Adverse Drug Effects

Question 1

what is an adverse drug effect?

Answer 1

any adverse, noxious or unintended effects of drugs

Question 2

what is an adverse drug reaction?

Answer 2

any noxious or unintended response to a drug that occurs at appropriate doses used for prophylaxis, diagnosis, or therapy, including any unusual failure of a drug to produce its expected pharmacological activity

Question 3

what is the difference between drug poisoning and drug-induced toxicity?

Answer 3

drug poisoning is when there is an overdose leading to adverse effects
drug-induced toxicity is an adverse effect regardless of the dose

Question 4

what is toxicosis?

Answer 4

the pathologic or clinical conditions or syndromes caused by the action of a toxicant

Question 5

what is toxicity?

Answer 5

the nature or degree of negative effects associated with a drug or chemical

Question 6

what are drug interactions?

Answer 6

when two drugs interact in the body

Question 7

are pharmacodynamic or pharmacokinetic interactions more likely to cross species?

Answer 7

pharmacodynamic

Question 8

what is a drug incompatibility?

Answer 8

when two drugs have a negative interaction when they are in contact- not usually when two drugs are given concurrently by separate injections
chemical interaction

Question 9

where are adverse drug effects reported?

Answer 9

on the package insert

Question 10

what are warnings/cautions/precautions?

Answer 10

things you should pay attention to and adjust your use of the drug accordingly

Question 11

what are contraindications?

Answer 11

when you should not use the drug in some situations

Question 12

what are the two classifications of adverse drug reactions?

Answer 12

dose-dependent
host-dependent

Question 13

what does it mean for an adverse drug reaction to be dose-dependent or host-dependent?

Answer 13

dose-dependent is pharmacologic or mechanism-based toxicity, intrinsic or chemical toxicity: if give more of a drug, will have worse
host-dependent is idiosyncratic toxicity: does not matter for dose necessarily

Question 14

what does it mean for something to have pharmacologic toxicity?

Answer 14

dose-dependent
reproducible and predictable
susceptibility may vary
toxicity is related to action at a specific receptor or target protein

Question 15

what do NSAIDs do?

Answer 15

non-selective COX inhibitor
anti-inflammatory
anti-pyretic
anti-platelet
anti-cancer
anti-endotoxemic

Question 16

what are the NSAIDs we use?

Answer 16

carprofen
meloxicam
phenylbutazone
deracoxib
firocoxib
flunixin

Question 17

what does intrinsic toxicity depend on?

Answer 17

dose-dependent
reproducible and predictable
susceptibility may vary
toxicity is dependent on the chemical properties, not pharmacological properties, of the drug
bioactivation to reactive, toxic intermediates is often responsible

Question 18

can you still use the drug in a patient with dose-dependent adverse effects?

Answer 18

yes, if manage dosing carefully

Question 19

what happens in host-dependent adverse effects?

Answer 19

idiosyncratic drug reactions
not classically dose-dependent
typically have delayed onset
frequently immunological component

Question 20

what does it mean that something is not classically dose-dependent?

Answer 20

reducing dosage does not reduce risk
not associated with elevated dose or plasma concentrations

Question 21

can you use a drug with host-dependent adverse effects in the patient again?

Answer 21

no

Question 22

what is the typical delayed onset of host-dependent adverse effects?

Answer 22

7-14 days if immune-mediated

Question 23

what drug that is used in cattle can lead to death if injected into a person?

Answer 23

tilmicosin
antibiotic

Question 24

what drugs are banned or restricted in food animals due to potential idiosyncratic reactions?

Answer 24

Chloramphenicol
Phenylbutazone
Sulfonamides
Dipyrone

Question 25

what are some key points to attributing an adverse drug reaction?

Answer 25

temporal association
previously described/known
alternative explanations
history of previous exposures
signs disappear with withdrawal
evidence of dosing error or elevated concentrations
predisposing factors to patient