adverse drug reactions

Question 1

ADR of aspirin

Answer 1

excessive bleeding

Question 2

why are children at risk of ADR

Answer 2

lower capacity to metabolize drugs

Question 3

what are elderly at risk of ADR

Answer 3

• altered PK and PD
• cognitive problems
• polypharmacology
• co-morbidity

Question 4

what are the 3 classifications of ADR

Answer 4

1. onset
2. severity
3. type

Question 5

how long does it take for acute, sub-acute, and latent ADR

Answer 5

• acute: 0-60 min
• sub-acute: 1-24 hours
• latent: more than 2 days

Question 6

the severity of ADR can be classified as __

Answer 6

1. mild
2. moderate
3. severe
4. lethal

Question 7

mild severity ADR

Answer 7

• no therapy

- no hospitalization

Question 8

moderate ADR

Answer 8

• change the drug therapy

- may hospitalize

Question 9

severse ADR

Answer 9

• life-threatening
• must stop drug
• get tx for ADR

Question 10

lethal ADR

Answer 10

pt dies

Question 11

what are the types of ADR

Answer 11

1. dose related
2. not dose related
3. dose related and time related
4. time related

Question 12

dose-related ADR is predictable based on ___

Answer 12

pharmacological action of drug

Question 13

not dose related ADR characteristics

Answer 13

• not predictable
• not related to action of drug
• not treatable by changing dose
• high mortality

Question 14

anaphylaxis is an example of what type of ADR

Answer 14

not dose-related

Question 15

dose-related and time related happens when ___

Answer 15

you take the drug for a long time and it accumulated

Question 16

time related ADR appear when?

Answer 16

• some time after use of drug

- delayed!

Question 17

4 types of allergic reactions

Answer 17

• anaphylactic
• cytotoxic
• immune complex-mediated
• cell-mediated

Question 18

during anaphylaxis, the drug interacts with what Ig on which cells

Answer 18

IgE on basophils and mast cells

Question 19

what happens to the cell during cytotoxic rx

Answer 19

lysis

Question 20

in cytotoxic reactions, drugs act as ____ and, when binding to protein, cause antibodies to form

Answer 20

haptens

Question 21

immune-complex mediated

Answer 21

• antigen-antibody complex reaches target cell
• complement is activated
• tissue destruction

Question 22

example of immune-complex mediated

Answer 22

serum sickness rxn

Question 23

what drugs cause serum sickness

Answer 23

• cefaclor
• penicillin
• erythromycin

Question 24

cell-mediated reaction

Answer 24

• drug binds to lymphocytes

- CK released

Question 25

examples of cell-mediated rxn

Answer 25

• eczema

- contact dermatitis

Question 26

teratogens effect __

Answer 26

the fetus

Question 27

penicillin can cause which type of rnx

Answer 27

-all 4, but type 1 is most common

Question 28

ADRs of penicillin

Answer 28

• skin rash

- diarrhea

Question 29

ADRs of clindamycin

Answer 29

• GI upset
• allergy
• c. difficle colitis

Question 30

ADRs of tetracyclines

Answer 30

• GI upset

- allergy

Question 31

should you take tetracylcines when you are pregnant

Answer 31

no

Question 32

ADRs of opioids

Answer 32

• nausea, vomiting
• constipation
• respiratory depression
• hypotension
• acute urine retention
• allergy
• opioid pruritus

Question 33

what is the most common ADR of local anasthetics

Answer 33

psychogenic effects

Question 34

list all the ADRs of local anasthetic

Answer 34

• psychogenic effects
• hyperventilation
• nausea, vomiting
• syncope
• change in HR and BP

Question 35

ADRs of NSAIDs

Answer 35

• bleeding
• dyspepsia
• gastric mucosal damage
• renal impairement