Adverse Rxns/Medication errors
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| Adverse events = ADE, includes (2) | show 🗑
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| show | noxious, unintended and undesired effect that occurs at normal drug dosages
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| show | includes unproven association with drug, drug interactions and overdosage
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| show | *side effect
*toxicity
*allergic reaction
*idiosyncratic effect
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| Adverse drug reactions - second 4 | show 🗑
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| show | nearly unavoidable secondary effect of a drug at a therapeutic dose
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| Side effect properties -3 | show 🗑
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| Toxicity definition | show 🗑
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| show | toxicity has come to mean a severe ADR regardless of dose that produced it (OD not required)
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| allergic reaction definition | show 🗑
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| 3 properties of allergic reaction | show 🗑
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| Idiosyncratic effect definition | show 🗑
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| show | *succinylcholine
*Isoniazid (INH) metabolized by acetylation - some are fast/slow acetylators
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| show | disease produced by physician, therapy or tx
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| show | admin antipsychotic --> Parkinsons symptoms. Given to a Parkinson's pt would worsen their s/s and iatrogenic seems appropriate
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| show | expected consequence of long term use of some drugs -->neurophysiological adaption that occurs on abrupt d/c, decreased dose, or use of antagonist
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| show | *opioids, ETOH, barbiturates, amphetamines
*TCAs, steroids, BNZs
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| show | predict/indicate addiction, predict abuse
*warning to pt appropriate
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| addiction definition | show 🗑
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| show | *loss of control of use
*preoccupation with use despite relief
*continuation of use despite adverse consequences
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| abuse indication | show 🗑
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| pseudoaddiction definition | show 🗑
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| show | inadequate pain relief. preoccupation is really with pain relief
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| how to distinguish psuedoaddiction from true addiction | show 🗑
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| carcinogenic effect agents | show 🗑
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| show | cyclophosphamide - bladder ca, leukemia develops years later
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| example of carcinogenic drug | show 🗑
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| teratogenic effects | show 🗑
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| organ-specific toxicity | show 🗑
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| hepatotoxicity | show 🗑
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| show | based upon its excretory role
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| show | QT prolongation predisposition to torsade de pointes --> vent fib
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| bone marrow toxicity mechanism | show 🗑
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| examples of bone marrow toxicity | show 🗑
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| example of dermatological toxicity | show 🗑
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| show | *CNS: sedation, psychiatric
*PNS: neuropathies
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| Identification of ADR factors 1-4 | show 🗑
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| identification of ADR factors 5-8 | show 🗑
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| show | *know ADR assoc with every drug admin
*know pt hx - u/l disease, conditions, organ dysfunction, allergy, intolerance
*educate pt s/s of ADRs
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| show | *esp imp in new drugs
*report severe & clusters of ADRs
*report via FDA's medwatch
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| 90% of all fatal med errors from | show 🗑
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| other sources of med errors | show 🗑
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| Types of med errors 'wrong . . . ' | show 🗑
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| show | 30% = performance
14% = knowledge deficits
13% = miscalculation
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| Sources of communication errors (16%) | show 🗑
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| RMSPH | show 🗑
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| NCC MERP | show 🗑
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| show | Institute for Safe Medicaton Practices
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| show | medwatch program
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| show | USP + ISMP
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| show | ISMP
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