Adverse drug reactions

Question 1

Adverse drug reaction

Answer 1

Harmful events at a dose intended for therapeutic effect

Question 2

What should you do about taking the drug if you have a ADR?

Answer 2

Reduce dose or withdraw

Question 3

4 features linking drug and ADR?

Answer 3

Time sequence, corresponds to know effects, cessation on removal, returns on starting

Question 4

Side effect

Answer 4

Unavoidable consequence of drug often integral to therapeutic effects

Question 5

Secondary ADR

Answer 5

Indirect causation

Opportunistic infection through glucocorticoid therapy

Question 6

Risk factors for ADR

Answer 6

Elderly, neonates
Females (lower CYP)
Disease
Current medication

Question 7

ADR classifications

Answer 7

A = Augmented
B = Bizarre
C = Chronic
D = Delayed
E = End of treatment

Question 8

Augmented ADR?

Answer 8

Heightened response based on pharmacological effect

Bradycardia from beta blockers

Question 9

Effect of muscarinic receptor antagonists

Answer 9

Inhibit/reverse parasympathetic effects
Pupils dilate
Bronchodilation
Increase HR
Decreased GI motility

Question 10

Some augmented ADR’s have effects that don’t link to therpatetic effects (like ipratropium used for bronchodilation - a muscarinic antagonist). Why?

Answer 10

Not selective binds m1-3

M2= increase heart rate = but only if it gets into systemic circulation

Question 11

Bizarre effects?

Answer 11

ADRs that cannot be linked to pharmacological effects

Uncommon and high mortality

Question 12

Chronic ADR

Answer 12

Chronic use of drug e.g. Cushings syndrome after chronic glucocorticoid therapy

Question 13

Example of end of treatment ADR

Answer 13

Stopping glucocorticoid therapy - adrenal glands cannot make cortisol

Question 14

Drug-drug interactions?

Answer 14

One drug modified the action of another

Question 15

2 types of drug-drug interactions

Answer 15

Pharmacodynamic = similar or opposing pharmacological effects
Pharmacokinetics = one drug interferes with elimination of another