Adverse Drug Reactions

(Side effects of drugs)

Adverse drug reaction (ADR, or adverse drug effect) is a broad term that includes the unwanted, unpleasant or dangerous effects of drugs.

Adverse drug reactions can be considered as a form of toxicity. The term toxicity but is mostly used for effects caused by excessive ingestion (accidental or intentional), or elevated blood levels or enhanced drug reactions when used as intended (eg. B., when the metabolism of the drug is temporarily inhibited by a disease or other drugs). For information on the toxicity of certain drugs see Table symptoms and treatment of specific Poisoned. Side effect is an imprecise term that indicates an undesired drug effect within the therapeutic range.

Adverse drug reaction (ADR, or adverse drug effect) is a broad term that includes the unwanted, unpleasant or dangerous effects of drugs. Adverse drug reactions can be considered as a form of toxicity. The term toxicity but is mostly used for effects caused by excessive ingestion (accidental or intentional), or elevated blood levels or enhanced drug reactions when used as intended (eg. B., when the metabolism of the drug is temporarily inhibited by a disease or other drugs). For information on the toxicity of certain drugs see Table symptoms and treatment of specific Poisoned. Side effect is an imprecise term that indicates an undesired drug effect within the therapeutic range. Since all drug can cause potentially adverse drug reactions, when prescribing drugs, a risk-benefit analysis is required (analysis of the likelihood of a benefit compared to the risk of ADRs). In the US 3-7% of hospital admissions made on the basis of adverse drug reactions. During a hospital stay occurs in 10-20% of patients UAW, 10-20% of which are severe. The incidence of deaths due to ADRs is not known. The proposed values ??of 0.5 to 0.9% could be erroneously high because many included in the study patients have serious or complex diseases. The incidence and severity of adverse drug reactions vary greatly with the characteristics of the patient (eg., Age, gender, race, comorbidities, genetic or geographical factors) and those of the drug (eg. As the type of product, type of application, duration of treatment , dosage, bioavailability). The incidence is higher with advanced age and polypharmacy. The severity of UAW is probably higher among older people (drug-associated problems in the elderly), although the age per se is not a primary cause for this. It is unclear what contribution prescribing errors and mistakes make by not complying with the Regulation on the incidence of ADRs. Tips and risks Adverse drug reactions occur in 10-20% of hospitalizations. Approximately 10-20% of these adverse drug reactions are severe. Etiology Most adverse reactions are dose-dependent. Others are allergic conditions or idiosyncratic. Dose-related ADRs are usually predictable. Independent dose UAW usually unpredictable. Dose-related ADRs are of particular importance when drugs have a narrow therapeutic index (z. B. bleeding on oral anticoagulants). UAW may be the result of reduced drug clearance with reduced kidney or liver function, or due to a drug interaction. Allergic UAW are not dose-dependent and require an earlier exposure. Allergies develop when a drug acts as an antigen or allergen. After the patient has sensitized, a subsequent drug exposure causes one or more different types of allergic reactions. Medical history and appropriate skin tests can sometimes be helpful in predicting an allergic reaction. Idiosyncratic ADRs are unexpected ADRs, the dose-independent and non-allergy related. These occur only in a small proportion of patients who received a drug. Idiosyncratic is an imprecise term that was defined as a genetically determined abnormal response to a drug, but not all idiosyncratic reactions have a pharmacogenetic cause. This term may be obsolete as soon as specific mechanisms of the UAW are known. Symptoms and complaints Adverse drug reactions are usually classified as mild, moderate, severe and fatal (see table: Classification of adverse drug reactions (ADRs) [ADRs]). Serious or fatal ADRs may be mentioned, especially in black-box warnings to the prescribing information of the manufacturer. Symptoms and complaints may show up after a first dose or only with chronic use. You can obviously result from the use of this product or to be subtle to be associated with the drug. In the elderly subtle UAW can cause functional deterioration, changes in mental status, weakness, loss of appetite, confusion and depression. Classification of adverse drug reactions (ADRs) Severity Description Example No light or antidote treatment is required; hospitalization is not extended. Antihistamines (some): drowsiness opioids: Constipation means a change in the treatment (. For example, dose modification, adjunctive therapy), but not necessarily a withdrawal of the drug; a hospital stay can be extended or a specific treatment may be necessary. Hormonal contraceptives: venous thrombosis Nonsteroidal anti-inflammatory drugs (NSAIDs): hypertension and edema Severe ADRs is a potentially life-threatening and requires discontinuation of the drug, and specific treatment of ADR. ACE inhibitors: angioedema phenothiazines: arrhythmia Deadly A UAW directly or indirectly initially the patient’s death. Paracetamol overdose: liver failure anticoagulants: hemorrhage Allergic UAW typically never occur shortly after taking the drug, but after the first dose. Usually allergic UAW occur when the medicine is used again after an initial dose. Symptoms include itching, redness, rash, edema of the upper or lower airways with breathing problems and hypotension. Idiosyncratic ADRs can cause almost all symptoms and signs and can not be foreseen usual. Renewed diagnostic exposure are considering reporting of suspected ADRs in Germany z. As to the Drug Commission of the German Medical Association AKdÄ symptoms that occur on taking the drug immediately following, can be easily associated with using the drug often. However, the diagnosis of symptoms associated with chronic drug use requires a considerable degree of suspicion and is often complicated. Sometimes the drug withdrawal is necessary, but this is difficult when the drug is essential and there is no acceptable substitute for this. When the detection of the relationship between symptoms and the drug is important rechallenge should be considered, except if there are serious allergic reactions. Doctors should the most suspected reactions of ADRs in Germany z. As to the Drug Commission of the German Medical Association AKdÄ (www.akdae.de – via the Internet address and a registration form is available) Report, an early warning system. Only by UAW can be detected and analyzed. The Drug Commission of the German Medical Association also monitors changes in the nature and frequency of the UAW. Forms for notification and information about UAW are in the Physicians’ Desk Reference, and FDA News Daily Drug Bulletins (will be sent to all physicians at least once a year) and online verfügbart under www.fda.gov/Safety/MedWatch/default.htm; Forms can also be ordered by phone at 800-FDA-1088th Pharmacists and other health professionals should also report ADRs. The incidence of serious or fatal adverse drug side effects is very small (usually less than 1 per 1000); they should not occur in clinical trials because they are not usually designed so that UAW are recorded with low incidence. Thus, these ADRs can only be found where a product for the general public was admitted and is often used. Doctors should not assume that all ADRs are known at an authorized medicinal product. The post-marketing surveillance is very important for uncovering UAW with low incidence. Treatment dosage adjustment if necessary terminate the medication switching to another Drug dose-related adverse reactions, a dose modification or the elimination or reduction of triggering factors may be sufficient. A Increasing the drug elimination rate is rarely necessary. In allergic or idiosyncratic UAW, the drug should be discontinued and not replaced. Often has to be changed to a different class of drugs in allergic UAW and sometimes even with dose-related ADRs. Prevention The prevention of adverse drug reactions requires the precise knowledge of the drug and its potential reactions. Computer-aided analysis should be used to check potential drug interactions. The analysis should always be repeated when drugs are changed or new ones join. For older drugs must and the initial dose be carefully chosen (see drug-associated problems in the elderly. Reasons for drug-associated problems). Upon the occurrence of non-specific symptoms should be considered before starting a symptomatic treatment always UAW.

Health Life Media Team

Leave a Reply