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level: Level 1 of ADVERSE DRUG REACTION.pptx

Questions and Answers List

level questions: Level 1 of ADVERSE DRUG REACTION.pptx

Question	Answer
Any noxious change which is suspected to be due to a drug, occurs at doses normally used in man, requires treatment or decrease in dose or indicates caution for in future use of the same drug. Defined by WHO as "a response to a drug that is noxious and unintended and occurs at doses normally used in man for the prophylaxis, diagnosis or therapy of disease, or for modification of physiological function"	Adverse Drug Reaction
Any untoward medical occurrence that may present during treatment with medicine , but which may not have causal relationship with the treatment.	Adverse Drug Event
1 ADR to drugs are most common cause of __ 2 __% of hospitalizations due to adverse reactions results in 3,000,000 hospitalizations annually in the US 3 Once hospitalized -> __% chance of ADR; risk of each course is __% 4 __% chance of life threatening reactions -> Rise of each course is __%	1 iatrogenic disease 2) 3-5% 3) 30%, 5% 4) 3%, 0.4%
Common causes of ADRs	1 Failing to correct dosages at the correct times 2 Overdosing 3 Allergies to chemical components of the drug 4 Combining med with alcohol 5 Taking other drug or prep that interact with the med 6 Taking med that was prescribed for someone else
Factors affecting ADR:	1 Patient-related factors 2 Drug-related factors
Factors affecting ADR: (Px-related factors)AGE 1 __ are often at risk because their capacity to metabolize drugs is usually __ 2 Children younger than 18 may be at risk of developing __ if given __ while infected with chickenpox or influenza	. 1 Children, NOT fully developed 2 Reye’s syndrome, Acetylsalicylic acid (aspirin)
Factors affecting ADR: (Px-related factors) ELDERLY 1 ADRs, including __, are a common cause of admission to hospitals in the elderly 2 Reasons for ADRs in the elderly: 3 These conditions are exacerbated by __ & __, common in the elderly	. 1 drug interactions 2) 1 Concomitant USE OF SEVERAL MEDICATIONS 2 DECREASED DRUG ADME ACTIVITY due to age 3 Malnutrition, Dehydration
Factors affecting ADR: (Px-related factors) Pregnancy 1 causes JAUNDICE & BRAIN DAMAGE in the FETUS 2 BIRTH DEFECTS, and increased RISK OF BLEEDING problems in newborns and mothers 3 DEFECTS of the HEART (Ebstein’s Anomaly), lethargy, REDUCED MUSCLE TONE, and UNDERACTIVITY of the THYROID GLAND (Fetus)	. 1 Sulfonamides 2 Warfarin 3 Lithium
Factors affecting ADR: (Px-related factors) Pregnancy 1 Drugs that can be passed from mother to infant via breast milk:	1 Amantadine (antiviral) 2 Cyclophosphamide (antineoplastic) 3 Cocaine (Schedule 2 FDA drug) ACC
Factors affecting ADR: (Px-related factors) GENDER 1 __ more susceptible to ADR 2 cause psychiatric AE and IMPAIRMENT OF CONCENTRATION 3 (longer QT interval than men)	. 1 WOMEN 2 Mefloquine ( antimalarial) 3 Drug-induced torsades de pointes associated with Sotalol and Erythromycin
Factors affecting ADR: (Px-related factors) Co-morbidities and concomitant medicines use EXAMPLES	1 Reduced hepatic and renal functions ↑ risk of ADR 2 Diabetes, Malignant dx, cardiac failure, etc
Factors affecting ADR: (Px-related factors) Ethnicity 1 POOR METABOLISM OF WARFARIN, occurs in WHITE INDIVIDUALS than black 2 INCREASE RISK OF ANGIOEDEMA for black patients	. 1 CYP2CP alleles 2 ACE inhibitors
Factors affecting ADR: (Px-related factors) Ethnicity 1 White and black pts. – CNS ADR with __ compared to Chinese and Japanese origin 2 INCREASE risk of MYOPATHY with ROSUVASTATIN	. 1 mefloquine 2 Asians
Drug-related factors	1 Dose 2 Duration 3 Inherent toxicity of the agent 4 Pharmacodynamic prop 5 Pharmacokinetic prop
Genetic Basis 1 FAULTY HYDROLYSIS: normal action of succinylcholine hydrolysis takes 5 MIN ,here it takes 1-2 HOURS, results in PROLONGED RESPIRATORY FAILURE 2 FAULTY OXIDATION, Phenytoin toxicity INCREASES in slow hydroxylators	. 1 Atypical pseudocholinesterase 2 Hydroxylase polymorphism
Genetic Basis 1 In fast acetylators → INH → __ → HEPATOTOXICITY 2 In slow acetylators → INH → __ 3 In slow acetylators → __ → HEMOLYSIS.	. 1 Acetyl hydrazine 2 peripheral neuritis 3 Dapsone
Genetic Basis 1 In __ → X linked recessive → __ causes HEMOLYTIC ANEMIA.	1 G6PD deficiency; Primaquine, sulfonamides, nitrofurantoin