risks and age stuff - Sheet1 Flashcards

1
Q

What are medication errors?

A

A major cause of morbidity and mortality, often caused by human factors, communication mistakes, or drug name confusion.

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2
Q

Why is the risk of med errors high in hospitals?

A

Complex processes and the nurse being the last line of defense.

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3
Q

What are some causes of medication errors?

A

Human factors, communication mistakes, drug name confusion, packaging issues, labeling errors, and delivery device problems.

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4
Q

How can med errors be reduced?

A

Empowering patients/families, fostering a culture of safety, using tools like computerized order entry and barcodes, avoiding error-prone abbreviations, and conducting medication reconciliation.

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5
Q

What abbreviations are banned by The Joint Commission (TJC)?

A

U, IU, QD, QOD, MS/MSO4/MgSO4, .0 (e.g., 1.0), or . (e.g., .5).

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6
Q

What is medication reconciliation?

A

A process to ensure consistency in medications during patient transitions in care.

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7
Q

What is the role of safety checklists?

A

They help prevent errors with high-alert drugs.

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8
Q

What is the MER Program?

A

A confidential system for reporting medication errors by phone, fax, or internet.

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9
Q

What is Just Culture?

A

A system focused on identifying ways to improve safety rather than assigning blame.

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10
Q

What is Root Cause Analysis (RCA)?

A

A method to investigate and address the root cause of a med error, e.g., misreading medication.

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11
Q

Can all drugs cross the placenta?

A

Yes, all drugs can cross the placenta to some extent.

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12
Q

Are drugs excreted in breast milk?

A

Many drugs are excreted in breast milk and can affect the infant.

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13
Q

What are Category A drugs in pregnancy?

A

Drugs with no risk to the fetus in any trimester (e.g., prenatal vitamins, insulin, folic acid).

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14
Q

What are Category B drugs in pregnancy?

A

No harm in animal studies, but no well-controlled studies in humans (e.g., penicillins, acetaminophen, ibuprofen in 1st & 2nd trimesters).

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15
Q

What are Category C drugs in pregnancy?

A

Adverse effects in animals, no adequate human studies (e.g., fluoroquinolones, SSRIs, corticosteroids).

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16
Q

What are Category D drugs in pregnancy?

A

Evidence of fetal risk, but benefits may outweigh risks in life-threatening cases (e.g., ACE inhibitors, alcohol, lithium, tetracyclines).

17
Q

What are Category X drugs in pregnancy?

A

Drugs contraindicated due to evidence of fetal abnormalities (e.g., isotretinoin, methotrexate, thalidomide, warfarin).

18
Q

Who are considered pediatric patients?

A

All patients younger than 16 years old.

19
Q

Why are pediatric patients more sensitive to drugs?

A

Due to organ system immaturity.

20
Q

What are some considerations when prescribing drugs to pediatric patients?

A
  • ⅔ of drugs are never tested in pediatric patients.
  • 20% are ineffective for children but effective for adults.
  • 30% cause unanticipated side effects.
  • 20% require different dosages than extrapolated adult doses.
21
Q

How are pediatric drug doses calculated?

A

Based on body surface area (BSA).

22
Q

What is the formula for approximate pediatric dosage?

A

BSA+1.73m2Adult Dose​

23
Q

Why are children at greater risk for adverse drug reactions (ADRs)?

A

Vulnerability to unique adverse effects due to organ immaturity and ongoing growth/development.

24
Q

What is the prevalence of prescription drug use in older adults?

A

High, often involving polypharmacy.

25
Q

Why are older adults at increased risk for drug-related problems?

A
  • Polypharmacy increases the risk of drug-drug interactions and ADRs.
  • They use multiple physicians/pharmacies, leading to duplicative or interacting therapy.
26
Q

What percentage of medication-related deaths occur in older adults?

A

0.5

27
Q

What is medication reconciliation?

A

A process to ensure all medications, including OTC, herbals, and dietary supplements, are accounted for to prevent duplications or interactions.

28
Q

What is unintentional nonadherence in older adults, and how can it be addressed?

A

Unintentional nonadherence occurs when patients forget or misunderstand instructions. Solutions include:
- Simplifying drug regimens
- Providing clear instructions
- Using easy-to-open containers
- Implementing daily reminders.

29
Q

What is intentional nonadherence in older adults?

A

When patients purposely avoid taking medications due to high costs, side effects, or perceptions like “dose too high” or “drug not necessary.”

30
Q

What is the Beers Criteria?

A

A list of potentially inappropriate medications for older adults due to high risks of ADRs.

31
Q

What are immunomodulators?

A

Drugs targeting diseases of the immune system or cancer.

32
Q

What are the three main types of immunomodulators?

A
  • Monoclonal antibodies (mAbs): “mab” drugs
  • Tyrosine kinase inhibitors: “nib” drugs
  • Proteasome inhibitors: “mib” drugs