Adverse Drug Reactions & Interactions

Question 1

ADRs are _____ and ______ response to a drug which is normally used in humans for ______ purposes. It does not apply to ______ drugs.

Answer 1

Noxious; unintended; therapeutic; illegal

Question 2

What percentage of hospital admissions are due to ADRs?

Answer 2

6%

Question 3

Outline 4 greater risk groups of ADR

Answer 3

Age (very old/young)
Gender (women)
Co-morbidities (renal/hepatic)
Polypharmacy

Question 4

Identify the 5 classifications of ADRs (ABCDE)

Answer 4

Augmented
Bizarre
Chronic
Delayed
End of dose

Question 5

Define augmented ADRs

Answer 5

Predictable, relatively common and dose-related.

High morbidity, low mortality.

Question 6

Define bizarre ADRs

Answer 6

Unpredictable and uncommon, included allergic reactions.

Low morbidity, high mortality.

Question 7

Define chronic ADRs

Answer 7

Develops after continuous or chronic use

Question 8

Define delayed ADRs

Answer 8

Develops some time after exposure to drug

Question 9

Define end of dose ADRs

Answer 9

Manifests when medication has been stopped - withdrawal effect

Question 10

What are the 4 classifications of ADRs based on SEVERITY

Answer 10

Mild: May not even be noticed
Moderate: Corrective measures necessary, but not hospitalised
Major: Organ damage and hospitalisation
Life-threatening: May be fatal

Question 11

What pneumonic helps in understanding ADR causality?

Answer 11

TRIP

Time, Recovery, Independent evidence, Predictable

Question 12

Define pharmacovigilance

Answer 12

Post-marketing surveillance of medicines in general population - generally newly added

Question 13

What 4 details are required when reporting an ADR?

Answer 13

Patient details, reporter details, suspected drug, suspected reaction(s)

Question 14

How do grapefruit juice and cranberry juice cause drug interactions?

Answer 14

Affect metabolism

Question 15

Why do milk/dairy products cause drug interactions?

Answer 15

Due to calcium

Question 16

Why does alcohol and caffeine cause drug interactions?

Answer 16

Due to CNS depression/stimulation

Question 17

What is NTW? What is its significance in drug interactions?

Answer 17

Narrow Therapeutic Window = Small dosage area where drug is effective and safe.
Smaller NTW means greater chance of interaction

Question 18

_______ (NTW) has two components. The _______ (MEC) and the ______ (MTC).

Answer 18

Narrow Therapeutic Window; Minimum Effective Concentration; Minimum Toxic Concentration

Question 19

What does competition for active secretion result in?

Answer 19

One drug cannot be secreted via kidney, so plasma level increases