Significance of ADR

Dispensing and medication errors

 Physician over prescribe to the patient,
generally contains potent drugs eg- antibitics
 Self medication of the patient leads to over

use or misuse of the drugs leadig to ADR

Failure to set therapeutic end point

 Failure of the physician to set therapeutic end

point is the reason for ADR
 example- digitalis, steroids, diuretics
Bioavailability difference
 Difference in bioavailability from different
formulation or brands
 digoxin, phenytoin, oxytetracyclines
 Result in toxicity
Patient factors
 Physiological and disease status of the
patient affect ADR
 Very young and old patient more susceptible

to ADR
 Patient with renal and hepatic damage
 Inherited deficiency of certain enzymes
Other factors
 Environment
 Diet
 Physical
 Psychic condition of the patient
How to avoid ADR
 ADR can be minimised by
 Decreasing rate of parentrals administration
 Decreasing frequency by use of prolonged

action formulations
 Buffering to the optimum pH before injecting

or applying medication
 Adjusting tonicity to suit body fluids
 Achieving appropriate rates of dissolution

and absorption of oral formulations

 Administering minimum effective dose for the
shortest possible time
 Monitoring closely the blood levels of toxic

drugs particularly those which are

hepatotoxic and nephrotoxic