1.8 Adverse reaction (+ order of kinetics) Flashcards
What is the difference between zero and first order kinetics?
first order: the rate of elimination is proportional to the amount of drug in the body at a given time, therefore in graph decrease exponential.
zero order: decline in plasma conc occurs at a constant rate and independent of the amount of drug in the body, this is because excretion limited by rate of metabolism e.g. ethanol where rate of ethanol oxidation maxes at low conc of ethanol
What is an adverse drug reaction?
A harmful or seriously unpleasant event occurring at a dose intended for therapeutic effect and that calls for a reduction of the dose or withdrawal of the drug.
What is another word for side effect?
secondary adverse effect
what is a side effect?
2) What is a secondary adverse effect?
a side effect is an • Unavoidable consequence of drug administration (less harmful than adverse drug reaction), Arising because the unwanted action is just as integral as the therapeutic effect to the pharmacology of the drug
– Can sometimes actually be of clinical benefit.
2) • Indirect causation, secondary to the drug, e.g opportunistic infections due to glucocorticoid therapy
What factors effect whether someone will have an adverse drug reaction?
- age: Old and neonates and children
- being female
- Medical history ( If ADR to one drug will be more likely to experience ADR to another drug, as it tells you about there autoimmunity )
- diseases (pharmakoinetic factorsO
- current medication (drug interactions)
- ethnicity (intrinsic vs extrinsic)
What are the elderly more susceptible to ADR?
2) Why are children and neonates?
1) older have less phase 1 metabolites, maybe increased medications or pharmacokinetic factors
2) difference in pharmacokinetic factors, they have a greater filtration rate. Express less phase 2 metabolites
Why does being female increase the risk of ADR?
Females more susceptible , express different levels of growth hormone e.g. SIP expression
Pharmacokinetic factors and hormonal influences
What intrinisic factors of ethnicity increase susceptibility to ADR?
– Pharmacokinetic factors
• Metabolism 90% Japanese are fast acetylators 50% of caucasians
– Pharmacodynamic
• Ashkenazi Jews susceptible to agranulocytosis after clozapine: 20% compared to 1% in normal population
• Response to β-blockers: Chinese> Caucasion>African
Name the type of ADR
A, B, C, D , E
Augmented pharmacological effect
Bizzare Effects
Chronic effects
Delayed effects
End of treatment effects
Define Augmented pharmacological effect
Adverse effect that is known to occur from the primary pharmacology of the drug and is usually dose dependent
What is ADR type is this:
Adverse effect that is known to occur from the primary pharmacology of the drug and is usually dose dependent
Augmented pharmacological effect
Define
Bizzare effect
Adverse effects that are unpredictable from the pharmacology of the drug
What is ADR type is this:
Adverse effects that are unpredictable from the pharmacology of the drug
type B (bizzarre effect)
Define:
type C
Occur as a result of chronic treatment of the drug
What is ADR type is this:
Occur as a result of chronic treatment of the drug
type C (chronic)
