adverse drug reactions Flashcards
why should we study adverse drug reactions
- affects QOL
-increase cost of patient care - may mimic disease
- common cause of death
what is an adverse drug reaction
Unwanted or harmful reaction following administration of a drug or combination of drugs under normal conditions of use and is suspected to be related to the drug.
difference between side effect and adr
adr - not beneficial
side effect- some may be beneficial
types of effects of adr
toxic effect
collateral effects
hyper- susceptibility effects
example of a collateral effect
beta blockers causing bronchoconstriction
example of hypersuspectibility reaction
if you are allergic to peniccilin you may have anapylaxis
mild symtpoms of adr
nausea, drowsiness, itching, rash
severe symptoms of adrs
respirtaoty depression, neutropenia, catastrophic haemorrhage
patient risk factors for adr
Gender (F>M)
Elderly
Neonates
Polypharmacy (21% 5 or more drugs)
Genetic predisposition
Hypersensitivity/allergies
Hepatic/renal impairment
Adherence problems
drug risk effect of adrs
Steep dose-response curve
Low therapeutic index
Commonly causes ADR’s
causes for adrs
-Pharmaceutical variation
-Receptor abnormality
-Abnormal biological system unmasked by drug
-Abnormalities in drug metabolism
-Immunological
-Drug-drug interactions
-Multifactorial
what is a type a adr
AUGMENTED PHARMACOLOGICAL
predictable, dose dependent, common (morphine and constipation, hypotension and antihypertensive)
80% all ADRs
example of adr with regards to time
-rapid reactions
- first dose reactions
- early reactions
- intermediate reactions
-late reactions
- delayed reaction
what is type b adr
bizzare
not predictable, not dose dependant
irreversible
what is type c adr
chronic
osteoporosis and steroids- long term use
type d adr
delayed
malignancies after immunosupression
dose related
type e adr
end of treatment- occur after abrupt drug withdrawl
type f adr
failure of therapy-
what is DoTS
Dose related
timing
patiet Susceptibility
what is idiosyncrasy
inherent abnormal response to a drug
rare and serious
when should we suspect an ADR
-Symptoms soon after a new drug is started
-Symptoms after a dosage increase
-Symptoms disappear when the drug is stopped
-Symptoms reappear when the drug is restarted
what should we do if there is an ADR
Assess if urgent action is required
Take a history
Review medication history
Review the adverse effect profile of suspected drug
Modify dose, stop or swap
Report
MOST COMMON DRUGS TO HAVE ADR
Antibiotics
Anti-neoplastics
Cardiovascular drugs
Hypoglycaemics
NSAIDS
CNS drugs
WHY REPORT adrs
Important for patient safety
To identify ADRs not identified in clinical trials
To identify new ADRs ASAP
To compare drugs in the same therapeutic class
To identify ADRs in ‘at risk’ groups
what does a black triangle on a medication mean
indicates medicine is undergoing additional monitoring
what is classed as a serious reacion
A reaction that
is fatal
is life threatening
is disabling or incapacitating
results in hospitalisation
prolongs hospitalisation
what to report on a yellow card
All suspected reactions for
herbal medicines
black triangle ▼ drugs
All serious suspected reactions for
established drugs, vaccines and contrast media
drug interactions
