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Renal Week 4 2017/18 > 4: Adverse drug reactions > Flashcards

4: Adverse drug reactions Flashcards

1
Q

What is an adverse drug reaction?

A

Illness caused by medication

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2
Q

What’s the difference between a side effect and an adverse drug reaction?

A

Side effects are caused by normal doses; subset of ADR (which may be caused by inappropriate doses e.g digoxin toxicity)

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3
Q

Which group of patients commonly suffer ADRs?

A

Elderly

Those with co-morbidities

Those on loads of drugs already

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4
Q

What is the therapeutic index of a drug?

A

Space between effective dose and toxic dose

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5
Q

The greater the therapeutic index of a drug, the ___ it is.

A

safer

and vice versa

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6
Q

How is therapeutic index calculated?

A

Therapeutic index = Toxic dose / Effective dose

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7
Q

Which enzyme family usually metabolises drugs in the liver?

A

CYP450

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8
Q

Where are most drugs excreted?

A

Bile

Urine

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9
Q

What process usually goes wrong to cause an ADR?

A

CYP450 - oxidation, reduction or hydrolysis

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10
Q

What are

Type A

Type B

ADRs?

A

Type A - predictable, dose-dependent reactions

Type B - unpredictable, dose-indepedent (weird reactions)

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11
Q

What is a

Type C

Type D

Type E

ADR?

A

Type C - chronic reactions

Type D - delayed reactions

Type E - reactions seen when the drug is withdrawn

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12
Q

What is a Type A ADR?

A

Predictable, dose-dependent reaction

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13
Q

What type of ADR is dehydration associated with diuretic overdose?

A

Type A

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14
Q

What type of ADR is ischaemic nephropathy associated with ACE inhibitor use during acute illness in someone with kidney disease?

A

Type A

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15
Q

What antibiotic has a very low therapeutic index?

What does it damage in toxic doses?

A

Gentamicin

CN VIII, kidney tubules

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16
Q

What can different drugs do to cause a Type A ADR?

A

Interact with one another

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17
Q

Where can you find drug interactions before prescribing them for patients?

A

BNF

18
Q

Which family of antibiotics cause drug interactions?

A

Macrolides

(e.g azithromycin, clarithromycin, erythromycin)

WITH theophylline, statins

19
Q

What is a common

a) side effect
b) interaction

of ACE inhibitors?

A

a) Dry cough

b) Amplify hypoglycaemia caused by sulphonylureas

20
Q

What should you always ask about when taking a drug history?

Why?

A

Medication

OTC drugs

Herbal remedies

Because they may interact with certain drugs

21
Q

Patients with which disorder have an increased risk of drug-induced confusion?

A

Parkinson’s

22
Q

Which cardio condition can NSAIDs exacerbate?

A

Heart failure

23
Q

Anticholinergic drugs may cause which renal condition in men with BPH?

A

Urine retention

because they constrict the ureters (usually used to TREAT incontinence)

24
Q

Which drugs commonly exacerbate constipation?

A

Calcium

Anticholinergics

CCBs

25
Q

Which drugs classically exacerbate asthma?

Why?

A

Beta blockers

may non-selectively BLOCK beta2 adrenoceptors

26
Q

Foods which are rich in potassium interact with which drugs?

A

ACE inhibitors

ARBs

Spironolactone and eplerenone

27
Q

Foods rich in Vitamin K interact with which drug?

A

Warfarin

28
Q

What electrolyte should be restricted in those on ACE inhibitors, ARBs and K-sparing diuretics?

A

Potassium

bananas!!!

29
Q

What is a Type B ADR?

A

Dose-independent, unpredictable reactions

30
Q

Out of Type A and Type B, which ADR is more dangerous?

A

Type B

31
Q

What is a derm presentation of potentially any drug?

A

Rash

32
Q

What is a haem presentation of potentially any drug?

A

Bone marrow suppression

33
Q

What is a Type C ADR?

A

Chronic, predictable drug reaction

34
Q

Long term steroid therapy can cause which ADRs?

A

Cushing’s

Osteoporosis

35
Q

Long term beta blocker use can cause which disease?

A

Diabetes

36
Q

What is a Type D ADR?

A

Delayed reaction

not the same as chronic, often many years after stopping

37
Q

What kinds of disease are caused by Type D ADR?

A

Congenital malformations, growth/developmental delay - teratogenic drugs

Malignancy - carcinogenic drugs

38
Q

What treatments FOR cancer can cause cancer?

A

Radiotherapy

Chemotherapy

Phototherapy

39
Q

What is a Type E ADR brought on by abruptly stopping beta blockers?

A

Rebound tachycardia

40
Q

What is a Type E ADR brought on by abruptly stopping long-term steroids?

A

Addison’s (disease or crisis)

41
Q

What is found next to newly licensed drugs (which may have ADRs) in the BNF?

A

Black triangle

42
Q

How do you report ADRs of drugs?

A

Yellow Card

Renal Week 4 2017/18 (4 decks)

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