Exam 1 - Adverse drug events / pharmacogenomics

Question 1

Side effect vs toxicity reaction

Answer 1

Side effect = undesired effect, usually tolerated, reversible, and does related
Toxicity = cell/tissue damage, permanent, intolerable

Question 2

Term for use of multiple medications in a given patient (over 5), includes excessive/unnecessary medications, usually in older adults.

Answer 2

polypharmacy (polyherbacy with herbs/supplements)

Question 3

The FDA categorizes adverse drug effects according to what 2 categories?

Answer 3

1. Body system (body as a whole, cardio, respiratory, skin, special senses, hypersensitivities ect.)
2. Organ System

Question 4

____ reaction to drugs in susceptible individuals can lead to classic allergic manifestations such as skin rash, asthmatic syndromes, rhinitis and anaphylaxis.

Answer 4

Hypersensitivity reactions - person must have a previous exposure to a drug to manifest later with an allergic reaction

Question 5

Term for ability of drugs or other agents to cause defects in developing embryo -If therapeutic benefit outweights their risk then can still be prescribed.

Answer 5

Teratogenicity

Question 6

Pregnancy risk categories A-D and X

Answer 6

A = controlled studies in pregnant women failed to demonstrate risk to fetus
B = Animal- reproduction studies have not demonstrated a fetal risk
C = Animal studies have revealed adverse effects on the fetus, but no data in humans exist
D - Positive evidence of human fetal risk, but the benefits to the mother may outweigh the risk
X= Studies show fetal abnormalities - Contraindicated

Question 7

What sedative in the 1960s was used to relieve symptoms of morning sickness but is a teratogen because it causes seal arms in the baby?

Answer 7

Thalidomide (OK for AIDS patients suffering with mouth ulcers, multiple myeloma, and leprosy sores - still has therapeutic benefit)

Question 8

Term for the study of genetic variability of drug effects

Answer 8

Pharmacogenetics

Question 9

Differences in genetic sequences = ?

Answer 9

polymorphisms - influence drug pharmacokinetics and pharmacodynamics

Question 10

What do “misspelled genes” do?

Answer 10

Encode differences in drug receptors or CYP metabolizing enzymes can create situations leading to drug adverse reactions or ineffectiveness

Question 11

Term defined as the range of responses per dose. An individual may require a higher/lower dose to produce the desired effect

Answer 11

Biological variation

Question 12

A greater than normal reaction to a drug?

Answer 12

Hypersusceptibility

Question 13

Response of the patient to the drug is qualitatively different from the usual or expected response

Answer 13

Drug idiosyncrasy

Question 14

Increasing amounts of drug are required to produce a consistent effect seen with addiction

Answer 14

Drug Tolerance

Question 15

A rapid development of tolerance after administration of only a few doses.

Answer 15

Tachyphylaxis

Question 16

When 2 or more drugs are taken at the same time by a patient, the resultant effect may often be different from the effects produced by each drug when given alone. ?

Answer 16

Drug interaction

Question 17

In someone with liver disease, drug metabolism is reduced. How should the dose of medications change?

Answer 17

Dose should be reduced (example of how the pathological state can influence effectiveness/safety of drugs)

Question 18

In pediatrics, what 4 things should you know about drug dosage?

Answer 18

1. Many drugs use same/similar dose in children and adults
2. Children have increased membrane permeability, drugs absorbed more quickly
3. Dose determined by manufacturer
4. Dose based on weight

Question 19

What 9 things are important to remember about normal elderly when giving medication?

Answer 19

1. Less binding capacity
2. decreased absorption due to increased stomach acid
3. Decreased liver metabolism (more active drug)
4. Decreased renal function
5. Decreased lean body mass
6. Decreased total body water
7. decreased plasma proteins
8. Increased body fat (drug storage)
9. GIVE LOWER DOSE

Question 20

Drug interaction mechanisms - The net drug response may result from ____ of the effects of one or the other drug. The ______ of ___ effects that are not observed with the drug alone. The _____ of the effect of one drug by another.

Answer 20

Enhancement
Development
New
Inhibition