Week 11 Complementary therapies, drug toxicology, monitoring drug toxicology

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FlashCards sobre Week 11 Complementary therapies, drug toxicology, monitoring drug toxicology, criado por Elizabeth Then em 16-10-2017.
Elizabeth Then
FlashCards por Elizabeth Then, atualizado more than 1 year ago
Elizabeth Then
Criado por Elizabeth Then mais de 7 anos atrás
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Resumo de Recurso

Questão Responda
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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