Adverse Drug Reactions

Question 0

Dose-related ADRs

Answer 0

Type A, non-immune

Primarily dye to PK, PD abnormalities that produce excess of known pharmacological drug effect

Question 1

Differentiate ADR from ADE

Answer 1

ADR: noxious and unintended response to a drug given in RECOMMENDED doses

ADE: unintended response in ANY dose and in which causality has not been established

Question 2

Non-dose related ADRs

Answer 2

Type B, immunologic or pharmacogenetic variation

Question 3

Gell and Coombs Classification

Answer 3

Type I: IgE-mediated
Type II: cytotoxic
Type III: immune-complex
Type IV: delayed, cell-mediated
Specific T cell activation
Fas/Fas-ligand induced

Question 4

Modified Gell-Coombs Classification

Type IIA vs Type IIB

Answer 4

Type IIa: cytotoxic

Type IIb: antibody-mediated cell stimulating

Question 5

Modified Gell-Coombs Classification

Type IV subtypes

Answer 5

A: CD4+ Th1 lymphocyte-mediated
B: CD4+ Th2 lymphocyte-mediated
C: cytotoxic CD8+ T lymphocyte
D: T-lymphocyte driven neutrophilic inflammation

Question 6

Long term effects of ADRs

Answer 6

Adaptive changes, e.g. tachyphylaxis, tolerance

Rebound phenomena, e.g. opposite effects

Question 7

Delayed effects of ADRs

Answer 7

Carcinogenesis, e.g. Anticancer drugs predilection to produce second cancer usually leukemia
Effects on reproduction, e.g. Teratogenesis, impaired fertility