Adverse Effects and Drug Interactions
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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
is caused from excessive dosing
- 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
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
What causes anaphylaxis physiologically
contraction of smooth muscles and increased vascular permeability
a disease produced by drugs. For example, some adverse effects of drugs produce symptoms which resemble naturally occurring disease
can be defined as a drug-induced birth defect
ability of drugs to cause cancer
When does neurotoxicity usually occur
exposure to drugs and other chemicals and gasses
Why is neural tissue extremely susceptible
- high metabolic rate,
- high lipid content,
- and high circulatory requirement.
what are the signs and symptoms of neurotoxicity?
- changes in level of consciousness
- auditory and visual distubances
- tonic-clonic (gran mal) siezures
What are the manifestations of hepatotoxicity
- elevated liver enzymes [laboratory values],
- and fatty infiltration of the liver.
- *primary site of drug metabolism
The kidneys are susceptible to nephrotoxicity because...
of the high vascularity of these organs
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
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
Nephrotoxicity manifests itself as_______ and can be tested by....
- acute tubular necrosis
- Blood urea nitrogen (BUN), creatinine, creatinine clearance
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.
a type of synergistic effect in which only ONE of the two drugs' effect is increased
when two or more “like” (in terms of effects) drugs are combined, and the result is the sum of the individual drug’s effects.
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
Blood products are not compatible with what?
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
When a nurse is suspicious of a QT interval drug, what does she test for?
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