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Year 2 > Adverse drug reactions > Flashcards

Adverse drug reactions Flashcards

1
Q

What is an adverse drug reaction?

A

Any undesirable reaction that results in a detriment to the wellbeing of a patient in any way in the absence of another plausible explanation that can be proven

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2
Q

What is a side effect?

A

An undesirable secondary reaction that results when using a medication within its normal dose

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3
Q

How does digoxin toxicity present?

A 
Nausea & vomiting
Visual disturbance (including colour vision)
Bradycardia 
Sweats 
Convulsions 
Death
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4
Q

Adverse drug reactions are more common in which groups of people?

A

Elderly
Multi-morbidity (reduced renal or hepatic clearance)
Polypharmacy

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5
Q

What is the therapeutic index?

A

50% of lethal dose / 50% of effective dose

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6
Q

What is the problem with drugs with a low therapeutic index?

A

The become toxic very quickly

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7
Q

List some drugs with low therapeutic indexes?

A 
Theophylline 
Warfarin
Vancomycin 
Lithium
Digoxin 
Gentamicin
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8
Q

When might acute drug reactions be detected?

A

Drug development phase
Clinical trial phase
Post-marketing

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9
Q

Describe the two phases of drug metabolism

A

Phase 1 - cytochrome P450 system oxidises/reduces/hydrolysis
Phase 2 - conjugation allowing for excretion in bile/urine

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10
Q

What are the classifications of adverse drug reactions?

A

Type A - dose dependent and predictable
Type B - bizzare effects (dose independent and unpredictable)
Type C - chronic effects
Type D - delayed effects
Type E - end of treatment effects
Type F - treatment failure (inappropriate prescription)

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11
Q

Which type of drug reaction is the most dangerous?

A

Type B because they are unpredictable

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12
Q

Which drugs can cause type A drug reactions resulting in pre-renal failure?

A

Diuretics - if taken when dehydrated

ACE/ARBs - if taken during episodes of diarrhoea and vomiting

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13
Q

Which drugs can cause type A drug reactions resulting in renal failure (AIN/ATN)?

A

Gentamicin - given to treat sepsis
Sulphonamides - given to treat rheumatoid
Aspirin - given in certain CVS diseases

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14
Q

Which drugs can cause type A drug reactions resulting in post-renal failure?

A

Methysergide - given to treat cluster headaches

Chemotherapy - given to treat acute leukaemia

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15
Q

When should a patient not take their ACE/ARBs?

A

If they have diarrhoea and vomiting

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16
Q

Give three examples of type B drug reactions

A

Drug rashes
Bone marrow aplasia
Hepatic necrosis

17
Q

Type A drug reactions have a high mortality. T/F

A

False - type B drug reactions

18
Q

When do type C drug reactions occur?

A

When the patient has been on drug therapy for a long time

19
Q

Which drugs can cause type C drug reactions?

A

Steroids - cause Cushing’s
Beta-blockers - cause diabetes
NSAIDs - cause hypertension

20
Q

Can type C drug reactions be anticipated? What is it important to do?

A

Yes

Warn patient of possible side effects

21
Q

When do type D drug reactions occur?

A

Often many months/years after stopping drug treatment

22
Q

Give two examples of type D drug reactions

A

Carcinogenic - post chemotherapy

Teratogenic - isotretinoin

23
Q

What is isotretinoin used for? What can it cause?

A

Acne

Craniofacial abnormalities

24
Q

How do type E drug reactions occur?

A

Abrupt withdrawal causing rebound effects

25
Q

Give three examples of type E drug reactions

A

Beta-blocker withdrawal - angina
Steroid withdrawal - addisionian crisis
Anti-convulsant withdrawal - increased frequency of seizures

26
Q

Type A drug reactions can result from three types of interactions, name these

A

Drug to drug interactions
Drug to disease interactions
Drug to food interactions

27
Q

The majority of adverse drug reactions are of which type?

A

Type A

28
Q

Give some examples of drug to drug type A interactions

A

Statins and macrolide antibiotics or fibrates increase risk of rhabdomyolysis
ACEi and sulphonylureas increase risk of hypoglycaemia

29
Q

Which drugs can exacerbate chronic heart failure?

A

NSAIDs

30
Q

Which drugs can increase risk of urinary retention in patients with BPH?

A

Decongestants

Anticholinergics

31
Q

Which drugs worsen calcium?

A

Calcium
Anticholinergics
Calcium channel blockers

32
Q

Which drugs lower seizure thresholds in patients with epilepsy?

A

Tramadol

Quinolone antibiotics

33
Q

Which drugs can worsen asthma?

A

Beta blockers

34
Q

A high sodium diet can interfere with the effectiveness of which drugs?

A

ACE/ARB

Diuretics (potassium sparing)

Year 2 (72 decks)

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