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Use and Abuse > Harmful Effects of Drugs > Flashcards

Harmful Effects of Drugs Flashcards

1
Q

What is the definition of an adverse reaction?

A

Harmful or seriously unpleasant effects at doses intended for therapeutic use and which call for a reduction in dose and/or withdrawal of drug.
(Lecture 12, Slide 4)

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2
Q

What is a therapeutic window?

A

The time range between injury and treatment in which the drug is still effective.
(Lecture 12, Slide 6)

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3
Q

What is the LD50 (Lethal Dose, 50%)?

A

The dose required to kill half the members of a tested population.
(Lecture 12, Slide 7)

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4
Q

What is LD50 used for?

A

To generally indicate a substance’s acute toxicity.
(Lecture 12, Slide 7)

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5
Q

What is LD50 usually expressed as?

A

The mass of substance administered per unit mass of test subject, e.g 5mg/kg
(Lecture 12, Slide 7)

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6
Q

How can Atropine cause blurred vision?

A

It binds to all muscarinic cholinoceptors (mACh) as a competitive antagonist, but many of these are present in the eyes, resulting in pupils dilating and causing blurred vision
(Lecture 12, Slide 12)

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7
Q

How can Aspirin cause gastric bleeding?

A

Blocks cyclooxygenase (COX) enzymes present at sites of inflammation, but these are also present in the wall of the gut, causing gastric bleeding
(Lecture 12, Slide 15)

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8
Q

How can Levodopa cause psychoses (losing touch with reality)?

A

It replaces dopamine lost in Parkinson’s disease, but excess dopamine can cause psychosis
(Lecture 12, Slide 17)

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9
Q

What is the definition of a side effect?

A

An unintended effect that can be predicted from known action of the drug
(Lecture 12, Slide 18)

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10
Q

What is an idiosyncratic reaction?

A

A genetically determined, abnormal response to a drug that cannot be predicted
(Lecture 12, Slide 21)

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11
Q

What is organ specific toxicity?

A

A side effect which is specific to a tissue or organ within the body
(Lecture 12, Slide 37)

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12
Q

How can chloroquine cause eye damage?

A

Accumulation of the drug may result in deposits that can lead to blurred vision and blindness.
(Lecture 12, Slide 43)

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13
Q

What correlation does drug allergy/hypersensitivity have with known actions of the drug?

A

None.
(Lecture 13, Slide 5)

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14
Q

What are 2 things drug allergy/hypersensitivity consist of?

A

One or more of the following;
Rash
Skin / mucous membrane swelling
Serum sickness syndrome
Asthma
Anaphylaxis
(Lecture 13, Slide 5)

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15
Q

What is type 1 hypersensitivity?

A

An allergic reaction, local or systemic provoked by re-exposure to a specific antigen
(Lecture 13, Slide 8)

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16
Q

What is the first step of type 1 hypersensitivity occuring?

A

Drug induces production of IgE immunoglobulin antibodies which then attach to mast cells.
(Lecture 13, Slide 8)

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17
Q

What happens after IgE immunoglobulin antibodies attach to mast cells in type 1 hypersensitivity reactions?

A

When drug (antigen) is re-administered, it binds to the IgE antibodies on the surface of the mast cells
(Lecture 13, Slide 8)

18
Q

What does the drug (antigen) attaching to the IgE antibodies in type 1 sensitivity induce and what does this result in?

A

Mast cell degranulation resulting in the release of chemical mediators, such as histamine
(Lecture 13, Slide 8)

19
Q

How long do type 1 hypersensitivity reactions take?

A

Immediate, within seconds to minutes
(Lecture 13, Slide 8)

20
Q

What is anaphylaxis?

A

Circulatory collapse with a massive fall in blood pressure
(Lecture 13, Slide 11)

21
Q

What are 3 examples of type 1 hypersensitivity?

A

Allergic asthma
Allergic conjunctivitis
Allergic rhinitis (“hay fever”)
Angioedema (swelling of deeper layers of the skin)
Atopic dermatitis (eczema)
Urticaria (hives)
(Lecture 13, Slide 12)

22
Q

What occurs first in type 2 hypersensitivity?

A

Drug associates with a protein on the cells which forms a complex which acts as an antigen.
(Lecture 13, Slide 15)

23
Q

What occurs after the drug forms a complex with a protein in type 2 sensitivity?

A

Leads to production of antibodies IgG and IgM
(Lecture 13, Slide 15)

24
Q

What happens after IgG and IgM are produced in type 2 sensitivity?

A

Antibody and drug-protein antigen can combine to activate complex, which destroys cells
(Lecture 13, Slide 15)

25
Q

How long does type 2 hypersensitivity reactions take?

A

From several hours to up to a day.
(Lecture 13, Slide 15)

26
Q

What is type 3 hypersensitivity?

A

Aggregation of antigens and antibodies
(Lecture 13, Slide 19)

27
Q

What occurs first in type 3 hypersensitivity?

A

Drug induces production of antibodies
(Lecture 13, Slide 19)

28
Q

What happens after the drug induces production of antibodies in type 3 sensitivity?

A

Antibody combines with the drug (as soluble complexes) and precipitates (deposited in solid form) on vascular walls (kidneys, skin, joints etc)
(Lecture 13, Slide 19)

29
Q

What happens after the antibody-drug complex precipitates onto vascular walls in type 3 hypersensitivity and what does it lead to?

A

Complement is activated leading to generalised symptoms
(Lecture 13, Slide 19)

30
Q

How long do type 3 hypersensitivity reactions take?

A

From hours to days
(Lecture 13, Slide 19)

31
Q

Name 2 consequences of type 3 hypersensitivity reactions.

A

Serum sickness syndrome
Kidney damage
Liver damage
Skin inflammation

32
Q

What is type 4 hypersensitivity mediated by?

A

T-cells
(Lecture 13, Slide 23)

33
Q

What is type 4 hypersensitivity associated with?

A

Skin application of drugs
(Lecture 13, Slide 23)

34
Q

How does type 4 hypersensitivity occur?

A

Inflammatory mediators cause swelling, rashes and erythema (abnormal redness of the skin)
(Lecture 13, Slide 23)

35
Q

How long do type 4 hypersensitivity reactions take?

A

2 - 3 days
(Lecture 13, Slide 23)

36
Q

What is carcinogenicity?

A

Drug-induced development of cancer or increased risk of cancer due to a drug.
(Lecture 13, Slide 26)

37
Q

Why can carcinogenicity be difficult to prove?

A

Due to the time course (length of time)
(Lecture 13, Slide 26)

38
Q

How does carcinogenicity exert its effects?

A

By mutagenesis, either caused by the drug itself or by a toxic intermediate produced by the drug
(Lecture 13, Slide 26)

39
Q

What is teratogenicity?

A

Drug-induced damage to the developing foetus
(Lecture 13, Slide 30)

40
Q

Name 2 ways in which the effect of teratogenicity may vary.

A

The stage of pregnancy at which the drug is used
Ability to cross placental barrier
Concentration in foetus
Individual and species variations
(Lecture 13, Slide 30)

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