Flashcards in Adverse Effects of Drugs Deck (20):
0
Adverse drug reactions in ___% of patients?
5%
1
3 risk factors for adverse drug reaction?
previous adverse drug reaction
Pharmacodynamics
pharmacokinetics
2
3 pharmacokinetic risks for ADR?
impairment of liver/kidney
extremes of age
polypharmacy
3
High or low therapeutic index better?
High therapeutic index, larger window
4
5 red flag low therapeutic index drugs?
anticoagulants
cardiac glycosides
anticonvulsants
lithium
hypoglycaemics
5
what are 3 dose-dependent drug reactions? and the 1 none-dose dependent reaction?
side effects
overdose effects
idiosyncratic effects
Hypersensitivity reaction
6
when do side effects occur? features? what levels?
at therapeutic level
frequent
predictable
7
2 examples of on-target therapy but that same target is at multiple sites?
selectivity: B-adrenoceptors heart and airways
context: muscarinic for reducing SLUD before Sx or for IBS Rx
8
Aspirin desired response vs. undesired response
analgesic vs. gastric bleeding
9
B-adrenoceptor antagonists desired response vs. undesired response
hypertension vs. worsened asthma
10
Adrenaline desired response vs. undesired response
local anaesthetic vs. cardiac excitability
11
example of off-target side-effects?
poor selectivity: tricyclic antidepressants
metabolism: terfenadine and grapefruit juice: inhibiting K+
12
overdose happens when drug accumulates where? which ones more likely?
plasma
more likely with low therapeutic index
14
2 deleterious overdose effects?
fatal: atropine (deadly night shade)
pathological damage: paracetamol
15
What takes care of NAPQI?
glutathione
16
suxamethonium is an example of what kind of adverse effect?
idiosyncratic effect? ppl with absent pseudocholinesterase = skeletal muscle paralysis
17
2 examples of idiosyncratic effects?
suxamethonium
codeine: if missing CYP2D6: does not convert to morphine
18
hypersensitivity reactions are or aren't dose dependent?
NOT dose dependent
19
single exposure in hypersensitivity reactions triggers what?
extreme responses: harmless rash to life threatening anaphylaxis
20