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Adverse Drug Reactions and Drug Interactions
Adverse Drug Reactions and Drug Interactions
Adverse Drug Reactions and Drug Interactions
Canadian, half of UK) & slow acetylators • Quinolones (ciprofloxacin, nalidixic acid,
- Small doses may elicit the reaction once the - Steep dose response curve
allergy is established 1. Verapamil
- Reaction disappears on withdrawal 2. Sulfonylureas
- Illness is often recognizable as a form of 3. Levodopa
immunologic reaction
- Patient dependent on therapeutic effect
Delayed adverse effects
1. Immunosuppresives (e.g. cyclosporin,
• Pigmentary retinopathy – phenothiazine tacrolimus)
• Vaginal carcinoma – stilbestrol 2. Glucocorticoids
• Malignancy – immunosuppressives and 3. Oral contraceptives
chemotherapeutic agents
4. Anti-epileptics
Adverse effects associated with drug withdrawal
5. Anti-arrhythmics
• Benzodiazepine withdrawal syndrome
6. Anti-psychotics
• Rebound hypertension – clonidine
7. Antiretrovirals
• Acute adrenal insufficiency - corticosteroids
- Saturable hepatic metabolism
DRUG INTERACTIONS:
1. Phenytoin
• Occurs when the effects of one drug are
2. Theophylline
changed by the presence of another drug,
Pharmacokinetic:
herbal medicine, or some environmental
chemical agent • Absorption
Inducers- rifampicin
Pharmacodynamic
• Antagonistic
• Additive /synergistic
- Antidepressants, hypnotics,
antihistamines