Lecture 14: Adverse Drug Reactions Flashcards
Define an adverse drug reaction.
Something occurring that was not intended as a result of a drug being given.
Define a medication misadventure.
Any sort of hazard or incident that occurred with a med or exam.
Examples:
Pt took wrong med.
Rash from an ABX.
Define a medication error.
PREVENTABLE event with POTENTIAL to lead to inappropriate med use or pt harm.
Examples:
Wrong order entered on pt that was caught.
Pt got 10x normal dose fentanyl.
Define an adverse drug event.
Any injury caused by a medication.
Examples:
Idiosyncratic thrombocytopenia
Pt got 10x normal dose fentanyl.
Give some examples of an adverse drug reaction.
Anaphylaxis from PCN.
Angioedema from lisinopril.
What does an ADR fall under in terms of categories?
It is a subcategory of med errors + ADEs.
What are some differences between ADEs and ADRs?
ADRs are NORMAL doses.
Directly linked to med use.
What are some of the methods used to prove an ADR?
Expert judgment/global introspection.
Assessment algorithm.
Bayesian probability estimations of epidemiologic data.
What are some of the assessment algorithms used to track ADRs?
Naranjo algorithm
WHO Causality algorithm
Venulet algorithm
Liverpool ADR Causality Assessment Tool (CAT)
What are the gradings for an ADR?
Minor
Moderate
Severe
Lethal
What are the reaction types for an ADR?
Type A and Type B.
Define the characteristics of a Type A reaction.
DOSE DEPENDENT
Related to drug’s MOA.
Reaction comes in a wide range.
80% of all ADRs.
Define the characteristics of a Type B reaction.
NOT DOSE DEPENDENT
NOT RELATED to drug MOA.
Influenced by patient specific factors.
Includes allergies, intolerances, and idiosyncractic responses.
What are the 5 mechanisms of ADR classification?
Idiosyncratic
Hypersensitivity
Intolerance
Drug interaction
Pharmacologic
Define idiosyncratic reactions.
Uncharacteristic response.
Does not occur on admin.
Unpredictable.
Small cohort of patients.
Example:
Drug-induced hepatitis
Define hypersensitvity reactions.
Caused by altered reactivity, including allergic reactions.