Lehne Book: Chapter 7 - Adverse Drug Reactions and Med Errors Flashcards
ADR (Adverse Drug Reactions) are any noxious, unintended, undesired effect that occurs at normal doses. Does this definition include undesired effects of excessive dosage?
No!
What is neutropenia?
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
What do neutropenia, hepatocellular injury, cardiac dysrhythmias, anaphylaxis and hemorrhage have in common?
They are all severe drug reactions.
A _______ _______ is a nearly unavoidable secondary drug effect produced at therapeutic dose. Ex. drowsiness, stomach upset.
Side Effect
___________ is an adverse drug reaction caused by excessive dosing. Can cause coma, hypoglycemia, neutropenia.
Toxicity
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.
Allergic Reaction
_______ is a life threatening response characterized by bronchospasm, laryngeal edema, and a precipitous drop in BP.
anaphylaxis
T or F: Intensity of allergic reactions is independent of dosage.
True.
_________ __________ 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.
Idiosyncratic Effect
“Disease produced bye a physician/drug.”
Iatrogenic Disease
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?”
Patients should be warned against abrupt discontinuation of any med without consulting a health professional.
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__________ __________ refers to the ability of certain medications and environmental chemicals to cause cancer.
Carcinogenic Effect
What is neoplasia?
the formation or presence of a new, abnormal growth of tissue.
_________ _______ is a drug-induced birth defect.
Teratogenic Effect (TUR RAT OH JEN ICK)
What are we looking for when we test a blood sample for aspartate or alanine aminotransferases?
We are checking liver function. This is done for patients who need to take known hepatotoxic drugs.
How can drugs that are not supposed to cause liver damage, end up causing liver damage?
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.
What are some signs/symptoms of liver damage?
Jaundice, dark urine, light-colored stools, nausea, vomiting malaise, abdominal discomfort, loss of appetite.
What is a QT interval?
Measure of time required for ventricles to repolarize after each contraction.
What are QT drugs?
Drugs that prolong the qt interval.
What happens when the QT interval is prolonged?
patients can develop dysrhythmias (abnormal rhythm known as torsades de pointes) which can lead to fatal ventricular fibrillaton.
How can we identify if a drug administered is causing the symptoms we see (what questions can we ask):
- Did symptoms appear shortly after the drug was first used?
- Did symptoms abate when the drug was discontinued?
- If drug was reinstituted, did symptoms reappear?
- Is the illness itself sufficient to explain the event?
- Are other drugs in the regimen sufficient to explain the event?
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If you suspect a brand new drug is causing an unknown adverse effect, what should you do?
Report it to MEDWATCH FDA Medical Products Reporting Program.
How can you effectively assist your patient in watching for ADRs?
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.
Can a provider or pharmacy withhold GDA med guides?
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).
