Adverse Drug Reactions

Question 1

Drugs with a therapeutic index less than what are potentially danagerous in terms of side effects?

Answer 1

<2

Question 2

What are the two phases of drug metabolism?

Answer 2

Phase 1 - Usually through CYP P450 (oxidation, reduction and hydrolysis)

Phase 2 - Conjugation

Question 3

Which phase of drug metabolism is usually responsible for adverse drug reactions?

Answer 3

Phase 1

Question 4

How are drug adverse reactions classified?

Answer 4

Types A to F

Question 5

What are type A adverse reactions?

Answer 5

Dose dependent and predictable

(the obvious)

Question 6

How can aspirin affect the kidneys?

Answer 6

Renal papillary necrosis

Question 7

Hoe does gentamicin affect the kidneys?

Answer 7

Tubular necrosis

Question 8

What are the different types of drug interaction?

Answer 8

Drug - Drug

Drug - Disease

Drug - Food

Question 9

Theophylline must not be used with which class of drugs?

Answer 9

Macrolide antibiotics

(e.g. asthmatic with penicillian allergy and chest infection)

Question 10

The use of statins and fibrates may cause which symptom which patients must watch out for?

Answer 10

Muscle pains and aches

(myopathy)

Question 11

Why may ACE inhibitors be dangerous in diabetic patients?

Answer 11

Increase hypoglycaemia when used with sulfonylureas

(inhibit liver gluconeogenesis)

Question 12

Which types of drugs can exacerbate chronic heart failure?

Answer 12

NSAIDs

COX-2 inhibitors

TZDs

Question 13

Vitamin K rich food (Bananas,oranges, green leafy vegetables) interact with which drugs?

Answer 13

ACEIs, ARBs, K-sparing diuretics

Question 14

Warfarin interacts with food high in which vitamins?

Answer 14

E and K

Question 15

What type of drug reactions are type B?

Answer 15

Dose dependent and unpredicatable

Question 16

Type B drug reactions have a ________ mortality

Answer 16

Type B drug reactions have a high mortality

Question 17

Type C drug reactions happen under which circumstances?

Answer 17

Long term drug use

(e.g. glucocorticoids causing osteoporosis)

Question 18

Long term beta blocker use can cause which condition?

Answer 18

Diabetes

Question 19

Long term NSAID use can cause which condition?

Answer 19

Hypertension

Question 20

Type D drug reactions are associated with which circumstances?

Answer 20

Drug reactions many years after taking a drug

Question 21

Give an example of a type D drug reaction?

Answer 21

1. Secondary malignancy post chemotherapy
2. Craniofacial abnormalities in children of women taking isotretinoin

Question 22

What are type E drug reactions?

Answer 22

Drug reactions from sudden withdrawal

Question 23

Abrupt drug withdrawal often causes _________ effects

Answer 23

Abrupt drug withdrawal often causes rebound effects

Question 24

What can happen if beta blockers are stopped abruptly?

Answer 24

Rebound tachycardia

Question 25

Steroid withdrawal may precipitate which severe condition?

Answer 25

Addisonian crisis

(adrenal atrophy)

Question 26

Which patient should be allergy tested for allopurinol before use?

Answer 26

SE Asian

(Possess HLA B5801 genotype which causes allergy in around 15%)