Type of ADRs Flashcards
Sulfonamide causes SJS
Bizarre
Halothane causes acute hepatic necrosis
Bizzare
Anesthetic drugs causing hyperthermia
Bizzare
Orthostatic hypertension
Augmented extension effect
Bronchospasm caused by beta blocker
Augmented side effect (bronchospasm is unintended)
Phenothiazines or haloperidol used to treat psychiatric
conditions may induce extra-pyramidal side reactions
that can be managed with small doses of benztropine or
diphenhydramine.
Augmented side effect
Anti-cancer drugs that induce nausea and vomiting can
be given anti-emetic agents.
Augmented side effects
Anaphylaxis,
hay
fever,
asthma,
urticaria
Type I Anaphylactic reaction
Antigen binds on IgE in the mast cells. Sensitize in the initial exposure, however upon repeated exposure, the allergen cross links the IgE antibodies, causing degranulation, releasing histamines, leukotrienes ang prostaglandins
Type I Anaphylactic reaction
Hemolytic
transfusion
reactions and
hemolytic disease
of newborns
(hemolytic anemia
and aplastic
anemia)
Hemolytic anemia:
caused by taking
methyldopa
Aplastic anemia:
caused by taking
chloramphenicol
Type II cytotoxic reaction
Involve the binding of IgG
and IgM antibodies to
antigens on cell surfaces.
This induces a cascade of
events that leads to cell
death (complement mediated lysis).
Type II cytotoxic reaction
IgG and IgM
which is directed against
antigens that are found on
cell membrane of a given
target cell,
ex: leukocytes &
erythrocytes resulting to
cell death.
Type II cytotoxic reaction
Mediators: antigen-antibody
complexes
Result from the formation of
antigen-antibody complexes
that settle on tissues and
organs. In an attempt to
remove these complexes,
underlying tissue is also
damaged.
Type III immunocomplex
Serum sickness,
rheumatoid
arthritis
(arthus
reaction) and SLE
(Hydralazine,
Phenytoin, INH/
Isoniazid,
Procainamide)
Type III immunocomplex
Regulated by T cells and
are delayed reactions to
antigens associated with
cells.
T-lymphocytes sensitized
by an antigen release
lymphokines after
subsequent contact with the
same antigen.
Lymphokines induce
inflammation and activate
macrophages.
Type IV delayed reactions
Mediators: T cells
Tuberculin
reactions and
contact dermatitis
Type IV delayed reactions
Condition where a person takes a drug compulsively,
despite potential harm to themselves of their desire to
stop.
•
Example: Marijuana, Opiates
Continuous(addiction)
•
Compulsion to take the drug repeatedly and experiences
unpleasant symptoms if discontinued.
•
Examples: BZD, Caffeine, Cocaine
Continuous (Dependence )
Physical dependence
Body
Psychological dependence
Mind
Larger doses required to produce the same effect.
Continuous (tolerance )
•
A rapid decrease in response to repeated doses over a
short period of time
**Drug Holiday
Tachyphylaxis (continuous)
stop the medication for a while and
reinitiate after few days for the drug to elicit its effects.
Drug holiday
Steroids causing cushing sydrome due to prolonged use
Continuous
Isoproterenol and nitrates causes tachyphylaxis
Continuous
Carcinogen and teratogen
Delayed
Delayed reaction: MTX
CNS and limb malformations
Delayed reaction
ACE inhibitors
prolonged renal failure in neonates,
decreased skull ossification, renal tubular dysgenesis
Delayed reaction
Anticholinergic drugs
neonatal meconium ileus
Delayed reaction
Methimazole
aplasia cutis
Delayed reaction
Carbamazepine
Neural tube defect
Delayed reactions
Cyclophosphamide
CNS malformations, secondary
cancer
Delayed reactions
Danazol
masculinization of female fetuses
Delayed reaction
NSAIDs
constriction of ductus arteriosus,
necrotizing
enterocolitis
Delayed reaction
Lithium
Eibstein anomaly
Delayed
Warfarin
Skeletal and CNS defects, Dandy- Walker
syndrome
Delayed reaction
Phenytoin
Fetal hydrantoin syndrome
Delayed reactions
Valproic acid
Spina bfida
Delayed reaction
Alcohol
Fetal alcoholic syndrome
Delayed reactions
Thalidomide
Phocomelia
Rebound HTN due to sudden stop of clonidine
End of use
Adrenal insufficiency due to stopping prolonged use of steroid
End of use
o Drug-Drug interactions
o Use of counterfeit drugs
o Drug instability
o Poor patient compliance
o Wrong route of administration
o Drug resistance
-AMR
FAILURE OF THERAPY
