Leading Cause Of Acute Liver Failure

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 Paradoxical effect: ● ● An effect that is the opposite of the intended drug response An example is insomnia and excitement occurring in some individuals when given benzodiazepines for sedation Iatrogenic disease: ● ● A disease that occurs as a result of medical care or treatment Can also refer to a disease produced by drugs Hepatotoxic drugs: ● Drugs that cause injury to the liver Iatrogenic liver disease ● ● A syndrome caused by drugs that closely resemble Parkinson's disease Occurs when hepatotoxic drugs convert into toxic products that injure liver cells Leading cause of acute liver failure ● ● ● Drugs are the leading cause of acute liver failure in the United States Incidence is less than 1 in 50,000, with known hepatotoxic drugs More than 50 drugs are known to be hepatotoxic Physical dependence on drugs ● ● ● Physical dependence occurs with long-term use of certain drugs like opioids, alcohol, barbiturates, and amphetamines Withdrawal reactions and abstinence syndrome can occur A variety of drugs, not just narcotics, can induce physical dependence Combining hepatotoxic drugs and other drugs ● ● Combining hepatotoxic drugs with certain other drugs can increase the risk of liver damage Acetaminophen (Tylenol) can damage the liver when taken in excessive doses or combined with alcohol Assessing liver function ● Liver function tests (LFTs) measure liver enzymes AST and ALT ● ● Blood levels of AST and ALT are normally low Patients taking hepatotoxic drugs should undergo baseline and periodic LFTs Drugs That Prolong the QT Interval, Induce Torsades De Pointes, or Both ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● Amiodarone [Cordarone] Chlorpromazine [Thorazine] Alfuzosin [Uroxatral] Disopyramide [Norpace] Clozapine [Clozaril] Amantadine [Symmetrel] Dofetilide [Tikosyn] Haloperidol [Haldol] Chloroquine [Aralen] Dronedarone [Multaq] Iloperidone [Fanapt] Cisapride [Propulsid] Flecainide [Tambocor] Paliperidone [Invega] Cocaine Ibutilide [Corvert] Pimozide [Orap] Felbamate [Felbatol] Mexiletine [Mexitil] Quetiapine [Seroquel] Fingolimod [Gilenya] Procainamide List of drugs: ● ● ● ● ● ● ● Procan, Pronestyl Risperidone, Risperdal Foscarnet, Foscavir Quinidine Thioridazine, Mellaril Fosphenytoin, Cerebyx Sotalol, Betapace ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● Ziprasidone, Geodon Galantamine, Razadyne Halofantrine, Halfan Indapamide, Lozol Bepridil, Vascor Lithium, Lithobid, Eskalith Isradipine, DynaCirc Dolasetron, Anzemet Methadone, Dolophine Moexipril Domperidone Midodrine, ProAmatine Nicardipine, Cardene Droperidol, Inapsine Octreotide, Sandostatin Granisetron, Kytril Pasireotide, Signifor Ondansetron, Zofran Pentamidine, Pentam, Nebupent Azithromycin, Zithromax Clarithromycin, Biaxin Phentermine, Fastin Ranolazine, Ranexa Erythromycin Arsenic trioxide, Trisenox Ritodrine, Yutopar Gemifloxacin, Factive Eribulin, Halaven Salmeterol, Serevent Levofloxacin, Levaquin Lapatinib, Tykerb Saquinavir, Invirase Moxifloxacin, Avelox Nilotinib, Tasigna Solifenacin, Vesicare Ofloxacin, Floxin Sunitinib, Sutent Tacrolimus, Prograf Telithromycin, Ketek Tamoxifen, Nolvadex Terbutaline Vandetanib, Caprelsa ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● ● Tizanidine, Zanaflex Vorinostat, Zolinza Fluconazole, Diflucan Tolterodine, Detrol Voriconazole, Vfend Vardenafil, Levitra Amphetamine/dextroamphetamine Amitriptyline, Elavil Atomoxetine, Strattera Citalopram, Celexa Dexmethylphenidate, Focalin Desipramine, Norpramin Dextroamphetamine, Dexedrine Doxepin, Sinequan Methylphenidate, Ritalin, Concerta Escitalopram, Lexapro Fluoxetine, Prozac Imipramine, Tofranil Phenylephrine, Neo-Synephrine, Sudafed PE Mirtazapine, Remeron Protriptyline, Pamelor, Aventyl Pseudoephedrine, Sudafed Sertraline, Zoloft Trimipramine, Surmontil Venlafaxine, Effexor