E02_03 Patient Safety / Recognition of Specific ADRs Flashcards
2017, 2018_Patient Safety / Recognition of Specific ADRs
Which of the following is a Type B adverse Drug Reaction?
A. Osteoporosis with oral steroids
B. Resistance to antimicrobials
C. Aplastic anemia with chloramphenicol
D. Bronchospasm with beta blockers
C. Aplastic anemia with chloramphenicol - Type B, bizarre
A. Osteoporosis with oral steroids - Type C, continuous
B. Resistance to antimicrobials - Type F, failure
D. Bronchospasm with beta blockers - Type A, augmented
2017, 2018_Patient Safety / Recognition of Specific ADRs
A patient given procainamide suddenly develop lupus erythematosus. This is what type of allergic reaction?
A. I
B. II
C. III
D. IV
C. III - serum sickness (RA, HSP, SLE, post-strep glomerulonephritis)
Type I - immediate, anaphylactic, IgE-mediated (AR, BA, Urticaria, food allergy)
Type II - cytotoxic antibody reactions (ABO blood incompatibility)
Type IV - delayed hypersensitivity reactions; only cell-mediated response (T1DM, MS, Crohn’s, Thyroiditis, Graft vs. Host)
2017, 2018_Patient Safety / Recognition of Specific ADRs
Which of the following best describes the “rule of 3’s”?
A. The drug’s toxic effect is observed three times in a patient to be considered significant
B. To reliably detect the toxic effect of a drug in clinical trial, three times the number of patients in the population studied need to be exposed to the drug
C. The dose used by the patient is within three standard deviation of the drug’s therapeutic dose when the adverse effect is observed.
D. At least three patients are proven to manifest adverse effect from a drug before its removal from the market.
B. To reliably detect the toxic effect of a drug in clinical trial, three time the number of patient’s in the population studied need to be exposed to the drug
in Premarket Drug Safety Profile
> AE occures in 1 in 20 000 patients. To detect toxicity, >60 000 patients must be exposed after the drug is marketed
2017, 2018_Patient Safety / Recognition of Specific ADRs
Which of the following statements is a misconception of ADRs?
A. All serious ADRs are documented only when the drug is already in the market.
B. All ADRs should be reported even if just suspected.
C. One reported case of ADR cannot make a difference.
D. All of the Above
C. One reported case of ADR cannot make a difference.
2017, 2018_Patient Safety / Recognition of Specific ADRs
In the PQRST acronym for ADR, the R stands for?
A. Response to treatment
B. Relationship to time
C. Reaction to other drugs
D. Route of exposure
A. Response to treatment
P - provoking or palliative
Q - quality (character or intensity)
R - response to treatment, radiation, reports in literature of similar cases
S - severity (extent), site
T - temporal relationship (onset, duration, frequency)
+ associated signs and symptoms
2017, 2018_Patient Safety / Recognition of Specific ADRs
To assess the causality of an ADR, the Naranjo algorithm was used. How would you classify the event if the score is 6?
A. Definite or certain
B. Probable or likely
C. Possible
D. Doubtful or unlikely
B. Probable or likely
Kramer and Naranjo and Jones algorithm >9: definite 5-8: probable 1-4: possible 0: doubtful
2018_Patient Safety / Recognition of Specific ADRs
Allergic contact dermatitis is
A. A non-immune response caused by direct action of an agent on the skin
B. An immediate type I hypersensitivity reaction
C. A delayed type IV hypersensitivity reaction
D. Characterized by the intensity of the reaction being proportional to the elicitation dose
C. A delayed type IV hypersensitivity reaction
2014_Patient Safety / Recognition of Specific ADRs
Most likely to produce aplastic anemia
A. benzene
B. diethylene glycol
C. methanol
D. acetone
A. benzene
Benzene causes leukocytopenia, pancytopenia, and thrombocytopenia which are consistent with aplastic anemia.
2014_Patient Safety / Recognition of Specific ADRs
Torsades de pointes is an adverse drug reaction that can be casued by:
A. sulfonamides
B. tricyclic antidepressants
C. terfenadine
D. antipsyhotics
C. terfenadine
Torsade de pointes has been seen in association with the use of terfenadine, astemizole, cisapride, grepafloxacin etc.
2014_Patient Safety / Recognition of Specific ADRs
Grapefruit juice causes food-drug interaction by
A. inducing cytrochrome p450
B. inhibiting cytochrome p450
C. displacement of tissue binding sites
D. alteration in local tissue barriers
B. inhibiting cytochrome p450
2014_Patient Safety / Recognition of Specific ADRs
Development of clear cell carcinoma of the vagina in the daughters of women who took diethylstilbesterol during pregnancy is what type of ADR
A. type A
B. type B
C. type C
D. type D
Type D is delayed reaction to a drug and is unrelated to the dosage.
D. type D
Type D is delayed reaction to a drug and is unrelated to the dosage.
2014_Patient Safety / Recognition of Specific ADRs
Tardive dyskinesia is a common drug reaction from taking which kind of drugs?
A. tricyclics
B. ACE inihibitors
C. antipsychotics
D. fluoroquinolones
C. antipsychotics
Also Metoclopromide
2014_Patient Safety / Recognition of Specific ADRs
Thalidomide has been banned from the market due to this toxic effect
A. teratogenicity
B. mutagenicity
C. carcinogenicity
D. immunogenicity
A. teratogenicity
Teratogenicity is defined as capability of producing fetal malformations as with babies who had phocomelia following exposure to thalidomide
2014_Patient Safety / Recognition of Specific ADRs
Allergic contact dermatitis is
A. non-immune response caused by a direct action of an agent on the skin
B. immediate type I hypersensitivity reaction
C. delayed type IV hypersensitivity reaction
D. characterized by the intensity of reaction being proportional to the elicitation dose
C. delayed type IV hypersensitivity reaction
Allergic contact dermatitis (ACD) is a delayed type of induced sensitivity (allergy) resulting from cutaneous contact with a specific allergen to which the patient has developed a specific sensitivity. (medscape)
2014_Patient Safety / Recognition of Specific ADRs
Reye’s syndrome, a potentially fatal illness associated with liver failure and encephalopathy is associated with administration of which OTC medication?
A. paracetamol
B. ibuprofen
C. aspirin
D. bromopherniramine
C. aspirin
