W13_10 drug interactions Flashcards
what was the sulfanilamide incident?
an antibiotic used to treat strep infections had been mixed into a liquid form with diethylene glycol and raspberry flavour, which caused ADR
what are the 6 types of adverse drug reactions?
augmented (dose dependent);
bizarre (dose-independent);
chronic (time and dose related);
delayed (time);
end of use (withdrawal);
failure of therapy
what are the most common reasons for hospitalization for ARs?
warfarin;
insulin;
anti-platelet;
oral hypoglycemic;
(these are all type A reactions)
note: type B ADRs are unwanted, unexpected, host dependent
ok
what’s anticonvulsant hypersensitivity syndrome?
triad of fever, rash, and internal organ involvement
what’s the pathogenesis of anticonvulsant hypersensitivity syndrome?
aromatic anticonvulsants get converted to toxic metabolites along the way (e.g. arene oxides)
what can ticlodipine cause?
hypersensitivity;
bleeding problem;
blood disorder;
severe liver impairment
(type B reaction)
what can amiodarone cause?
toxicity in all organs half life of 3 months (type C reaction)
methotrexate, amiodarone, and aminoglycosides are examples of which type of ADR?
type C - chronic reactions (can build up in organ systems over time to cause toxicity)
note: doxorubicin can cause heart failure in 10 years
can cause early sinus tachycardia/ECG abnormalities. In 10 years, it’s a delayed-type ADR
note: narcotics is an example of a symptom of (end of use) withdrawal
ok
what can happen with beta-blocker withdrawal?
tachycardia, hypertension, angina, sweating/tremor;
type E reaction;
better to taper off than stop cold turkey
what’s an example of the failure of ADR in anti-platelet drugs?
clopidigrel doesn’t get turned into active metabolite by 2C19;
note - omeprazole can inhibit 2C19
