Exam II Pt II Flashcards
What are the 4 main types of drug reactions?
Drugs with other drugs
Drugs with dietary supplements
Drugs with food/beverages
Nutrient depletions
The rate of adverse drug reactions increases dramatically after a patients in on how many meds?
4 or more mediactions
What is a noteable metabolic feature of St. John’s wort
Inducer of CYP450 enzyme system, which means it can reduce the ceoncetration of medications in the blood
What is the definition of a food-drug interaction?
A change in how a medicine works caused by food, caffeine, or alcohol
In what ways can food effect medication in vivo, and what can be done to avoid these interactions?
May cause delayed, decreased, or enhanced absorption of a medication, can affect the bioavailability, metabolism, and exretion of some meds.
Reduce interactions by taking meds 1 hour before, or 2 hours after eating.
What kind of food-drug interaction can alcohol induce?
Can increase or decrease the effect of many drugs, recommended to avoid.
What is a noteable fruit-drug interaction?
Grapefruit. More than 40 interactions. (e.g. Ca+ channel blockers, statins, antihistamines, cylosporine).
What are MAOIs?
Monoamine oxidase inhibitors.
What foods do patients on MAOIs need to avoid?
Avoid high tyramine foods to prevent spike in BP and possible stroke (e.g. aged cheeses, draft beer, red wine, soy sauce, sauerkraut, sausage, pepperoni, slami, banana, choclate, avocado, fava bean pods).
How can smoking affect the bodily effects caffeine?
Speeds up same enzymes needed to clear caffeine..
What has St. John’s wort historically been used to treat?
Anxiety and depression.
What kind of food-drug-supplement interactions has St. John’s wort been linked to and what are the safety recommendations for avoiding these?
Increases CYP enzyme clerance, interacts with many, many meds and supplements. Do NOT take if taking any type of meds or supplements. Avoid high tyramine foods.
What problems can supplements or foods that interfere with CYP enzymes cause?
Toxicity, or other life-threatening reactions.
If you are aware that a patient is taking any kind of meds or supplements, what should rule of thumb must you live by in recommendation of other supplements/foods?
DO NOT give/recommend supplements/foods that interfere with CYP enzymes to patients taking other supplements or any medications
What is the definition of a poison?
A substance taken into the body that interferes with normal physiological functions and causes harm
What is an antidote?
A substance that neutralizes poisons or toxic substances
What is an emetic?
An agent that induces vomiting
What is an example of an absorbent?
Activated charcoal
What is gastric lavage?
Pumping the stomach
What is the most common type of poisoning?
Ingestion. Children between 1-5 most at risk
What is the most common type of poisoning?
Ingestion. Children between 1-5 most at risk
What are the methods of poisoning?
Inhalation
External poisoning
Sting and snakebites
What should you do for a sting?
Cleanse, remove stinger, apply ice. May require epinephrine and corticosteroids
What should you do for snakebites?
Do NOT apply tourniquet or ice. If poisonous snake, requires antivenin
What is the characteristic odor of cyanide?
Bitter almonds
What is the characteristic odor of organophosphates, Arsenic?
Garlic
What is the characteristic odors of DKA, Isopropyl alcohol?
Fruity
T/F
The majority of poisonings are intentional, and the majority of deaths secondary to poisoning are unintentional
False,
The majority of poisonings are unintentional, and the majority of deaths secondary to poisoning are intentional
Where do most poisonings occur?
Home
What is the #1 cause of unintentional overdose?
Opioid narcotics
What is the #1 drug used fro intentional overdose?
Acetaminophen
What is the most commonly reported poison?
Analgesics (specifically acetaminophen)
What is the least commonly reported poisoning?
Alcohol
Which poisoning is associated with most deaths?
Analgesics (specifically opioid narcotics)
Which is associated with the least deaths due to poisoning?
Hydrocarbons
What is the #1 poisonous killer
CO
What methylxanthine is most toxic?
Theophylline
What is the antidote for acetaminophen poisoning?
N-acetylcysteine
What is the antidote for lead?
EDTA
What is the antidote for benzodiazepines?
Flumazenil
What is the antidote for carbamate insecticides?
Atropine
What is the antidote for Warfarin (Coumadin), heparin
Vitamin K (phytonadione)
What disease is associated with brown lung?
Byssinosis (textile factory workers).
What are the early symptoms of CO poisoning and what is it often mistaken with?
Headaches, nausea, and fatigue. Often mistaken for the flu because the deadly gas goes undetected in a home. Prolonged exposure can lead to brain damage and even death
How does radon gas enter buildings?
Through openings or cracks in the foundation
Where are people generally exposed to radon gas?
Home or workplace
What is the cancer incidence attributed to radon poisoning?
#2 cause of lung cancer overall #1 cause of lung cancer in non-smokers.
Radon and CO are odorless, colorless gasses, but arsenic is…
Odorless and flavorless
How harmful is arsenic?
Large amounts can kill human quickly. Small, long-term exposure can lead to a much slower death or other illness.
How harmful is arsenic?
Large amounts can kill human quickly. Small, long-term exposure can lead to a much slower death or other illness.
What is the first stage of arsenic poisoning/toxicity?
First stage: metallic taste in mouth, excessive saliva production, problems swallowing
What is the next
Next stage: vomiting and diarrhea, garlic-like breath, stomach cramps, and excessive sweating.
What is the second stage of arsenic poisoning/toxicity?
Next stage: vomiting and diarrhea, garlic-like breath, stomach cramps, and excessive sweating.
What is the final stage of arsenic poisoning?
Seizures and shock, death within a few hours (or after a few days with renal failure)
What are the 2 ways you are likely to experience mercury toxicity?
Eating mercury contaminated fish
Direct exposure
FDA limit for human consumption of mercury is 1 part per million; mostly occurs in which fish?
Shark, tuna, and swordfish
What is the toxicity limit of mercury (with tuna consumption) for pregnant women?
Should not consume > 7 oz of tuna per week
What two organs are most effected by mercury toxicity?
Brain and kidney
Who is most susceptible to lead poisoning?
Children. More than 400,000 children
What organ is most effected in children with lead exposure?
No organ system is immune, but brain is most concerning.
What is a tell tale symptom of lead poisoning in children?
Blue gums
Where does the greatest source of aluminum exposure come from?
Municipal water supply
What symptoms of which conditions does aluminum toxicity mimic?
Many symptoms mimic those of Alzheimer’s disease and osteoporosis
Where do dioxins, polychlorinated biphenyls (PCBs) come from?
Industrial solvents/lubricants/byproducts
