Adverse Drug Reactions

Question 1

ADR

Answer 1

Adverse drug reactions

Question 2

Onset of ADRS:

Answer 2

Acute - within 60 mins

Sub-acute - 1-24 hours

Latent - 2 days

Can be : mild, moderate, severe

Question 3

Classification of ADRS

Answer 3

Augmented- slowness of heart 
Bizarre 
Chronic
Delayed
End of treatment
Failure of treatment

Question 4

Predisposing factors

Answer 4

Multiple drug therapies
Inter-current disease (renal and hepatic impairment)
Age
Sex
Race & genetic polymorphism

Question 5

Type A

Answer 5

Augmented
Obvious
Predictable
No usually life-threatening
E.g beta blockers 

Augmentation of: primary effect, secondary effect

Question 6

Reasons for type A ADRS

Answer 6

Too high a dose
Pharmacokinetic variation
Pharmacodynamic variation

Question 7

Pharmacodynamic variation

Answer 7

Differences in how you respond to drug

Question 8

Liver disease (alcoholic)

Answer 8

Can make people extremely sensitive to certain drugs

Question 9

Type B ARDS

Answer 9

Bizzare

Unpredicted

Question 10

Idiosyncratic

Answer 10

Inherent abnormal response to drug
Enzyme deficiency
Enzyme/ receptor abnormality

Question 11

Type C/ long term effects

Answer 11

Semi-predictable
Cushing disease
Osteoporosis
Opiate dependence

Question 12

Type D effects (Delayed)

Answer 12

Occur after a long time
Carcinogenesis
Hodgkin’s disease (enlarged lymph node)

Question 13

Tetraogenesis

Answer 13

Eg. Phalidomide

Question 14

What % of pregnant women take prescribed medicines?

Answer 14

50%

Question 15

Type E

Answer 15

End of treatment

Eg unstable angina & MI when beta blockers stopped.

Question 16

Addisonian crisis

Answer 16

Can cause death immediately
When come off of steroids, body cannot make self steroids.
Stopping alcohol - tremors

Question 17

What is a rebound phenomena?

Answer 17

Happens when drug, including alcohol is suddenly stopped.
Antidepressants
Beta-blockers

Question 18

Type F adr

Answer 18

Failure of therapy
Normally antibiotic related
Dose related

Question 19

Diagnosing ADR

Answer 19

Be suspicious
History taken gives 9/10 of diagnosis

Differential diagnosis
Medication history (past and present)
Dosage

Question 20

Who is at most risk?

Answer 20

Age
Multiple medication
Co-morbidities
Inappropriate prescription
End-organ dysfunction
Prior history of ADRS
Dose and duration
Genetic predisposition

Question 21

Drugs commonly used

Answer 21

Antibiotics
Antineoplastics
Anticoagulants
Cardiovascular drugs
Hypoglycaemic
Antihypertensives
Opiates

Question 22

Steroid usage

Answer 22

Can cause stretch marks

Treats bad asthma