Intro to pharm pt 4

therapeutic, predictable, desired response

what is the primary or intended effect after administering a medication?

palliative

relief of signs or symptoms

ie. morphine for acute pain after surgical procedure

supportive

support integrity of body function until another medication can become affected

(helps symptoms associated w disease)

ie ibuprofen for fever from infection

substitutive

replace chemical that the body lacks

(you don't have a chemical your body needs)

ie insulin for diabetics

chemotherapeutic

destroys disease producing organisms or cells

ie chemo for cancer or antibiotics for bacterial infection

restorative

restore normal health

make you back to your normal health ie. vitamins and mineral supplements

non-therapeutic responses

What are secondary or unintended effects

side effects

unintended, often predictable, and physiological, usually adaptable

adverse effects

harmful, unintended predictable

toxic effect

dangerous and damaging to organ or tissue

ie. hepatotoxicity, nephrotoxicity, ototoxicity, ocular damage

allergic reaction

immune ids med as foreign substance that should be destroyed

ie. anaphylactic, serum sickness, delayed allergic

idiosyncratic reaction

extreme sensitivity, paradoxical, lack of response

ie sensitivity or opposite reaction

cumulative effect

increased response to repeated doses of a drug that occurs when rate of administration> then rate of metabolism and excretion

electrolyte disturbances

hyper/hypoglycemia

hyper/hypokalemia

hyper/hyponatremia

drug induced tissue and organ damage

dermatological, gastrointestinal, blood dyscraias, super infections

anaphylaxis

acute, life threatening, multisystem syndrome from mast and basophil mediator release into circulation

anaphylaxis

SYMPTOMS

hives, itching, flushing, swollen lips or tongue

shortness of breath (wheezing or hypoxia)

reduced BP (syncope, incontinence)

severe crampy abdominal pain (vomit)

delayed allergic reactions

classified as appearing after one house but typically being six hours to days after treatment

serum sickness

rash, fever, and joint pain one to two weeks after first exposure to agent and resolves in few weeks, may appear ill during FEBRILE stage

-self limiting and resolves when agent is stopped

sodium

what do you need to check with natremia

potassium

what do you need to check with kalemia

fingerstick glucose

what do you need to check with glycemia

hepatotoxicity

SYMPTOMS

jaundice

malaise

colicky/ abdominal pain

hepatotoxicity

You may need to decrease dosing

monitor Liver function testing

Be conscience of patient's alcohol consumption

nephrotocicity

may need to decrease dosing

monitoring: intake/output, daily weight, RFP, BP

ototoxicity

hearing loss or tinnitus

ocular damage

visual acuity changes

may need frequent eye exams

dermatological

photosensitivity

uticaria

serum sickness

stevens johnson and toxic epidermal necrolysis

skin changes, itching

what do you need to monitor in dermatological changes

stevens johnson

severe cutaneous adverse reactions characterized by extensive necrosis and detached of the epidermis, often mucus membranes are also effected

c diff

bacteria colonize the GI tract after the normal gut flora has been disrupted most commonly by antibiotic therapy

c diff

SYMPTOMS

watery diarrhea ( 3 or more in 1 day)

mucus or occult blood

abdominal pain and cramping

fever

nausea

loss of appetite

**report symptoms to provider and encourage good hydration

blood dyscrasia

any disease or disorder that affects blood, bone marrow or bone tissue

ie. hemolytic anemia

bone marrow suppression

neutropenia/leukopenia

thrombocytopenia

blood dyscrasia

SYMPTOMS

easily bleeding, bruising

pallor

fatigue

fever

super infections

yeast infection post antibiotic course

c diff infection post antibiotic course

anticholingergic

What are symptoms affecting the CNS? (antagonist)

bat, hatter, bone, beet, desert

blind as a ____ (dilated pupils)

mad as a ____ (confused)

dry as a _____ (dry mouth, urine retention)

red as a ____ (flushed skin)

hot as the ____ (hyperthermia)

dilated pupils

blind as a bat

confused

mad as a hatter

dry mouth, urine retention

dry as a bone

flushed skin

red as a beet

hyperthermia

hot as the desert

akathisia

agitation, restlessness

extrapyramidal

fixed postures of facial muscles and tongue including torticolis (twisting of neck) and bizzare eye movements and shuffling gate, akathisia

**similar to parkinsons, tongue sticks out, shuffle gait, neck twisted ZOMBIE

neuroleptic malignant syndrome

Fever

Altered mental status

Leukocytosis

Tremor

Elevated CPK

Rigidity

serotonin syndrome

Shivering

Hyperreflexia and myoclonus

Increased temperature

Vital signs instability (increased HR, RR, and decreased BP)

Encephalopathy (altered LOC)

Restlessness

Sweating

teratogenic

risk of embryo-fetal toxicity or harm

advise women or any one who is of reproductive age