TOXIC DRUG REACTIONS Flashcards
List the categories of adverse drug reactions
side effect
augmented response
toxic response / reaction
Describe a side effects (and give example)
- off target response
- marginal impact on health
- may impact patient compliance
EXAMPLE
dry mouth with antidepressants
Describe augmented response (and give example)
- extension of pharmacologic effect
- usually dose-dependent
- may seriously impair health
EXAMPLE
bradycardia with propranolol
Describe Toxic Response / reaction (and give example)
- not predicted from pharmacology of drug
- sometimes not dose-dependent
- can seriously impact health
EXAMPLE
e.g., carbamazepine-induced liver injury
List the mechanisms by which a drug provokes a toxic response
cellular dysfunction
cellular destruction
genotoxicity
Describe cellular dysfunction
Cell survives, but normal metabolic process are impaired
Describe cellular destruction
Dysregulation by toxicant results in cell death
Describe genotoxicity
Occurs via…
Direct mechanisms (DNA)
Indirect mechanisms (non-DNA)
Identify the likely clinical outcome when somatic cells experience genomic damage
cancer
Identify the likely clinical outcome when germ cells experience genomic damage
Birth defects
Childhood cancers
Identify the likely clinical outcome when developing embryos experience genomic damage
Miscarriages
Stillbirths
Birth defects
During which gestation stage for a woman would a teratogen be likely to result in embryo death
Weeks 1-2
During which gestation stage for a woman would a teratogen be likely to result in major congenital anomalies
Weeks 3-8
During which gestation stage for a woman would a teratogen be likely to result in functional defects and minor anomalies
Weeks 9-38
During weeks 1-2 of gestation, what is the likely result of a teratogen
Death of embryo & spontaneous abortion
During weeks 3-8 of gestation, what is the likely result of a teratogen
Major congenital abnormalities
During weeks 9-38 of gestation, what is the likely result of a teratogen
Functional defects & minor abnormalities
State the criteria for classification of an agent as a teratogen
- Exposure results in a characteristic set of malformations
- Effect occurs with exposure at a specific stage of development
- Effect is dose-dependent
