Adverse Drug Reactions Flashcards
who is most at risk of suffering ADRS
elderly and frail, multimorbid (renal and kidneys), polypharmacy, HLA genetics
name some drugs with a narrow therapeutic index (toxic) (8)
theophylinne, warafin, lithium, digoxin, gentamicine, vancomycine, carbamzepine, levothyroxine
what are the phases of ADR detection
drug development (pre-clinical) –> clinical trials (phase I-III) –> post marketing surveillance (phase IV)
what happens in phase 1 of drug metabolism
oxidation, reduction, hydrolysis (CP450 cycle)
what happens in phase 2 of drug metabolism
conjugation and adding organic compound so it can be excreted
in what phase of drug metabolism are ARD most likely to happen
phase 1
what is type A ADR
augmented pharmacological effect // known reactions and side effects
is type A dose dependent
yes - and predictable
in a renal context, what drugs cause type A drug reactions
diuretics, ACEi/ ARBs, gentamicin, sulphonamides, aspirin, chemo
give 2 examples of drugs that can cause drug-drug interactions
warfarin, St John’s Wort
give an example of drug-disease interaction
where drug and pathophysiology of disease react eg beta blockers and asthma
what can cause drug-food interactions
foods that are rich in certain vitamins and can affect pH
what is type B ADR
bizarre - unpredictable and dose independent
give 3 examples of type B ADR and what is thought to cause them
drug rashes, bone barrow aplasia, hepatic necrosis, death // usually genetic polymorphisms and multifactorial
what is type C ADR
chronic effects
