Adverse Effects of Drugs Flashcards
What drugs have a low therapeutic index?
anticoagulants, cardiac glycosides, anticonvulsants, lithium, hypoglycaemics
What are the different types of adverse drug reactions?
side effects, overdose effects, idiosyncratic effects and hypersensitivity reactions
What are side effects?
dose dependent frequent non-deleterious effects of a drug often related to their selectivity and metabolism
What are on target side effects?
side effects caused by the same effect at a different location
What are examples of on target side effects?
worsened asthma from beta-adrenoceptors or gastric bleeding from aspirin
What are off target side effects?
side effects caused by action different to the desired action
What are examples of off target side effects?
terfenadine causes ventricular arrhythmia when taken with grapefruit juice which affects its metabolism - not completely converted to fexofenadine
What is an overdose effect?
when the drug accumulates in the plasma and causes either pathological damage or is fatal
What drugs have a high risk of overdose effect?
drugs with low therapeutic index
What is an example of an overdose effect?
liver damage caused by paracetamol
What is an idiosyncratic effect?
a genetically determined dose dependent abnormal response
What is an example of an idiosyncratic effect?
codeine - slowed metabolism to morphine due to defect in CYP2D6
What is a hypersensitivity?
a non dose dependent pharmacologically abnormal infrequent response
What are some causes of hypersensitivity?
low level exposure (e.g. antibiotics in food) or cross sensitisation by low MW compounds
