Safe drug use Flashcards
Define medication error
Failure in the treatment process that leads to or can lead to harm to the patient - may lead to adverse drug reaction
Can involve an error in the manufacturing, dispensing or supply of drugs or in the prescribing or administration of drugs
Allergy
Wrong dose
Wrong route
Omission
Name some cytochrome P450 inducers
Carbamazepine
Phenytoin
Chronic alcohol
Rifampicin
Describe the speed of cytochrome P450 induction
Slow
Describe the speed of cytochrome P450 inhibition
Fast
Name some drugs which inhibit cytochrome P450
Amiodarone Ciprofloxacin Erythromycin Clarithromycin Metronidazole Fluconazole Isoniazid Alcohol (acute) Grapefruit juice
How may phases are there to drug metabolism?
2
Describe the possible outcomes of phase 1 of drug metabolism
Drug - Active (pro-drug), inactive or toxic
What processes are involved in phase 1 drug metabolism
Oxidation - P450 cytochrome
Reduction
Hydrolysis (esterases)
Describe phase 2 drug metabolism
Drug solubilisation by conjugation
- Glucornidation
- Acetylation
- Sulfation
- Methylation
Elimination in urine or bile
What is an adverse drug reaction?
Any undesirable experience that has happened to the patient while taking the drug that is suspected to be caused by the drug
How much do adverse drug reactions cost the NHS per year?
£466 million
What questions should you always ask before prescribing a drug?
What current or regular medications do you take? Any over the counter medications? COCP? Homeopathic? Any drug allergies or sensitivities?
Give some examples of sources for the drug history
Must be recent Must be correct patient From the patient Relatives Carers GP NHS summary care records Nursing home Discharge summaries from previous admissions
What important co-morbidities should you look for before prescribing drugs?
Hepatic impairment
Cardiac problems
Renal impairment
Pregnant/breastfeeding
Which drugs are renally excreted?
Aminoglycosides
Glycopeptides
Penicillins
Morphine sulfate
