Adverse Drug Reactions Flashcards
Drugs with a therapeutic index less than what are potentially danagerous in terms of side effects?
<2
What are the two phases of drug metabolism?
Phase 1 - Usually through CYP P450 (oxidation, reduction and hydrolysis)
Phase 2 - Conjugation
Which phase of drug metabolism is usually responsible for adverse drug reactions?
Phase 1
How are drug adverse reactions classified?
Types A to F
What are type A adverse reactions?
Dose dependent and predictable
(the obvious)
How can aspirin affect the kidneys?
Renal papillary necrosis
Hoe does gentamicin affect the kidneys?
Tubular necrosis
What are the different types of drug interaction?
Drug - Drug
Drug - Disease
Drug - Food
Theophylline must not be used with which class of drugs?
Macrolide antibiotics
(e.g. asthmatic with penicillian allergy and chest infection)
The use of statins and fibrates may cause which symptom which patients must watch out for?
Muscle pains and aches
(myopathy)
Why may ACE inhibitors be dangerous in diabetic patients?
Increase hypoglycaemia when used with sulfonylureas
(inhibit liver gluconeogenesis)
Which types of drugs can exacerbate chronic heart failure?
NSAIDs
COX-2 inhibitors
TZDs
Vitamin K rich food (Bananas,oranges, green leafy vegetables) interact with which drugs?
ACEIs, ARBs, K-sparing diuretics
Warfarin interacts with food high in which vitamins?
E and K
What type of drug reactions are type B?
Dose dependent and unpredicatable
Type B drug reactions have a ________ mortality
Type B drug reactions have a high mortality
Type C drug reactions happen under which circumstances?
Long term drug use
(e.g. glucocorticoids causing osteoporosis)
Long term beta blocker use can cause which condition?
Diabetes
Long term NSAID use can cause which condition?
Hypertension
Type D drug reactions are associated with which circumstances?
Drug reactions many years after taking a drug
Give an example of a type D drug reaction?
- Secondary malignancy post chemotherapy
- Craniofacial abnormalities in children of women taking isotretinoin
What are type E drug reactions?
Drug reactions from sudden withdrawal
Abrupt drug withdrawal often causes _________ effects
Abrupt drug withdrawal often causes rebound effects
What can happen if beta blockers are stopped abruptly?
Rebound tachycardia
Steroid withdrawal may precipitate which severe condition?
Addisonian crisis
(adrenal atrophy)
Which patient should be allergy tested for allopurinol before use?
SE Asian
(Possess HLA B5801 genotype which causes allergy in around 15%)
