Adverse Drug Reactions

Question 1

Difference between a side effect and an idiosyncratic effect

Answer 1

Side effects are predictable due to MOA of drug, idiosyncratic are not predictable and may be genetically linked

Question 2

Rate of A.E.s in hospitalized patients

Answer 2

6-20%

Question 3

Which types of adverse effects are dose-dependent and which are dose-independent

Answer 3

Side effect and idiosyncratic are dose-dependent, allergic/hypersensitivity are dose-independent

Question 4

MedWatch

Answer 4

FDAs post-marketing surveillance database

Question 5

What events are excluded by definition from Adverse Drug Reactions (ADRs)?

Answer 5

Overdoses, drug abuse, all preventable Adverse Drug Events (pADEs)

Question 6

Drug interactions by type of response

Answer 6

Additive, synergistic, antagonistic

Question 7

Drug interactions by mechanism type

Answer 7

Pharmakokinetic, pharmacodynamic, combined

Question 8

Four examples of serious drug interactions with narrow therapeutic index

Answer 8

Anticoagulants, cardiac drugs, MAO inhibitors, hypoglycemic drugs

Question 9

Drug-drug interaction between Cimetidine and tricyclic antidepressants and the clinical significance

Answer 9

Cimetidine increases serum levels of the antidepressant. Clinical significance is unclear (effects of increased serum antidepressant not known)

Question 10

What effect does epinephrine have on absorption of local anesthetics?

Answer 10

Slows absorption/minimizes distribution by constricting blood vessels

Question 11

Name a drug-food interaction involving warfarin

Answer 11

Eating leafy green vegetables (which have Vitamin K) can cause bleeding episodes when taking warfarin

Question 12

What important enzyme does grapefruit juice affect and does it induce or inhibit?

Answer 12

Inhibits CYP3A4

Question 13

What enzymes does apple juice affect?

Answer 13

Inhibits Organic Anion Transporting Polypeptide Proteins (OATP)