pharm lecture 3 Flashcards
ADR
Adverse drug reaction
What is an adverse drug reaction?
Unintended effects of a medicine
Mild ADR - 4
Drowsiness
itching
nausea
rash
Severe ADR
respiratory depression
organ injury
anaphylaxis
death
respiratory depression
trouble breathing
2 organs in pharmacology that could have injury
liver and kideny
Anaphylaxis
severe allergic reaction
ADR considerations - 3
What increases the risk?
What is the impact- for whom?
How can harm be minimized?
Who is at high risk for ADR - 4
very ill
old
young
immunocompromised
How can harm be minimized? - 4
Looking at the drugs that affect each other
Making sure you have the correct patient
Patient education
Through assessment after medicine
How can harm be minimized? - 4
Looking at the drugs that affect each other
Making sure you have the correct patient
Patient Education
Through assessment after medicine
side effect
a nearly unavoidable secondary drug effect produced at therapeutic doses
toxicity
any severe ADR, regardless of the dose that caused it
allergic reaction
immune response, the intensity of which is determined by immune system, not dosage
Idiosyncratic effect
uncommon drug response resulting from a genetic predisposition
Paradoxical effect
opposite of the intended drug response
who is at high risk for a paradoxical effect?
old and young
iatrogenic disease
occurs as the result of medical care or treatment, including disease produced by drugs
physical dependence
the body has adapted to drug exposure in such a way that abstinence syndrome will develop if discontinued
carcinogenic effect
the ability of certain medications and chemicals to cause cancers
teratogenic effect
drug-induced birth defect
hepatotoxic
damage to liver
DILI
drug induced liver injury
liver is the primary site of _________
Metabolism
leading cause to liver failure
drugs
QT
damage to heart
prolonged QT interval
slows heart rate
how can some medicine affect the heart
causes prolonged QT interval
what do kidneys do
filter metabolites out of body
furosemide
lasix
ototoxic
medicine toxic to ears
nephrotoxic
medicine toxic to kidneys
what part of the ear can be harmed
inside
pneumotoxic
toxic to the lungs
polypharmacy
someone who takes a lot of drugs
who would you expect to have polypharmacy - 3
old
immunocompromised
chronically ill
questions to ask - 5
did symptoms appear shortly after drug use?
did symptoms abate when the drug was discontinued?
Did symptoms reappear when the drug was reinstituted?
is the illness itself sufficient to explain the event?
are other drugs in the regimen sufficient to explain the event?
Black Box Warning
the strongest safety warning a drug can carry and still remain on the market, the most serious warning required by the FDA
Considerations when faced with a BBW - 5
does the benefit outweigh the risk
are there safer equally effective alternatives
would a safer but less effective alternative be appropriate
is the BBW applicable to the patient
can action be taken to ameliorate the potential for an adverse reaction
medication errors
any preventable event that may cause or lead to inappropriate medication use or patient harm while the medication is in the control of the healthcare professional, patient, or consumer
Causes of medication errors - 3
human factors
communication mistakes
name confusion
Factors affecting individual response - 3
body composition
age
pathophysiology
Tolerance
diet
comorbidities
patient compliance
med. errors
has an immature organ system
infants
has a decline in organ function
older adults
tolerance
decreased responsiveness to a drug as a result of repeated drug administration
comorbidities
drugs taken to manage one condition may complicate the management of another condition
geriatric concerns - 4
organ function
comorbidities
polypharmacy
noncompliance
absorption in geriatric pts
rate slows, gastric acidity declines
what causes reduced plasma drug levels
increased body fat
what causes increased plasma drug levels - 3
decreased lean body mass
decreased total body water
decreased serum albumin concentration
metabolism in geriatric patients
tends to decline withnage
excretion in geriatric patients
begins to decline progressively in early adulthood
what is the most important cause of ADRs in older adults
excretion
