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36 Cards in this Set

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