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Eslam Fahmy

https://t.me/splenotes
00201011922837
Classification of adverse drug reactions
Type Features Examples Management
A Augmented • Common 1- Drugs with narrow TI ✓ Reduce dose or withhold
• Related to pharmacological action. 2- Toxic effects of drugs:
• Predictable • Digoxin toxicity
✓ Low mortality (↓↓) • Serotonin toxicity with SSRI
• Dose related • Anticholinergic effects of TCA
B Bizarre • Uncommon 1- Penicillin hypersensitivity ✓ Withhold and avoid in future
• Not related to pharmacological action. 2- Idiosyncratic reactions:
• Unpredictable • Acute porphyria
 High mortality (↑↑) • Malignant hyperthermia
• Non-dose related • Pseudo allergy
C Chronic • Uncommon 1- Cortisone for long time cause ✓ Reduce dose or withhold.
• Dose related → Related to cumulative dose suppression of Hypothalamic pituitary ✓ withdrawal may have to be
• Time related adrenal axis. prolonged.
D Delayed • Uncommon 1- Teratogenicity ✓ Intractable
• Time related 2- Carcinogenesis
3- Tardive dyskinesia
E End of use (Withdrawal) • Uncommon 1- Opiate withdrawal syndrome ✓ Reintroduced
• Occur soon after withdrawal of drug. 2- Beta blocker withdrawal ✓ withdraw slowly
• Myocardial ischemia)
F Failure • Common 1- Oral contraceptive failure when taken ✓ Increase dosage
• Often caused by drug interaction with enzyme inducer drug.

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