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M4 Pharmacy Adverse Drug Reactions Cheat Sheet (DRAFT) by

Course Audit Module 4 ADR

This is a draft cheat sheet. It is a work in progress and is not finished yet.

DEFINI­TIONS

Pharma­cov­igi­lance
science and activities relating to the detection, assess­ment, unders­tan­ding, and prevention of adverse effects and other medici­ne-­related problems
Adverse Drug Reaction
one which is noxious (cause discom­fort), uninte­nded, and which occurs at doses normally used in man for prophy­laxis, diagnosis, and therapy of disease
Adverse Drug Events
any adverse event associated with the use of drug in humans, whether or not considered drug related
ADR - caused by drug at normal dose
ADE - any event, may not be caused by drug

TYPES OF ADR

A - Augmented
"­greater in size or value"
 
1. Extension effects - exagge­ration of supposed indication
 
2. Side effects - not related to indication
B - Bizarre
1. Idiosy­ncrasy - genetic factors
 
2. Hypers­ens­itivity - immune factors
C - Continuous
cummul­ative dose of drug; effects require prolonged period of exposure to develop
 
1. Addiction - person takes drug COMPUL­SIVELY despite potential harm and DESIRE TO STOP
 
2. Dependence - without the drug, the patient experi­ences WITHDRAWAL EFFECTS; can be Physical or Psycho­logical
 
Tolerance and Tachyp­hylaxis - less or no effect at normal dose (i.e. Nicotine)
D - Delayed
1. Carcin­oge­nicity - ability to cause cance, neoplams, malignancy
 
2. Terato­gencity - ability to cause fetal malfor­mations
 
Thalid­omide tragedy that caused phocomelia
E - End of Use
withdrawal symptoms

Severity Reaction (ADR)

Mild
bothersome but requires no change in therapy
Moderate
requires change in therapy, additi­onal, hospit­ali­zation
Severe
disabling or life-t­hre­atening

MEDICATION ERRORS (ADE)

Category A
"ala pa"; potential harm but no error
Category B
"buti nalang­"; did not reach the patient
Category C
"char lang" did not cause harm
Category D
neeD monitoring
Category E
need trEatment or Interv­ention
Category F
Frolonged hospit­ali­zation
Category F
"­GG"; permanent patient harm
Category H
Hingalo; near death
Category I
Ililibing; caused death of patient
 

DRUG INTERA­CTIONS

Alcohol + antihi­stamine
additive (CNS depres­sion)
Antacid + fluoro­qui­nolone
chelation (dec. absorp­tion) -> delay
Antibiotic + estrogen
alter microbial flora (dec. estrogen effect­ive­ness)
Barbit­urates + other drugs
enzyme induction (dec. effect­ivitiy)
Erythr­omycin + other drugs
enzyme inhibition (inc. effect­ivity)
MAOI + tyramine
cheese effect­/sy­ner­gistic
Thiazide + digitalis
hypoka­lemia
Warfarin + green leafy vegetables
antago­nistic
Aminog­lyc­oside + loop diuretic
additive - both muscle relaxation
Aminog­lyc­oside + curare
muscular relaxation