Exam 1 - Adverse drug events / pharmacogenomics Flashcards
Side effect vs toxicity reaction
Side effect = undesired effect, usually tolerated, reversible, and does related
Toxicity = cell/tissue damage, permanent, intolerable
Term for use of multiple medications in a given patient (over 5), includes excessive/unnecessary medications, usually in older adults.
polypharmacy (polyherbacy with herbs/supplements)
The FDA categorizes adverse drug effects according to what 2 categories?
- Body system (body as a whole, cardio, respiratory, skin, special senses, hypersensitivities ect.)
- Organ System
____ reaction to drugs in susceptible individuals can lead to classic allergic manifestations such as skin rash, asthmatic syndromes, rhinitis and anaphylaxis.
Hypersensitivity reactions - person must have a previous exposure to a drug to manifest later with an allergic reaction
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.
Teratogenicity
Pregnancy risk categories A-D and X
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
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?
Thalidomide (OK for AIDS patients suffering with mouth ulcers, multiple myeloma, and leprosy sores - still has therapeutic benefit)
Term for the study of genetic variability of drug effects
Pharmacogenetics
Differences in genetic sequences = ?
polymorphisms - influence drug pharmacokinetics and pharmacodynamics
What do “misspelled genes” do?
Encode differences in drug receptors or CYP metabolizing enzymes can create situations leading to drug adverse reactions or ineffectiveness
Term defined as the range of responses per dose. An individual may require a higher/lower dose to produce the desired effect
Biological variation
A greater than normal reaction to a drug?
Hypersusceptibility
Response of the patient to the drug is qualitatively different from the usual or expected response
Drug idiosyncrasy
Increasing amounts of drug are required to produce a consistent effect seen with addiction
Drug Tolerance
A rapid development of tolerance after administration of only a few doses.
Tachyphylaxis
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. ?
Drug interaction
In someone with liver disease, drug metabolism is reduced. How should the dose of medications change?
Dose should be reduced (example of how the pathological state can influence effectiveness/safety of drugs)
In pediatrics, what 4 things should you know about drug dosage?
- Many drugs use same/similar dose in children and adults
- Children have increased membrane permeability, drugs absorbed more quickly
- Dose determined by manufacturer
- Dose based on weight
What 9 things are important to remember about normal elderly when giving medication?
- Less binding capacity
- decreased absorption due to increased stomach acid
- Decreased liver metabolism (more active drug)
- Decreased renal function
- Decreased lean body mass
- Decreased total body water
- decreased plasma proteins
- Increased body fat (drug storage)
- GIVE LOWER DOSE
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.
Enhancement
Development
New
Inhibition
