Drug Reactions Flashcards
How can you classify adverse drug reactions?
Type A: intolerance and side effects: dose dependant and predictable
Type B: idiosyncratic effect
Type C: chronic effect
What are the two categories of adverse drug reactions?
Drug induced illnesses
Drug drug interactions
What are the 8 features of adverse drug reactions?
Over dose Intolerance Idiosyncrasy Side effect Teratogenic Hypersensitivy Drug interactions
How dose a drug overdose occur?
Ingestion or application of a drug in quantities greater than are recommended
May lead to death
What is the max dose of aspirin in 24hours?
4g
What are the signs of aspirin overdose?
Tinnitus Deafness Hyperventilation Sweating coma Reye's syndrome
What is Reye’s syndrome?
Causes liver and brain damage Persistant vomiting Loss of energy Delerium and mood changes Drowsiness
How do you treat aspirin overdose?
Gastric lavage
Activated charcoal
Sodium bicarbonate and hameodialysis if severe
What is the max dose of paracetamol in 24 hours?
4g
What are the signs of paracetamol over dose?
Nausea and vomiting Encephalopathy Hypoglycaemia Cerebral oedema Death Hameorrhage
How do you treat paracetamol overdose?
Gastric lavage
Activated charcoal
Liver transplant
Parvolex
What are the signs of opioid toxicity?
Sedation Unresponsive nausea Myoclonus jerks Low RR Constricted pupils Hypotension
What is the antidote for opioids?
Naloxone
What is intolerance? Which factors may predispose to intolerance?
A lower threshold to the normal pharmacological action of a drug
Associated with age and renal and hepatic impairment
What is idiosyncrasy?
Abnormal refrain to a drug to an abnormality of the individual
Eg lack of enzyme
What are side effects?
Undesirable action of a drug
What are secondary effects?
Unwanted and indirect consequence of taking a drug
When are foetus most at risk from teratogenic effects?
First trimester
What is a hypersensitivity reaction?
Immunologically mediated reaction characterised by specificity and recurrence on re exposure
What is the Gell and Cloombs classification?
Hypersensitivy
1-4
What are the features of hypersensitivity type 1?
Name examples
Immediate
IgE mediated
Degranulation of mast cells
Eg asthma, anaphylaxis
What are the features of hypersensitivity type 2?
Name examples
Antibody antigen mediated
IgM/G
Graves’ disease and drug induced thrombocytopenia
What are the features of hypersensitivity type 3?
Name examples
Immune complex mediated
Immune complexes deposit in tissues
Eg rheumatoid arthritis , SLE
What are the features of hypersensitivity type 4?
Name examples
Delayed type
T helper cells sensitised resulting in macrophage and Tcyto accumulation
GvHD
What are drug interactions?
When one drug is modified by another
What are the drug causes of oral ulceration?
Olanzipine
R
Alendronate
Losartan
sUlphonamides L Cytotoxic, clarithromycin, captopril, cocaine sErataline inhibitors pRotease inhibitors A T Immunosuppresants I O NSAIDs nicorandil
What drugs are associated with EM?
Antibiotics: penicillins, hydantoins, tetracyclines, clindamicin
Anti hypertensives: verampiril, minoxidil
Pain and CNS: barbiturates, phenytoin, carbamazepine, codeine
OCP
How can drugs affect the salivary glands?
Xerostomia
Hyper salivation
Pain
Swellings
Which drugs can cause xerostomia?
Antocholinergics Antidepressants Antipsychotic Anti hypertensives Antihistamine Antimuscarinic Diuretics
Benzodiazepines and opiates
Which drugs are associated with hyper salivation?
Anticholinesterases
Clozapine
Which drugs cause salivary gland swelling?
ACCI Antihypertensives CHX Cytotoxic Iodides
What drugs are associated with mucosal pigmentation?
CHX Betel Gold Amlgam OCP Anticonvulsants Antimalarial
Which drugs are associated with gingival hyperplasia?
Calcium channel blockers
Phenytoin
Ciclosprorin
OCP
Which drugs are associated with involuntary facial movements?
LPC Lithium L dopa Phenytoin Carbamazepine
Which drugs are associated with Trigeminal Parasthesia?
VAALP
Vincristine Articaine Acetelozamide Labetol Protease inhibitor
Which drugs can cause halitosis?
ABC Anti thyroid Biguanides Baclofen Captopril Calcitonin Metronidazole
Which drugs can lead to angioedema?
Ace inhibitors
Captopril
Clindamicin