Pharmacology 1.6

Front 1

any unexpected, unintended, undesired or excessive response to a medication that leads to discontinuation of a drug, dose medication, necessitates use of supportive treatment, prolonged hospital stay, hospitalization, or leads to patient harm or death

Back 1

adverse drug reactions

Front 2

a response to a drug which is noxious and unintended and which occurs at doses normally used in man for prophylaxis, diagnosis or therapy of disease or modification of physiologic function

Back 2

adverse drug reactions

Front 3

a serious adverse event in which the patient outcome is death, life threatening, hospitalization, disability, congenital anomaly, or required intervention to prevent permanent impairment or damage

Back 3

adverse drug reactions

Front 4

an expected well known reaction resulting in little or no change in patient management

Back 4

side effect

Front 5

an example would be drowsiness or dry mouth resulting from certain antihistamines or nausea associated with the use of antineoplastic agents

Back 5

side effect

Front 6

T/F: Accidental poisoning, drug overdose complications are ADRs.

Back 6

false

Front 7

What percentage of the population experience adverse drug reactions?

Back 7

10-20%

Front 8

What percentage of hospitalized patients experience adverse drug reactions?

Back 8

5-10%

Front 9

Why is the percentage of hospitalized patients experiencing ADRs less than the population?

Back 9

because the patients are being monitored

Front 10

involves chart review to detect adverse drug reactions after patient has been treated and discharged from the hospital; patient has gone home and reports later

Back 10

retrospective review

Front 11

involves the detection and reporting of ADRs as soon as they occur; patient in hospital

Back 11

prospective/concurrent review

Front 12

Who is most likely to develop an adverse drug reaction?

Back 12

patients on multiple medications
patients given medications they are allergic to
patients with renal insufficiency
elderly patients

Front 13

essential to avoid giving patients medications they are allergic to

Back 13

documenting patient allergies

Front 14

What occurs most often in patients who are on medication long-term and have not been dose adjusted?

Back 14

adverse drug reactions

Front 15

What ADR do antihistamines (Benadryl) treat?

Back 15

hypersensitivity reactions
drug rashes

Front 16

What ADR does atropine treat?

Back 16

bradycardia

Front 17

What ADR does dexatrose 50% treat?

Back 17

hypoglycemia

Front 18

What ADR does naloxene treat?

Back 18

narcotic antagonism

Front 19

What ADR do steroids treat?

Back 19

hypersensitivity reactions, drug rashes

Front 20

What ADR does flumazenil treat?

Back 20

Benzodiazepine antagonist

Front 21

What ADR does Vitamin K treat?

Back 21

Coumadin antagonist

Front 22

What ADR does epinephrine treat?

Back 22

hypersensitivity reaction

Front 23

What ADR does calcium chloride treat?

Back 23

calcium channel blocker overdose

Front 24

What ADR does calcium gluconate treat?

Back 24

calcium channel blocker overdose

Front 25

What ADR do steriods (topical) treat?

Back 25

hypersensitivity reaction

Front 26

What ADR does dantrolene treat?

Back 26

malignant hyperthemia, neuroleptic malignant syndrome

Front 27

What ADR does digoxin immune fab (digibind) treat?

Back 27

digoxin overdose

Front 28

What ADR does sodium polystyrene sulfonate (Kayexelate) treat?

Back 28

hyperkalemia

Front 29

What do you do when an ADR occurs?

Back 29

1. notify physician
2. monitor patient and provide supportive measures
3. document ADR on Medication Safety form and forward to pharmacy

Front 30

an ADR accurred that did not result in patient harm

Back 30

Level I

Front 31

an ADR occurred that resulted in the need for increased patient monitoring but no chane in vital signs and no patient harm

Back 31

Level II

Front 32

an ADR occurred that resulted in the need for increased patient monitoring with a change in vital signs or increased laboratory monitoring but no ultimate patient harm

Back 32

Level III

Front 33

an ADR occurred that resulted in the need for treatment with another drug or an increased length of stay (or that affected patient participation in an investigational drug study)

Back 33

Level IV

Front 34

an ADR occurred that resulted in permanent patient harm (initiate root cause analysis)

Back 34

Level V

Front 35

an ADR occurred that resulted in patient deat (initiate root cause analysis)

Back 35

Level VI

Front 36

Why report ADRs?

Back 36

1. to meet regulatory agency guidelines
2. to prevent preventable ADRs
3. to implement process changes and formulary changes when applicable
4. to maintain and improve patient care

Front 37

What ADR should you watch for with insulin?

Back 37

hypoglycemia

Front 38

What ADR should you watch for with heparin?

Back 38

bleeding

Front 39

What ADR should you watch for with coumadin?

Back 39

bleeding

Front 40

What ADR should you watch for with lovenox?

Back 40

bleeding

Front 41

A patient who experienced rash and urticaria to sulfonamides in the past received sulfadiazine cream for wound care. An hour after cream was applied to the patient's legs, the patient experienced urticaria of the neck and arm. The cream was washed off and patient received diphenhydramine and hydrocortisone with relief of symptoms.

T/F: this patient had experienced an ADR reaction to sulfadiazine cream.

Back 41

true because you must give another drug to counteract it; allergy, not side effect

Front 42

While reviewing the patient's chart, no trigger medications were identified from the physician's orders. However, laboratory values indicate an accucheck of 33. No documentation on progress notes regarding low glucose levels or changes in insulin orders. Nurses notes indicate patient being very shaky, lethargic, and slightly confused--accucheck was 33. Physician notified and dextrose 50$ half ampoule prescribed with accucheck follow-up. Later MD writes orders to change the sliding scale insulin.

T/F: you would consider this an ADR resulting from insulin.

Back 42

true because it is an undesired affect you must counteract

Front 43

Patient is on Levaquin 500mmg IVPB for pneumonia. Physician discontinues IV Levaquin after 2 doses and orders Benadryl 25mg IV now, followed by 25mg PO Q6 hrs PRN itching. In progress notes, physician documents that patient developed a rash from Levaquin.

A. this patient has had an adverse drug reaction to Levaquin

B. you would document this on an ADR/Med Safety Form and send to Pharm
C. you'll call the FDA to report this reaction
D. A & B
E. A & C

Back 43

D