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77 Cards in this Set
- Front
- Back
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short term insommnia
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more than 7 days, less than 3 weeks
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transient insomnia
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less than 7 days
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long term insomnia
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more than 3 weeks
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insomnia lasting less than ___________ is self treatable with OTC medications
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2 weeks
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drugs approved for OTC treatment of insomnia
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diphenhydramine and doxylamine
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OTC sleep aids are contraindicated in people with
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breathing problems, glaucoma, difficulty urinating due to enlarged prostate
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Sleep aid - analgesic combos should only be recommended for patients who have_______
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sleeplessness combined with occasional minor aches and pains
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alternative therapies (sleep aids)
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melatonin
valerian neither proven safe or effective. should not be recommended |
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patient behaviors and practices that effect sleep
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sleep hygiene
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alcohol as a sleep aid
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does induce sleep, but heavy drinkers subjected to more awakenings than normal
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only sleep disturbance treatable with OTCs
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insomnia
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sleep efficiency
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percentage of time in bed that one is actually asleep
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sleep latency time
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period of time from laying down to falling asleep
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insomnia (definition)
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unusual difficulty falling asleep and sleeping, sleep that is unusually disturbed, or sleep that causes the individual to suffer from residual daytime tiredness
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caffeine, nicotine, alcohol
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should be avoided to promote sleepfullness
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most-dangerous sleep related problem
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obstructive sleep apnea
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OTC product
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one that can be used safely by a person who reads and follows all instructions provided in the package insert
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label content requirements
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requirements for categories of information on the label
include: title, headings and time of information that must be included beneath each heading |
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label format requirements
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specifies the method of presentation of that information
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systematic approach to answering questions
(5 steps) |
1. classification of the request
2. obtaining background information 3. systematic search 4. response 5. reclassification |
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modified systematic approach
(7 steps) |
1. secure demographics of requestor
2. obtain background information 3. determine/catagorize ultimate question 4. develop strategy, conduct search 5. preform evaluation, analysis, synthesis 6. formulate/provide response 7. conduct follow-up and documentation |
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requestor demographics
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position, training, anticipated knowledge, mechanism for delivery of response
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background questions
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"why is requestor asking for this information?"
-name/contact info/affiliation -patient specific/ academic -resources checked |
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formulation/provision of response
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think about how info will be used.
present both sides of conflicting data |
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follow up
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process of verifying the appropriateness, correctness, and completeness of a response following the communication
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follow-through
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process of readdressing a request based on availability of new data or a change in the situation/circumstances that were decisive factors in synth of response.
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analysis
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critical assessment of the nature, merit and significance of individual elements, ideas or factors
review/evaluation of weight of available evidence negative findings should NOT be overlooked |
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synthesis
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careful,systematic, orderly process of combining varied/diverse info/factors into a coherent response.
integration of info about patient, disease, and medication with background info to arrive at judgment or conclusion. |
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primary literature
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journals.
original research results published for the first time |
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secondary literature
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databases and search devices that lead to primary or tertiary
ie, PubMed |
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tertiary literature
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references, textbook
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adverse drug reaction
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drug response that is noxious, unintended and occurs at NORMAL doses
harm directly caused by drug at NORMAL doses |
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medication error
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any PREVENTABLE event that may cause or lead to inappropriate medication use or patient harm while the medication is in control of the healthcare professional, patient or consumer
inappropriate use of drug that may or may not result in harm |
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side effect
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predictable or dose-dependent effect of drug that is not principal effect for which drug was chosen.
may be desirable, undesirable or inconsequential. |
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majority of medical errors result of _______________
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faulty systems
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swiss cheese model
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gaps in defense, if line up, error occur
no indiv. caused the error --> system error |
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prescribing errors
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med should have appropriate indication
order = legible verbal order = minimized include relevant patient info (ie weight, age etc) avoid abbreviations incl directions for use |
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dispensing errors
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order reviewed by RPh
patient profiles = current properly designed dispensing area establish series of checks labels read >3x RPh counsel patients |
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communication errors
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inability to reach prescriber
prescriber's unwilling to listen omission of important patient info insufficient drug identity knowledge assumptions patient factors (ie literacy, vision, etc) |
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administration errors
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5 rights
-right drug -right patient -right dose -right time -right route BARCODES |
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joint commission mandated do not use
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NO:
trailing 0s U for units spell out drugs, use leading zeros |
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TALL man lettering
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some letters capitalized to make differences in similar drug names stand out.
predniSONE prednisoLONE |
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NDC
(national drug code) |
# that identifies drug
00135 - 0315 - 52 labeler code (FDA) 00135 -firm that manuf., repacks, or distributes drug product product code 0315 -strength, dosage form, formulation package size 52 |
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high-alert medications
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meds that bear a heightened risk of causing significant patient harm when used in error
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CDER
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center for drug evaluation and research
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ISMP
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institute for safe medication practices
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AHRQ
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agency for healthcare research and quality
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NCC MERP
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national coordinating counsel for medication error reporting and prevention
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quantitative
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exact numerical measurements
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qualitative
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reported as a positive or negative result
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accuracy
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how close is mean to true value
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precision
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reproducibility of a measurement
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screening test characteristic
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high sensitivity (lower FN)
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diagnostic test characteristic
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high specificity
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ability of test to identify POSITIVE RESULTS in patients who ACTUALLY have the disease
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sensitivity
(true positive rate) |
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ability of test to identify NEGATIVE RESULT in patients who DON'T HAVE the disease
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specificity
(true negative rate) |
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semiqualitative
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associated with degrees of positivity or negativity
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sensitivity
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[TP / (TP + FN)] *100
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specificity
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[TN / (TN + FP)] *100
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reference range
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encompasses +/- 2SDs
95% of population |
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BUN
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5-25 mg/dL
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SCr
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0.5 - 1.3 mg/dL
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Chem 7 profile
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includes:
Na. Cl. BUN Glucose K CO2 SCr |
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Na
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135 - 145 mEq/L
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Cl
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98 - 107 mEq/L
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K
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3.5 - 5.0 mEq/L
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CO2
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22 - 30 mEq/L
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glucose
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70 - 110 mg/dL
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complete blood count (CBC)
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HgB
WBC Plts Hct |
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WBC
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4000 - 11000 /mm3
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HgB
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male: 12 - 17 gm/dL
female: 11 - 15 g/dL |
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Hct
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male: 40 - 50%
female: 38 - 47% |
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Plts
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150,000 - 400,000 /mm3
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critical value
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result that is far enough outside the reference range that it indicates impending morbidity
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number needed to screen
(definition) |
number of people that need to be screened for a given duration to prevent one death or one adverse event
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laboratory error
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result that is not the true result
inaccurate results that occur because of error made by laboratory personnel or equipment |
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categories of drug-laboratory interactions
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-methodological interference
-drug induced end-organ damage -direct pharmacologic effect -miscellaneous |
