ADR's Flashcards
What % of admission to hospital are ADR’s?
5%
What are type A ADR’s?
Predictable dose related effects
What are type B ADR’s?
Non predictable/bizarre long term effects
What are type A’s usually due to?
- A pharmacokinetic/pharmacodynamic abnormality
What does this pharmacodynamic or kinetic abnormality result in?
An excess pharmacological effect
What is an example of a type A ADR?
- Insulin induced hypoglycaemia
- Beta blocker induced bradycardia
What can be the reason for the pharmacoKINETIC variation in type A?
- Altered metabolism through disease or pharmacogenetics
- Drug - drug interactions
What can be the reason for the pharmacoDYNAMIC variation in type A?
- Hepatic disease
- Dehydration
What is the nature of type B ADR’s?
- Unpredictable
- Immunological
What are examples of delayed effects of type B
- Tardive dyskinesia (involuntary jerks of the face and trunk)
- Carcinogenesis
What are examples of ADR surveillance methods?
- Anecdotal reporting
- Voluntary reporting
- Intensive event recording
- Cohort studies
- Pop statistics
What percentage of inpatients get ADR’s?
10-20%
How many deaths result from ADR’s?
5000-10000
What are augmented ADR’s?
- Predictable
- Dose dependent
- Recognised before drug is available
When do augmented ADR’s resolve?
When the drug is stopped
What are bizarre ADR’s?
- Unpredictable
- Rare
- Unrelated to dose
What can bizarre ADR’s result in?
Death
What is an example of augmented ADR’s?
Galactorrhoea with domperidone
What are chronic ADR’s related to?
- Dose
- Length of treatment
Are chronic ADR’s predictable?
To a certain extent
What are delayed ADR’s?
- Occur years after treatment
- Can occur in the children of the patient
What is an example of a delayed ADR?
Cancer in immunosuppressed individuals
End of treatment ADR example?
Seizure after anti-epileptics are stopped
Example of a chronic ADR?
Latrogenic Cushings Disease