Pharmacology Quiz 3 Flashcards
Adverse drug reaction:
Any noxious, unintended, undesired effect that occurs at normal drug doses
ADR effects: mild
Drowsiness, itching, nausea, and rash
ADR effects: severe
Respiratory depression, organ injury, anaphylaxis, and death
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:
The opposite of the intended drug response
latrogenic disease:
Occurs as the result of the medical care or treatment, including disease produced by drugs
physical dependence:
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 cancer
teratogenic effect:
Drug-induced birth defect
Hepatotoxic drugs:
Liver is primary site of metabolism, drugs can also cause liver failure, combining hepatotoxic drugs increases risk of liver injury
QT drugs:
QT drugs- prolong QT interval, can cause life-threatening dysrhythmias, females at higher risk, multiple QT drugs should not be given concurrently
Filter metabolites out for body, cumulative exposure can cause damage
Kidneys
Black box warnings:
Strongest safety warning a drug can carry and still remain on the marker, concise summary of the adverse effects of concern
Communication mistakes are __% of fatal errors
90%
tolerance:
Decreased responsiveness to a drug as a result of repeated drug administration
comorbidities and drug interactions
Drugs taken to manage one condition may complicate management of another condition
Good diet can elicit therapeutic responses and reduce harm from ADRs
Diet
ototoxic reactions cause permanent damage, very important to catch it early
ears
the ___ ear are affected by drugs
inner
identifying ADR:
underlying illness, polypharmacy, and unknown
ways to minimize ADRs
early identification is key, know major ADRs that a drug can produce, monitoring of organ function if toxic drugs are being given, individualizing therapy, and patient teaching
medication error: definition
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
pathophysiology-kidney disease:
reduces rate of drug excretion - drugs may accumulate to toxic levels
pathophysiology - liver disease
reduces rate of drug metabolism - drugs may accumulate to toxic levels
geriatric concerns:
organ function, comorbidities, polypharmacy, noncompliance
pharmacokinetic changes: ADME (elderly)
absorption, distribution, metabolism, and excretion
absorption in eldery:
rate of absorption slows down, gastric acidity declines
distribution in elderly:
increased body fat % (plasma drug levels reduced), decreased % lean body mass (plasma drug levels increased), decreased total body water, and decreased serum albumin concentration
metabolism in elderly
tends to decline with age
excretion in elderly:
begins to decline progressively in early adulthood (MOST important cause of ADRs in older adults)
important risk factors (elderly)
reduced function- drug accumulation, polypharmacy, greater severity of illness, low therapeutic index drugs, increased individual variation, inadequate supervision of long-term therapy, poor adherence
synthetic thyroxine (T4)
levothyroxine (Synthroid, Levoxyl) most common form is pill in mcg, can be IV
what is reason for synthetic thyroxine (T4)
hypothyroidism - a lot in obese patients, cardiovascular disease, and COPD
side effects of synthetic thyroxine (T4)
tachycardia, palpations, dyspnea on exertion, and goiter (irregular thyroid gland growth)
synthetic thyroxine (T4) you administer on ____ & most commonly at ____ in the morning in the hospital
empty stomach, 0730
if a levothyroxine dose is too low, watch for:
bradycardia, lethargy, constipation, excessive fatigue, and excessive sleeping
if levothyroxine dose is for high, watch for:
irritability, palpitations, tachycardia, diarrhea, tremors, and insomnia
proton pump inhibitors:
pantoprazole (protonix), omeprazole (prilosec), lansoprazole (prevacid)
indications for a proton pump inhibitor:
GERD, peptic ulcer disease (PUD), and stress ulcer prophylaxis
pantoprazole is given in the hospital very often for
stress ulcer prophylaxis
forms of pantoprazole
PO dosage, IV push dosage (given slowly over 2 minutes), and IV piggyback (GI bleed)
side effects of proton pump inhibitors:
cutaneous lupus, clostridium difficile, gastroenteritis, diarrhea, bone fracture, and hypomagnesemia
hydrocodone indications:
pain, cough
hydrocodone commonly given in a combination form with other meds:
hydrocodone/acetaminophen = norco, vicodin, or lortab for pain
hydrocodone/chlorpheniramine = tussionex for cough
adults can only have _____ of acetaminophen a day
4000 mg (4g), risk of liver damage
black box warnings for hydrocodone:
-addiction, abuse, misuse
- life-threatening respiratory depression
- risks from use with benzodiazepines or other CNS depressants
- interactions with alcohol
other adverse reactions for hydrocodone:
constipation, itching, vomiting, hypotension, CNS depression, and withdrawal
