Lecture 6 -Pharmacovigilance And Pharmacogenetics Flashcards

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1
Q

What is pharmacovigilance?

A

The science and activities relating to the detection, assessment, understanding and prevention of adverse effects or any other possible drug-related problem

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2
Q

What is the point of pharmacovigilance?

A

Enhance patient care and saftey in relation to use of medicines

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3
Q

What is the MHRA?

A

Agency for the department of health and social care that’s responsible for ensuring that medicines and medical devices work and are acceptably safe

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4
Q

What are ADRs?

A

Adverse drug reactions

A repsonse to a drug which is noxious and unintended and which occurs at doses normally used in man (a causal link)

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5
Q

What is the relationship of Thalidomide and ADRs?

A

Was used as a sedative and hypnotic

Was used with pregnant women when we didn’t know it was extremely Tetragenic

Dad to babies being born with phocomelia or limb malformation

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6
Q

What is thalidomide used for today?

A

Cancer
Leprosy treatments

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7
Q

What is an adverse drug event?

A

An injury that occurs during treatment and is not necessarily a caused by the drug itself

Adverse drug reaction is caused by the drug itself

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8
Q

What are augmented drug reactions/events?

A

Dose dependant

E.g bleeding after anticoagulants

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9
Q

What are bizarre drug reaction/events?

A

Dose independant

Urticaria from aspirin(not sure how it happens)

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10
Q

What are the 4 different types of mechanism of action for an adverse drug reaction?

A

-Exaggerated response
-Desired pharmacological effect at an alternate/different site (GTN headache)
-additional secondary pharmacological effect
-Triggering an immunological response (anaphylaxis)

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11
Q

Why are clinical trials limited in terms of assessing adverse drug reactions/longn term side effects?

A

Hard to identify reactions that are low frequency

Just might not see it in a trial population

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12
Q

What is the yellow card scheme?

A

Where all suspected ADRs including minor ones and reactions to vaccines are reported to the MHRA

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13
Q

What is pharmacogentics?

A

How a persons genetics afffects their ability to metabolise and respond to drugs

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14
Q

What is pharmacogenomics?

A

The study of how populations enter genomes affect their ability to respond to drugs (not just individual genes)

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15
Q

What is precision medicine?

A

When an indivudals genome is assessed along with other clinical and diagnostic information and then drugs are given to that patient on that basis

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16
Q

What are some factors that contribute to interindividual variability in drug responses?

A

Age
Race
Weight
Gender
Disease
Drugs
Compliance
Social factors
Bio markers
Genetics

17
Q

What factors are important in pharmacokinetics?

A

ADME

Absorption
Distribution
Metabolism
Excretion

18
Q

What are some genetic variations that can affect pharmacodynamics?

A

Receptors
Ion channels
Enzymes
DNA

19
Q

What are the 4 Ps in personalised medicine?

A

Predication and prevention
Personalised
Precise
Paraticipatory

20
Q

What is a key example of use of different treatments for different ethnicities?

A

The first step of antihypertensive treatment

21
Q

What are Calcium Channel Blockers given to those who are of black-African or African-Caribbean descent without T2DM instead of ACEi or ARBs?

A

Renin typically lower in this ethnicity populations so they aren’t really going to affect RAAS

(Renin the enzyme that converts Angiotensinogen to Angiotensin I)

22
Q

Why do we screen for individuals before giving the drug Abacavir?

A

Likely to develop hypersensitivity if they have the HLA ((human leukocytes antigen) allele

23
Q

What is an important CYP450 enzyme isoform which is responsible for lots of drug metabolism whose presence varies in populations?

A

CYP2D6

Some people lack it completely,other have more of it than others

24
Q

What is Warfarin?

A

Anticoagulant

25
Q

How does Warfarin act as an anticoagulant?

A

Inhibits vitamin K Epoxide reductase essentially interrupting the recycling of vitamin K helping prevent blood clotting process

26
Q

What isomer of CYP450 metabolises warfarin?

A

CYP2C9

27
Q

What does simvastatini increase the risk of?

A

Myopathy
Rhabdomyolysis