = Risk (↑)
TYPE C: CONTINOUS
person takes the drug compulsively
Addiction
craving and compulsive drug seeking behavior (body)
Physical Dependence
abstinence from drug produces physiological symptoms (mind)
Psychological Dependence
- reduced effect with repeated used of thedrug;decreased in physiological response to the susbtancewiththecontinuous use of the same dose
Tolerance
Marijuana and Opiates
Addiction
Physical Dep
Psychological Dep
Tolerance
Addiction
Painkillers & Nicotine
Addiction
Physical Dep
Psychological Dep
Tolerance
Tolerance
BZD, CAFFEINE, COCAINE
Addiction
Physical Dep
Psychological Dep
Tolerance
Psychological Dep
Time-Dependent type of ADR
TYPE D: DELAYED
Other name of Carcinogenicity
Malignant Neoplasms
drug that causes neural tube defectcs
Carbamazepine
drug that causes increase risk of development of vaginal and adenocarcinoma after puberty
Diethylstilbestrol (DES)
drug that causes fetal hydantoin syndrome
Phenytoin
drug that causes 8th nerve damage
STREPTOMYCIN
drug that causes discoloration of teeth
TETRACYCLINE
drug that causes phocomelia
THALIDOMIDE
drug that causes powerful teratogen
ISOTRETINOIN
-Adequate, well-controlled studies of pregnant mothers
-No risk of fetal abnormalities in animals
Category A
No adequate, well – controlled studies of pregnant mothers
-No risk of fetal abnormalities in animals
Category B
No adequate, well – controlled studies of pregnant mothers ○ Animal studies – showed adverse effects
CATEGORY C
Adequate, well – controlled studies of pregnant mothers ○ Risk present ○
Benefit > risk
CATEGORY D
Adequate, well – controlled studies
of pregnant mothers ○ Contraindications ○ Benefit < risk
CATEGORY X
Adequate and well-controlled studies have failed to demonstrate a risk to the fetus in the first trimester of pregnancy (and there is no evidence of risk in later trimesters)
CATEGORY A
Animal reproduction studies have failed to demonstrate a risk to the fetus and there are no adequate and well-controlled studies in pregnant women.
CATEGORY B
Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.
CATEGORY C
There is positive evidence of human fetal risk based on adverse reaction data from investigational or marketing experience or studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.
CATEGORY D
Studies in animals or humans have demonstrated fetal abnormalities and/or there is positive evidence of human fetal risk based on adverse reaction data from investigational or marketing experience, and the risks involved in use of the drug in pregnant women clearly outweigh potential benefits.
CATEGORY X
Use of the product is contraindicated in women who are or may become pregnant
CATEGORY X
Use of Lansoprazole
CATEORY B
Use of Leflunomide
CATEORY X
Teratogenic Effect of:
LITHIUM
EBSTEIN ANOMALY
Teratogenic Effect of:
VPA Valproic Acid
SPINA BIFIDA
Teratogenic Effect of:
Anabolic Steroids
Masculinization of female fetus
Teratogenic Effect of:
THALIDOMIDE
PHOCOMELIA
3 Manifestations of Phocomelia
Polyneuriti
Limb deformities Mental retardation
Teratogenic Effect of:
CARBAMAZEPINE & VALPROIC ACID
Neural birth defects
Teratogenic Effect of:
DES Diethylstilbestrol
Risk of developing vaginal adenocarcinoma
after puberty
Teratogenic Effect of:
PHENYTOIN
Fetal Hydantoin Syndrome
Teratogenic Effect of:
Tetracycline
Discoloration & defects of teeth & altered bone growth
Teratogenic Effect of:
Streptomycin
8th Cranial Nerve
-Unexpected failure of Therapy
-common
-Dose-related
TYPE F: FAILURE OF THERAPY
It refers to any ADR produced by the administration of drug or co-exposed of the drug to another substance, which modified the patient’s response to the drug
DRUG INTERACTION
5 Drug Interactions
○ Drug-food
○ Drug-laboratory
○ Drug-drug
○ Drug-herb
○ Drug-disease
- one that causes the interaction
PRECIPITANT DRUG
- one that is affected in the interaction
OBJECT DRUG
Effect:
Bisacodyl + Milk
Alteration of pH
Effect:
Barbiturates + Alc
INC Sedation
Lidocaine + Phenytoin =
Excessive Cardiac Depression
Lidocaine + Procainamide =
Additive Neurological Effects
Management for Lidocaine ADR
Pramoxine
Erythromycin
Should not be given with food =
Erythromycin stearate
Erythromycin
Can be given with food =
Estolate and Ethylsuccinate
Occurs when two or more drugs, with or without the same overt effect, are used together to yield a combined effect that has an
outcome greater than the sum of the single drugs active
components alone
SYNERGISTIC/SYNERGISM
Describes a particular type of synergistic effect-a drug interaction
in which only one of two drugs exerts the action that is made
greater by the presence of the second drug
POTENTIATION
Has antagonistic effect and common to antidotes
ANTAGONISM
is a type of chemical incompatibility wherein
chemical reaction can be reduced by mixing the solution in
dilute forms or by changing the order of mixing
Tolerated
This refers to the potential of effect when 2 drugs with the same
active ingredient or with the same action are taken at the same
time
ADDITIVE
supported by well proven clinical studies
Established
very likely but might not be proven clinically
Probable
might occur and some data might be available
Suspected
could occur and limited data are available
Possible
doubtful ; no good evidence of an alteredclinical effect is available
Unlikely
