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CSON IM1 > Pharm Quiz 3 > Flashcards

Pharm Quiz 3 Flashcards

1
Q

adverse drug reaction (ADR)

A

any noxious, unintended, undesired effect occurs at normal drug doses

defined by WHO, med error

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2
Q

mild ADR effects

A
  • drowsiness
  • itching
  • nausea
  • rash
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3
Q

severe ADR effects

A
  • respiratory depression (bradypnea, distress)
  • organ injury
  • anaphylaxis (extreme allergice reaction)
  • death
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4
Q

what increases risks for ADR?

A
  • comorbidities (especially liver/kidney problems)
  • young/old age
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5
Q

who is impacted by an ADR?

A
  • pt
  • family
  • staff
  • other pts (more time is required for the pt with the ADR)
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6
Q

how can harm be minimized considering ADRs?

A
  • EMR
  • allergy band
  • pt ID & verification
  • monitor pts when administering a new med
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7
Q

side effect

A

nearly unavoidable secondary drug effect produced at therapeutic doses

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8
Q

toxicity

A

severe ADR, regardless of the dose that caused it

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9
Q

allergic reaction

A

immune response, the intensity of which is determined by immune system, not dosage

pt was exposed to drug, body made antibodies>next exposure?bad reaction

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10
Q

allergic reaction

A

immune response, the intensity of which is determined by immune system, not dosage

pt was exposed to drug, body made antibodies>next exposure> bad reaction

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11
Q

idiosyncractic effect

A

uncommon drug response resulting from a genetic predisposition

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12
Q

paradoxical effect

A

the opposite of the intended drug response

kids tend to have a paradoxical. effect to sedatives

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13
Q

paradoxical effect

A

the opposite of the intended drug response

kids tend to have a paradoxical. effect to sedatives

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14
Q

iatrogenic disease

A

occurs as the result of medical care/tx, including disease produced by drugs

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15
Q

physical dependence

A

body has adapted to drug exposure in such a way that abstinence syndrome will develop if discontinued

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16
Q

carcinogenic effect

A

ability of certain medications & chemicals to cause cancers

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17
Q

teratogenic effect

A

drug-induced birth defect

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18
Q

hepatotoxic drugs

A
  • liver is primary metabolism site
  • drugs are leading cause of liver failure
  • over 50 commonly given drugs are hepatotoxic
  • some drug metabolites are hepatotoxic
  • combining hepatotoxic drugs increases risk of liver injury
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19
Q

statin & cholesterol drugs

A
  • extremely hepatotoxic
  • many Americans need them
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20
Q

QT drugs

A
  • prolonged QT interval
  • can cause life-threatening dysrhythmias
  • found in several drug classes
  • females at higher risk (usually dx in late teens/20s)
  • multiple QT drugs should not be given concurrently
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21
Q

QT interval

A

some meds are not appropriate for pts with prolonged QT interval

22
Q

possible kidney damage

A
  • kidneys filter metabolites out of body
  • cumulative exposure can cause damage
23
Q

ototoxic drugs

A
  • cause permanent damage to inner ears
  • very important to dx early

ex: lasix, must be slow IV push or could cause hearing loss

24
Q

ototoxic drugs

A
  • cause permanent damage to inner ears
  • very important to dx early

ex: lasix, must be slow IV push or could cause hearing loss

25
pneumotoxic
* damage to lungs * over 600 drugs
26
identifying/preventing ADRs
* underlying illness * polypharmacy (pt takes multiple meds, EMR helps to keep everything straight, ensures staff knows pts meds) * unknown- idiosyncratic (uncommon drug response)
27
questions to ask when ADR occurs | 5
* did **symptoms appear shortly after first admin** ? * did **symptoms abate** (go away) when the drug was dc? * did **symptoms reappear** when the drug was reinstituted? * is the **illness** itself sufficient to explain the event? (was it the med or the illness that caused the symptoms?) * are **other drugs** in the regimen sufficient to explain the event?
28
ways to minimize ADRs
* **early identification** is key (vitals & assess immediately upon noticing ADR) * **know major ADRs** of each drug * **monitor organ function** if drugs are toxic * individualizing therapy * **pt ed** (side effects, cautions)
29
black box warning
* **strongest safety warning** a drug can carry & still remain **on the market ** * concise summary of the **adverse effects** of concern (warnings & precautions) * **most serious medication** warning req by **FDA** | alerts perscriber & pt
30
questions to ask yourself with a black box warning | 5
* does the potential benefit/tx outweigh the risk? (cancer tx outweighs liver failure) * are there safer (effective) alternatives? * would a safer but less effective alternatibve be appropriate? * is the warning applicable to this specific pt? * can action be taken to ameliorate (relieve) the potential for ADR?
31
medication error | definition
any preventable event that may cause or lead to inappropriate medicaiton use/ pt harm while the med is in the control of the healthcare professional, pt, or consumer | wrong med, pt, dose, route, etc
32
how many major types of med errors are there?
13 | direct & indirect harm
33
causes of med errors
* human factors * communication mistakes (90% of fatal errors) * name confusion (drugs or pts) * packaging, formulations, & delivery services
34
how does body composition affect ADR?
drug concentration will be higher in a smaller/lighter pt than in a heavier pt
35
how does age affect ADR?
* infants- immature organ systems * elderly- decline in organ function | not metabolizing/excreting as quickly
35
how does age affect ADR?
* **infants**- immature organ systems * **elderly**- decline in organ function | not metabolizing/excreting as quickly
36
how does kidney disease effect ADR?
**reduces** rate of drug **excretion** (drugs may accumulate to toxic levels)
37
how does liver disease affect ADR?
**reduces** rate of drug **metabolism** (drugs may accumulate to toxic levels)
38
a decline in liver or kidney function
leads to an increase of drug levels in the body | can be toxic
39
how does tolerance affect ADR?
decreased responsiveness to a drug as a result of repeated drug admin
40
how do comorbidities/drug interactions affect ADR?
drugs for one condition may complicate management of another condition
41
how does diet affect ADR?
* good died can elicit therapeutic responses & reduce harm from ADR * some foods can interact w drugs & cause ADR
42
how does pt compliance affect ADR?
can be **intentional** non-compliance or **unavoidable** due to mental status, physical disabilities, finances, home situation, etc. (not always "won't", sometimes it's "can't") * manual dexterity & visual acuity * intellectual capacity & psychologic state * attitude & belief toward drugs * ability to pay
43
when can med errors happen? who is the last line of defense?
* any step in the process * RN is last line of defense
44
geriatric concerns for ADR
* decreased organ fuction * comorbidities (cause decreased organ function, likely to be fatal/chronic) * polypharmacy * noncompliance
45
drug absorption in geriatric pts
* slower rate * gastric acidity declines (may not be able to physically handle drugs as well as before)
46
drug distribution in geriatric pts
* increased body fat % (stores meds longer, higher drug levels in body) * decreased % lean body mass, total body water, & serum concentration (less drug levels)
47
drug excretion in geriatric pts
declines progressively **most important** cause of ADRs in older adults
48
how much more likely is an ADR for a geriatric pt than a young adult?
7x
49
elderly drug reations account for what % of hospital ADRs? % of medication-related deaths?
* 16 % hospital admissions * 50% medication-related deaths
50
ADRs in elderly pts
* mostly dose related * symptoms are non-specific * pts are less likely to share alcohol/drug use * mostly avoidable
51
process of drug administration
* **assessment**: drug hx, compliance * **monitoring**: clinical responses, plasma drug levels (especially for strong drugs, new admins) * **teaching**: administration, compliance * **advocating**: simplist regimen possible, easy to open containers, large print, cost

CSON IM1 (15 decks)

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