Lecture 16 - Adverse Medicine REactions

Question 1

Definition of adverse effects?

Answer 1

response to drug which is noxious and unintended, at a regular therapeutic dose

Question 2

Allergy vs side effect?

Answer 2

adverse drug reaction mediated by immune response, vs expected and known drug effect not intended therapeutically

Question 3

Type A adverse effected?

Answer 3

augmented pharmacological effect - predictable and dose dependent, 2/3 of cases

Question 4

Type B adverse reactions?

Answer 4

bizarre - drug allergy, rare and unpredictable, dose independent

Question 5

Type C adverse reaction?

Answer 5

chronic - associated w long term use, accumulation of dose/damage

Question 6

Type D, E and F adverse reactions?

Answer 6

delayed effect (carcinogenicity), end of treatment, failure of treatment

Question 7

Classification of ADRs - DoTS?

Answer 7

dose (supra-, standard and subtherapeutic doses), time (independent or dependent), susceptibility

Question 8

Why do ADRs mater?

Answer 8

death, hospital usage, costs, preventable

Question 9

Three most commonly implicated drug classes of adverse reactions?

Answer 9

anticoagulants, opiates, insulin

Question 10

Patients at higher risk of ADRs?

Answer 10

young, old, comorbid patients, polypharmacy, women, race and genetic polymorphism

Question 11

Doctor-based strategies of avoiding ADRs?

Answer 11

avoid high risk drugs, discontinue unnecessary drugs, consider drugs as cause of all new symptoms, avoid drug-drug interactions

Question 12

Systems based strategies for avoiding ADRs?

Answer 12

computerised order entry, bar coding, smart pumps, medication reconciliation

Question 13

What to do when suspect ADR?

Answer 13

withdraw trigger medicine, record on chart, inform patient, complete CARM adverse drug reactions form