10889447
Descripción
Fichas por Elizabeth Then, actualizado hace más de 1 año
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Creado por Elizabeth Then
hace alrededor de 7 años
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| Pregunta | Respuesta |
| Complementary/ alternative medicines (CAM) | Wide range of therapies and procedures comp: used with standard medical treatments alt: used instead of standard medical therapy |
| CAM facts | 50% of australians use them particularly patients with chronic diseases: cancer, arthritis, chronic pain, AIDS, GI probelms |
| CAM Herbals/ vitamins | st johns wort, selenium for AIDS, vitamins used most |
| Pregnancy/labour | raspberry leaf, ginger |
| UTIS | cranberry juice, BUT interaction with warfarin |
| COLDS/FLU | echinacea, BUT allergic reactions possible |
| Depression | St john's wort, BUT drug interactions with SSRIS = SERTONIN SYNDROME |
| Issues with CAM aes: | hepatoxicity, nephrotoxicity, strokes. contain contaminants (heavy metals, toxins, drug contaminants) |
| Issues with CAM | Patients do not inform health professional they are using CAM "Viewed as healthy" |
| Therapeutic goods administration | international sale not regulated, some medicine exempt |
| Where drugs produce toxicity | all organs of body, particularly in liver, blood, kidney (altered perfusion/function) gut (ulcers) all are exposed to drug or conc of drug as part of metabolism or excretion |
| Drug induced liver injury | 1. intrinsic hepatotoxins: predictable, dose-related toxicity paracetomol 2. hypersensitivity: hepatotoxins e.g. halothane, unpredictablem dose-unrelated, rare 3. cholestatic hepatotoxicants: e.g. ethanol: cessation of bile flow/formation = jaundice |
| Adverse drug reactions | noxious and unintended drug response which occurs at therapeutic doses |
| Type A ADRS | augmented, over- extension of drugs intended action, common, usually predicatable and reversible e.g. postural hypotension with antihypertensives |
| Type B ADRS: | Bizzare, uncommon, usually unpredicatble and not dose related, often severe with high morbidity/mortality e.g. penicillin anaphylaxis |
| ADRs exponentially | increase with more than 4 concurrent medications (drug interactions) |
| ADRS | can be due to drug interactions, diet, CAM interations PK related / PD related |
| Examples of ADRS from interactions | PK: viagra and grapefruit juice or terfenadine and antifungals 'azoles' PD: angina drugs (nitrates) and viagra Complementary medicines and drugs: St John's wort and anti-coagulants (PK-related therapeutic failure) or SSRIs (Serotonin syndrome) |
| General approach to deliberate self poisoning | resus risk assessment decontamination screening tests enhanced elimination antidotes supportive care and disposition |
| Risk assessment | most important step to early management of poisoning takes in acc age co morbidities agent(s) dose (s) time since ingestion symptom progression since ingestion physical examination screening tests (BSL, ABG, ECG, Paracetamol, Local tox epidemiology) |
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