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Pharmacology > Adverse Drug Reactions (ADRs) > Flashcards

Adverse Drug Reactions (ADRs) Flashcards

1
Q

Define ADR

When does an ADR occur in terms of dosage

A

Harmful/unwanted effect of a drug

Often display dose response relationship

Many but not all ADRs are produced at doses much higher than the therapeutic dose

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2
Q

Most common adverse effect of statins

A

muscle pain/weakness that can progress to rhabdomyolysis or death

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3
Q

What statin was withdrawn from the market in 2001

A

Cerustatin (Baycol)

Side effects of secere adverse muscle reactions and in some cases death

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4
Q

FDA classification of drugs

A
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5
Q

What weeks are critical in pregnancy & why

A

3rd and 11th weeks

Increased free drug in plasma

Dangers to foetus before birth

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6
Q

What drugs have teratogenic effects

A

Isotretinoin

Anti-epileptic drugs

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7
Q

When was thalidomide administered in pregnancy

A

During 1st trimester for morning sickness

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8
Q

What did thalidomide (now FDA category X) produce

A

Phocomelia (deletion of long bones of limbs)

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9
Q

What is thalidomide now used as treatment for

A

Leprosy

Multiple myeloma

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10
Q

What can sodium valproate (used to treat epilepsy and bipolar disorder) during pregnancy result in

A

Foetal vaproate syndrome (FVS)

Cognitive difficulties

Learning disabilities

Autism

Physical abnormalities

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11
Q

What measures did the MHRA introduce with regard to treatment

A
  1. Women must be fully informed of the risks
  2. Advised on the importance of using effective contraception
  3. Invited for a yearly review of their treatment
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12
Q

What must drug therapy in the young account for

A
  • GIT absorption (pH and emptying times)
  • Plasma binding is reduced in neonates
  • Conjugation deficient in some neonates (chloramphenicol)
  • All aspects of renal function are reduced at birth

* A number of drugs are absolutely contraindicated while the mother is breast-feeding

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13
Q

Erythematous eruptions

A

skin rash, most common type of drug-induced skin reaction

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14
Q

Pruritus

A

may be the first sign of drug hypersensitivity

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15
Q

Urticaria

A

“hives”, “nettle rash”

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16
Q

Anaphylactic shock

A
  • Life- threatening reaction
  • Release of various substances, among which is histamine causing vasodilatation, increased capillary permeability, tissue oedema
  • Hypotension, urticaria and erythema of face and neck
  • Treat with adrenaline, chlorpheniramine (histamine receptor blocker), corticosteroids (anti-inflammatory drugs)
17
Q

Aplastic anaemia

A

Suppression of all bone marrow functions

18
Q

Agranulocytosis

A

Complete absence of neutrophils in the blood

19
Q

Thrombocytopenia

A

Reduction in platelet count

20
Q

What are the National Institute for Health and Clinical Excellence (NICE) guidelines for schizophrenia

A

in individuals with evidence of treatment resistant schizophrenia, clozapine should be introduced at the earliest opportunity

21
Q

Agranulocytosis incidence rate in patients taking clozapine

When is it highest

A

1% of patients - highest between 6-18 weeks after commencement

Full blood count should be monitored regularly

Agranulocytosis is an idiosyncratic reaction - difficult to predict

22
Q

What harmful side effect does thioridazine have (used to treat schizophrenia)

A
  • Prolongs QT interval by blockade of the delayed rectifier cardiac potassium channel (Ik) coded for by HERG
  • QT prolongation leads to serious ventricular arrhythmias
  • Withdrawn from the market in 2005
23
Q

What is a side effect of centrally acting drugs

A

Dizziness

24
Q

Side effect of aminoglycosides

A

Tinnitus

25
Q

Side effect of antipsychotics

A

Parkinsonism

26
Q

What is codein converted to in the body

A

Morphine

27
Q

What sort of drug is rimonabant

A

Cannabinoid (CB1) receptor antagonist developed for the treatment of obesity

28
Q

What did postmarketing surveillance of rimonabant reveal

A

Doubling of the risk of psychiatric disorders in obese patients

29
Q

What does TGN1412 do physiologically

What was it developed to treat

What happened in the trial

A

Stimulates and increases T lymphocytes, enhancing the immune system

Developed to treat rheumatoid arthritis and other autoimmune disorders

6/8 volunteers received iv TGN1412 and all had multi-organ failure (especially lungs and kidneys) caused by a cytokine storm - a rapid release of proinflammatory cytokines

Pharmacology (23 decks)

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