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Adr
Adr
Adr
SHABANA ALI
ADR= significant morbidity & mortality Range from mild reactions (drowsiness, nausea, itching& rash); disappear after discontinuation of drug
OR
Severe reactions (respiratory depression, neutorpenia, hepatocellualr
Classification of ADR
Rawlin & Thompson classification Traditional classification A&B About 80% of ADR----Type A reactions
ABCD
1) Type A Reactions
a) Related to pharmacological action of drug Extensions of the principal pharmacological action of the drug
Cont.
b) Predictable
Relatively easily predicted by preclinical and clinical pharmacological studies
c) Common
Type A reactions not serious---common
d) Dose-dependent
Usually dose dependent
e.g., hepatic failure with dose of paracetamol Headache with antihypertensives hypoglycemia with sulfonylurea;
blood
conc.= toxicity
2) Type B Reactions
Unrelated
to known pharmacological actions of drug Unpredictable Often caused by immunological & pharmacogenetic mechanisms Unrelated to dosage Comparatively rare & cause serious illness or death cont.
Results
(more
likely)
in withdrawal of
marketing authorization Often not discovered until after drug is marketed Both environmental & genetic factors = important in this reaction
ii) Hypersensitivity (immunological reaction) Immune mediated response to a drug agent in sensitized patient e.g., anaphylaxis with penicillin
form involve
Type IgE
I
(non
hypersensitivity
immunologic reactions)
E.g., Anemia (hemolysis) by antioxidant drugs (G6PD deficiency) Paralysis due to succinylcholine (enzyme
deficiency)
drug=abstinence syndrome
E.g. opoids, alcohol, barbiturates
Carcinogenic Effect
Medication lead to cancer; take >20 y to develop
Teratogenic Effect
Drug- induced birth defects
Mechanisms of ADR
Type A =non immunological, reversible with reduction
of dose, non serious, extension of pharmacological effects
Type B
Biochemical mechanism unrelated to pharmacological Immunologic = Hypersensitivity (Type I, II, III, IV) OR Non immunologic (direct)= Pseudoallergic, idiosyncratic, intolerance
ii) Bind to NA