Adverse drug events Flashcards
Adverse event
Harm caused by the medication → no scientific basis, poor quality and failed to deliver, improper exposure → exaggerated or therapeutic effects
Adverse reaction
Unintended response to a drug that occurs at dose intended causing an expected effect/ toxicity (type A) or bizarre effect (type B)
Avoiding adverse drug events
Recognize: know what to look for
Reduce: Understand risk factors
Report
Non IV durgs
Nothing white goes IV except for propofol (slow release)
Type A (1): Augmented (adverse drug reactions)
Reflects plasma drug concentrations
Expected pharm. response (primary, secondary, toxic)
Predictable
Avoidable
At risk tissues/ organs
Protective barriers (skin, GI, resp.)
Organs that concentrate drugs (liver and kidney, bone, fat)
High blood flow (heart, brain)
Metabolically active (brain, kidney, eye)
Type A adverse drug reaction medications
Propranolol
Gentamicin (aminoglycoside)
Analgesics (Acetaminophen and carprofen)
Propanolol adverse drug reaction
Exaggerated primary response: cardiac → - chrono and inotrope (hypotension)
Secondary: respiratory→ bronchoconstriction (B2)
Gentamicin (aminoglycoside) adverse reaction
Low dose: reduced response → therapeutic failure → septicemia and infection
High dose → toxic response → tubular nephrosis and renal disease
Carprofen
Normal to overdose → type A ADE→ GI ulceration and hepatotoxicity
Acetaminophen
Over dose →Type A ADE → methemoglobinemia (cat) and acute hepatic necrosis (dogs and humans)
Type B (2) adverse reaction
Bizarre reaction from allergies type 1-5, idiosyncrasy, and genetics
Unexpected, small % of patients
Type 1 drug allergy (anaphylaxis)
Mast cell degranulation
CS: skin locally, GI affects (dog/ horse), Lungs (cat/cow)
Immediate CS
Anaphylactoid reaction
Direct, dose dependent, mast cell degranulation
No Ag
Basic (catonic) drugs: amphotericin B, radiocontrast materials and morphine derivatives
Avoiding anaphylactoid reactions
Pre-test with small dose
Slow administration
Pre-treat
