Lecture 10: Toxic drug reactions

Question 1

Adverse drug reactions

Answer 1

-side effects
-augmented responses
-toxic reactions

Question 2

Side effects

Answer 2

-off target response
-marginal impact on health
-impact patient compliance

Question 3

Augmented response

Answer 3

-extension of pharmacologic effect
-dose-dependent
-may seriously impair health
-bradycardia with propranolol

Question 4

toxic reactions

Answer 4

-not predicted from pharmacology of drug
-sometimes dose-dependent
-seriously impact health
-carbamazepine-induced liver injury

Question 5

determinants of toxic responses

Answer 5

1. individual susceptibility
2. accessibility of drug to target
3. Compensatory mechanisms
4. reactivity of drug with target

Question 6

Reactive metabolites

Answer 6

-carcinogenicity
-necrosis
-apoptosis
-hypersensitivity

Question 7

Primary mechanisms of toxic responses

Answer 7

-cellular dysfunctional
-cellular destruction
-genotoxicity

Question 8

cellular dysfunction

Answer 8

-cell survives but normal processes impaired

Question 9

Cellular destruction

Answer 9

-dysregulation results in cell death
-ATP depletion
-Ca2+ accumulation
-ROS/RNS generation

Question 10

Genotoxicity

Answer 10

-somatic cells = cancer
-germ cells = birth defects
-developing embryo = stillbirth

Question 11

Mechanisms of genotoxicity

Answer 11

-direct (DNA) or indirect
-multiplicity means that multiple types of screening tests are necessary
-CANCER

Question 12

Teratogenicity

Answer 12

-causes abnormality in development

Question 13

Classification of teratogen

Answer 13

1. exposure results in malformations
2. effect occurs with exposure at specific stage of development
3. effect is dose dependent

Question 14

exposure to teratogen periods of prenatal development

Answer 14

-1-2 weeks: death
-3-8 weeks: major anomalies
-9-38 weeks: functional defects and minor anomalies

Question 15

DES effects in women exposed in utero

Answer 15

-40 x increase in clear cell adenocarcinoma