4: Adverse drug reactions Flashcards Preview

Renal Week 4 2017/18 > 4: Adverse drug reactions > Flashcards

Flashcards in 4: Adverse drug reactions Deck (42):
1

What is an adverse drug reaction?

Illness caused by medication

2

What's the difference between a side effect and an adverse drug reaction?

Side effects are caused by normal doses; subset of ADR (which may be caused by inappropriate doses e.g digoxin toxicity)

3

Which group of patients commonly suffer ADRs?

Elderly

Those with co-morbidities

Those on loads of drugs already

4

What is the therapeutic index of a drug?

Space between effective dose and toxic dose

5

The greater the therapeutic index of a drug, the ___ it is.

safer

and vice versa

6

How is therapeutic index calculated?

Therapeutic index = Toxic dose / Effective dose

7

Which enzyme family usually metabolises drugs in the liver?

CYP450

8

Where are most drugs excreted?

Bile

Urine

9

What process usually goes wrong to cause an ADR?

CYP450 - oxidation, reduction or hydrolysis

10

What are

Type A

Type B

ADRs?

Type A - predictable, dose-dependent reactions

Type B - unpredictable, dose-indepedent (weird reactions)

11

What is a

Type C

Type D

Type E

ADR?

Type C - chronic reactions

Type D - delayed reactions

Type E - reactions seen when the drug is withdrawn

12

What is a Type A ADR?

Predictable, dose-dependent reaction

13

What type of ADR is dehydration associated with diuretic overdose?

Type A

14

What type of ADR is ischaemic nephropathy associated with ACE inhibitor use during acute illness in someone with kidney disease?

Type A

15

What antibiotic has a very low therapeutic index?

What does it damage in toxic doses?

Gentamicin

CN VIII, kidney tubules

16

What can different drugs do to cause a Type A ADR?

Interact with one another

17

Where can you find drug interactions before prescribing them for patients?

BNF

18

Which family of antibiotics cause drug interactions?

Macrolides

(e.g azithromycin, clarithromycin, erythromycin)

WITH theophylline, statins

19

What is a common

a) side effect

b) interaction

of ACE inhibitors?

a) Dry cough

b) Amplify hypoglycaemia caused by sulphonylureas

20

What should you always ask about when taking a drug history?

Why?

Medication

OTC drugs

Herbal remedies

Because they may interact with certain drugs

21

Patients with which disorder have an increased risk of drug-induced confusion?

Parkinson's

22

Which cardio condition can NSAIDs exacerbate?

Heart failure

23

Anticholinergic drugs may cause which renal condition in men with BPH?

Urine retention

because they constrict the ureters (usually used to TREAT incontinence)

24

Which drugs commonly exacerbate constipation?

Calcium

Anticholinergics

CCBs

25

Which drugs classically exacerbate asthma?

Why?

Beta blockers

may non-selectively BLOCK beta2 adrenoceptors

26

Foods which are rich in potassium interact with which drugs?

ACE inhibitors

ARBs

Spironolactone and eplerenone

27

Foods rich in Vitamin K interact with which drug?

Warfarin

28

What electrolyte should be restricted in those on ACE inhibitors, ARBs and K-sparing diuretics?

Potassium

bananas!!!

29

What is a Type B ADR?

Dose-independent, unpredictable reactions

30

Out of Type A and Type B, which ADR is more dangerous?

Type B

31

What is a derm presentation of potentially any drug?

Rash

32

What is a haem presentation of potentially any drug?

Bone marrow suppression

33

What is a Type C ADR?

Chronic, predictable drug reaction

34

Long term steroid therapy can cause which ADRs?

Cushing's

Osteoporosis

35

Long term beta blocker use can cause which disease?

Diabetes

36

What is a Type D ADR?

Delayed reaction

not the same as chronic, often many years after stopping

37

What kinds of disease are caused by Type D ADR?

Congenital malformations, growth/developmental delay - teratogenic drugs

Malignancy - carcinogenic drugs

38

What treatments FOR cancer can cause cancer?

Radiotherapy

Chemotherapy

Phototherapy

39

What is a Type E ADR brought on by abruptly stopping beta blockers?

Rebound tachycardia

40

What is a Type E ADR brought on by abruptly stopping long-term steroids?

Addison's (disease or crisis)

41

What is found next to newly licensed drugs (which may have ADRs) in the BNF?

Black triangle

42

How do you report ADRs of drugs?

Yellow Card