CVR 40 Flashcards
Stats on ADRs
5% of all admissions
4-50% of in-pts suffer
Two main types of ADR
A = augmented pharma effect 75%
B = Bizarre 20%
Name the adverse Warfarin - Insulin - due to insulin injection Digoxin - Beta-adrenergic blockers - Alpha-lockers - Opiates - Non-steroidal anti-inflammatory drugs - perforation Salbutamol -
Warfarin - bleeding
Insulin - hypoglycaemia due to insulin injection
Digoxin - heart block, ventricular tachycardia
Beta-adrenergic blockers - bronchospasm / asthma
Alpha-adrenergic blockers - postural hypotension
Opiates - respiratory depression
Non-steroidal anti-inflammatory drugs - gastric and duodenal ulcers, bleeding and perforation
Salbutamol - tachycardia
What are the drugs that give these Type B reactions
Anaphylactic
Teratogenic
Hypersensitivity
Other
anaphylactic - ACE and angiodema
Terato - antiepileptics, RAAS blockers, chemo, thalidomide, retinoid, warfarin
Hypersnsitivity - penicillin, stroptokinase, contrast media
What is AKI?
AKI is acute interstitial nephritis (AIN), which is characterized by the presence of an inflammatory cell infiltrate in the interstitium of the kidney. AIN is caused by an immunological reaction after NSAID exposure of about a week.
Anaphylactic drug reaction types
1 = EgE 2 = IgG and IgM 3 = Immune comlpex 4 = cellular very rare
Symptoms of Type 1 Allergy IgE dependent
atopic dermatitis
asthma
Anaphylaxis
Comes from pennicilin, heparin, vacicines, chlorohexidine, latex
Causes of Type 2 Allergy IgG and IgM
methyldopa
heparin or clopidogrel
Presentation and causes of type 3 allergy
blood vessels manifestation in skin rasha nd general immune disease
Serum sickness (lupus) fever and cutaneous erutpons arthalgia, GI, headaches
Stevens johnson syndrome
What is type 4 allergy
T cell mediated
Prcainamide causing systemic lupus
Phenytoin infliximab and genetic deficiencys
What are Type C ADRs like
only during prolonged treatment
amiodarone gives you eye thyroid and skin toxicity
What are Type D ADRs like
Happen remote from treatment. 2nd cancers from treatment, clear cell vaginal carcinoma in daughters of cancer patients who took deithylstillbestrol
What symbol denotes post marketing surveilance
black triange
How many patients and for how long are involved in phases 1-3
200-300 for 4-30 weeks
What are Type E ADRs like
end of treatment - withdrawal.
Unstable angina if beta blockers are halted
Addisons - hypoadrenalism after coming of steroids
benzo - rebound insomnia and anxiety
SSRI - withdrawal
