Block 4: Adverse Drug Rxns

Front 1

Any effect of a drug that adversely effects the pt

Back 1

Adverse drug rxn

Front 2

What rationalizes the use of drugs that are frequently toxic?

Back 2

Serious illness

Front 3

TRUE or FALSE: length of hospital stay is significantly increased by drug related morbidity

Back 3

TRUE (if it's in the NEJM, it's probably true)

Front 4

Despite major advances drug info and hospital dispensing, what continues to happen?

Back 4

Prescribing and dispensing errors

Front 5

Drug-induced disease occurs in what percentage of medical inpts?

Back 5

10%

Front 6

5%-15% of admissions to the hospital medical service are a result of what?

Back 6

iatrogenic illness

Front 7

According to an NEJM study, what % of adverse events in hospital pts were drug-related?

Back 7

20%

Front 8

TRUE or FALSE: the majority of these events were unavoidable.

Back 8

FALSE

Front 9

What 2 failures were involved in the majority of these adverse events?

Back 9

1)failure to properly use a drug
2)failure to follow-up

Front 10

Name 3 contributing factors to outpt ADRs.

Back 10

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

Front 11

Studies showed that 10% of outpts being seen for *what* actually had reversible drug-induced disease?

Back 11

dementia

Front 12

Type A ADRs are what type of rxn?

Back 12

Predictable rxns

Front 13

Minimizing *this* is a primary strategy for reducing the impact of drug-induced disease in medical practice.

Back 13

Minimizing Type A ADRs.

Front 14

Type B ADRs are what type of rxn?

Back 14

Unpredictable rxns

Front 15

TRUE or FALSE: Type B ADRs are generally unrelated to normal pharm. effects or dosing

Back 15

TRUE

Front 16

Name the 3 usual mechanisms of Type B ADRs

Back 16

1)drug allergy
2)genetic-based metabolic differences (think malignant hyperthermia)
3)idiosyncratic

Front 17

Which ADR is the most common?

Back 17

Type A

Front 18

Name 6 predisposing factors to ADRs (hint: PAH PAP)

Back 18

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)

Front 19

TRUE or FALSE: the FDA has a voluntary reporting system for ADRs.

Back 19

TRUE-- reports from docs are given priority

Front 20

TRUE or FALSE: manufacturers have a voluntary reporting system for ADRs.

Back 20

FALSE-- they're required to report serious ADRs to the FDA in 15 days, less serious ones annually.

Front 21

TRUE or FALSE: hospitals have a voluntary reporting system for ADRs

Back 21

FALSE-- reporting is a requirement for certification by the Joint Commission

Front 22

TRUE or FALSE: when prescribing, always go with what's new on the market for that condition.

Back 22

FALSE

Front 23

You should always determine creatinine clearance for which 2 pt populations?

Back 23

1)pt w/abnormal creatinine clearance
2)age >65 y/o