Adverse drug reactions

Question 1

1st gen antihistamines such as promethazine can give u

Answer 1

sedation

Question 2

tergenadine (antihistamine) can give u

Answer 2

arrhythmias (drug acts on histamines receptors but also act on cardiac K+ channels as well)

Question 3

drugs with narrow therapeutic window

Answer 3

digoxin
warfarin
aminoglycosides

Question 4

drugs with steep dose-response curve

Answer 4

sulphonylureas
verapamil
levodopa

Question 5

hypersensitivity reactions if immediate are

Answer 5

IgE mediated aka drug allergy

or if delayed, its non-IgE mediated

in the initial exposure theres no ADR, but it sensitises the body. its with SUBSEQUENT exposure that u get ADRs

Question 6

type 2 hypersensitivity reaction example

Answer 6

haemolytic anaemia from penicillin

Question 7

type 3 hypersensitivity reaction example

Answer 7

serum sickness from anti-thymocyteglobulin

Question 8

type 1 hypersensitivity reaction example

Answer 8

anaphylaxisfrom penicillin

IgE-mediated

Question 9

pseudoallergy example

Answer 9

red-man syndrome with vancomycin

Question 10

corticosteroids can give u

Answer 10

cushings

Question 11

alkylating agents can give u

Answer 11

secondary cnacers

Question 12

diuretics and digoxin

Answer 12

diuretics gets rids of K+
Digoxin inhibits the Na+/K+ ATPase
if u have less K+, then that channel won’t work very well,
=get digoxin toxicity e.g. dysrhythmia

Question 13

sildenofil (viagra) and nitrates

Answer 13

sildenafil blocks the thing (PDE-5) that breaks down cGMP
nitrates stimulate cGMP to do vasodilation
so if u have more cGMP, nitrates can work more
=get hypotension

Question 14

st johns wort and SSRIs

Answer 14

st johns wort inhibits 5HT uptake
SSRIs also inhibit 5HT uptake
=can get serotonin toxicity

Question 15

drugs that induce cytochrome P450 (cytochrome P450 breaks down drugs)

Answer 15

rifampicin

st johns wort

Question 16

drugs that block cytochrome P450 (cyto P450 breaks down drugs)

Answer 16

grapefruit juice

Question 17

st johns wort

Answer 17

have both pharmacokinetic interaction and pharmacodynamic interaction

induces CYP3A4 in liver

same effect as SSRIs, so if given together get serotonin syndrome

Question 18

2 drugs that increase urine flow

Answer 18

diuretic s and digoxin

Question 19

2 drugs that compete for the same transporter during renal drug excretion

Answer 19

penicillin & probenecid