Adverse Drug Effects

Question 1

ABCD

Answer 1

Augmented, Bizarre, Continuous/Chronic, Delayed

Question 2

Augmented

Answer 2

On target, predictable

Question 3

Bizarre

Answer 3

Idiosyncratic, unpredictable

Question 4

Continuous

Answer 4

Long-term use

Question 5

Delayed

Answer 5

After the drug is gone

Question 6

Example of augmented

Answer 6

Digitalis

Question 7

Example of bizarre

Answer 7

Allergies, EG: penicillin allergy

Question 8

Penicillin allergy types:
1)
2)
3)

Answer 8

1) IgE-mediated mast cell activation, leading to anaphylaxis
2) Urticaria.
3) Non-allergenic side-effects

Question 9

Urticaria cause

Answer 9

Penicillin binds to proteins in skin cells, makes these proteins become immunogenic

Question 10

Example of chronic

Answer 10

Opioid tolerance and dependence
Glucocorticoid-induced adrenal gland insufficiency
Analgesic nephropathy

Question 11

Analgesic nephropathy cause

Answer 11

Long-term overuse of APC tonics

Aspirin, phenacetin, paracetamol, caffeine, codeine

Question 12

Ways to avoid adrenal insufficiency with glucocorticoids:
1)
2)

Answer 12

1) Inhaled glucocorticoids

2) Topical application (only if in low doses)

Question 13

Phenacetin

Answer 13

Converted to paracetamol in the liver

If present in high enough concentration, not all is converted, becomes bioavailable, is addictive

Question 14

Example of delayed

Answer 14

Cancers, infertility

Thalidomide

Question 15

Morphine
A:
B:
C:
D:

Answer 15

A: Respiratory depression, constipation
B: Allergic-like mast cell reactions (not in everyone)
C: Addiction
D: Withdrawal syndrome

Question 16

Cortisone
A:
B:
C:
D:

Answer 16

A: Immunosuppression, fluid retention
B:?
C: Thin skin after topical treatment
D: Long-lasting adrenal suppression

Question 17

Danger of taking aspirin with kidney damage

Answer 17

1) Kidneys filter aspirin out of the blood
2) If kidneys are impaired, more aspirin is stored for longer in the body
3) Analgesic nephropathy

Question 18

Why are nephrons at risk of hypoxia?
1)
2)
3)

Answer 18

1) Nephrons require a lot of O2
2) O2 transfers from arterioles to venules by countercurrent exchange
3) Loop of Henle is in a state of relative hypoxia

Question 19

Mode of nephronic active transport

Answer 19

1) Active pumps pump Na+ from the lumen into the blood
2) This creates a Na+ c
3) Na+ concentration gradient drives cotransporters to transport glucose

Question 20

Substances dangerous for kidneys

Answer 20

Those that decrease renal perfusion

Question 21

‘Triple whammy’

Answer 21

Combine diuretic, ACE inhibitor (or AT1 antagonist) and NSAID
Leads to renal faliure

Question 22

ACE inhibitor

Answer 22

Inhibits angiotensin 2 synthesis

Question 23

AT1 antagonist

Answer 23

Inhibits angiotensin action

Question 24

Reason for NSAID danger to the kidneys

Answer 24

Prostaglandin-mediated vasodilation preserves renal blood flow

Question 25

Use of a diuretic and ACE inhibitor

Answer 25

Decreasing hypertension