Adverse drug reactions Flashcards
Define adverse drug reaction
ANY undesirable reaction, whether expected, predictable or not that results in a detriment to the wellbeing of the patient in ANY way, whether symptomatic, detectable or not, in the absence of another biologically plausible explanation that can be proven
How are adverse drug reactions classified ?
- Type A: Augmented pharmacologic effects - dose dependent and predictable
- Type B: Bizarre effects (or idiosyncratic) - dose independent and unpredictable
- Type C: Chronic effects
- Type D: Delayed effects
- Type E: End-of-treatment effects
- Type F: failure of therapy
Why do you need to be careful when giving someone an ACEi/ARB and diuretic ?
Because the ACEi/ARB increases the chances of the diuretic causing hypotension
Give some examples of Type A adverse drug reactions
- Diuretics + ACEi/ARB causing hypotension
- Gentamicin causing acute tubular necrosis
Give some examples of Type B adverse drug reactions
- 1) Drug rashes
- 2) Bone marrow aplasia –Chloramphenicol antibiotic
- 3) Hepatic necrosis - haloth
Give some examples of Type C adverse drug reactions
- Steroid therapy – Cushings disease
- Beta-blockers – Diabetes
- NSAIDs – Hypertension
Give some examples of Type D adverse drug reactions
Secondary malignancies post chemotherapy
Give some examples of Type E adverse drug reactions
- Withdrawl of Beta-blocker resulting in angina
- Steroid withdrawal resulting in addisonian crisis
What are the 3 different types of drug interactions ?
- Drug-drug interactions (with other drugs)
- Drug-disease interactions
- Drug-food interactions
Give some examples of drug-drug interactions
- ACE inhibitors increase hypoglycemic effect of sulfonylureas
- Clopidogrel and PPI’s
Give some examples of drug-disease interactions
- B-blockers and asthma
- NSAIDs/COX-2/TZD’s can exacerbate CHF
Give an example of a drug-food interaction
- Bananas,oranges, green leafy vegetables (K+-rich)
- Interacts with: ACEIs, ARBs, K-sparing diuretics
