Medication problems

What are medication problems?

Issues that arise from drug use, including hypersensitivity, adverse reactions, interactions, contraindications, and drug transfer

What is hypersensitivity?

An exaggerated immune response to a drug perceived as foreign, leading to allergic reactions

What triggers hypersensitivity?

Substances acting as antigens that stimulate the immune system

What is the most severe form of hypersensitivity?

Anaphylaxis

What happens during anaphylaxis?

Sudden bronchospasm, vasospasm, and severe hypotension that can lead to death

What are common signs of drug hypersensitivity?

Rashes and altered reactions to medications

What is an adverse drug reaction (ADR)?

An unintended or undesirable effect of a drug

Can ADRs include hypersensitivity?

Yes, hypersensitivity is one type of ADR

What are the consequences of ADRs?

Decreased treatment effectiveness, poor therapeutic outcomes, prolonged illness, increased hospital stay, higher costs, and increased mortality

How are ADRs managed?

By adjusting the dosage or discontinuing the medication

Why is monitoring for ADRs important?

To ensure patient safety and prevent serious complications

What are common predisposing factors for adverse drug reactions (ADRs)?

Age, gender, dose, polypharmacy, medical history, and genetic factors

Why are elderly and neonates at higher risk of ADRs?

They have altered metabolism and drug sensitivity

Why are ADRs more common in females?

Differences in body size, composition, and hormonal factors

How does dose affect ADR risk?

Higher doses increase the likelihood of adverse effects

What is polypharmacy?

Taking multiple different medications simultaneously

Why does polypharmacy increase ADR risk?

Drug interactions and cumulative side effects are more likely

How does medical history affect ADR risk?

Chronic conditions or frequent medication use increase susceptibility

How do genetic factors influence ADRs?

Inherited enzyme deficiencies can alter drug metabolism

What is a drug-drug interaction (DDI)?

When the pharmacological effect of one drug is altered by another drug

What can result from a drug-drug interaction?

Enhanced therapeutic effect, reduced effect, or an adverse reaction

Do DDIs occur only with prescription drugs?

No, they can occur with prescription and non-prescription medications

Why are DDIs clinically important?

They contribute to a significant number of hospital admissions

What is a contraindication?

A condition or factor that makes a drug unsafe or inappropriate to use

What are examples of contraindications?

Pregnancy, lactation, infants, neonates, elderly, liver or kidney dysfunction, and allergies

Why are contraindications important?

They help prevent harmful or dangerous drug effects

What should be done if a contraindication is present?

The drug should not be prescribed or administered

What is drug transfer?

The movement of drugs from a pregnant woman to the fetus via circulation or to a newborn via breast milk

How can drugs reach the fetus?

Through maternal blood circulation across the placenta

How can drugs reach a neonate?

Through breast milk during feeding

Give examples of drugs that can transfer to the fetus or neonate.

Codeine, aspirin, antibiotics, caffeine

What factors influence potential harm from drug transfer?

Drug properties, dosage, and gestational age of the fetus

Why is gestational age important in drug transfer?

Different stages of development have varying vulnerability to drug effects

What happens during the first trimester?

Organ systems are developing, making the fetus highly sensitive to teratogens

What happens during the third trimester?

Placental blood flow is greatest, increasing drug transfer potential

What are teratogenic drugs?

Drugs known to cause harm or developmental abnormalities in the fetus

Why do healthcare providers avoid prescribing drugs during pregnancy?

To reduce potential risk to the developing fetus

When might drug therapy still be required during pregnancy?

For conditions such as hypertension, epilepsy, diabetes, or infection

What must be considered when prescribing drugs during pregnancy?

The balance between maternal benefit and fetal risk