Finals Reporting Flashcards
systematic assessment of a patient’s medication management
aim:
optimize quality use of medicines minimize medication-related problems.
MEDICATION REVIEW
a multidisciplinary responsibility that ensures the ongoing safe and
effective use of medicines at
all stages of the medication
management pathway.
MEDICATION REVIEW
TYPES OF MEDICATION REVIEW
MEDICATION ORDER REVIEW
MEDICATION ADHERENCE REVIEW
review of individual medication orders and/or prescription validity. It may take place w/o the patient present.
MEDICATION ORDER REVIEW
review of a patient’s medicine-taking behavior (how they actually take their medicines and what their beliefs about medicines are).
MEDICATION ADHERENCE REVIEW
comprehensive review of a patient’s medicines in the context of their clinical conditions. Partnering with the patient/carer is essential.
clinical medication review
Conducting ______ medication reviews can optimize the medications used and reduce medicine-related problems.
evidence-based
In conducting amedication review it should be based on the ______.
-knowledge of processes for managing medicines,
-therapeutic knowledge on medicines use,
- ability to effectively communicate
clinicians’ knowledge and skill
The delivery models for medication review are just the same across health service organizations.
T or F
F
may vary across
Patients with a higher risk of experiencing medication-related harm should be given priority.
Risk assessment and stratification should be based on evidence and local organizational priorities.
T or F
T
A reduction in efficacy due to an
interaction can sometimes be just as
harmful as an increase.
T or F
T
A reduction in efficacy due to an
interaction can sometimes be just as
harmful as an increase.
T or F
T
it is said to occur when the effects of one drug are changed by the presence of another drug, herbal medicine, food, drink or by some environmental chemical agent.
interaction
The more drugs a patient takes the
lesser the likelihood that an adverse
reaction will occur.
T or F
F
greater
Drug interaction incidence is
expected to be higher in the adults
because ageing affects the functioning of the kidneys and liver.
T or F
F
Elderly
Treating patients with more than one drug at a time is extremely risky. Some quite essential drug interactions remained virtually unnoticed for many years.
T or F
T
5 Patient factors contributing to DI:
Age
Drug dose
Serum drug level
Drug metabolism
Polypharmacy
_____interactions are those that can affect the processes by which drugs are absorbed, distributed, metabolized and excreted (the so- called ADME interactions).
Pharmacokinetic
Drug Absorption Interactions:
- Effects of changes in gastrointestinalI pH
- Adsorption, chelation & other complexing mechanisms
- Changes in gastrointestinal motility
- Induction or inhibition of drug transporter proteins
Malabsorption caused by drugs
Drug Distribution Interactions:
- Protein-binding interactions
- Induction or inhibition of drug transport proteins
Drug Metabolism (Biotransformation) Interactions:
Changes in first-pass metabolism
Enzyme induction
Enzyme inhibition
Genetic factors in drug metabolism
Cytochrome P450 isoenzymes & predicting drug interactions
(involving oxidation, reduction
or hydrolysis), turn drugs into more polar compounds
phase I reactions (functionalization)
coupling drugs with some other substance (e.g. glucuronic acid, known as glucuro- nidation) to make usually inactive compounds.
phase II reactions (conjugation)
Drug Excretion Interactions:
Changes in urinary pH
Changes in active renal tubular excretion
Changes in renal blood flow
Biliary excretion & the entero-hepatic shunt
are those where the effects of one drug are changed by the presence of
another drug at its site of action.
Pharmacodynamic interactions
If two drugs that have the same pharmacological effect are given together the effects can be additive.
Additive or Synergistic Interactions
pairs of drugs with activities that are opposed to one another.
Antagonistic or Opposing Interactions
number of drugs with actions that occur at adrenergic neurons can be prevented from reaching those sites
of action by the presence of other drugs.
Drug or Neurotransmitters Uptake Interactions
they prevent the reuptake of noradrenaline (norepinephrine) into peripheral adrenergic neurons.
tricyclic antidepressants
what type of drugs are most susceptible to alterations of GI absorption?
drugs that are not absorbed completely under optimum circumstances
by increasing Gl motility, may increase the rate at which another drug passes through the GI tract.
CATHARTICS
by decreasing GI motility, also
may influence drug absorption
ANTICHOLINERGICS
increases motility of the
upper GI tract,
METOCLOPRAMIDE
