Adverse Side Effects Question and Answers

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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

Read And Learn More: Pharmacology Question and Answers

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:

Adverse Side Effects Teratogenic Drugs

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

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.

Adverse Side Effects Tetratogenicity

    • 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 Drug Nomenclature

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

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