Drug Interactions, Adverse Drug Reactions, and Medication Errors

Question 1

describe the consequences of drug interactions

Answer 1

intensification of effects

• can be therapeutic or adverse
• if adverse, either heavily monitor or discontinue therapy to find a better combo

reduction of effects

• can also be therapeutic or adverse
• monitor for efficacy of each drug, and if one drug isn’t as efficacious as needed, try another combination that is safe for the patient

creation of a unique response
-if patient starts to present with a unique response, hold the drug and assess risk/benefit of continuation. If toxic, stop all drugs and figure out something else.

KEEP PT SAFETY IN MIND THROUGHOUT EVERYTHING

Question 2

explain the importance of the cytochrome p450 group of enzymes in drug metabolism

Answer 2

They are essential for the metabolism of many drugs. There are more than 50 CYP450 enzymes, but the CYP1A2, CYP2C9, CYP2C19, CYP2D6, CYP3A4, and CYP3A5 enzymes metabolize 90 percent of drugs.

Question 3

define potentiative, inhibitory, inducing agents

Answer 3

Potentiative: to make effective or active or more effective or more active also : to augment the activity of (something, such as a drug) synergistically.

inhibitory: slowing down or preventing a process, reaction, or function. Inhibitory agents–drug A inhibits drug B, so you have to give more of drug B to help the level stay up at a therapeutic concentration in the body.

inducing agents: Inducing agents are medications that cause another medication to be metabolized faster, so one medication is an inducer and causes the second medication to be metabolized at an increased rate. so, you may need a larger dose of the second medication due to the faster metabolism.

Question 4

identify factors that affect how a drug interacts in the body

Answer 4

disease, genetics, age,

Question 5

describe the four basic mechanisms of drug interactions

Answer 5

direct chemical or physical interactions
-when drugs mix in an IV

pharmacokinetic interactions—altered absorption, distribution, renal excretion

pharmacodynamic interactions–can be at the same receptor of at separate receptors

combined toxicity
-drugs that are fine on their own, but toxic when combined. AS SOON AS PT SHOWS SIGNS OF TOXICITY STOP THE DRUG

Doug
Played
Pretty
Cleverly

Question 6

what are the outcomes of food on drug admin?
What about grapefruit juice on drug metabolism?
Of herbs on drug metabolism?

Answer 6

Food can increase or decrease the absorption of a drug
grapefruit juice can increase the risk of serious toxicity for drugs by inhibiting the metabolism of certain drugs
the impact of herbs is not well known, but St. John’s wort induces drug-metabolizing enzymes and reduces the blood levels of many drugs

Question 7

define side effects

Answer 7

Side effects, also known as adverse events, are unwanted or unexpected events or reactions to a drug. Side effects can vary from minor problems like a runny nose to life-threatening events, such as an increased risk of a heart attack.

Question 8

toxicity

Answer 8

Toxicity refers to how poisonous or harmful a substance can be. In the context of pharmacology, drug toxicity occurs when a person has accumulated too much of a drug in his bloodstream, leading to adverse effects on the body.

Question 9

allergic reaction

Answer 9

Allergic reaction: The hypersensitive response of the immune system of an allergic individual to a substance. When an allergen enters the body, it causes the body’s immune system to develop an allergic reaction in a person with an allergy to it.

Question 10

immune response

Answer 10

The way the body defends itself against substances it sees as harmful or foreign.

Question 11

idiosyncratic effect

Answer 11

Idiosyncratic drug reactions may be defined as adverse effects that cannot be explained by the known mechanisms of action of the offending agent, do not occur at any dose in most patients, and develop mostly unpredictably in susceptible individuals only.

Question 12

iatrogenic disease

Answer 12

Iatrogenic disease is the result of diagnostic and therapeutic procedures undertaken on a patient that can turn into disease.

iatrogenic literally means “disease from the physician”

Question 13

physical dependence

Answer 13

Physical dependence is when the body requires a specific dose of a particular drug, such as a prescription opioid, in order to prevent withdrawal symptoms.
This typically happens when a patient uses a drug long-term (six months or longer) to manage pain associated with a medical condition.

Question 14

carcinogenic effect

Answer 14

Carcinogenicity is the ability or tendency to cause cancer. A carcinogen is a substance that is capable of increasing the incidence of a tumor or is able to shorten the time to tumor occurrence.

Question 15

teratogenesis

Answer 15

the process by which congenital malformations are produced in an embryo or fetus.

Question 16

common causes of medication errors

Answer 16

human factors, communication mistakes, name confusion, packaging, formulations, and delivery devices

Question 17

ways to reduce medication errors

Answer 17

• computer medication system, barcode system, medication reconciliation, no error-prone abbreviations, senior pharmacist accompanies on rounds.
• company culture (safety), use up to date technology