Adverse Drug Reactions

Question 1

What is an ADR and how is it different to side effects

Answer 1

More harmful effects which happen at a therapeutic dose

Question 2

What are secondary adverse effects

Answer 2

Indirect causation eg immunosuppressants giving rise to opportunistic infection

Question 3

Why would the young and old have more adverse effects

Answer 3

Pharma kinetics like slower metabolism and glomerular filtration rate

Question 4

Which gender is more susceptible and why

Answer 4

Females due to hormones affecting kinetics

Question 5

Does previous history of adrs increase likeliness of another

Answer 5

Yes

Question 6

Ethnicity is an intrinsic factor. How is kinetics between Japanese and Caucasian different

Answer 6

Japanese 90% have more acetylators unlike 50% of Caucasians

Question 7

Give some extrinsic risk factors

Answer 7

Alcohol and smoking

Question 8

What is class A adrs

Answer 8

Augmented (enhanced effect)

Question 9

How can B blockers cause augmented adrs

Answer 9

B blockers block heart rate

Enhanced augmented adrs mean this causes bradycardia

Question 10

If a muscarinic antagonist is given for motion sickness and causes eye dilation, what adr is this

Answer 10

Augmented

Question 11

Which adr is most common

Answer 11

Augmented

Question 12

What are B class adrs

Answer 12

Bizarre. Their pharmacology doesn’t add up to the effect

Question 13

Which bizarre adr does penecillin give rise to

Answer 13

Anaphylaxis

Question 14

Which is the most uncommon adr

Answer 14

Bizarre. It is highly fatal

Question 15

How is TGN1412 either a or b class of adr

Answer 15

Tgn 1412 is an autoimmune drug which caused excess cytokine storm and things like decreased bp and organ failure

Question 16

Which bizarre effect does chloramphenicol cause

Answer 16

Bone marrow suppression

Question 17

What type of class is C adr

Answer 17

Chronic - effects after long term use

Question 18

Give an example of a chronic adr

Answer 18

Cushing’s syndrome from long term glucocorticoid use

Question 19

What is a class D adr

Answer 19

Delayed effect adr after treatment and can be given to child

Question 20

How is accutane an example of class D adr

Answer 20

Causes birth defects

Question 21

Which class D adr drug transferred the adr to the offspring causing uterine cancers

Answer 21

Diethylstilbestrol

Question 22

Which type of cancer drug gave rise to second cancers and is a class D adr

Answer 22

Hodgkins

Question 23

What is class E adr

Answer 23

End of treatment withdrawal effects

Question 24

How does cortisol cause a class E edr

Answer 24

Excessive take of corticoids allows regulation of the release of acth etc from the hypothalamus. This regulation stops and no cortisol is released from adrenal glands = adrenal atrophy

Question 25

How is h1 antagonists and ethanol cns suppressor example of an adverse drug interaction

Answer 25

Both act synergistically pharmacodynamics and cause sedation

Question 26

What are the 2 types of adverse drug interactions

Answer 26

Potentiators eg H1 and ethanol sedatives

Attenuators - antagonist effect eg MAOI blocking amine metabolism or h2 blocking cyps