Adverse Drug Reactions Flashcards
what is an adverse drug reaction?
undesirable reaction in the absence of another explanation
RF for adverse drug reactions
polypharmacy
narrow therapeutic index
renal/hepatic problems
phases of drug metabolism
phase 1= CYP450s with oxidation, reduction and hydrolysis
phase 2= conjugation enables excretion in urine and bile
classification of adverse drug reactions
type A-F
what is type A?
dose dependent and predictable effects
examples of type A adverse reactions in the kidney
pre-renal= diuretics, ACEI/ARB, D&V-sick day rules renal= ATN- gentamicin, sulphonamide, aspirin post-renal= fibrosis/calculi- methysergide, chemotherapy
type A interaction types
- drug-drug
- drug-disease
- drug-food
which drugs can exacerbate heart failure (fluid retention)?
NSAIDs
COX-2
TZDs
what can exacerbate urinary retention in BPH?
nasal decongestants
anticholinergics
which drugs can worsen constipation?
CCBs
anticholinergics
which drugs lower seizure thresholds?
neuroleptics
tramadol
quinolones
what is a type B reaction?
bizarre effects due to the genetic differences between patients
what are type C reactions?
chronic effects from prolonged pharmacological therapy
examples of type C reactions
Cushing’s from prolonged steroid use
DM from beta blockers
hypertension from NSAIDs
what are type D reactions?
delayed effects
