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LSM3211 > Adverse Drug Reactions > Flashcards

Adverse Drug Reactions Flashcards

1
Q

relation between therapeutic indec and side effects

A

lower the Ti higher the rick of side effects

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2
Q

contraindication meaning

A

contraindication is a specific situaiton in which a drug should not be used because t may be harmful to the persons

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3
Q

special precautions meaning

A

condition that may increase te risk of adverse reactions

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4
Q

adverse drug reaction meaning

A

unwanted and unintended and undesired effect of a drug at doses normally used in man for therapy

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5
Q

in cases of adverse drug reaction it requires us to

A

discontinue the drug
modify the dose
hospital adminssion
termporary ot permaney harm, disability to death

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6
Q

adverse drug event meanign

A

untoward/unexpected medical occurrence of a drug that do not necessarily have a causal relationship with the treatment

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7
Q

ADR vs ADE

A

adr - type of ADE whose casue can be directly attributed to a drug
adr - occur despite appropriate prescribing and dosing

ade could be due to inappropriate use of the drug(overdose and drug abuse)
ade may be caused by medication error, drug durg interaction

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8
Q

what does TYPE A ADR means?

A

augmented
- common, dose dependent, predictable, low mortality,

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9
Q

drug examples of Type A ADR

A

antihypertensive drug: orthostatic hypotension
blood thinner: bleeding
tricyclic antidepressant : dry mouth
anti-diabetic drugs: hypoglycemia
antihistamine: drowsiness
cox-2 selective inhibitors: thromboebolism

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10
Q

what does TYPE B ADR means?

A

Bizarre
uncommon,
dose independent - as soon as taken may have reactions
unpredictable - not related to pharmacology rxn– related to drug itself
high mortality
unrelated to pharmacological action
hypersensitivity - relate to immune response
idosyncratic - doesn’t require immune response

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11
Q

drug examples for Type B ADR

A

penicillin, cephalosporin: anaphylaxis
aromatic anticonvulsant phenytoin and carbamazepine: fever , rash , hepatitis
sulfonamide(sulfa) drugs: stevens- johnsons syndrome
angiotensin0 Converting Enzyme(ACE) inhibitors: angioedema

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12
Q

what is type I type B ADR reaction and what is the mechanism

A

IgE- medicated
Drug-IgE complex binding to mast cells with release of histamine

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13
Q

Clinical Manifestation of Type I Type B ADR

A

urticaria, angioedema, pruritus, anaphlaxis

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14
Q

what is type II type B ADR reaction and what is the mechanism

A

cytokine
Ig G or IgM directed at drug hapten coated cells

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15
Q

what is type III type B ADR reaction and what is the mechanism

A

immune complex

Drug antibody complex deposition with complemttart activation and inflammation

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16
Q

what is type IV type B ADR reaction and what is the mechanism

A

delayed cells medicated
drugs molecules presentation to T cells with cytokine and mediator release

17
Q

clinical manifestation of type II Type B ADR

A

Hemolytic anemia
thrombocytopenia

18
Q

clinical manifestations of type III Type B ADR

A

serum sickness
fever
rash
glomerulonephritis
vasculitis

19
Q

clinical manifestations of type IV Type B ADR

A

contact dermatisis
rash
stevens-johnsons syndrome

20
Q

what are the risk factor of drug hypersensitivity

A
  1. large molecualr with greater structual complexity are more likely immunogenic
  2. small molecule drugs forming simple chemical carrier complexes become immunogenic
  3. route of administration: likeliness to induce hypersensitivity: topical» IM, IV(more serious)» oral
21
Q

examples of large molecules with greater structure complexity

A

non human source of antisera
protein(streprokinase, insulin)
carbohydrates(heparin)

22
Q

examples of small molecules

A

antibiotics(penicillin, cephalosporin)
anti hypersensitivity(methyldopa)
CVD drugs(procainamide)

23
Q

what is idiosyncratic ADRs

A

it is a ADR that is not exactly drug hypersensitivity
- resemels immediate hypersensitivity reaction but are not mediated by allergen Ig E interaction
- occurs when the mast cells, responsible primarily for becoming activated in the allergy and anaphylaxis are activated(eg mas-related G protein coupled reactors X2 has been identified)
- it is also called pseudoallergic or anaphylactoid reaction

24
Q

name some readtions that are idiosyncratic ADR

A

opiates(morphin, codeine): flushing, urticarial, redman syndrome
vancomycin: similar to opiates
radiocontrast media: similar to opiates

25
Q

names other types of idioscncratic ADRs

A

general anesthetic gas halothane: melignat hyperthermia
anti malarial drug: promaquine: hemolytic anemia in glucose 6 phosphate dehydrogenase deficient patients

26
Q

what are type c ADRs called

A

chronic

  • related to both dose and time
    uncommon
    cumulative dose
    long time use
27
Q

what are some examples of Type C ADRS

A

NSAID: NEPHROTOXICITY
BISPHOSPHONATES: osteonecrosis of the jaw

28
Q

what are type D ARDs called

A

delayed
time related ,
uncommon
dose related,
apparent sometimes after use of drugwh

29
Q

what are some exampels of type D ADRS

A

cytokine drugs: carcinogenic
tthalidomide, warfarin: teratogenic

30
Q

what are type E ADRs

A

End of Dose( eg end of the drug use)
withdrawal syndome

31
Q

types of Type E ADRs

A

benzodiazepines(sedative-hypnotic): insomnia, anxiety, perceptual disturbance
carticosteroids: hypothalamus - pituitary adrenal axis insufficiency crisis

32
Q

list the populations that are greatest risk for ADR

A
  1. Pediatrics(newborns, infants and children)
    - because new drugs are tested on adults and may need adjustment before given to kids
  2. geriatrics
    - v old
    decreased renal/hepatic clearance, increased half life of drugs
  3. renal or hepatic impairment
    adjuet dosing to prevent ADRS
  4. genetic variation
    personlaised drugs and medicine with genotyping services to prevent ADRs: pharmacogenetics
33
Q

drugs that were withdrawn due to cariovascular events

A

rofecoxib. and valdecoxib

LSM3211 (14 decks)

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