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physiology + pharmacology > Adverse Drug Reactions And Drugs Of Abuse > Flashcards

Adverse Drug Reactions And Drugs Of Abuse Flashcards

1
Q

Define adverse drug reactions

A

Any response to a drug which is noxious, unintended, and occurs at doses used in man for prophylaxis or diagnosis or therapy.

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2
Q

what factors about a person can cause change in the reaction to a drug

What factors can explain reasons ADR

A

Genetic
Age related
Sex related
Physiological (pregnancy)
Exogenous (drugs)
Disease related

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3
Q

What groups are ADR separated into

A

Group A and group B ( however it goes all the way to F )

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4
Q

What does a type A ADR stand for

A

Augmented ADR (dose related)

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5
Q

What does type B ADR stand for

A

Bizarre (ideosincratic)

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6
Q

What does type C ADR stand for

A

Chronic

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7
Q

What does type D ADR stand for

A

Delayed

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8
Q

What does type E ADR stand for

A

End of treatment

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9
Q

What does type E ADR stand for

A

End of treatment

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10
Q

What are some features of type A ADRs

A

Common and related to pharmacological reactions of drugs
Predictable effects
Low mortality
High morbidity

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11
Q

Why might type A reactions occur

A

1- pharmaceutical variation : changes in bioavailability
-out of date formulations
- contamination

2- pharmacokinetic variation : liver disease
- renal disease
- cardiac disease

3- pharmacodynamic variation : changes in fluid / electrolyte balance

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12
Q

What’s an example of pharmaceutical variation

A

Outdated tetracycline
- once out of date breaks down into anhydrotetracycline which is toxic and can cause fanconis syndrome
- which causes an impairment in proximal tubule function
- meaning substances that are usually absorbed back into the blood are lost in the urine

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13
Q

What’s an example of pharmacokinetic variation

A

E.g. liver disease
- severe hepatitis or advanced cirrhosis can reduce clearance of drugs
- means first pass metabolism will be reduced, so more drug gets into the system unchanged, possibly causing a class A ADR

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14
Q

What’s an example of pharmacodynamic variation

A

E.g. digoxin (used to treat heart disease)
- it works by blocking the Na/k pump of cardiac muscle cells
- when potassium levels are low, more digoxin can bind
- increases its effects - toxic

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15
Q

Hypernatururea

A

Increase in sodium in the urine

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16
Q

What’s one way to treat a type A ADR

A

By changing the amount of the drug administered

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17
Q

What are the features of a type B ADR

A

Uncommon and not related to the pharmacological reactions of drugs.
Unpredictable
High mortality/ low morbidity

18
Q

How can type B ADRs be managed

A

By withholding and avoiding the drug in the future

19
Q

Why might type B reactions occur

A

Immunological reasons
Pseudo-allergic reactions

20
Q

What’s an example of a Type B immunological reaction

A

Allergy e.g to penicillin
- can cause anaphylactic shock

21
Q

What’s an example of a type B pseudo-allergic reaction

A

Aspirin sensitive asthmatics
— 3-5% of asthma sufferers suffer attacks that can be triggered by aspirin

22
Q

What is a pseudo allergic reaction

A

Reactions that resemble allergic reactions but no immunological basis can be found

23
Q

What are the types of type C ADRs

A

Tolerance, adrenal suppression, tardiness dyskinesia

24
Q

What is the adrenal suppression Type C ADR

A

-the production of glucocorticoid hormones are controlled by negative feedback ( which are used to treat chronic inflammatory conditions)
- prolonged treatment with high does can cause the body to suppress glucocorticoid by the adrenal cortex

25
Q

What is tardive dyskinesia

A

Involuntary jerking movements in the face or the neck

26
Q

What’s are the features of Type D ADRs

A

Uncommon
Dose related
Occurs after some time using the drug

27
Q

How can type D ADRs be managed

A

They’re often intractable

28
Q

What are the features of Type E ADRs

A

Uncommon
Occurs soon after the withdrawal of the drug

29
Q

How can type E ADRs be managed

A

Reintroduce and withdraw slowly

30
Q

What’s an example of a type E ADR

A

Opiate withdrawal syndrome

31
Q

What are the features of a class F ADR

A

Common
Dose related
Often caused by drug interactions

32
Q

How can class F ADRs be managed

A

Increased dosage
Consider effects of combinant treatment

33
Q

What’s an example of a type F ADR

A

Inadequate dosage of oral contraceptives

34
Q

Define pharmacogenetics

A

The study of the influence of hereditary on both the pharmacokinetics of drugs and the pharmacodynamic responses to them

35
Q

What are some examples of pharmacogenetic variation

A
36
Q

What are some classes of drugs of abuse

A

Opioids - morphine, methadone
CNS Depressants - alcohol, ketamine
Psychomotor stimulants - cocaine, amphetamine

37
Q

What makes drugs of abuse different than other drugs

A

They induce feelings of euphoria and reward
- chronic exposure causes continual reliance on its effects
-

38
Q

Describe Neuro adaptation as a cause of drug tolerance

A

Receptor expression is dynamic and can change when a drug impacts the system (reduced receptor expression for agonists, increased for antagonists)
This reduces drug effects and leads to withdrawal symptoms

39
Q

What is the reward pathway

A

A dopaminergic pathway from the ventral tegmengal area to the nucleus accumbens and prefrontal cortex

40
Q

What is an example of research behind the reward pathway

A

Experiment on rats self administering cocaine due to the pleasure it causes them

41
Q

What are the features of opioids and how do they work

A

They’re agonists at mu-opioid receptors in the cns to produce main action
- also act on other opioid receptor subtypes
- they also act on peripheral mu-receptors e.g in the gastrointestinal tract

42
Q

Why do we have opioid receptors int he first place

A

We have endogenous agonists of these receptors
- endomorphins
- dynorphins
These peptides posses analgesic activity through their precise function in the CNS
and elsewhere poorly understood
They act on opioid receptors of which there are 3 types
Mu, delta, and kappa

physiology + pharmacology (13 decks)

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