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Y2 LCRS Pharm HR > Adverse drug reactions > Flashcards

Adverse drug reactions Flashcards

1
Q

Recall how ADRs are classified by timeframe of reaction

A

Acute (<1hr)
Subacute (1-24hrs)
Latent (>2 days)

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2
Q

Recall how ADRs are classified by severity

A

Mild: no change in therapy required
Moderate: Change therapy + add treatment
Severe: disabling/ life-threatening

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3
Q

Recall the 5 classes of conventional classification for ADRs

A 
Augmented
Bizarre
Chronic
Delayed
End
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4
Q

Into which category of ADR do carcinogenic drugs fall?

A

Type D

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5
Q

Into which category of ADR do allergies and pseudo-allergies fall?

A

Type B

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6
Q

Which class of ADR classifications is most predictable?

A

Type A

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7
Q

Which of the ADR classifications is most likely to be dose-dependent?

A

Type A

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8
Q

Under which class of ADR does foetal-damage resulting from thalidomide fall?

A

Type D

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9
Q

What is the underlying cause of Type A ARDs?

A

These ADRs are due to the PHARMACOLOGICAL effect of the drug (and so are often dose-dependent)

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10
Q

What are the main 2 types of reaction that fall under the Type B classification of ADRs?

A

Idiosyncratic or immunological

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11
Q

Give an example of a pseudoallergy

A

Angiodema associated with ACEi use - due to reduced bradykinin breakdown

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12
Q

Recall an example of a very rare but very acute Type B ADR

A

Chloramphenicol: causes severe aplastic anaemia in about 1 in 10,000

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13
Q

Give 2 examples of Type C ADRs

A

Methotrexate –> liver fibrosis

Anti-malarials –> ocular toxicity

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14
Q

What is the name of the scheme that allows anybody to record side effects of drugs and when + why was it introduced?

A

Yellow card
1964
Thalidomide

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15
Q

What is a type E ADR?

A

Withdrawal, rebound or “adaptive” reaction

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16
Q

Give 3 commonly-implicated drugs for withdrawal reactions

A

BDZs
Corticosteroids
Opiates

17
Q

Give 3 commonly-implicated drugs for rebound reactions

A

Clonidine
Beta blockers
Corticosteroids

18
Q

What sort of drug is clonidine?

A

Antihypertensive

19
Q

Give an example of an “adaptive” reaction

A

Neuroleptic tranquiliser

20
Q

Recall 2 drugs associated with pseudoallergy and the main symptom of each of these ADRs

A
  1. NSAIDS - bronchospasm

2. ACEi - cough + angiodema

21
Q

Why is bronchospasm in response to NSAID use a pseudoallergy?

A

It is a totally pharmacological response so not sure why only some peopke react

22
Q

How do NSAIDS cause bronchoconstriction?

A

Increase leukotriene production

23
Q

How does ACEi use cause cough and angiodema?

A

Descreases bradykinin breakdown

24
Q

What is a pseudoallergy?

A

An ADR that is mediated pharmacologically rather than immunologically

25
Q

What are the 4 main factors affecting ADRs?

A

Polypharmacy
Diet
Age
Renal fx

26
Q

What are the 3 types of drug-drug interaction?

A

Pharmacodynamic, pharmacokinetic and pharmaceutical

27
Q

What are pharmacokinetic drug drug interactions?

A

DDIs that relate to the body’s effect on the drug

28
Q

Give an example of a pharmacokinetic DDI

A

Impaired absorption due to chelation occurs when quinolones are absorbed alongside dairy products

29
Q

What are pharmacodynamic DDIs?

A

DDIs that are related to the drug’s effect on the body

30
Q

Recall 3 examples of phamacodynamic DDIs

A
  1. Synergistic action of antibiotics
  2. Overlapping toxicities of drugs eg BDZs and ethanol
  3. Antagonistic effects eg amitryptiline and ACEi
31
Q

What is a pharmaceutical DDI?

A

Drugs ineracting outside the body eg precipitating in IV solution

32
Q

What is the main difference between enzyme-induced and enzyme-inhibited changes in drug metabolism?

A

Drug inhibition can occur within minutes but induction takes hours/ days

33
Q

Recall 5 key examples of CYP450 inhibitors

A
  1. SSRIs
  2. HIV drugs
  3. Anti-fungals
  4. Antibiotics
  5. Grapefruit juice
34
Q

Recall 3 key examples of CYP450 inducers

A
  1. Rifampicin (antibiotic)
  2. Carbamazepine (anti-epileptic)
    3, St John’s Wort
35
Q

Recall 2 key examples of where drug elimination is inhibited by a DDI

A
  1. Penicillin excretion reduced by probenecid

2. Lithium reduces thiazide clearance

36
Q

Recall 4 examples of where drugs are coprescribed deliberately for their interactions

A
  1. Levodopa and carbidopa
  2. ACEi and thiazides
  3. Penicillin and gentamycin
  4. Salbutamol and ipratropium

Y2 LCRS Pharm HR (31 decks)

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