Module 1 Flashcards
Are events associated with drug therapies that can or do hamper optimal patient health outcomes.
This includes:
•medication errors,
•adverse drug reactions, and
•side effects.
Also similar to the term medication misadventures.
MEDICATION-RELATED PROBLEMS
CLASSIFICATION OF MEDICATION ERRORS:
ADPMT
ADMINISTRATION ERROR
DISPENSING ERROR
PRESCRIBING ERROR
MONITORING ERROR
TRANSCRIPTION AND/OR INTERPRETATION ERRORS
FACTORS CONTRIBUTING TO THE OCCURRENCE OF MEDICATION-RELATED PROBLEMS:
SOUND-ALIKE AND LOOK-ALIKE DRUGS (SALAD)
SLOPPY COMMUNICATION PRACTICES
-Illegible handwriting, incorrect transcription and verbal communications
DISTRACTIONS AND OVERWORK
POOR DESIGNED LABELS
POOR PERSONNEL MANAGEMENT PRACTICES
-Inadequate performance feedback
LACK OF A QUALITY IMPROVEMENT SYSTEM
EQUIPMENT FAILURES
Are DRPs that are unexpected, unintended, undesired, or excessive responses to a drug that require some type of medical response (discontinuing the drug, changing therapy, making major dose modifications)
ADVERSE DRUG REACTIONS
resulting in a negative outcome (hospital admissions, prolonged treatment, harm, disability or death).
ADVERSE DRUG REACTIONS
ADVERSE DRUG REACTIONS:
ALLERGIC REACTIONS
IDIOSYNCRATIC REACTIONS
ADVERSE DRUG EVENTS (ADE)
DRUG-RELATED MORBIDITY
SENTINEL EVENTS
Immunologic hypersensitivities to drugs.
ALLERGIC REACTIONS
Abnormal responses drugs that are peculiar to individuals.
IDIOSYNCRATIC REACTIONS
Result in injury, expected (drug withdrawal symptoms, drug-abuse symptoms, accidental poisonings and drug-overdose management).
ADVERSE DRUG EVENTS (ADE)
Failure of drug to achieve intended outcomes
DRUG-RELATED MORBIDITY
Unexpected incidents resulting in death or potential serious physical and psychological injury
SENTINEL EVENTS
Expected, unavoidable reactions of the appropriate use of many drugs.
Example: Potential upset stomach associated with NSAIDS.
SIDE EFFECTS
MEDICATION-RELATED PROBLEMS:
LATENT INJURIES
POTENTIAL INJURIES
ERROR OF COMMISSION
ERROR OF OMISSION
Propensity or predisposition for harm during process of care.
Does not result in patient injury.
LATENT INJURIES
Results from errors in prescribing, dispensing, or medication administration.
Potential to cause an injury but did not, either by luck or because they were intercepted.
POTENTIAL INJURIES
Patient receives either correct or incorrect drug.
ERROR OF COMMISSION
Patient failing to receive drugs that can be beneficial.
Receiving no drug occur.
ERROR OF OMISSION
PREVENTION OF MEDICATION ERRORS:
Improvement of health information technology
Pharmacovigilance
Active health workers and organizations.
Pharmacist must keep with medication literature
Pharmacist should verify the accuracy of new prescription
Patient education
PHARMACISTS ROLE IN RESOLVING MEDICATION ERRORS
Patient engagement in their medication regimens.
Prescription filling technology must be assessed and improved.
Pharmacists monitoring of ADRs and high risk of side effects.
Pharmacists should routinely review patient medication records.
WHO defines _____ as an unintended noxious response occurring after the normally used in man for the prophylaxis. Diagnosis or therapy of disease, for the modification of physiological function (WHO, 1972).
ADR
CLASSIFICATION OF ADRS
RAWLINS-THOMPSON CLASSIFICATION
DoTS System
based on the type of ADR occurred
RAWLINS-THOMPSON CLASSIFICATION
-Dose relatedness, Timing and patient Susceptibility (Aronson and Ferner, 2003).
-examine the various factors that both describe a reaction and influence an individual patient’s susceptibility.
-the dose of the drug
Example: Increasing the dose of a cardiac glycoside will increase the risk of digitalis toxicity.
DoTS System
FACTORS AFFECTING SUSCEPTIBILITY TO ADRS:
AGE
GENDER
CO-MORBIDITES AND CONCOMITANT
MEDICINE USE
ETHNICITY
-> CYTOCHROME P450 GENOTYPE
GENETIC VARIATION
ERYTHROCYTE GLUCOSE-G-PHOSPHATE DEHYDROGENASE DEFICIENCY (G6PD)
PORPHYRIAS
