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BDS3 Human Disease > Adverse drug reactions and interactions > Flashcards

Adverse drug reactions and interactions Flashcards

1
Q

Adverse drug reactions, 2 types?

A

Augmented

Bizarre

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2
Q

Type a adr?

A

Exaggeration of intended therapeutic effect e.g.
- hypotension with antihypertesinves
- dehydration with diuretics

Unrelated to intended therapeutic effect e.g.
- hyponatraemia with thiazides
- brethlessness with. Beta blockers

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3
Q

Increased risk of type A ADR?

A

Drug concentrations - higher dose

Patient factors

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4
Q

Management of the A ADR?

A

Reduce dose

Try alternative

Keep on if necessary and treat the ADR

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5
Q

What are high risk clinical scenarios for augmented ADRs?

A

Liver impairment

Heart failures

Elderly/frail

Dehydration

Renal impairment

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6
Q

What drugs make to at high risk of ADR when pt has heart failure?

A

Nsaids

Glitazones

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7
Q

What drugs make out at high risk of ADR if pt has renal impairment?

A

Nsaids

ACE/ARBS

Metaformin

LMWH

Digoxin

Antibiotics

Opiates

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8
Q

What drugs make you at higher risk of ADR if ou have liver impairment?

A

Nsaids

Metoformin

Warfarin

Benzodiazepines

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9
Q

Can you predict type B ADR?

A

No, immune or genetic factors

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10
Q

Management of type B ADR?

A

Stop causative agent

Deal with the ADR

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11
Q

What is type C ADR?

A

Chronic

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12
Q

Are type C ADR predictable?

A

Predictable form known pharmacology

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13
Q

What are examples of type C chronic ADR?

A

Osteoporosis of the jaw with bisphosphonates

Osteoporosis with long-term high dose steroids

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14
Q

When can you notic type C chronic ADR?

A

Effects require prolonged period of exposure to develop

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15
Q

Management of type C ADR?

A

Use prophylaxis

Monitoring

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16
Q

What is type D ADR?

A

DELAYED

17
Q

What is type d ADR?

A

Effects do not arise until prolonged period of exposure

Even though drug withdrawn it may still have effects in the future

E.g. chemo therapy… increased risk of lymphomas in later life

18
Q

Type E ADR?

A

End of use

19
Q

What is type e ADR?

A

Effect seen on medicines withdrawal: withdraw reactions

20
Q

What drugs do you see type E ADR with?

A

Benzodiazepine

Opiates

SSRI

Steroids

Beta blockers

21
Q

General prophylaxis for ADR?

A

Avoid certain medicines for high risk pt

Consider reducing dose - check BNF

Monitor side effects

Offer prophylaxis

Avoid known drug interactions

22
Q

What is pharmacovgilance?

A

The process involving detection, assessment, understanding and prevention of ADRs

Continual assessment o the risk and benefits of each drug resulting in th best drug therapy for pt

23
Q

Main metho for post-marketing surveillance of ADR in UK?

A

Yellow card scheme

24
Q

What does the yellow card scheme for collect information on? (5)

A

Side effects (AKA ADR)

Medical device adverse incidents

Defective medicines (those that are not of an acceptable quality)

Counterfeit or fake medicines or medical devices

Safety on Erin’s e.g. e-cigarettes or their refill containers

25
Q

Information to include on a red card report?

A
26
Q

Cytochrome P450 inhibitors?

A

Omeprazole
Erthyromycin
Isoniazid
Ethanol
Sulphonamides
Disulfiram
Valproate

27
Q

Cytochrome p450 inducers?

A

Alcohol
Barbiturates
Carbamezepine
Phenytoin
Rifampicin

28
Q

Pts susceptible to ADR?

A

Elderly

Renal impairment
Diabetes mellitus
Epilepsy

Young

Critically ill

Pts undergoing complicated surgical procedures

Due to polypharmacy

29
Q

Agonistic interactions of drugs?

A

Blood pressure of ramipril and idapamide

Increased sedative effect wen ethanol and diazepam are combined

30
Q

Antagonistic effect of drugs example?

A

Atenolol and salbutamol

Naloxone and morphine

31
Q

Pharmacokinetic drug interactions?

A

When one drug affects the absorption istrinution, metabolism or exertion of another

32
Q

Drug interaction which affects proetin binding and distribution?

A

E.g. drug A displaces drug B from the carrier proetin then there is an increase in active drug B

E.g. amiodarone displaces digoxin and can lead to digitoxicity

33
Q

Drug interactions in relation to metabolism?

A

Drug A induces/inhibits the enzyme metabolism of drug b

E.g. metabolism of warfarin is inhibited by amiodarone leading to an increase in anticoagulan effect of warfarin

34
Q

Cytochrome p450?

A

Microbial enzyme found in the liver and gut

Metabolises many dugs

35
Q

Where are the majority fo drugs excreted?

A

Kidneys

36
Q

What drug can make increase risk of methotrexane toxicity and why?

A

NSAIDS

Competition for renal tubular excretion

BDS3 Human Disease (33 decks)

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