Adverse Drug Effects Flashcards

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1
Q

What is a type A adverse drug reaction?

A

an exaggeration of a drug’s normal pharmacological action when given at the therapeutic dose

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2
Q

What is a type B adverse drug reaction?

A

idiosyncratic responses that cannot be predicted from the known pharmacology of the drug

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3
Q

What does a black triangle on drug packaging indicate?

A

the drug is new or is intensely monitored for side effects

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4
Q

What report system is used for pharmacological side effects?

A

Yellow Card Report

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5
Q

Give 3 common features of adverse drug reactions:

A

1) skin reactions
2) acute dystonia
3) blood dyscrasias

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6
Q

What is dystonia?

A

Involuntary sustained muscle contractions, producing twisting or squeezing movement and abnormal postures

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7
Q

What is blood dyscrasias?

A

disorders of the blood, bone marrow, lymph tissue or clotting factors

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8
Q

Give two examples of skin reactions associated with adverse drug reactions:

A

1) Stevens-Johnson Syndrome
2) Toxic epidermal necrolysis

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9
Q

What drug reduces the absorption of tetracycline antibiotics?

A

oral iron

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10
Q

Considering that oral iron reduces the absorption of tetracycline antibiotics by 90%, how should these drugs be taken together?

A

iron should be given 3 hours before/ after tetracycline

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11
Q

What drug group can displace warfarin from plasma protein binding sites?

A

NSAIDs

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12
Q

What drug reduces the effect of desogestrel contraception?

A

phenytoin

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13
Q

Describe the drug interaction between phenytoin and desogestrel:

A

phenytoin induces the metabolism of desogestrel which reduces its effect and allows for ovulation to occur

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14
Q

What drug interacts with simvastatin to cause myopathies and rhabdomyolysis?

A

clarithromycin

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15
Q

Describe the drug interaction between clarithromycin and simvastatin:

A

clarithromycin induces the CYP3A4 enzyme responsible for metabolising simvastatin, thus activating more simvastatin, resulting in toxicity

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16
Q

Give two clinical features of a clarithromycin/simvastatin drug interaction:

A

1) myopathy
2) rhabdomyolysis

17
Q

What two blood thinners should not be prescribed together?

A

enoxaparin and apixaban (heparin and DOAC)

18
Q

Why is prescription of both enoxaparin and apixaban contraindicated?

A

they both act on factor Xa, increasing the risk of bleeding

19
Q

What drug can decrease the antiplatelet effects of clopidogrel?

A

omeprazole

20
Q

What two drugs when given together carry a high risk of bone marrow suppression?

A

methotrexate and trimethoprim

21
Q

What is the effect of the interaction between methotrexate and trimethoprim?

A

bone marrow suppression and subsequent pancytopenia

22
Q

What two cardiac drugs when taken together can cause cardiac depression?

A

verapamil and beta blockers

23
Q

Give 3 effects of taking both verapamil and beta blockers?

A

1) bradycardia
2) asystole
3) sinus arrest

24
Q

What is the effect of enzyme inducer drugs on other drugs?

A

reduced drug concentration and reduced pharmacological effect

25
Q

Name 6 enzyme inducing drugs (GP RAPS):

A

1) griseofulvin
2) phenytoin
3) rifampicin
4) alcohol (chronic)
5) phenobarbital
6) sulfonylureas e.g. glicazides

26
Q

What type of drug is griseofulvin?

A

Antifungal

27
Q

What is phenytoin used to treat?

A

epilepsy (seizures)

28
Q

What is rifampicin used to treat?

A

tuberculosis

29
Q

What are gliclazides used to treat?

A

type 2 diabetes

30
Q

What is phenobarbital used to treat?

A

epilepsy (seizures)

31
Q

What is the effect of enzyme inhibitor drugs on other drugs?

A

they decrease the metabolism of other drugs, resulting in increased drug concentration and increased pharmacological effect

32
Q

Name 6 cytochrome enzyme inhibitor drugs: (SIC FAM)

A

1) sodium valproate
2) isoniazid
3) cimetidine and carbamazepine
4) azole antifungals
5) alcohol (acute binge)
6) macrolides/ metronidazole

33
Q

What is sodium valproate used to treat?

A

epilepsy

34
Q

What is isoniazid used to treat?

A

tuberculosis

35
Q

What is cimetidine used to treat?

A

Gastric or duodenal ulcers, HCl hypersecretion, esophagitis, and gastric reflux

36
Q

What is carbamezapine used for?

A

trigeminal neuralgia and temporal lobe epilepsy

37
Q

What is metronidazole used for?

A

anaerobes e.g. bacterial vaginosis