Toxic Drug Reaction

Question 1

Given a patient response to drug, identify the nature of the adverse reaction (side
effect, augmented response, or toxic response)

Answer 1

Side effect: off target response, marginal impact on health, may impact patient compliance

Augmented: extension of pharmacologic effect, usually dose-dependent, may seriously impair health

Toxic Reaction: not predicted from pharmacology of drug, sometimes not dose dependent, can seriously impact health

Question 2

Identify the 4 determinants of toxic drug responses and provide an example of each.

Answer 2

Individual Susceptibility
Accessibility of Drug to Target
Compensatory Mechanism
Reactivity of Drug with Target

Question 3

Given the mechanisms by which a drug provokes a toxic response, provide potential interventions to prevent or minimize the toxic response.

Answer 3

Prevent/reduce exposure, enhance elimination from body, and block/repair cellular effects

Question 4

Given a cell type that experiences genomic damage, identify the likely clinical outcome.

Answer 4

Somatic cells -> cancer
Germ cells -> birth defects/childhood cancers
Developing embryo -> miscarriages, stillbirths, amd birth defects

Question 5

Provided a specific gestational stage for a woman, identify whether a teratogen is likely to result in: 1) embryo death, 2) major congenital anomalies, or 3) functional defects and minor anomalies.

Answer 5

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

Question 6

State the criteria for classification of an agent as a teratogen

Answer 6

1. exposure results in a characteristic srt of malformations
2. Effect occurs with exposure at a specific stage of development
3. Effect is dose-dependent