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23 Cards in this Set

  • Front
  • Back
Any effect of a drug that adversely effects the pt
Adverse drug rxn
What rationalizes the use of drugs that are frequently toxic?
Serious illness
TRUE or FALSE: length of hospital stay is significantly increased by drug related morbidity
TRUE (if it's in the NEJM, it's probably true)
Despite major advances drug info and hospital dispensing, what continues to happen?
Prescribing and dispensing errors
Drug-induced disease occurs in what percentage of medical inpts?
10%
5%-15% of admissions to the hospital medical service are a result of what?
iatrogenic illness
According to an NEJM study, what % of adverse events in hospital pts were drug-related?
20%
TRUE or FALSE: the majority of these events were unavoidable.
FALSE
What 2 failures were involved in the majority of these adverse events?
1)failure to properly use a drug
2)failure to follow-up
Name 3 contributing factors to outpt ADRs.
1)pts seeing multiple physicians
2)use of OTCs and nutritional supplements
3)difficulty pts and docs have nailing down all the meds the pt is on
Studies showed that 10% of outpts being seen for *what* actually had reversible drug-induced disease?
dementia
Type A ADRs are what type of rxn?
Predictable rxns
Minimizing *this* is a primary strategy for reducing the impact of drug-induced disease in medical practice.
Minimizing Type A ADRs.
Type B ADRs are what type of rxn?
Unpredictable rxns
TRUE or FALSE: Type B ADRs are generally unrelated to normal pharm. effects or dosing
TRUE
Name the 3 usual mechanisms of Type B ADRs
1)drug allergy
2)genetic-based metabolic differences (think malignant hyperthermia)
3)idiosyncratic
Which ADR is the most common?
Type A
Name 6 predisposing factors to ADRs (hint: PAH PAP)
1)Polypharmacy
2)Azotemia
3)Hx of previous ADR to same or another drug
4)Presence of infxn
5)Age (>65 y/o)
6)Pharmacogenetic factors (again w/the malignant hyperthermia)
TRUE or FALSE: the FDA has a voluntary reporting system for ADRs.
TRUE-- reports from docs are given priority
TRUE or FALSE: manufacturers have a voluntary reporting system for ADRs.
FALSE-- they're required to report serious ADRs to the FDA in 15 days, less serious ones annually.
TRUE or FALSE: hospitals have a voluntary reporting system for ADRs
FALSE-- reporting is a requirement for certification by the Joint Commission
TRUE or FALSE: when prescribing, always go with what's new on the market for that condition.
FALSE
You should always determine creatinine clearance for which 2 pt populations?
1)pt w/abnormal creatinine clearance
2)age >65 y/o