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36 Cards in this Set
- Front
- Back
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5 types of medication errors
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omission error
wrong dose wrong drug wrong patient wrong route |
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MC ADR
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Type A
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Which type of ADR is preventable
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Type A
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Def Type A ADR
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dose-dependent extensions of the pharmacologic effect of the drug. Can be predicted
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Type A or B: Imipenem or meperidine causes seizures if dose isn't reduced in renal failure
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Type A
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Type A or B: glyburide-induced hypoglycemia if dosage isn't reduced in hepatic impairment
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Type A
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Type A or B: digoxin-induced arrhythmia in presence of hypokalemia
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Type A
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Type A or B: incidence of ADRs increases with no of drugs prescribed
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Type A
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Def Type B ADR
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idiosyncratic reactions
not predictable |
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Type A or B: hypersensitivity rxns
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Type B
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What type of hypersensitivity is: anaphylaxis, urticaria, angioedema
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Type I
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What type of hypersensitivity is: thrombocytopenia
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Type II
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What type of hypersensitivity is: serum sickness
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Type III
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What type of hypersensitivity is: contact dermatitis
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Type IV
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What type of hypersensitivity rxn does penicillin cause?
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I and III
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What type of hypersensitivity rxn does heparin cause?
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II
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What type of hypersensitivity rxn does PABA-containing sunscreen cause?
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IV
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Mechanism of hypersensitivity rxns
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I - immediate, IgE
II - IgG or IgM bind cells that have drug attached --> cytotoxic reaction III - immune complex deposition; IgG & IgM IV - cell-mediated, DTH |
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Who is predisposed to procainamide or hydralazine-induced lupus
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slow acetylators
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Who is predisposed to type I responses
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atopic pt
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Who is predisposed to maculopapular rash
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monomucleosis
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ADR of terfenadine
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prolonged QT --> TdP
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ADR of cispride
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prolonged QT --> TdP
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ADR of dofetalide
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prolonged QT --> TdP
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ADR of vioxx
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MI and stroke
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ADR of phenytoin
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stevens-johnson syndrome (hypersensitivity rxn). Discontinue if rash appears
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Causes of stevens-johnson syndrome (SJS)
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Viral infections: herpes simplex, influenza, mumps, cat-scratch fever, histoplasmosis, EBV
Drugs: valdecoxib, penicillins, barbs, sulfas, phenytoin, lamotrigine, nevirapine,Ibuprofen, ethosuximide, ginseng |
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symptoms of SJS
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flu-like prodromal period --> sudden development of circular mucocutaneous lesions. begin as macules and can develop into papules, vesicles, blisters, or urticarial plaques.
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ADR of clozapine
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agranulocytosis
monitor WBC |
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ADR of ketoconazole, phenytoin, nitrofurantoin, kava
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hepatotoxicity
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ADR of gentamycin
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nephrotoxicity
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ADR of risperidone
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tardive dyskinesia
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Where do most reports of ADR come from
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pharmacy alterting orders
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limitations of spontaneous reporting system
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underreporting
biases lack of denominator quality of reports |
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4 mechanisms of type A ADR
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renal impairment
hepatic impairment electrolyte imbalance Drug interactions |
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3 characteristics used to determine if an ADR was actually drug induced
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Causality
Literature Nomograms |
