Adverse Drug Reactions

Chapter 7_ Adversed Drug Reactions and Medication Errors Learning Objectives 1. Describe types of medication errors, causes of medication errors, ways to reduce medication errors, and ways to report medication errors. ● Types of medication errors include mistakes in prescribing, dispensing, or administering medications. Causes of medication errors include confusion, lack of communication, and incorrect dosage calculations. Ways to reduce medication errors include implementing safety measures, improving communication, and using technology. Medication errors should be promptly reported to ensure proper action is taken. Chapter 7 Reading In Chapter 7, the significance of adverse drug reactions (ADRs) and medication errors is discussed. A rise in ADRs was observed, with over 800,000 outpatients and 1,735,500 hospitalized inpatients experiencing adverse outcomes. Medication errors, which can lead to ADRs, are also explored, including their definitions, causes, and ways to minimize them. Bullet points Adverse Drug Reactions ● ● ● ADRs refer to noxious, unintended, and undesired effects of drugs at normal doses. They can range in intensity from mild to life-threatening. Proper use of drugs can help avoid or minimize ADRs. Scope of the Problem ● ● ● In 2011, there was a dramatic rise in ADRs, with over 800,000 outpatients seeking emergency treatment due to Organ-Specific Toxicity ADRs. 1,735,500 hospitalized inpatients experienced adverse outcomes due to drug reactions and medication errors, resulting in the death of over 53,800 patients. Many of these incidents were preventable. Medication Errors ● ● ● ● ● Medication errors are a major cause of ADRs. They refer to mistakes in the prescribing, dispensing, or administration of medications. Common causes include confusion, lack of communication, and incorrect dosage calculations. Ways to reduce medication errors include implementing safety measures, improving communication, and using technology. Medication errors should be promptly reported to ensure proper action is taken. Toxicity ● ● ● Toxicity refers to the degree of detrimental physiological effects caused by excessive drug dosing. Severe toxicity examples include respiratory depression from a morphine overdose and severe hypoglycemia from an insulin overdose. Some side effects, like neutropenia caused by anticancer drugs, can be considered as toxicities even at therapeutic doses. Allergic Reactions ● ● ● Allergic reactions occur as an immune response to prior sensitization to a drug. They can range from mild itching to severe rash to anaphylaxis, a life-threatening response characterized by difficulty breathing and a drop in blood pressure. Patients can be more vulnerable to ADRs, with older adults and young individuals being at higher risk. Increased risk of adverse drug reactions: ● ● Illness increases the risk for an adverse drug reaction (ADR) ADR is more common in patients receiving multiple drugs Allergic reactions: ● ● Intensity of allergic reaction is determined by degree of sensitization of the immune system, not drug dosage Very few medications cause severe allergic reactions, but penicillins are known to cause serious reactions Carcinogenic effect: ● Certain medications and environmental chemicals can cause cancer Idiosyncratic effect: ● ● Uncommon drug response resulting from a genetic predisposition An example is glucose-6-phosphate dehydrogenase (G6PD) deficiency Teratogenic effect: ● ● Drug-induced birth defect Medicines and chemicals that cause birth defects are called teratogens Organ-specific toxicity: ● ● Many drugs are toxic to specific organs Examples include kidney injury caused by amphotericin B, heart injury caused by doxorubicin, lung injury caused by amiodarone, and inner ear injury caused by aminoglycoside antibiotics