4.2.1 Pharmacovigilance Flashcards

1
Q

What is pharmacovigilence?

A

Science and activites relating to detection, assessment, understanding and prevention of adverse effects or any other possible drug-related problem

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2
Q

Why is pharmacovigilence important?

A

Enhance patient care and safety

Support public health programs by providing reliable information for the effective assessment of risk-benefit profilfe of medicines

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3
Q

What is the agency for pharmacovigilence in the UK?

A

MHRA

Pharmaceutrical companies need to get permission when they want to license medicines

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4
Q

What is the most common clinical adverse event?

A

Drug reaction

6.5% of hospital admissions
15% of patients in hospital

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5
Q

Why are ARDs important?

A

Uses resources when it is avoidable

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6
Q

What was thalidomide used for initially?

A

Sedative and given for morning sickness in pregnant women

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7
Q

Why did thalidomide cause phocomelia or limb malformation?

A

R-enantiomer has sedative effects
S-enantiomer is teratogenic

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8
Q

How many people were affected by thalidomide?

A

10,000 babies
2000 deaths

Identified in Germany but link was not made, thought to be environmental

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9
Q

What was learnt from thalidomide?

A

Adequate testing
Government regulation
Reporting systems
Implications of unfounded claims
Most medicines DO cross the placenta
Avoidance of unncessary drug use in pregnancy

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10
Q

How many cases are required for drug investigation?

A

10

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11
Q

What is thalidomide used for today?

A

Cancer and leprosy

If given to women, must ensure they know they cannot become pregnant

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12
Q

When are ADRs identifed?

A

70% ADRS based on known pharmacokinetics and dynamics

Removed from market if ADRs are serious enough/common

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13
Q

Why is it difficult to identify ADRs?

A

When opening up drugs to entire populations more likely to get an ADR as a trial can only test on a limited number of people

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14
Q

When are ADRs classified as serious?

A

Fatal
Life-threatening
Prolonged hospitalisation
Long-term disability
Congenital abnormalities

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15
Q

What is the difference between adverse drug reactions and events?

A

Adverse drug event- injury that occurs during treatment, not necessarily due to drug

Adver drug reaction- response to drug which is noxious and unintended, occurring at doses normally used in man

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16
Q

Fill in the table

A
17
Q

What is the usual nature and mechanism of ADRs?

A

Mimic disease or syndrome that occurs naturally

May have non-therapeutic causes

Some syndroms causaility solely due to therapeutic agents

e.g. Fibrosing colonpathy, large doses of pancreating enzymes used in treating children with CF

18
Q

What are the 4 broad mechanisms of action for an ADR?

A

Exaggerated response
Desired pharmacological effect at alternative/additional site (GTN –
headache)
Additional/secondary pharmacological effect (QT length)
Triggering an immunological response (anaphylaxis)

19
Q

Why do we need pharmacovigilence?

A

Clinical trials are limited:
Population
Timescale
Dose
Conditions
Concomitant illness and therapy

Limited ability to identify low-frequency adverse events or long-term side effects

20
Q

What does detection in a clinical trial depend on?

A

Number of patients required to be 95% sure of detecing an ADR depends on predicted incidence

Basically if an ADR is rare would need huge amounts of people to see, if something is 1/1000, would need 3000 people

21
Q

Why is reporting ADRs so important?

A

Leads to further questioning

22
Q

What is the Yellow card scheme?

A

System to report ADRs for recently introduced products

Accessible by everyone, all suspected ADRs including minor ones, all reactions to vaccines

Established products, serious or unusual suspected reactions

23
Q

How do you know if a drug is new under the yellow card scheme?

A

Black triangle pointing down