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Community Health > Pharmacology > Flashcards

Pharmacology Flashcards

1
Q

What is adverse drug event

A

Any untoward medical occurrence that may present during treatment with a pharmaceutical product which does necessarily have causal relationship with this treatment

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2
Q

Adverse drug rxn

A

Response to drug which is noxious and unintended

Occurs at doses normally used in man for prophylaxis, diagnosis, therapy or modification of physiological function

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3
Q

What is a significant ADR

A

Any unexpected, unintended, undesired or excessive response to drug that requires discontinuing drug , changing drug, modifying the dose significantly , admission to the hospital, prolong stay in healthcare supportive treatment,, complicate diagnosis , affect prognosis negatively, temporary or permanent harm , disability or death

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4
Q

Can you have ADR if prescription and dosage are correct

A

Yes

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5
Q

T or F ? ADE are associated with inappropriate use of drug or other confounded occurring during drug therapy but not necessarily caused by drug pharmacology

A

True

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6
Q

Is causal relation required for ADE

A

No

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7
Q

Which can be caused by medication errors , ADE or ADR ?

A

ADE

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8
Q

Medication error definition

A

Any preventable event that may cause or lead to inappropriate use or patient harm while medication is in the control of the health care professional, paient or consumer

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9
Q

Pharmacovigilance définition

A

Study of drug related injuries and making warning or withdrawal recommendation for pharmaceutical agents through detection, assessment, understanding and prevention of ADRs

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10
Q

Classification of ADRs

A 
Type A - augmentation effect
Type B - bizarre effect 
Type C - chronic effect 
Type D - delayed effect 
Type E- withdrawal effect 
Type D - unexpected failure of therapy
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11
Q

Is augmented type rxn dose related

A

Yes

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12
Q

Characteristics of augmented type rxn

A

Common

Exaggerated pharmacological response of drug

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13
Q

Is augmented type rxn predictable

A

Yes

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14
Q

Mortality level of augmented type response

A

Low mortality

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15
Q

Example of augmented rxn

A 
TCA dry mouth 
Opioids respiratory depression 
Warfarin bleeding 
SSRI serotonin syndrome 
Digoxin toxicity
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16
Q

Management of augmented rxn

A

Reduce dose
Withhold drug
Consider effect of concomitantt therapy

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17
Q

Is bizarre type rxn dose related

A

No

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18
Q

Is bizarre type rxn common

A

Uncommon

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19
Q

Is bizarre type rxn related to pharmacology of drug

A

No

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20
Q

Is bizarre type rxn predictable

A

Unpredictable

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21
Q

Mortality level in bizarre type rxn

A

High

22
Q

Example of bizarre type rxn

A

Anaphylaxis to penicillin

Malignant hyperthermia with general anesthetics

23
Q

Bizarre type rxn management

A

Withhold

Avoid in future

24
Q

Chronic type rxn dose related ?

A

Yes

25
Q

Is chronic type rxn common

A

Uncommon

26
Q

How is chronic type rxn related to dose

A

Related to cumulative dose

27
Q

Example of chronic rxn

A

HPA axis suppression by corticosteroids

Osteonecrosis of jaw by biphosphonates

28
Q

Is delayed type rxn dose related

A

Usually

29
Q

Is delayed type relation time related

A

Yes

30
Q

Is delayed type rxn common

A

Uncommon

31
Q

Example of time delayed rxn TPE

A

Crcinogenesis estrogen

Tardive dyskenisia levodopa

Tératogénies is thalidomide

Leucopenia lomustine

32
Q

Management of delayed rxn

A

Intractable

33
Q

Withdrawal rxn occur at which moment in treatment

A

At the end of use

34
Q

Is withdrawal rxn common

A

Uncommon

35
Q

Example of withdrawal rxn

A

Opiates

Benzodiazepines

36
Q

Management of withdrawal rxn

A

Reintroduce drug and withdraw slowly

37
Q

Failure of therapy rxn common ?

A

Common

38
Q

Is unexpected failure of therapy dose related

A

Yes

39
Q

Main cause of failure of therapy rxn

A

Drug interactions

40
Q

Example of unexpected failure of therapy

A

Inadequate dosage of oral contraceptive with enzyme inducer

Resistance to anti microbial agents

41
Q

Management of unexpected failure of treatment

A

Increase dosage

Concomitant therapy consideration

42
Q

Another way to classification ADR

A

Non immunologic

Immunologic

43
Q

What are predictable non immunologic rxn

A 
Side effects ( antihistamine dry mouth )
Drug toxicity (hepatotoxicity methotrexate )
Drug drug interaction ( theophylline seizure with erythromycin )
Drug overdose ( seizure from excessive lidocaine )
44
Q

Unpredictable non immunologic rxn

A

Pseudoallergic ( anaphylaxis avec radio contrast )
Idiosyncratic ( hemolytic anemia in G6PD deficiency after primaquine therapy )
Intolerance ( tinnitus after single small dose of aspirin )

45
Q

Immunologic rxn

A

Type I -IgE mediated (b-lactam)
Type II - cytotoxic ( hemolytic anemia penicillin )
Type III- immune complex (serum sickness form antithymocyte globulin complex)
Type IV- delayed cell mediated ( contact dermatitis topical antihistamine )
Specific T cell activation (morbiliform rash from sulfonamides)
Fas / Fas ligand induced apoptosis (Steven Johnson syndrome )
Drug induced
Anticonvulsant
Hypersensitivity syndrome
Lupus like syndrome

46
Q

Example of cutaneous ADRS

A

drug reaction with eosinophilia and systemic symptoms

Acute geenralized exanthématiques pustulosis

Toxic epidermal necrolysis

47
Q

Drug classes most responsible for ADRs

A 
Corticosteroids 
Antibiotics 
Anticoagulants 
Antineoplastic 
Immunosuppressive drugs 
Cardiovascular drugs 
NSAIDs
Opiates
48
Q

Children most prevalent classes drugs for ADRs

A

Anti infective drugs
Respiratory drugs
Vaccines

49
Q

Grading of ADRs

A

Minor -> no therapy nothing
Moderate -> change in drug therapy , specific treatment /prolong hospital stay
Severe -> life threatening , permanent damage , intensive medical treatment
Lethal -> direct or indirect contribution to death

50
Q

Name of assessment done to each ADRs to find future drug therapies

A

Causality assessment

Community Health (11 decks)

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