Adverse Side Effects Question and Answers

Adverse Side Effects Important Notes

1. Cummulation

• • Accumulation of a drug in the body if the rate of administration is more than elimination resulting in toxicity
  • Example: digitalis

2. Tolerance

• • Requirement of a large dose of a drug to produce a given response
  • It may be natural or acquired

3. Tachyphylaxis

• • It is the rapid development of tolerance
  • The dose of the drug is repeated in quick succession resulting in a marked reduction in response
  • This is seen with directly acting catecholamines
  • Example: ephedrine, tyramine, amphetamine, 5-HT

4. Idiosyncrasy

• • It is the unpredictability of drug reaction due to other than immune reactions
  • It is genetically determined

5. Side effect

• • It is the undesired effect produced by the administration of a therapeutic dose of a drug

6. Teratogenic drugs

• • Drugs that cause fetal malformations when taken during the first trimester of pregnancy
  • They are:

7. Dependence

• • A state, psychic and
  • Sometimes also physical results from the interaction between a living organism and a drug characterized by a compulsion to take the drug
    • Drugs causing psychic and physical dependence
    • Barbiturates
    • Alcohol morphine
• Drugs cause more psychic but less physical dependence
• • Amphetamine
  • Opioid antagonist
• Drugs causing only psychic dependence
• • Cocaine
  • Caffeine
  • Cannabis

Read And Learn More: Pharmacology Question and Answers

Adverse Side Effects Long Essays

Question 1. Write in detail about Drug Toxicity in men.
(or)
Adverse drug reactions.

Answer:

Drug Toxicity Definition:

• WHO has defined an adverse drug reaction as any response to a drug that is noxious and unintended and that occurs at doses used in men for prophylaxis, diagnosis, or therapy.

Adverse drug reactions Types:

1. Side-effects:

• • These are unwanted but unavoidable pharmacodynamic effects of drug occurring at therapeutic doses. They are predictable and common.
  • Example: Sedation caused by promethazine

2. Secondary effects:

• • Corticosteroids cause immunosuppression which leads to latent TB.

3. Toxic effects:

• • These are results of Examplecessive action of the drug due to prolong usage or overdosage.
  • Overdosage may be accidental, suicidal absolute, or relative.
  • They are predictable & dose related.
  • Organs affected commonly are CNS, CVS, kidney, liver, lung, skin & blood-forming organs.
  • Poisoning can occur when the dose of the drug crosses the therapeutic index.

Adverse drug reactions Treatment:

• • Maintain airway by adequate ventilation.
  • Maintain BP and pulse rate.
  • Terminate the Exampleposure to the drug.
  • Exampleposure of the patient to fresh air.
  • Gastric lavage is done in case of ingested poison.
  • Preventing absorption of ingested poisons by use of suspension of 20-40 g of activated charcoal in 200 ml of water.
  • Inducing. diuresis.

4. Intolerance:

• • It is a characteristic toxic effect of a drug at a therapeutic dose.
  • Indicates a low threshold of the individuals to the action of the drug.
  • Example: Single dose of triflupromazine induces. Muscular dystonia in some individuals.

5. Idiosyncrasy:

• • It is genetically determined abnormal reactivity to a chemical.
  • It is a type of intolerance of some patients to specific drugs.
  • Some drugs without any genetic cause lead to ad- verse effects.
  • Such drugs are also included in it.
  • Example: Chloramphenicol causing agranulocytosis.
  • Some patients may be highly sensitive to even low doses while others may be highly insensitive even to high doses of the drug.

6. Drug Allergy:

• • The drug can induce cell-mediated or humoral-mediated immunity.
  • The drug or its metabolite acts as an antigen and induces an immunological reaction.
  • Organs affected by it are the skin, respiratory tract, gastrointestinal tract, blood and blood vessels.

Drug Allergy Types:

• Type 1 – Anaphylactic reaction.
• Type 2 – Cytolytic reaction
• Type 3 – Arthus reactions
• Type 4 – Delayed hypersensitivity reaction.

7. Photosensitivity:

• It is a cutaneous reaction resulting from drug-induced sensitization of the skin to UV radiation.

Photosensitivity Types:

• Phototoxic.
  • Drug or its metabolite accumulates in the skin, absorbs light, and undergoes photochemical reactions followed by photobiological reactions, resulting in local tissue damage and sunburn.
  • Example: Tetracyclines.
• Photoalergic.
  • Drug or its metabolite induces a cell-mediated immune response on Exampleposure to UV resulting in contact dermatitis.
  • Example: Sulphonamides.

8. Drug dependence/Addition:

• Drug dependence.
  • It is a state of compulsive use of drugs in spite of the knowledge of the risks associated with its use
  • Example: Alcohol.
• Addiction.
  • It is the dependence of a person on a drug to an Exampletent that influences the behavior and mood of the person.
  • Example: Barbiturates.

9. Teratogenicity.

• • It is an ability of a drug to cause fetal abnormalities when administered to a pregnant lady.
  • Depending on the stage of pregnancy during which the teratogen is administered, it can produce various abnormalities.

• • Example: ACE inhibitors can cause hypoplasia of organs.

10. Drug withdrawal reactions.

• • Certain drugs on sudden cessation result in adverse effects.
  • It may cause a worsening of the clinical condition.
  • Example: Acute adrenal insufficiency may be precipitated by abrupt cessation of corticosteroid therapy.

11. Carcinogenicity and mutagenicity.

• • It refers to the capacity of a drug to cause cancer and genetic defects.
  • It generally takes several years to develop
  • Example: Anticancer drugs, and radioisotopes.

12.  Drug-induced diseases – iatrogenic diseases.

• • They are functional disturbances caused by drugs that persist even after the causative drug has been withdrawn.
  • Example: Hepatitis by isoniazid.

Adverse Side Effects Short Essays

Question 1. Anaphylactic reaction.

Answer:

It is the type 1 hypersensitivity reaction.

• It is the only type of allergic reaction that the dentist may have to treat by himself.

Anaphylactic reaction Mechanism:

The drug or its metabolite act as an antigen
↓
It induces the synthesis of IgE antibodies which get fixed on mast cells.
↓
On Exampleposure of the drug, antigen-antibody complExample is formed.
↓
It causes the degranulation of mast cells which results in the release of
histamine, leukotrienes, prostaglandins, and platelet-activating factor
↓
Results in clinical manifestations of anaphylaxis.

Anaphylactic reaction Clinical features:

• Bronchospasm.
• Laryngeal edema.
• Hypotension.
• Urticaria.
• Itching.
• Angioedema.
• Rhinitis.
• Anaphylactic shock.
  • Example: Penicillin, cephalosporin, lignocaine, procaine, etc.
• Skin tests are carried out to detect it.

Question 2. Drug nomenclature.

Answer:

A drug can have three names.

1. Chemical name.
2. Non-proprietary name and
3. Proprietary name.

Adverse Side Effects Short Answer

Question 1. Drug resistance.

Answer:

It refers to the unresponsiveness of a microorganism to an antimicrobial agent.

Drug resistance Types:

1. Natural resistance.
   • Some microbes have always been resistant to certain antimicrobial agents.
   • Example: Gram-negative bacilli are unaffected by penicillin G.
2. Acquired resistance.
   • It is the development of resistance by an organism due to the use of antimicrobial agents over a period of time.
   • Example: Gonococci resistant to penicillin.

Question 2. Drug cumulation.

Answer:

When the rate of administration is more than the elimination rate, the drug will cumulate in the body and causes toxicity.

Example: Prolonged use of chloroquine causes retinal damage.

• The sometimes cumulative effect is desired.

Example: Use of phenytoin in the treatment of epilepsy.

• Substances like lead can remain deposited in bone without producing toxic effects.

Drug cumulation Prevention:

• Stop drug administration.
• Select the proper route of administration
• Check liver and kidney function before and during administration.

Question 3. Teratogenetic agents

Answer:

• Drugs that cause fetal malformations when taken during the first trimester of pregnancy
• They are:
  • Thalidomide
  • Amelia, phocomelia
  • Phenytoin
  • Cleft lip and palate, microcephaly
  • Tetracycline
  • Hypoplasia of teeth
  • Aspirin
  • Premature closure of ductusarterious

Viva Voce:

• Toxicity occurs at overdosage or prolonged dosage
• Side effects occur at the therapeutic dose
• Idiosyncrasy is genetically determined
• The first trimester is the most vulnerable period for teratogenicity