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FPT > Pharmacodynamics - 3 (Adverse Drug Reactions) > Flashcards

Pharmacodynamics - 3 (Adverse Drug Reactions) Flashcards

1
Q

science and activates relating to the detection, assessment, understanding and prevention of adverse effects or any other drug related problems.

A

pharmacovigilance.

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2
Q

any noxious change which is suspected to be due to a drug, occurs at doses normally used in man, requires treatment or decrease in dose or indicates caution in the future use of the same drug.

A

adverse drug reaction (ADR)

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3
Q

list the 6 classification of ADR and what do they mean?

A

1- A = augmented.
2- B = bizarre.
3- C = continuous use.
4- D = delayed.
5- E = end of dose.
6- F = failure of therapy.

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4
Q

which type of ADRs is directly related to the pharmacological action of the drug?

A

type A

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5
Q

which type of ADRs is idiosyncratic and genetically determined?

A

type B

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6
Q

which type of ARDs is associated with long term use of the drugs?

A

type C

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7
Q

which type of ARDs is associated with long term use of the drugs?

A

type C

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8
Q

give an example of type C ADRs?

A

tardive dyskinesia with neuroleptics.

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9
Q

which type of ARDs is related to teratogenicity or carcinogenicity?

A

type D

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10
Q

give an example of type D ADRs?

A

fetal phenytoin syndrome.

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11
Q

which type of ARDs is due to abrupt stoppage of the drug?

A

type E

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12
Q

give an example of type E ADRs?

A

beta blockers and corticosteroids.

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13
Q

which type of ARDs is due to a unexpected failure of therapy (often due to drug interaction)?

A

type F

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14
Q

give an example of type F ADRs?

A

oral contraceptive failure when used with antitubercular therapy resistance to antimicrobial agents.

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15
Q

list the 4 levels of severity or ADRs?

A

1- minor.
2- moderate.
3- severe.
4- lethal.

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16
Q

which level of severity of ADR requires no treatment/ antidote or hospitalization?

A

minor

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17
Q

which level or ADRs requires change in drug therapy, specific treatment, and increase in hospitalization by at least one day?

A

moderate.

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18
Q

which level or ADRs is potentially life threatening, causes permanent damage or requires intensive care.

A

severe.

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19
Q

which level or ADRs directly or indirectly contributes to death of the patient?

A

lethal.

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20
Q

list the 12 adverse drug reactions?

A

1- side effects.
2- secondary effects.
3- toxic effects.
4- intolerance.
5- idiosyncrasy.
6- drug allergy.
7- photosensitivity.
8- drug dependence.
9- drug withdrawal reactions.
10- teratogenicity.
11- mutagenicity and carcinogenicity.
12- drug induced diseases.

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21
Q

which type of ADRs has unwanted but unavoidable pharmacodynamic effects?

A

side effects

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22
Q

which type of ADRs occurs at normal doses?

A

side effects

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23
Q

which type of ADRs is not serious and can be predictable?

A

side effects.

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24
Q

which type of ADRs reduction in dose decreases the symptoms?

A

side effects.

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25
Q

list the 3 types of side effects?

A

1- side effects are based on the same action as therapeutic effect.
2- side effects are different than therapeutic effect.
3- side effect in on context and therapeutic effect in the other.

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26
Q

give an example where side effects are the same as therapeutic effect?

A

atropine as preanesthetic drug also caused dryness of the mouth.

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27
Q

give an example where side effects are different than therapeutic effect?

A

anti-histaminics used for allergies also cause sedation.

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28
Q

give an example where side effects are in one context and therapeutic effects are in another?

A

codeine used for cough produces constipation- thus also used traveller’s diarrhea.

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29
Q

which type of ADRs is an indirect consequences of a primary action?

A

secondary effects.

30
Q

give an example of a secondary effects?

A

suppression of bacterial flora by broad spectrum antibiotics causes superinfection.

31
Q

which type of ADRs is an excessive pharmacological action of the drug?

A

toxic effects.

32
Q

which type of ADRs is caused by over dosage or prolonged use?

A

toxic effects.

33
Q

which type of ADRs where overdosage can be absolute or relative?

A

toxic effects.

34
Q

give an example of absolute symptoms?

A

giving 20 tablets of paracetamol to a healthy patient.

35
Q

give an example of relative symptoms?

A

going 2 tablets of paracetamol to an alcoholic.

36
Q

which type of ADRs are where symptoms are predictable and dose related?

A

toxic effects.

37
Q

which type of ADRs are where symptoms are due ro functional alteration or tissue damage?

A

toxic effects.

38
Q

list the 2 types of toxic effects?

A

1- extension of the pharmacological profile.
2- action beside the therapeutic effect.

39
Q

give an example of toxic effects cause by extension of the pharmacological profile?

A

barbiturates in over does produce coma.

40
Q

give an example of a toxic effect where action beside therapeutic effect is responsible for toxic manifestation?

A

morphine for analgesia produces respiratory failure in overdose.

41
Q

which type of ADRs appearance of toxic effect in an individual at therapeutic doses?

A

intolerance.

42
Q

give an example of intolerance?

A

single dose of triflupromazine induces muscular dystonias.

43
Q

which type of ADRs is genetically determined abnormal reactivity to a chemical?

A

idiosyncrasy.

44
Q

which type of ADRs is related to the genotype of the individual?

A

idiosyncrasy.

45
Q

give an example of idiosyncrasy?

A

single dose of chloramphenicol caused bone marrow suppression.

46
Q

which type of ADRs is immunologically mediated reaction producing typical symptoms which are unrelated to the pharmacodynamic profile of the drug?

A

drug allergy.

47
Q

list the 4 types of drug allergy, which reaction does it cause and is it humoral or cell mediated?

A

humoral:
1- type 1: anaphylactoid reactions.
2- type 2 : cytolytic reactions.
3- type 3: arthus reactions.

cell mediated:
4- type 4: delayed hypersensitivity reactions.

48
Q

which type of ADRs where cutaneous reactions resulting from drug induced sensitization of the skin to UV radiation?

A

photosensitivity.

49
Q

list the 2 types of photosensitivity?

A

1- phototoxic.
2- photoallergic.

50
Q

which type of ADRs is a state in which use of drugs for personal satisfaction is given a higher priority than other basic needs, often in the face of known risk to health?

A

drug dependence.

51
Q

list 2 types of drug dependence?

A

1- phycological dependence.
2- physical (physiological) dependence.

52
Q

which type of ADRs is caused by a sudden cessation of therapy with certain drugs resulting in worsening of clinical condition of the patient?

A

withdrawal reactions.

53
Q

give 3 examples of drugs that cause withdrawal reactions?

A

1- corticosteroids: acute adrenal insufficiency.
2- clonidine: severe hypertension and sympathetic overactivity.
3- beta-blockers: worsening of angina, precipitation of MI.

54
Q

which type of ADRs is the capacity of the drug to cause fetal abnormalities when given during pregnancy?

A

teratogenicity.

55
Q

the type of malformation in teratogenicity depends on what?

A

the drug and the stage at which exposure occurred.

56
Q

what is the most important stage of pregnancy regarding teratogenicity?

A

first trimester.

57
Q

list the 3 stage where drugs can affect fetus during pregnancy?

A

1- fertilization and implantation.
2- organogenesis.
3- growth and development.

58
Q

all drugs should be avoided during which trimester?

A

first trimester.

59
Q

what type of drugs should be preferred in pregnancy over combination of therapy?

A

well known single component drugs should be preferred to combination therapy.

60
Q

which drugs are safer compared to new drugs in pregnancy?

A

drugs which have been used extensively in pregnancy.

61
Q

neural tube defects are reduced by ____ during pregnancy?

A

folate.

62
Q

give examples of 5 drugs that can cause teratogenicity and what effects do they have?

A

1- ACE inhibitors: hypoplasia of organs.
2- Alcohol: low IQ baby, growth retardation, fetal alcohol syndrome.
3- indomethacin: premature closure of ductus arteriosus.
4- phenytoin: hypoplastic phalanges, cleft lip, microcephaly.
5- tetracyclines: discolored and deformed teeth, retarded bone growth.

63
Q

which type of ADRs is the capacity of the drug to cause genetic defects and cancers respectively?

A

mutagenicity and carcinogenicity.

64
Q

drug exposure needs to be _____ in mutagenicity and carcinogenicity.

A

prolonged.

65
Q

list the 3 mechanisms involved in mutagenicity and carcinogenicity?

A

1- alteration of DNA.
2- immunosuppression.
3- hormonal.

66
Q

list drugs that can cause diseases in the eye and which diseases can they cause?

A

1- toxic cataracts: chloroquine, steroids.
2- corneal opacities: phenothiazines, chloroquine.
3- retinal injury: indomethacin.
4- visual field defects: vigabatrin.

67
Q

list drugs that can cause diseases in the CNS and which diseases can they cause?

A

tardive dyskinesia: neuroleptics.

68
Q

list drugs that can cause diseases in the lungs and which diseases can they cause?

A

amiodarone causes pulmonary fibrosis.

69
Q

list drugs that can cause diseases in the kidney and which diseases can they cause?

A

gold salts cause nephropathy.

70
Q

list drugs that can cause diseases in the liver and which diseases can they cause?

A

methotrexate causes hepatic fibrosis.
amiodarone induces steatohepatitis

FPT (17 decks)

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