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MODULE 1 > Pharmacology Quiz 3 > Flashcards

Pharmacology Quiz 3 Flashcards

1
Q

What is an Adverse Drug Reaction?

A

Any noxious, unintended, undesired effect that occurs at a normal drug dose.

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2
Q

What are some mild ADR effects?

A
  1. Drowsiness
  2. Itching
  3. Nausea
  4. Rash
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3
Q

What are some severe ADR effects?

A
  1. Respiratory Depression
  2. Organ Injury
  3. Anaphylaxis
  4. Death
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4
Q

What are some ADR considerations?

A
  1. What increases the risk?
    - Multiple illnesses
    - Age
  2. What is the impact?
    - For whom?
  3. How can harm be minimized?
    - Checking the MAR (Medication Administration Record)
    * Verifying armband
    * Asking allergies
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5
Q

What is a Side Effect?

A

A nearly unavoidable secondary drug effect that is produced at a therapeutic doses.

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6
Q

What is Toxicity?

A

Severe ADR, regardless of the dose that caused it.

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7
Q

What is an Allergic Reaction?

A

It is an immune response. The intensity is determined by the immune system, not the dosage.

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8
Q

What is an Idiosyncratic effect?

A

An uncommon drug response resulting from a genetic predisposition.

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9
Q

What is a Paradoxical effect?

A

The opposite of the intended drug response.

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10
Q

What is an Iatrogenic disease?

A

Occurs as a result of medical care or treatment, including disease produced by drugs.

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11
Q

What is physical dependence?

A

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

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12
Q

What is the Carcinogenic effect?

A

The ability of certain medications and chemicals to cause cancers.

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13
Q

What is the teratogenic effect?

A

A Drug-induced birth defect.

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14
Q

What are 5 characteristics of hepatoxic drugs?

A
  1. The liver is the primary site of metabolism.
  2. Drugs are the leading cause of liver failure.
  3. Over 50 commonly given drugs are hepatoxic.
  4. Some drug metabolites are hepatoxic.
  5. Combing hepatoxic drugs can increase the risk of liver injury.
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15
Q

What are characteristics of QT drugs?

A
  1. QT drugs - prolong QT interval.
  2. Can cause life-threatening dysrhythmias.
  3. QT drugs found in several drug classes.
  4. Females are at a higher risk.
  5. Multiple QT drugs should not be given concurrently.
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16
Q

True or false: Some medications are not appropriate for patients with prolonged QT interval.

A

True

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17
Q

How are the kidneys affected by ADR?

A
  1. Kidneys filter metabolites out of body.
  2. Cumalitive exposure can cause damage.
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18
Q

How are the ears affected by ADR?

A

Oxotoxic reactions can cause permanent damage.

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19
Q

How are the lungs affected by ADR?

A

They can be pneumotoxic.
- Over 600 drugs are pneumotoxic.

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20
Q

What are some questions you should ask when trying to determine if your patient is having an ADR?

A
  1. Did the symptoms appear shortly after the drug was first used?
  2. Did symptoms abate when the drug was discontinued?
  3. Did the symptoms reappear when the drug was reinstituted?
  4. Is the illness itself sufficient to explain the event?
  5. Are other drugs in the regimen sufficient to explain the event?
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21
Q

What are some ways to minimize ADR’s?

A
  1. Early identification is KEY!
  2. Know major ADR’s that a drug can produce
  3. Monitoring of organ function if toxic drugs are being given
  4. Individualizing therapy
  5. Patient teaching
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22
Q

What are black box warnings?

A

The strongest safety warning a drug can carry and continue to be on the market.

23
Q

What does the black box warning contain?

A

A concise summary of the adverse effects of concern.

24
Q

True or false: The most serious medication warning required by the FDA is the black box warning?

A

True

25
Q

What are some considerations when faced with a BBW (Black box warning)?

A
  1. Does the potential benefit of treatment outweigh the risk?
  2. Are there safer (and equally effective) alternatives?
  3. Would a safer but less effective alternative be appropriate?
  4. Is the boxed warning applicable to this specific patient?
  5. Can action be taken to ameloriate the potential for an adverse reaction?
26
Q

What is a medication error?

A

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.

27
Q

True or false: A medication error can cause both direct and indirect harm?

A

True

28
Q

What are the causes of medication errors?

A
  1. Human factors
  2. Communication mistakes (90% of fatal errors)
  3. Name confusion
  4. Packaging, formulations, and delivery services.
  5. Labeling and reference materials
29
Q

True or false: If the same dose of a drug is given to a big person and a small person, the drug concentration will be lower in the small person?

A

False - it would be higher.

30
Q

What are some factors affecting individual response to a drug?

A
  1. Body composition
  2. Age
    - Infacts: immature organ system
    - Older adults: Decline in organ function
  3. Pathophysiology
  4. Tolerance
  5. Comorbidities and drug interactions
  6. Diet
  7. Patient Compliance
  8. Medical errors
31
Q

How does kidney disease affect an individual response to a medication?

A

Reduced the rate of a drug excretion- drugs may accumulate to toxic levels.

32
Q

How does liver disease affect an individual response to a medication?

A

Reduces the rate of drug metabolism- drug may accumulate to toxic levels.

33
Q

How does tolerance affect an individual’s response to a drug?

A

It decreases responsiveness to a drug as a result of repeated drug administration.

34
Q

How does comorbidities and drug interactions play a factor in an individual’s response to a drug?

A

Drugs taken to manage one condition may complicate the management of another.

35
Q

How does diet play a factor in an indivudal response to a drug?

A
  1. Good diet can elicit therapeutic responses and reduce harm from ADR’s.
  2. Some foods can interact with drugs and cause ADR’s.
36
Q

How does patient compliance play a factor in an individual’s response to a drug?

A

Failure to take the drug.

37
Q

What are some reason a patient may not be able to comply with taking medication?

A
  1. Maual dexterity and visual acuity
  2. Intellectual capacity & Psychologic state
  3. Attitude and belief toward drugs
  4. Ability to pay
38
Q

What are some geriatric concerns with drug therapy?

A
  1. Organ function
  2. Comorbidities
  3. Polypharmacy
  4. Noncompliance
39
Q

What are two things that happen to the elderly when absorbing drugs?

A
  1. Rate of absorption slows
  2. Gastric acidity declines
40
Q

In the elderly, the ability of distribution is affected by many factors including?

A
  1. Increased body fat % - plasma drug levels reduce
  2. Decreased % lean body mass - plasma drug levels increase
  3. Decreased total body water - plasma drug levels increased
  4. Decreased serum albumin concentration - plasma drug levels increase.
41
Q

In the elderly, metabolism tends to ______ with age.

A

Decline (highly variable)

42
Q

In the elderly, execretion begins to decline progressively in _______ adulthood.

A

Early

43
Q

What is the most important cause of ADR’s in older adults?

A

Execretion

44
Q

True or false: ADR’s are seven times more common in older adults.

A

True

45
Q

ADR’s in the elderly population account for what percentage of hospital admissions?

A

16%

46
Q

ADR’s in the elderly population account for what percentage of all medication-related deaths?

A

50%

47
Q

True or false: ADR’s are mostly dose related in the elderly?

A

True

48
Q

True or false: ADR’s in the elderly are unavoidable?

A

False - they can be avoided.

49
Q

True or false: Older adults are less likely to share alcohol or drug recreation use?

A

True

50
Q

True or false: Symptoms of ADR’s in the elderly tend to be nonspecific?

A

True

51
Q

What are the most important risk factors for ADR’s in the elderly?

A
  1. Reduced renal function - drug accumulation
  2. Polypharmacy
  3. Greater severity of illness
  4. Low therapeutic index drugs
  5. Increased individual variation
  6. Inadequate supervision of long-term therapy
  7. Poor adherence
52
Q

What is the goal of drug therapy?

A

Reduce symptoms and improve quality of life.

53
Q

What should the nurse plan look like for drug therapy / preventing ADR’s?

A
  1. Assessment - drug history, compliance
  2. Monitoring - Clinical responses & plasma drug levels
  3. Teaching - How to take meds, strategies for compliance
  4. Advocating - simplest regimen possible, easy to open containers, large print, cost.

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