Adverse drug rxns Flashcards
def. adverse reaction
noxious and unintended effects of a product
6 WHO types of adverse events
- Augmented - dose related
- Bizarre - non-dose related
- Chronic - dose and time related
- Delayed - time related
- End of use - withdrawal
- Failure - of therapy
features augmented reaction
- expected
- unwanted
- dose dependent
examples of augmented reactions
- digoxin toxicity
- nocturnal insulin hypoglycemia
- B-blocker- brady cardia
- benzo - sedation
- narco - constipation
4 most common reasons for hosp. because of AEs
- warfarin
- insulin
- anti-platelet
- oral hypoglycemic
features of bizarre type
- unwanted, unexpected, host dependent
- pharma +/- immunologic rxn
example of bizarre
phenytoin - anticonvulasnt hypersentitivty reaction
- 1-8 weeks later
- familial
Sx of anticonvulasnt hypersentitivty reaction
triad of fever, rash, internal organ involvment
2nd example of bizarre
ticlopidine - pancytopenia + hepatic damage
baseline screening for ticlopidine (4)
- hypersenitivity
- bleeding problems
- blood disroders
- severe liver impairment
2 possible AE of sulfa drugs
- mild - maculopalar rash - may or may not be drug related
2. severe - toxic epidermal necrolysis
3 lessons about bizarre rxns
- respect vague Hx
- check records
- ARDs can’t always be avoided, but minimize risk
2 examples of chronic reactions
- amiodarone (anti-arrhytmic) - accumulates in organs
2. methotrexate (immune suppressant) - also builds up
possible chroinc SEs (2) of aminoglycosides
- ototoxin to hair cells
2. nephrotoxic
example of a delayed type rxn
doxorubicin for breast cancer causes CHF 2-3 month after treatment
