Adverse Drug Reactions

Question 1

What is an adverse drug reaction?

Answer 1

Any response to a drug which is noxious, unintended and occurs at doses used in man.

Question 2

How many ADR admissions are there every year?

Answer 2

1,000,000

Question 3

What is an acute onset?

Answer 3

Within 60 minutes

Bronchoconstriction

Question 4

What is a subacute onset?

Answer 4

1-24 hours

Rash, serum sickness

Question 5

What is a latent onset?

Answer 5

2 days

Eczematous eruptions

Question 6

What are the 3 severities of reactions?

Answer 6

Mild
Moderate
Severe

Question 7

What are the classifications of ADRs?

Answer 7

A - Augmented
B - Bizarra
C - Chronic
D - Delayed
E - End of treatment
F - Failure of treatment

Question 8

Explain Type A.

Answer 8

Dose related

Predictable

Question 9

Explain Type B.

Answer 9

Idiosyncratic and unpredictable.

Question 10

What are the predisposing factors of ADRs?

Answer 10

Multiple drug therapy
Age
Sex

Question 11

Are Type A reversible?

Answer 11

Yes

Question 12

What % of ADRs are Type A?

Answer 12

80

Question 13

What are the 2 types of type A?

Answer 13

Augmentation of primary effect

Secondary effect

Question 14

What are the 4 reasons for Type A ADRs?

Answer 14

High dose
Pharmaceutical variation
Pharmacokinetic Variation
Pharmacodynamic variation

Question 15

What can cause pharmacokinetic variation?

Answer 15

Absorption
Distribution
Metabolism
Liver disease
Elimination

Question 16

What can cause pharmacokinetic variation?

Answer 16

Absorption
Distribution
Metabolism
Liver disease
Elimination

Question 17

What is a pharmacogenetic drug?

Answer 17

Metabolised via acetylation which is under genetic control.

Question 18

What are two types of disease?

Answer 18

Renal and hepatic

Cardiac failure

Question 19

What are the pharmacodynamic variations?

Answer 19

Natural variability

Disease states can alter

Question 20

What are the features of Type B ADRS?

Answer 20

Bizarre
Unpredictable
Rare
Serious illness/Death
Unidentified
Unrelated to dose

Question 21

What is the mechanism of Type B ADRs?

Answer 21

Immunological

no relation, delay between exposure, no dose, manifests as rash

Question 22

What are Type B more common with?

Answer 22

Macromolecules

Patients with asthma, eczema

Question 23

What are idiosyncratic reactions?

Answer 23

Inherent abnormal

Question 24

What are the two genetic abnormalities?

Answer 24

Enzyme

Receptor

Question 25

What are drug allergies also called?

Answer 25

Hypersensitivity reactions

Question 26

What are features of type C reactions?

Answer 26

Semi-predictable
Iatrogenic cushing’s disease
Steroid induced osteoporosis
Opiate dependence

Question 27

What are the features of Type D effects?

Answer 27

Occur long time after treatment
Teratogenesis
Carcinogenesis
Children of treated patients

Question 28

What cancers can Type D effects be seen in?

Answer 28

Second, treated with alkylating agents.

Question 29

What are some teratogenic agents?

Answer 29

Cytotoxics
Vit A
Antithyroid drugs
Steroids

Question 30

What are the features of Type E treatments?

Answer 30

Occur when a drug treatment is stopped especially suddenly.

Question 31

What happens when anti-epileptics are stopped?

Answer 31

Withdrawal seizures.

Question 32

What happens when anti-epileptics are stopped?

Answer 32

Withdrawal seizures.

Question 33

When does rebound phenomena occur?

Answer 33

When a drug is suddenly withdrawn.

Question 34

What are the features of Type F ADRs?

Answer 34

Common
Dose related
Frequently caused by drugs
Seen in children with too low doses

Question 35

What are the 4 steps of diagnosis in ADRs?

Answer 35

Differential diagnosis
Medication history
Time of onset and dose
Lab investigations

Question 36

How do you report ADRs?

Answer 36

Yellow card scheme