Adverse Drug Reactions

Question 1

What is the definition of an Adverse Drug Reaction (ADR)?

Answer 1

Any response to a drug which is noxious, unintended and occurs at doses used in a human for prophylaxis, diagnosis or treatment

Question 2

What are the three classifications of onset of an ADR?

Answer 2

Acute (<60mins),

Sub-acute (1-24hrs) and Latent (>2days)

Question 3

What are the four classifications of severity?

Answer 3

Mild (no change in therapy required), Moderate (change in therapy required) and Severe (disabling or life-threatening)

Question 4

How do we classify ADRs in the Rawlins System?

Answer 4

A, A, B, C, D, E, F

Question 5

What is type A and give an example(s)?

Answer 5

Augmented (incorrect dosage)

Primary - Bradycardia due to B-blockers
Secondary - Galactorhhoea with domperidome

Question 6

What is type B and give an example(s)?

Answer 6

Bizarre

E.g. G6PD deficiency (Sex-linked) susceptible to haemolysis when given primaquine

Question 7

What is type C and give an example(s)?

Answer 7

Chronic

Iatrogenic Cushings disease

Question 8

What is type D and give an example(s)?

Answer 8

Delayed Effects

E.g. Thalidomide related phocomelia

Question 9

What is type E and give an example(s)?

Answer 9

End of treatment

E.G.
Addisonian crises

Question 10

What is type F and give an example(s)?

Answer 10

Failure of therapy (typically due to multiple medication interactions)

Failure of oral contraceptive when given with hepatic enzyme inhibitors/antibiotics