W13_10 drug interactions Flashcards Preview

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Flashcards in W13_10 drug interactions Deck (13)
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1
Q

what was the sulfanilamide incident?

A

an antibiotic used to treat strep infections had been mixed into a liquid form with diethylene glycol and raspberry flavour, which caused ADR

2
Q

what are the 6 types of adverse drug reactions?

A

augmented (dose dependent);
bizarre (dose-independent);
chronic (time and dose related);
delayed (time);
end of use (withdrawal);
failure of therapy

3
Q

what are the most common reasons for hospitalization for ARs?

A

warfarin;
insulin;
anti-platelet;
oral hypoglycemic;
(these are all type A reactions)

4
Q

note: type B ADRs are unwanted, unexpected, host dependent

A

ok

5
Q

what’s anticonvulsant hypersensitivity syndrome?

A

triad of fever, rash, and internal organ involvement

6
Q

what’s the pathogenesis of anticonvulsant hypersensitivity syndrome?

A

aromatic anticonvulsants get converted to toxic metabolites along the way (e.g. arene oxides)

7
Q

what can ticlodipine cause?

A

hypersensitivity;
bleeding problem;
blood disorder;
severe liver impairment
(type B reaction)

8
Q

what can amiodarone cause?

A

toxicity in all organs half life of 3 months (type C reaction)

9
Q

methotrexate, amiodarone, and aminoglycosides are examples of which type of ADR?

A

type C - chronic reactions (can build up in organ systems over time to cause toxicity)

10
Q

note: doxorubicin can cause heart failure in 10 years

A

can cause early sinus tachycardia/ECG abnormalities. In 10 years, it’s a delayed-type ADR

11
Q

note: narcotics is an example of a symptom of (end of use) withdrawal

A

ok

12
Q

what can happen with beta-blocker withdrawal?

A

tachycardia, hypertension, angina, sweating/tremor;
type E reaction;
better to taper off than stop cold turkey

13
Q

what’s an example of the failure of ADR in anti-platelet drugs?

A

clopidigrel doesn’t get turned into active metabolite by 2C19;
note - omeprazole can inhibit 2C19

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