Lehne Book: Chapter 7 - Adverse Drug Reactions and Med Errors

Question 1

ADR (Adverse Drug Reactions) are any noxious, unintended, undesired effect that occurs at normal doses. Does this definition include undesired effects of excessive dosage?

Answer 1

No!

Question 2

What is neutropenia?

Answer 2

presence of abnormally few neutrophils in the blood, leading to increased susceptibility to infection. It is an undesirable side effect of some cancer treatments.

neutro = neutrophils
penia = lack of

Question 3

What do neutropenia, hepatocellular injury, cardiac dysrhythmias, anaphylaxis and hemorrhage have in common?

Answer 3

They are all severe drug reactions.

Question 4

A _______ _______ is a nearly unavoidable secondary drug effect produced at therapeutic dose. Ex. drowsiness, stomach upset.

Answer 4

Side Effect

Question 5

___________ is an adverse drug reaction caused by excessive dosing. Can cause coma, hypoglycemia, neutropenia.

Answer 5

Toxicity

Question 6

An _____ ______ is an immune response. In order for this to take place, prior exposure/sensitization must have taken place. Can range from itching to rash or even anaphylaxis.

Answer 6

Allergic Reaction

Question 7

_______ is a life threatening response characterized by bronchospasm, laryngeal edema, and a precipitous drop in BP.

Answer 7

anaphylaxis

Question 8

T or F: Intensity of allergic reactions is independent of dosage.

Answer 8

True.

Question 9

_________ __________ is an uncommon drug response resulting from a genetic predisposition. One example is succinylcholine. The effects may last longer because the person produces the enzymes that inactivate the drug slower than normal.

Answer 9

Idiosyncratic Effect

Question 10

“Disease produced bye a physician/drug.”

Answer 10

Iatrogenic Disease

Question 11

Physical dependence develops during long-term use of certain drugs. If this occurs, an abstinence syndrome will result when the drug is discontinued. Is it a good or bad idea to stop “cold turkey?”

Answer 11

Patients should be warned against abrupt discontinuation of any med without consulting a health professional.

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Question 12

__________ __________ refers to the ability of certain medications and environmental chemicals to cause cancer.

Answer 12

Carcinogenic Effect

Question 13

What is neoplasia?

Answer 13

the formation or presence of a new, abnormal growth of tissue.

Question 14

_________ _______ is a drug-induced birth defect.

Answer 14

Teratogenic Effect (TUR RAT OH JEN ICK)

Question 15

What are we looking for when we test a blood sample for aspartate or alanine aminotransferases?

Answer 15

We are checking liver function. This is done for patients who need to take known hepatotoxic drugs.

Question 16

How can drugs that are not supposed to cause liver damage, end up causing liver damage?

Answer 16

When they are mixed with other substances. An example is tylenol + alcohol. Therapeutic dose of tylenol is not toxic. 2-3 drinks combined with it can cause severe liver injury.

Question 17

What are some signs/symptoms of liver damage?

Answer 17

Jaundice, dark urine, light-colored stools, nausea, vomiting malaise, abdominal discomfort, loss of appetite.

Question 18

What is a QT interval?

Answer 18

Measure of time required for ventricles to repolarize after each contraction.

Question 19

What are QT drugs?

Answer 19

Drugs that prolong the qt interval.

Question 20

What happens when the QT interval is prolonged?

Answer 20

patients can develop dysrhythmias (abnormal rhythm known as torsades de pointes) which can lead to fatal ventricular fibrillaton.

Question 21

How can we identify if a drug administered is causing the symptoms we see (what questions can we ask):

Answer 21

1. Did symptoms appear shortly after the drug was first used?
2. Did symptoms abate when the drug was discontinued?
3. If drug was reinstituted, did symptoms reappear?
4. Is the illness itself sufficient to explain the event?
5. Are other drugs in the regimen sufficient to explain the event?

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Question 22

If you suspect a brand new drug is causing an unknown adverse effect, what should you do?

Answer 22

Report it to MEDWATCH FDA Medical Products Reporting Program.

Question 23

How can you effectively assist your patient in watching for ADRs?

Answer 23

Inform them of what possible ADRs there are with the med being given. This way if something happens, they can report it before it’s too late to treat.

Question 24

Can a provider or pharmacy withhold GDA med guides?

Answer 24

Yes, if it will deter the patient from taking the med. However, if the patient asks for it, it must be given to the patient (even if it was intentionally witheld).