Pharm 2060B Module 10

Front 1

define adverse drug reactions

Back 1

the unintended and undesired responses from drugs

Front 2

what percent of people admitted to hospitals are admitted for ADRs?

Back 2

7.5%

Front 3

T/F side effects are unexpected

Back 3

true

Front 4

t/f side effects occur at therapeutic doses/toxic doses

Back 4

both

Front 5

what are two reasons side effects occur?

Back 5

poor specificity and selectivity of the drug

Front 6

how does antihistamine treat allergies?

Back 6

antihistamines bind to H1 receptors on sinus arteries, this causes vasoconstriction of the vasodilated arteries, removing the allergic symtoms.

Front 7

How are side effects by antihistamine occurred?

Back 7

one of the main reasons side effects occur is because the drug has poor selectivity/specificity for receptors. in the case of antihistamine, it binds to receptors in the brain as well, causing drowsiness, dry mouth and urinary retention.

Front 8

define drug toxicity

Back 8

any severe adverse drug event

Front 9

T/F drug toxicity is often mediated by overdose

Back 9

True

Front 10

drug toxicity reactions are often extensions of?

Back 10

the therapeutic effect

Front 11

What is an example of drug toxicity?

Back 11

too much insulin can cause hypoglycemia

Front 12

what are allergic reactions mediated by?

Back 12

the immune system

Front 13

allergic reaction requires prior...

Back 13

sensitization

Front 14

explain how allergic reactions will initiate

Back 14

an allergen will sensitize the mast cell, which causes it to produce antibodies to that drug. the next time this allergen comes into contact, the antibodies will bind to the allergen and cause the release of histamines. these histamines cause the allergic reactions of rashes, itches, and anaphylaxis

Front 15

Intensity of allergic reactions are dependent/independent of drug concentration

Back 15

independent. you only need a couple of molecules to start the response

Front 16

____ % of all ADRs are related to allergic rxn

Back 16

10%

Front 17

What is the most common class of drugs that causes allergies? Name 2 others.

Back 17

Penicillin

2 others are NSAIDs and sulfonamides

Front 18

which area of the body is most susceptible to allergic rxn? least?

Back 18

most is the trunk. least is the extremeties + head

Front 19

what are idiosyncratic reactions?

Back 19

reactions that occur rarely and unpredicably in the population

Front 20

what accounts for the majority of idiosyncratic reactions?

Back 20

genetic polymorphisms

Front 21

the majority of polymorphisms causing idiosyncratic reactions occur in what?

Back 21

drug metabolizing enzymes and drug transport proteins

Front 22

approximately what percent of what race has a polymorphism that decreases the metabolism of CYP2C9?

Back 22

15% of caucasians have a polymorphism that decreases the metabolic activity of CYP2C9

Front 23

what percent of what race(s) have a polymorphism that makes them poor metabolizers of codeine in CYP2D6

Back 23

10% of caucasians and africans

Front 24

what percent of patients have decreased TPMT activity? what percent have no activity? what does this cause?

Back 24

10% and 0.3%. this can cause increased bone marrow suppression

Front 25

What is OATP1B1, and what does the polymorphism cause. what percent of which race have it?

Back 25

OATP1b1 is an uptake transporter in the liver. polymorphism causes decreased function,which leads to higher free drug concentrations and myopathy in some cases. 15% of asians and caucasions have it.

Front 26

What is DES?

Back 26

diethylstilbestrol was a drug used to prevent spontaneous abortion, but was pulled off the shelves because it caused vaginal cancer

Front 27

what is a mutagenic drug?

Back 27

a drug is able to change the DNA

Front 28

a mutgenic drug is also often a

Back 28

carcinogen or teratogenic

Front 29

How are drugs tested to be mutagens? What is the process?

Back 29

by the Ames test. this test evaluates the ability of the test drug to cause a mutation in a specialized strain of bacteria.

Front 30

What are teratogenic drugs? name 2 characteristics for this.

Back 30

drugs that are known to produce birth defects and impair fertility

Front 31

What 3 factors encompass birth defects

Back 31

1. physical deformations

2. behavioral defects

3. metabolic defects

Front 32

explain how sensitivity to teratogens changes throughout the pregnancy

Back 32

during the first trimester, the baby is most susceptible to changes, and deformations of gross anatomy may occur. In the second and third trimesters, teratogens disrupt gross function as opposed to anatomy.

Front 33

When is transfer of drugs greatest across the placental barrier? Name 2 reasons why.

Back 33

Transfer of drugs across the placental barrier is greatest in the third trimester. This is because as the fetus develops, the surface area for placental transfer increases, and also because the placenta gets thinner

Front 34

Describe category A in the pregnancy risk categories

Back 34

human studies have shown there is no risk to fetus throughout pregnancy

Front 35

Describe category B in the pregnancy risk categories

Back 35

2 options

1. animal studies have shown no risk to the fetus but there are no human studies

or

2. animal studies have shown there is risk to the fetus but human studies have shown no risk

Front 36

Describe category C in the pregnancy risk categories

Back 36

Animal studies have shown no risk to the fetus but there are no human studies

potential risks outweigh benefits

Front 37

Describe category D in the pregnancy risk categories

Back 37

human studies have shown risk to he fetus

potential risk outweights benefits

Front 38

Describe category X in the pregnancy risk categories

Back 38

Studies in both animals and humans have shown risk to fetus

potential risks outweigh benefits

these drugs should never be used in pregnant women

Front 39

What is the most sensitive part of the body in terms of defects during pregnancy? What two defects can occur?

Back 39

The CNS. Neural tube defects and mental retardation can occur.

Front 40

name 6 places organ specific drug toxicity can occur

Back 40

kidney , lung, liver, heart, muscle, inner ear

Front 41

what are the 2 most common organs for organ specific drug toxicity?

Back 41

liver and heart

Front 42

What is the most common reason for a drug to be removed from the market? Why?

Back 42

Hepatotoxic effects. The liver could metabolize them into more toxic compounds, which can cause liver injury.

Front 43

t/f some hepatotoxic drugs are administered to patients

Back 43

true

Front 44

what 2 enzymes are measured for to determine levels of liver toxicity? where?

Back 44

AST and ALT levels are measured in the blood. they should be low in a healthy person.

Front 45

Name some signs of liver toxicity. What happens to blood levels of AST and ALT?

Back 45

jaundice, dark urine, light colored stool, and a toxic liver will elicit an increased amount of AST and ALT released into the blood

Front 46

What is the QRS complex? What is the T wave?

Back 46

QRS complex on an ECG is the rapid depolarization of ventricles. The t wave is the repolarization of ventricles

Front 47

What does the QT interval represent? What can prolongation cause?

Back 47

it represents the time it takes for the ventricles to repolarize.

Prolongation of this can cause the development of a condition called torsades de pointes, a form of verntricular arrhythmia

Front 48

T/F women have longer QT intervals than men

Back 48

true

Front 49

patients with low sodium levels should take drugs that prolong the QT interval with caution

Back 49

false. low potassium levels

Front 50

name the therapeutic use and withdrawal effects of opiates

Back 50

Therapeutic use is analgesia

Withdrawal effects include anorexia, weakness, muscle spasms

Front 51

Name the therapeutic use and withdrawal effects of opiates

Back 51

TU: anxiety

Withdrawal: panic, insomnia, anxiety, convulsions

Front 52

Name the therapeutic use and withdrawal effects of beta blockers

Back 52

TU: hypertension, decrease heart rate

withdrawal: increased heart rate, heart attack, arrhythmia

Front 53

what is the most common cause of adverse drug reactions?

Back 53

medication errors

Front 54

what are medication errors caused by health care pros called?

Back 54

iatrogenic errors

Front 55

what is a dispensing error?

Back 55

the pharmacist dispenses the wrong drug

Front 56

what is an administration error and who makes this error?

Back 56

when the wrong dose of a drug is administered. either the health care pro or the patient makes this error

Front 57

what is a patient error?

Back 57

when the patient understands the instructions but doesnt follow them

Front 58

confusion over drug naming represents what % of medication errors?

Back 58

15%

Front 59

what should we write instead of IU?

Back 59

units

Front 60

what do q.d. and q.o.d. stand for?

Back 60

every day and every other day. write them out.