CPTP 3.8 - Adverse Drug Reactions

Question 1

Define pharmacodynamics?

Answer 1

What the drug does to the body -

Targets - therapeutic effects/toxic effects

Question 2

Define pharmacokinetics?

Answer 2

What the body does to the drug
Absorption
Distribution 
Metabolism
Excretion

Question 3

Name three ways in which side-effects may be brought about?

Answer 3

Too high drug level at therapeutic target site = exaggerated response
Drug action at therapeutic target site in another tissue
Drug/metabolite acting on different target to the therapeutic target

Question 4

Define adverse drug reaction?

Answer 4

Adverse drug reaction ATTRIBUTED to a suspected action of a drug

Question 5

Define adverse drug event?

Answer 5

An adverse outcome that results after the use of a drug but which may NOT be linked to the use of the drug

Question 6

Name a severe adverse drug reaction within the blood?

Answer 6

Haemolytic anaemia

Question 7

Name a severe adverse drug reaction within the cardiovascular system?

Answer 7

Hypertension

Cardiac failure

Question 8

Name a severe adverse drug reaction within the G.I system?

Answer 8

Colitis

Hepatic dysfunction

Question 9

Name a severe adverse drug reaction within the immune system?

Answer 9

Anaphylaxis

Question 10

What percentage of adverse drug reactions are avoidable?

Answer 10

70%

Question 11

Under the ‘ABCDEF’ classification of adverse drug reactions what does each letter pnumonically stand for?

Answer 11

Augmented
Bizarre
Chronic
Delayed
End
Failure

Question 12

Under the ‘ABCDEF’ classification of adverse drug reactions describe Type.A?

Answer 12

Normal pharmacological reaction but quantitatively exaggerated
Most common type and DOSE dependent with predictable effects

Question 13

Under the ‘ABCDEF’ classification of adverse drug reactions describe Type.B?

Answer 13

Unrelated to the drugs normal pharmacology
Uncommon and unpredictable
eg - anaphylaxis with penicillin//Stevens-Johnsons syndrome (toxic epidermal necrosis) with Lamotrigine

Question 14

Under the ‘ABCDEF’ classification of adverse drug reactions describe Type.C?

Answer 14

DOSE related and TIME related

Uncommon reaction related to cumulative dose (long term usage)

Question 15

Under the ‘ABCDEF’ classification of adverse drug reactions describe Type.D?

Answer 15

TIME related
Uncommon and usually dose-related - occurs some time after drug use
eg - Tardive kinesia following antipsychotic drugs (haloperidol)

Question 16

Under the ‘ABCDEF’ classification of adverse drug reactions describe Type.E?

Answer 16

Withdrawal

Uncommon and occurs soon after withdrawal from the drug

Question 17

Under the ‘ABCDEF’ classification of adverse drug reactions describe Type.F?

Answer 17

Unexpected failure of therapy

Common and DOSE related and often caused by other drug interactions

Question 18

Under the ‘DoTS’ classification of adverse drug reactions describe “Do”?

Answer 18

Dose - toxic effects at higher than usual dosing
Collateral effects = ADR occurring at standard dose
Hypersusceptibility reactions = ADR occurring at sub-clinical dosing

Question 19

Under the ‘DoTS’ classification of adverse drug reactions describe “T”?

Answer 19

Time -
Time independent = ADR occurs at any time throughout the course of treatment
Time dependent = rapid//early//later//delayed

Question 20

Under the ‘DoTS’ classification of adverse drug reactions describe “S”?

Answer 20

Susceptibility - Higher in certain individuals = age//sex//ethnicity//disease

Question 21

Name the four classes of drugs with adverse drug reaction rates of greater than 50%?

Answer 21

NSAIDs
Anti-platelet drugs
Anti-coagulants
Diuretics