pt's over 65 years old are ____ as likely to experience ADE's than young adults
TWICE
which clients are usually hyperreactive to a drug? (4)
geriatric
children
decreased kidney function
decreased liver function
the bioavailability of a drug is affected by its accumulation in ________
muscle
how are ADE's classified by? (hint: type)
type A and B
which type is most responsible for ADE's?
type A
which type is predictable and avoidable?
type A
type A ADE's are generally associated with the admin of _______ dosages of a drug instead of _________ doses
therapeutic
high
which type includes cytotoxic and toxic reactions? these can result from what? Are they more or less common?
type A
drug overdose
less common
some type A ADEs occur due to interactions with which three causes?
drug-drug
drug-food
drug-disease
which type of ADEs are independent of the dose and are unpredictable or avoidable?
type B
hypersensitivity or allergy related can be from which type?
type B (the BEE gave me an allergic reaction)
which type ADEs are the most life threatening and serious?
type B
T/F type b reactions are a major cause of important drug-induced illnesses.
true
which type most commonly affects the liver, spleen, bone marrow, and skin?
type B
how long can it take for type b rxn's to become clinically noticeable?
up to 12 wks
dental hygienists need to review the medical history to identify patients taking ___________ and advise them of the possibility of _____ when the drug is taken.
bisphosphonate
ONJ
what is ONJ?
osteonecrosis of the jaw (bone death!)
what is bisphosphonate used for?
the prevention of bone density changes during cancer chemo or for the prevention of osteoporosis
what are cytotoxic reactions?
substances that are toxic to cells
What kind of interaction is characterized as pharmacologic, physiologic, or chemical interactions, or drug-related receptor alterations?
pharmacodyanmic drug-drug interaction
What are changes in plasma levels of a drug as a result of a rate alteration of absorption, distribution, metabolism, and excretion called?
pharmacokinetic drug-drug interaction
what can cause a decrease in metabolism?
grapefruit
what can block absorption?
some nutrients
what can increase absorption?
fat diet
what may act as a mechanical barrier to prevent access to mucosal surfaces?
nutrients
a meal with high fatty acid content will increase the absorption of ______ _______ drugs
lipid soluble
what does chelating mean?
binding (chele = claw of a lobster or crab, therefore "chelation" = "grabbing")
chelating can produce _______ complexes that cannot cross the intestinal mucosa during the absorption phase
inactive
components of grapefruit juice inhibit the ________ 3A4 isoenzyme in the ______
CYP450
liver
Probenecid inhibits renal tubular excretion of penicillin, therefore _______ the duration of action
increasing
diazepam
midazolam
triazolam are all examples of _____________
benzodiazepines ("am")
what is benzodiazepine?
a depressent
amlodipine,
felodipine,
and nifedipine, are all examples of _______ ______ ________ agents
