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Flashcards in Pharm Deck (24):
1

What are the risk factors for adverse drug reactions?

History
Pharmacodynamics
Pharmacokinetics

2

What are the pharmacodynamic issues that may cause adverse drug responses?

– Target selectivity
– Target distribution

3

What are the pharmacokinetic issues that may cause adverse drug responses?

– Impairment of the organs of excretion (hepatic or renal dysfunction)
– Extremes of age
– Polypharmacy • Drug-interactions

4

What does LD50/ED50

The amount that it takes to help 50% and the amount of drug that it takes to kill 50% (of mice)

5

What are the two drugs that we need to remeber with a low therapeutic index?

• Anticoagulants
• Cardiac glycosides

6

What are the dose dependant adverse drug reactions?

Side Effects
Overdose Effects
Idiosyncratic Effects

7

What are the not dose-dependant adverse drug reactions?

Hypersensitivity reactions

8

Why is adrenaline used in anaesthetic solutions?

It vasconstricts allowing fro a localised response

9

What is terfenadine?

It is a H1 receptor antagonist
It is a prodrug - it is converted to fexofenadine

10

What is a contradindication for Terfenadine?

Grapefruit juice (or CYP3A4 antagonists)

11

What are the adverse affects or Terfenadine?

It is a H1 receptor antagonist but it also inhibits K+ channels and can cause arrhythmias

12

What happens in paracetamol toxicity?

Cytochromes break it down using glutathione which can then be excreted

If the glutathione pathway is fully occupied then the reactive intermediates interact with cellular proteins and cause liver damage

13

What is suxamethonium?

Antcholinesterase

14

How is codeine converted to morphine

CPY2D6

15

What causes issues when taking suxamethonium?

Absence of pseudocholinesterase means that is cannot be broken down and continues to exert its effect

16

What is a hypersensitivity reaction to drugs?

single exposure triggers extreme response harmless skin reaction to life threatening anaphylaxis, hemolysis or bone marrow depression

17

Type 1 hypersensativity reactions?

- immediate, inflammation - anaphylaxis

- allergen specific IgE, mast cells

- penicillins, lignocaine, atropine, aspirin

18

Type 2 hypersensativity reactions?

- cytotoxic, anaemia, thrombocytopaenia

- cell surface antigens IgG/IgM

- sulphonamides, penicillins. halothane - liver damage

19

Type 3 hypersensativity reactions?

- serum sickness (antivenoms, antisera)

- circulating immune complex

20

Type 4 hypersensativity reactions?

- Delayed, contact dermatitis (poison ivy)

- T-lymphocytes lymphokines

- Penicillins -> mercury, latex

21

Side effects of atropine?

• anti-Salivation Lacrimation Urination Defecation • context specific

22

Effects of Atropine overdose?

• blurred vision, difficulty swallowing, sedation, death

23

Ideosyncratic effects of atropine?

Slowed metabolism

24

Hypersensativity effects of atropine?

“red eye” Type I allergic response