Adverse Drug Effects Flashcards
what is an adverse drug effect?
any adverse, noxious or unintended effects of drugs
what is an adverse drug reaction?
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
what is the difference between drug poisoning and drug-induced toxicity?
drug poisoning is when there is an overdose leading to adverse effects
drug-induced toxicity is an adverse effect regardless of the dose
what is toxicosis?
the pathologic or clinical conditions or syndromes caused by the action of a toxicant
what is toxicity?
the nature or degree of negative effects associated with a drug or chemical
what are drug interactions?
when two drugs interact in the body
are pharmacodynamic or pharmacokinetic interactions more likely to cross species?
pharmacodynamic
what is a drug incompatibility?
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
where are adverse drug effects reported?
on the package insert
what are warnings/cautions/precautions?
things you should pay attention to and adjust your use of the drug accordingly
what are contraindications?
when you should not use the drug in some situations
what are the two classifications of adverse drug reactions?
dose-dependent
host-dependent
what does it mean for an adverse drug reaction to be dose-dependent or host-dependent?
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
what does it mean for something to have pharmacologic toxicity?
dose-dependent
reproducible and predictable
susceptibility may vary
toxicity is related to action at a specific receptor or target protein
what do NSAIDs do?
non-selective COX inhibitor
anti-inflammatory
anti-pyretic
anti-platelet
anti-cancer
anti-endotoxemic
what are the NSAIDs we use?
carprofen
meloxicam
phenylbutazone
deracoxib
firocoxib
flunixin
what does intrinsic toxicity depend on?
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
can you still use the drug in a patient with dose-dependent adverse effects?
yes, if manage dosing carefully
what happens in host-dependent adverse effects?
idiosyncratic drug reactions
not classically dose-dependent
typically have delayed onset
frequently immunological component
what does it mean that something is not classically dose-dependent?
reducing dosage does not reduce risk
not associated with elevated dose or plasma concentrations
can you use a drug with host-dependent adverse effects in the patient again?
no
what is the typical delayed onset of host-dependent adverse effects?
7-14 days if immune-mediated
what drug that is used in cattle can lead to death if injected into a person?
tilmicosin
antibiotic
what drugs are banned or restricted in food animals due to potential idiosyncratic reactions?
Chloramphenicol
Phenylbutazone
Sulfonamides
Dipyrone
what are some key points to attributing an adverse drug reaction?
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
