Di / 17B16: Classify and describe adverse drug reactions with examples of each
17B16: Exam Report
Classify and describe adverse drug reactions with examples of each
44% of candidates passed this question.
Candidates should have provided a definition of adverse drug reactions and then a classification. There are at least two widely accepted systems for classification, either was acceptable; though candidates often switched between both which led to a less structured answer. The WHO classification is comprehensive and logical, though both Rang and Dale and Goodman and Gilman also have sections on this topic.
Common errors were the citing of examples with the incorrect mechanism, describing only drug interactions rather than all adverse reactions and focussing the answer on the 4 hypersensitivity reactions which could only score a low mark. Some candidates confused drug errors with adverse reactions.
Di / 17B16: Classify and describe adverse drug reactions with examples of each
ADR = any response to a drug which is noxious, unintended and occurs at doses used in man for prophylaxis, diagnosis or therapy (WHO)
Classification
A – Augmented
Example
Dose dependant & predictable
Augmentation of known pharmacological effects of drug
Eg orthostatic hypoT w AHTNs
Classification
B – Bizzare
Example
Uncommon & unpredictable
Independent of dose
Affect small % popn
Eg Anaphylaxis to SUX
Classification
C – Chronic
Example
Uncommon
Related to cumulative dose
Eg Hypothalmic-Pit-Adrenal axis suppression by corticosteroids
Classification
D – Delayed
Example
Uncommon
Usually dose related
Only becomes apparent sometime after use of drug
Eg Tardive dyskenisia w Metaclopramide
Classification
E – End of use
Example
Uncommon
Occurs after drug withdrawal
Eg Withdrawal syndrome with opiates/BZD
Classification
F – Failure of Tx
Example
Common
Dose related
Often due to drug interactions
Eg inadequate dose of OCP when used with enzyme inducer. a/b resistance
- Author: Krisoula Zahariou