Adverse Effects of Drugs

Question 0

3 risk factors for adverse drug reaction?

Answer 0

previous adverse drug reaction
Pharmacodynamics
pharmacokinetics

Question 1

Adverse drug reactions in ___% of patients?

Answer 1

5%

Question 2

3 pharmacokinetic risks for ADR?

Answer 2

impairment of liver/kidney
extremes of age
polypharmacy

Question 3

High or low therapeutic index better?

Answer 3

High therapeutic index, larger window

Question 4

5 red flag low therapeutic index drugs?

Answer 4

anticoagulants
cardiac glycosides
anticonvulsants
lithium
hypoglycaemics

Question 5

what are 3 dose-dependent drug reactions? and the 1 none-dose dependent reaction?

Answer 5

side effects
overdose effects
idiosyncratic effects

Hypersensitivity reaction

Question 6

when do side effects occur? features? what levels?

Answer 6

at therapeutic level
frequent
predictable

Question 7

2 examples of on-target therapy but that same target is at multiple sites?

Answer 7

selectivity: B-adrenoceptors heart and airways
context: muscarinic for reducing SLUD before Sx or for IBS Rx

Question 8

Aspirin desired response vs. undesired response

Answer 8

analgesic vs. gastric bleeding

Question 9

B-adrenoceptor antagonists desired response vs. undesired response

Answer 9

hypertension vs. worsened asthma

Question 10

Adrenaline desired response vs. undesired response

Answer 10

local anaesthetic vs. cardiac excitability

Question 11

example of off-target side-effects?

Answer 11

poor selectivity: tricyclic antidepressants

metabolism: terfenadine and grapefruit juice: inhibiting K+

Question 12

overdose happens when drug accumulates where? which ones more likely?

Answer 12

plasma

more likely with low therapeutic index

Question 14

2 deleterious overdose effects?

Answer 14

fatal: atropine (deadly night shade)

pathological damage: paracetamol

Question 15

What takes care of NAPQI?

Answer 15

glutathione

Question 16

suxamethonium is an example of what kind of adverse effect?

Answer 16

idiosyncratic effect? ppl with absent pseudocholinesterase = skeletal muscle paralysis

Question 17

2 examples of idiosyncratic effects?

Answer 17

suxamethonium

codeine: if missing CYP2D6: does not convert to morphine

Question 18

hypersensitivity reactions are or aren’t dose dependent?

Answer 18

NOT dose dependent

Question 19

single exposure in hypersensitivity reactions triggers what?

Answer 19

extreme responses: harmless rash to life threatening anaphylaxis

Question 20

what is the basis for hypersensitivity reactions? 2 example?

Answer 20

immunological basis
cross sensitisation low MW
widespread antibiotics in food chain