Adverse drug reations Flashcards
What percentage of hospital admissions do ADRs occur in?
5%
What percentage of hospital patients suffer an ADR?
10-20%
What percentage of hospital deaths occur due to ADRs?
0.3- 3%
Describe the 3 classes of onset of ADRs and give examples
Acute - within 60 minutes - bronchonstriction
Sub- Acute - 1-24 hours - rash, serum sickness
Latent - > 2 days - eczematous eryptions
Give the classifications of ADRS
A - Augmented B - Bizarre C - Chronic D - Delayed E - End of treatment F - Failure of treatment
Describe type A ADRS
Predictable, dose related effects that resolve when the drug is reduced or stopped
Normally due to pharmokinetic/ pharmodynamic variation
What factors lead to pharmokinetic variation
altered absorption, distribution, metabolism and excretion
What factors lead to pharmodynamic variation
disease state eg. renal/ hepatic variation
Describe Type B ADRs
Bizarre, unpredictable, rare and serious
Not related to dose
immunological or idiosyncratic (inherit abnormal response eg. enzyme deficiency)
Describe type C ADRs
Related to duration of treatment and dose dependent
Pro longed and semi- predictable
eg. steroid induced osteoporosis, opiate dependence
Describe type D ADRs
Occur some time after treatment
eg. carcinogenesis from alkylating agents/ immunosuppressants
teterogenisis - passed from mother to child (uteroexposure)
Describe type E ADRs
Occurs when drugs are stopped suddenly
eg. seizures from no alcohol
Addison crisis after long term steroids (heavily suppressed adrenal gland)
Describe type F ADRs
Common and dose related
Caused by mistakes
What is the most common cause of type F ADRs
drug - drug interactions
How may you detect an ADR
Medication history
Assess onset time in relation to dose
Investigate plasma concentration
Allergy tests
