Pharmacology Quiz 3

Question 1

ADR effects that are mild (4)

Answer 1

• drowsiness
• itching
• nausea
• rash

Question 2

ADR effects - severe (4)

Answer 2

Respiratory depression
Organ injury
Anaphylaxis
Death

Question 3

What increased the risk - ADR

Answer 3

• very ill patients
• increase for a adverse drug reaction
• very young
• very old
• immunocompromised
• human error

Question 4

Side effect

Answer 4

A nearly unavoidable secondary drug effect produced at therapeutic doses

Question 5

Toxicity

Answer 5

Any severe ADR regardless of the dose that caused it

Question 6

Allergic reaction

Answer 6

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

Question 7

Idiosyncratic effect

Answer 7

Uncommon drug response resulting from a genetic predisposition

Question 8

Paradoxical effect

Answer 8

The opposite of the intended drug response

Question 9

Iatrogenic disease

Answer 9

Occurs as the result of medical care of treatment, including disease produced by drugs

Question 10

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

Answer 10

Physical dependence

Question 11

The ability of certain medications and chemicals to cause cancers

Answer 11

Carcinogenic effect

Question 12

Drug induced birth defect

Answer 12

Teratogenic effect

Question 13

Liver is primary site of

Answer 13

Metabolism

Question 14

Drugs are leading cause of

Answer 14

Liver failure

Question 15

Over 50 commonly given drugs are

Answer 15

Hepatotoxic

Question 16

Some drugs metabolites are

Answer 16

Hepatotoxic

Question 17

Combining hepatotoxic drugs increase risk of

Answer 17

Liver injury

Question 18

QT drugs

Answer 18

Prolong QT interval

Question 19

QT drugs can cause

Answer 19

Life threatening dysthymias

Question 20

Kidneys

Answer 20

Filter metabolites out of body
Cumulative exposure can cause damage

Question 21

Ears

Answer 21

Ototoxic reactions cause permanent damage
Very important to catch early

Question 22

Lungs

Answer 22

Over 600 drugs are pneumotoxic

Question 23

What 5 ways to minimize ADRs

Answer 23

• early Identification
• know major ADRs that a drug can produce
• monitoring of organ function of toxic drugs are being given
• individualizing therapy
• patient teaching

Question 24

Black box warnings

Answer 24

Strongest safety warning a drug can carry and still remain on the market

Question 25

Risperdal (black box warning)

Answer 25

Older people- risk for death Calm and induce sleep

Question 26

Celebrex (black box warning)

Answer 26

An increase risk of serious cardiovascular thrombotic events - arthritis - heart attacks - strokes - GI bleed

Question 27

13 major types of medications errors What 2 ?

Answer 27

Direct harm Indirect harm

Question 28

Cause of medication errors

Answer 28

Human factors Communication mistakes (90% of fatal errors) Name confusion

Question 29

If the same dose of a drug is given to a big person and a small person the drug concentration will be higher in the smaller person

Answer 29

Body composition Larger people will need a high dose of medication

Question 30

Factors affecting individual response

Answer 30

- age - infants - older adults - immature organ systems - decline in organ function

Question 31

Reduces rate of drug excretion , drugs may accumulate to toxic levels

Answer 31

Kidney disease

Question 32

Reduces rate of drugs metabolism, drugs may accumulate to toxic levels

Answer 32

Liver disease

Question 33

—— drug levels in our system, ——- in liver or kidney function

Answer 33

Increased; decline

Question 34

Decreased responsiveness to a drug as a result of repeated drug administration

Answer 34

Tolerance

Question 35

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

Answer 35

Comorbidities and drug interactions

Question 36

Good diet can elicit therapeutic responses and reduce harm from ADRs - some foods can interact with drugs and cause ADRs

Answer 36

DIET

Question 37

Failure to take as prescribed

Answer 37

Patient compliance Medication errors

Question 38

Elderly pharmacokinetic changes

Answer 38

Absorption & distribution

Question 39

Elderly - Absorption

Answer 39

Rate of absorption slows Gastric acidity declines (drugs don’t get broken down)

Question 40

Elderly - distribution

Answer 40

Increase body fat Decrease % lean body mass Decreased total body water Decreased serum albumin concentration

Question 41

Increase body fat (what happens to the plasma)

Answer 41

Plasma drug levels reduce

Question 42

Decreased % lean body mass - plasma

Answer 42

Plasma drugs increase

Question 43

Decreased total body water - plasma

Answer 43

Plasma drug levels increase

Question 44

Decreased serum albumin concentration- plasma

Answer 44

Plasma drug levels increase

Question 45

Metabolism tends to ___ with ___ , highly variable

Answer 45

Decline with age

Question 46

Excretion begins to —- progressively in —- —- The most important cause of ADRs in older adults

Answer 46

Decline

Question 47

ADRS are 7x more common in

Answer 47

Older adults

Question 48

ADRs in the elderly account for

Answer 48

16% of hospital admissions of older adults 50% of all medication related deaths

Question 49

ADRs mostly —- related

Answer 49

Dose

Question 50

In elderly ADRs symptoms tend to be

Answer 50

Nonspecific

Question 51

Older adults less likely to share

Answer 51

Alcohol or drug use

Question 52

ADRs are mostly

Answer 52

Avoidable

Question 53

Risk factors of ADRs in elderly

Answer 53

- reduce renal function (drug accumulation) - poly pharmacy - greater severity of illness - low therapeutic index drugs - increased individual variation - inadequate supervision of long term memory - poor adherence

Question 54

Goal of treatment

Answer 54

Improve quality of life Reduce symptoms

Question 55

Assessment

Answer 55

Drug history Compliance

Question 56

Monitoring

Answer 56

Clinical responses Plasma drug levels

Question 57

Teaching

Answer 57

How to take medications Strategies for compliance