F3 Clinical pharmacology 3: Adverse Drug reactions

Question 1

What are type A ADRs?

Answer 1

Augmented responses:

• normal pharmacological response is undesirable
• dose related
• predictable
• usually managed by dose adjustment

Question 2

What are type B ADRs?

Answer 2

unrelated to pharmacology 
unpredictable 
rare 
often severe 
often related to genetics or immunology

Question 3

How to pencilling work, what do they cause and what can treat them?

Answer 3

penicillin couple to proteins, forming immunogens causing hypersensitivity reactions. treat with a H1 antagonist

Question 4

What do NSAIDs inhibit?

Answer 4

cyclooxygenase

Question 5

What doe NSAIDs do and what is unique to low dose aspirin?

Answer 5

• pain relief
• anti inflammatory
• anti- pyretic
• anti platelet - aspirin

Question 6

What are NSAIDs and corticosteroids associated wit?

Answer 6

peptic damage/ ulceration

Question 7

What actions can be taken to reduce GI side effects with NSAIDs?

Answer 7

paracetamol
prophylaxis with PPI
H2 antagonist are less or ineffective
give with combo with misoprostol- stable PGE1 analogue, acts on prostanoid receptors to inhibit gastric H+ secretion

Question 8

What is the point of “with or after food”?

Answer 8

probably won’t reduce chances of NSAID induced ulceration, may however reduce gastritis/ irritation
food may delay absorption of NSAID and increase time of response

Question 9

How do you report an ADR?

Answer 9

yellow card in BNF submit to CSM, who monitor ADRs

report all black triangle drugs