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What is the difference between a side effect and an adverse effect?
- An adverse effect is an effect that is something other than the desired effect of the drug therapy
- a side effect refers to a minor effect such as nausea, nearly unavoidable secondary drug effect
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Toxicity
is caused from excessive dosing
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Idiosyncratic effect
- an uncommon drug response resulting from a genetic predisposition.
- sometimes refered to as a paradoxical response
- thought to occur because of genetic enzymatic deficiencies that alter the drug’s metabolism
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grapefruit juice effect
- grapefruit inhibits its isoenzyme responsible for its intestinal metabolism of multiple drugs
- can persist up to 3 days
- basically what it does is increase amount of drug available for absorption, thereby increasing blood levels of the drug
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What causes anaphylaxis physiologically
contraction of smooth muscles and increased vascular permeability
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Iatrogenic disease
a disease produced by drugs. For example, some adverse effects of drugs produce symptoms which resemble naturally occurring disease
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terotagenic effect
can be defined as a drug-induced birth defect
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carcinogenic effect
ability of drugs to cause cancer
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When does neurotoxicity usually occur
exposure to drugs and other chemicals and gasses
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Why is neural tissue extremely susceptible
- high metabolic rate,
- high lipid content,
- and high circulatory requirement.
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what are the signs and symptoms of neurotoxicity?
- changes in level of consciousness
- auditory and visual distubances
- nystagmus
- tonic-clonic (gran mal) siezures
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What are the manifestations of hepatotoxicity
- hepatitis,
- jaundice,
- elevated liver enzymes [laboratory values],
- and fatty infiltration of the liver.
- *primary site of drug metabolism
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The kidneys are susceptible to nephrotoxicity because...
of the high vascularity of these organs
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Why are QT interval drugs dangerous?
Prolongation of this interval can deteriorate to torsades de points which then can progress to the potentially fatal ventricular fibrillation
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What is Ototoxicity?
- affects the eight cranial nerve and result is inner ear or auditory nerve damage.
- can affect the cochlea, vestibule, and semicircular canals
- *this may or may not be reversible
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Nephrotoxicity manifests itself as_______ and can be tested by....
- acute tubular necrosis
- Blood urea nitrogen (BUN), creatinine, creatinine clearance
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Synergistic effect
when two or more “unlike” drugs are used together to produce a combined effect, and the outcome is a drug effect greater than any of either drug’s activity alone.
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Potentiation
a type of synergistic effect in which only ONE of the two drugs' effect is increased
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Additive effect
when two or more “like” (in terms of effects) drugs are combined, and the result is the sum of the individual drug’s effects.
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What is a inhibitory interaction and what is another name for it?
- the opposite of synergism. It results in a therapeutic effect that is less than the effect of either drug alone because the second drug either diminishes or cancels the effect of the first drug.
- aka Anagonistic interaction
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Blood products are not compatible with what?
Dextrose
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When a medication is supposed to be taken on "an empty stomach," what kind of time frame are we looking at?
- 1 hour before meal
- or 2 hours after
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When a nurse is suspicious of a QT interval drug, what does she test for?
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