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Flashcards in Adverse Drug reactions Deck (25):
1

What is the frequency of ADRs in hospital in patients

10-20%

2

What is the 3 onsets for ADRs and their timings

acute - 60mins
sub-acute - within 24hrs
latent - >2days

3

what is the severity of ADRs range from

Mild requiring - no change in therapy
Moderate - additional therapy
severity - life threatening / disabling

4

What is the classification of ADRs divided into

Type A Augmented
Type B Bizarre
Type C Chronic
Type D Delayed
Type E End of treatment
Type F Failure of treatment

5

What are the features of a type A reaction

predictable
dose dependant
resolved when drug therapy is stopped

6

what are the reasons for type A reaction

Too high a dose
Pharmaceutical variation
Pharmacokinetic variation
Pharmacodynamic variation

7

In type A reactions what factor in the ADMEs result in the greatest therapeutic failure

absorption

8

What effects absorption

Gut motility
formulation
first pass metabolism
dose

9

What condition can effect absorption from the gut

oedema

10

Why is liver disease particularly important when considering drug therapy

Has a very narrow therapeutic index

11

What two factors need to be considered in the elimination of drug therapies and why?

If patient has renal impairment or a reduced glomerular filtrate rate, these two factors in drug therapy can result in increased toxicity

12

What is the outcome if a patient is a slow metaboliser

metabolise drugs by acetylation therefore more prone to drug toxicity

13

What is the secondary effect of type A reactions

when ADRs is not related to the therapeutic effect of the drug

14

What is an example of a pharmogenetic variation

isoniazid used to treat tuberculosis can induces peripheral neuropathy in some people

15

What is the result of cardiac failure with regards to ADR

Oedema prevents absorption from the gut
poor renal perfusion and decreased GFR
Hepatic congestion

16

What is the features of type B ADRS

rare
unpredictable
unidentified

17

What is the immunological features of type B ADRs

No relation to the pharmacological action of the drug
Delay between exposure and ADR
No dose response curve
Manifests as rash, asthma, serum sickness

18

What are some important factors in type B ADRs

More common with macromolecules
Patients with asthma and eczema
Patients HLA status

19

What are the features of type C ADRs

semi predictable
related to duration of treatment as well as dose
not due to single dose

20

Example of chronic ADRs

steroid dependancy eg coristol steroid
opiate dependancy
antipsychotic medications

21

What is the features of type D ADRs

Can occur a long time since treatment has been given in the patient or the patients children

22

Give an example of a type D ADRs affecting a patient child

Tetratogeneic agents e.g. phalidamide disrupt growth of fetus

23

What causes type E ADRs

sudden stop of treatment following long term use resulting in rebound phenomena

24

Examples of drugs causing rebound phenomena

Steroids - addisonian
beta blockers - unstable angina
alcohol - withdrawal seizures

25

How are ADRs diagnosed

differential diagnosis
past medical history
time of onset and drug dosage
lab investigations