Lec 10: Adverse Drug Reactions Flashcards
True of adverse drug reaction EXCEPT
A. any undersired or unintended response to a drug
B. may occur due to overdose of an appropriate drug
C. appears within a reasonable time after drug administration
D. same as drug allergy or drug hypersensitivity
E. NOTA
D
ADR is not entirely synonymous with drug allergy. Drug allergy is only a part (10%) of the ADR spectrum.
What are the two main classification of adverse drug reactions?
predictable
non-predictable
Types of predictable ADRs EXCEPT
A. side effects B. drug interactions C. intolerance D. overdose E. secondary effects F. NOTA
C
Intolerance is a non-predictable ADR.
What are the two main classification of UNPREDICTABLE ADRs?
immune mediated
non-immune mediated
What are the three classification of non-immune mediated unpredictable ADRs?
pseudoallergic
idiosyncratic
intolerance
Tinnitus with small doses of salicylates and quinine is an example of what ADR?
A. side effect B. intolerance C. overdose D. secondary effects E. NOTA
B
Intolerance is a genetically determined quantitative increase in pharmacologic effect produced by an unusually small dose of medication.
True of idiosyncratic ADRs EXCEPT
A. quantitatively abnormal reaction to a drug
B. similar to hypersensitivity but is not
C. a type of non-immune mediated ADR
D. includes drug-induced hemolytic anemia in G6PD deficiency
E. NOTA
A
Idiosyncratic ADRs are QUALITATIVE reactions to a drug.
Give three drugs that can induce hemolytic anemia in G6PD-deficient children.
sulfonamides
nitrofurans
water-soluble vitamin K analogues
T/F
Pseudoallergy is an anaphylactoid response.
T
It is not anaphylaxis, only anaphylactoid.
T/F
Pseudoallergy requires previous exposure to the drug.
F
It is independent of the IgE mechanism and does not involve IgE antibodies therefore no previous exposure or sensitization is required.
Enumerate three drugs that may cause pseudoallergy.
opiates
vancomycin
polymyxin B
T/F
Drug allergy is a type of unpredictable ADR.
T
The following are host-related risk factors of drug allergy EXCEPT
A. atopy B. comorbidities C. prior drug reactions D. drug exposure E. NOTA
D
Drug exposure, along with the nature of the drug, is a drug-related factor, not host-related.
The Section of Immunology gets around 20 referrals per year of type I reaction due to these drugs.
A. B-lactam antibiotics B. insulin and hormones C. vaccines D. cis and carboplatin E. NOTA
D
Cisplatin and carboplatin are chemotherapeutic (antineoplastic) agents.
Give other drugs that may elicit type 1 reactions.
streptokinase
L-asparaginase
latex
This is a small molecule that can elicit an immune response only when attached to a large carrier such as a protein.
hapten
True of angioedema EXCEPT
A. swelling of the soft tissues B. synonymous to anasarca C. can be unilateral D. prominent in thin parts of the face E. NOTA
B
Anasarca is generalized edema.
The classic red man syndrome is an adverse reaction to what drug?
vancomycin
The classic red man syndrome falls under what class of adverse drug reactions?
pseudoallergy (non-immune mediated unpredictable)
Adverse reactions to heterologous antisera fall to what catergory of ADRs?
type II immune-mediated unpredictable
Enumerate three drugs that may cause drug-induced lupus.
hydralazine procainamide isoniazid chlorpromazine methyldopa quinidine
Enumerate three drugs that may cause type IV contact dermatitis
neomycin
benzocaine
ethylenediamine
This is the most common rash due to ADRs.
erythema multiforme
This is the worst kind of allergic reaction aside from anaphylaxis.
toxic epidermal necrolysis
What is the management for toxic epidermal necrolysis?
wound care same as in burn patient
administration of IV Ig for 2 weeks
