Adverse Drug Reactions Flashcards
Are adverse effects different from side effects?
Yes
What are the 6 classes of adverse effects.
A - augmented, dose dependent, predictable
B - bizarre, dose independent, unpredictable
C - chronic
D - delayed
E - end of treatment effects
F - failure of therapy
What are the 4 mechanisms of Type A effects.
- Pre renal failure
- Renal - tubular necrosis etc
- Post renal
- Drug interactions
What mechanism are diuretics and ACE Is involved in?
pre renal
What effect do ACE Is and ARBs have in terms of pre renal failure?
D and V
What effect do diuretics have in terms of pre renal failure?
dehydration
Give 3 examples of type a renal adverse effects.
gentamicin - sepsis
sulphonamides - RA
aspirin - CV disease
Give 2 examples of post renal effects.
methysergide - cluster headaches
chemotherapy - acute leukemias
What are 3 examples of Type B.
Drug rashes
Bone marrow aplasia - chloramphenicol antibiotic
Hepatic necrosis - halothane
Do Type B reactions have a high mortality?
YES
What type is associated with prolonged therapy?
Type C
Give 3 examples of type C effects.
Steroids - Cushings
Beta blockers - Diabetes
NSAIDs - hypertension
Can type C reactions be anticipated?
yes
Give 2 examples of Type D effects.
Secondary malignancies post chemotherapy
Craniofacial abnormalities in children of women taking isotretinoin
What type is associated with withdrawal?
TYPE E
Give an example of a a rebound effect in Type E
beta blocker withdrawal - angina
Give an example of a loss of physiological coping in Type E
steroid withdrawal and Addisonian crisis
Give an example of a mechanism dependent biological activity in Type E
anticonvulsant withdrawal/changes and epilepsy frequency
What does theophylline interact with?
macrolides
What do statins interact with?
macrolides
fibrates
What do TCAs interact with?
type 1 anti arrythmics
ACE Is increase hypoglycaemic effect of what?
sulfonylureas
Clopidigrel interacts with what?
PPIs
