Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Year 3 - SCRIPT modules > Adverse Drug Reactions > Flashcards

Adverse Drug Reactions Flashcards

1
Q

Features of rhabdomyolysis

A 
Muscle swelling
Tenderness
Weakness
Dark urine
High CK
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What causes the dark urine in rhabdomyolysis?

A

Myoglobin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is a serious complication of rhabdomyolysis and why?

A

Myoglobin deposits in the renal tubules, causing renal stenosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What drug causes rhabdomyolysis? What is this dependent on?

A

Simvastatin - dose dependent, can range from muscle weakness to muscle breakdown

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What factors can increase the risk of rhabdomyolysis?

A

Increased age,
Being of female sex
Genetic predisposition to this ADR
Pre-existing renal impairment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What drug, when given in combo with simvastatin, increases the risk of toxicity? Why?

A

Diltiazem - inhibits the metabolism of simvastatin (by inhibiting the cytochrome P450 isoenzyme CYP3A4). This increases the serum concentration of simvastatin, and so increases the risk of toxicity.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Management of acute ADR from simvasatin

A
  • Stop the simvastatin.
  • If renal failure -> dialysis
  • IV fluids (to prevent renal failure)
    Consider sodium bicarbonate to alkalinize the urine and reduce the precipitation of myoglobin in the renal tubules.
    Monitor serum potassium concentration, and correct if necessary.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

When was the yellow card scheme developed?

A

1964

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Features of Type A drug reactions

A

Dose-related
Common, predictable
Related to the pharmacology
Unlikely to be fatal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Features of Type A drug reactions

A

Dose-related
Common, predictable
Related to the pharmacology
Unlikely to be fatal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Examples of Type A reaction

A

Digoxin toxicity
Bruising with warfarin
Constipation with opiates

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Features of Type B (bizarre) drug reactions

A

Not dose-related (within the therapeutic dose range)
Uncommon, unpredictable
Not related to the pharmacology
Often fatal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Examples of Type B reaction

A

Penicillin hypersensitivity, and malignant hyperthermia and hepatitis caused by anaesthetic agents.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Features of Type C (chronic) drug reactions

A

Uncommon
Unrelated to cumulative dose
Time-related

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Examples of Type C reaction

A

Suppression of HPA with long term corticosteroids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Features of Type D (delayed) drug reactions

A

Dose related

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Examples of Type D reaction

A

Carcinogen

18
Q

What is a type E drug reaction and example

A

Opiate withdrawal syndrome / seen on withdrawal

19
Q

What is type F drug reaction? Features

A

Failure of drug to work, often due to interaction with other drugs

20
Q

Example of type F

A

A drug not working e.g. anticoag not working and pt still having stroke

21
Q

What new system of ADR classification was invented by Aronson and Ferner?

A

Hypersusceptibility reactions - at low doses
Collateral effects - at therapeutic doses
Toxic effects at higher than therapeutic doses

22
Q

Another way of classifying ADRs

A

Time dependent

Time independent

23
Q

What might make someone susceptible to ADRs?

A 
Immunological reactions (allergies)
Genetics (G6PD deficiency)
Age (old and young)
Sex
Physiology (pregnancy)
Exogenous (other drugs/food)
Disease states (renal dysfunction, liver disease)
24
Q

What three things makes kids more prone to ADRs?

A

Immature BBB
Reduced albumin and protein content
Higher body-water content

25
Q

Name three drugs that cause more ADRs in women than men

A

Antimalarial mefloquine
Hyponatremia with diuretics
Torsade de pointes linked to erythromycin and sotalol

26
Q

Name an antiretroviral drug and the gene that is screened for to reduce risk of hypersensitivity reactions

A

Abacavir

HLA-B*5701

27
Q

Name the ADR caused by certain antiepileptic drugs and the gene that is screened for to reduce risk of hypersensitivity reactions

A

SJS and toxic epidermal necrolysis

HLA-B*1502

28
Q

What ADR does a GD6P deficiency cause?

A

Haemolytic anaemia

29
Q

Drugs that might cause toxicity with GD6P deficiency

A

Anti-malarials (e.g. primaquine and chloroquine)
Nitrofurantoin
Quinolone antimicrobials (e.g. ciprofloxacin)
Rasburicase
Sulphonamides (e.g. co-trimoxazole)

30
Q

What is rasburicase used for?

A

Clearance of excess uric acid from tumours

31
Q

What is porphyria?

A

An inherited defect in haem synthesis

32
Q

Who is affected by GD6P deficiency?

A

Men from the Mediterranean, tropical Africa, and Asia

33
Q

Presentation of porphyria crises?

A

Abdo pain

Neuropsych

34
Q

Name an antipsychotic that causes blood results to go awry and what this is

A

Clozapine - agranulocytosis

35
Q

Name another drug that can cause agranulocytosis/neutropenia and what it is used to treat

A

Carbimazole (hyperthyroidism)

36
Q

What is used by the yellow card scheme to identify ADRs?

A

Proportional reporting ratios

37
Q

What info does the yellow card scheme collect?

A

Prescription meds
OTCs
Herbal
Vaccines

38
Q

What info do you need to provide for the yellow card scheme when making an entry?

A

Info about pt
Info about drug
Info about reaction
Info about reported

39
Q

What symbol is used to alert to medicines that are new/still need more info/require further monitoring?

A

Black triangle

40
Q

Explain very common to very rare ADRs and the percentage of the population it affects

A 
Very Common >10%
Common >1% but <10%
Uncommon >0.1% but <1%
Rare >0.01% but <0.1%
Very Rare <0.01%
41
Q

Name an ADR that occurs when the drug is given too rapidly?

A

The ‘red man’ syndrome, also known as the ‘red neck’ or ‘red person’ syndrome, is only seen when vancomycin is given as a bolus injection, rather than over at least 60 minutes.

Year 3 - SCRIPT modules (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions