Adverse Effects of Drugs

Question 1

What are the types of adverse drug reactions?

Answer 1

• Type A= augmented pharmacologic effects 75%
• Type B = bizarre Effects 20%
• Type C= chronic effects
• Type D = delayed effects
• Type E = end of life treatment effects
• Type F= unexpected failure

Question 2

What is considered an ‘augmented pharmacologic effects’?

Answer 2

known to occur from the pharmacology of the drug -

ex) warfarin= bleeding risk

insulin = hypoglycaemia

Question 3

What is the therapeutic index?

Answer 3

• The ratio between the toxic dose and the therapeutic dose of a drug,
• Used as a measure of the relative safety of the drug for a particular treatment.

Question 4

What are ‘bizarre’ adverse drug reactions?

Answer 4

• anaphylactoid reactions
• hypersensitivity/anaphylaxis
• teratogenicity
• liverdisease
• kidney disease etc

*unpredictable, unrelated to the pharmacology of drug, and associated witha high rate of morbidity and mortality

Question 5

What are the types of allergies and anaphylaxis in response to a drug reaction?

Answer 5

• Type 1 = IgE dependent
• Type 2 = IgG and IgM dependent
• Type 3 = immune complex
• Type 4= cellular (very rare)

clinical manifestations = anaphylactic shock, haematological reactions, allergic liver disease, and hypersensitivity

Question 6

most penicilllin deaths are caused by what type of allergic reaction?

Answer 6

Type 1 = IgE dependent reaction -

Question 7

Stevens Johnson syndrome is an example of what type of reaction?

Answer 7

Type 3 allergy = immune complex allergy

Question 8

what is an example of Type 4 allergy?

Answer 8

Cellular allergies

ex) systemic lupus erythematosus - T cell mediated drug hypersensitivity - Antigen presentation with major histocompatibility complex to T cells and cytokine and inflammatory mediator. – usually occurs after 7 -20 days

Question 9

what is an example of a Type D adverse Drug reaction?

Answer 9

delayed effects - like 2nd cancers in patients treated with alkylating agents for Hodgkin’s lymphoma

Question 10

What is a type C adverse drug reaction?

Answer 10

Chronic - longterm effects

• only occur during prolonged treatment and not with single doses

Question 11

What is a Type E drug effect?

Answer 11

occur when treatment is stopped - withdrawal effects