CLASSI FICATI ONOFADVERSEDRUGREACTI ONS

Ty peofr eaction Feat ures Exampl es Management

TypeA: Common Toxi cef fects: digoxin Reducedoseor
Dose-Rel at ed toxicit y,ser otonin withhol d;
Relatedtophar macol ogical
(Augment ed) syndr omewi t
hSSRI s Consi deref fectsof
acti
onoft hedr ug
Sideef fect s: concomi tantt herapy
Predict
ableLowmor t
ali
ty Ant ichol inergicef fects
ofTCAs
TypeB: • Uncommon Immunol ogical Wi t
hhol dandav oidi
n
Non-DoseRel ated • NotRel atedt o react ions: penicill
in future
(Bizar r
e) phar macol ogical hyper sensi tivi
ty
actionoft hedr ug Idi
osy ncr at i
cr eactions:
•Unpr edi ct
abl e Acut epor phy ri
a
•Highmor talit
y Mal ignant
  hyper ther mia
Pseudoal lergy( eg.,
ampi cill
inr ash)
TypeC: • Uncommon Hy pot hal ami c-pituit
ary- Reducedoseor
Dose-r elat edand • Rel at edt ocumul ati
ve adr enal axis withhol d;Wi thdrawal
Time- r
elat ed dose suppr essi onby mayhav etobe
(Chr onic) cort i
cost eroids prolonged
TypeD: • Uncommon Ter atogenesi s Ofteni ntractable
Time- r
elat ed •Usual lydose- r
elated Car cinogenesi s
(Del ayed) • Occur sorbecomes Tar div edy ski nesia
appar entsomet i
me
aftert heuseoft he
drug
TypeE: • Uncommon Opi atewi thdr awal Reintroduceand
Wit hdrawal • Occur ssoonaf ter syndr ome withdrawsl owl y
(Endofuse) withdr awal ofdrug My ocar dial ischemi a(β  
-bl
ockerwi thdr awal)
TypeF: • Common Inadequat edosageof I ncreasedosage
Unexpect edf ailureof •Dose- related anor al cont racept ive Consi deref fectsof
ther apy • Of tencausedbydr ug- part i
cul ar l
ywhenused concomi tantt herapy
(Failure) i
nter act ion withspeci ficenzy me
i
nducer s
 CLASSI
FICATI
ONOFMEDI
CATI
ONERRORS

1-Typeofe
rror
 Pr
esc
ribi
nge
rror
:Er
ror
sint
hisc
ate
gor
yar
efa
irl
ybr
oad,butge
ner
all
yf usoni
oc nappr
opr
iat
edr
ug
s
ele
cti
on,dos
e,dos
agef
orm,orr
out
eofa
dmi
nis
tra
tion.
 Wr
ongt
imee
rror
:Inge
ner
al,t
hist
ypeofe
rroroc
cur
swhe
nados
eisnota
dmi
nis
ter
edi
nac
cor
danc
ewi
th
apr
ede
ter
mine
dadmi
nis
tra
tioni
nte
rva
l.
 Omi
ssi
one
rror
:Anomi
ssi
one
rroroc
cur
swhe
napa
tie
ntdoe
snotr
ece
iveas
che
dul
eddos
eofme
dic
ati
on.
Thi
sisc
ons
ide
redt
obet
hes
econdmos
tcommone
rrori
ntheme
dic
ati
onus
epr
oce
ss,be
hindwr
ongt
ime
e
rror
s.
.
 Una
uthor
ize
ddr
uge
rror
:Thi
stypeofe
rroroc
cur
swhe
npa
ti
ent
sre
ceveadr
i ugt
hatwa
snota
uthor
ize
dby
a
nappr
opr
iat
epr
esc
ribe
r.Thi
smi
ghti
ncl
udegi
vingt
hewr
ongpa
ti
entame
dic
ati
on
 I
mpr
ope
rdos
eer
ror
:Thi
ser
roroc
cur nt
swhe hedos
eadmi
nis
ter
edi
sdi
ff
ere
ntt
hanwha
twa
spr
esc
ribe
d,
a
ssumi
ngt
hatt
hepr
esc
ribe
ddos
ewa
sappr
opr
iat
e
 Wr
ongdos
agef
orme
rror
:Thi
ser
roroc
cur
swhe
napa
ti
entr
ece
i sados
ve agef
ormdi
ff
ere
ntf
romt
hat
pr
esc
ribe
d,a
ssumi
ngt
hea
ppr
opr
iat
edo
sagef
ormwa
sor
igi
nal
lyor
der
ed.
 Wr
ongdr
ugpr
epa
rat
ione
rror
:Whe
nme
dic
ati
onsr
equi
res
omet
ypeofpr
epa
rat
ion,s
ucha
sre
cons
ti
tut
ion,
t
hist
ypeofe
rrorma
yoc
cur
.The
seki
ndsofe
rror
sma
yal
sooc
curi
nthec
ompoundi
ngofva
rious
i
ntr
ave
nousa
dmi
xtur
esa
ndot
herpr
oduc
ts
 Wr
onga
dmi
nis
tra
tiont
echni
que
:The
see
rror
soc
curwhe
nadr
ugi
sgi
vent
oapa
tie
nti
nappr
opr
iat
ely.
Exa
mpl
e:whe
nana
gentme
antf
ori
ntr
amus
cul
ara
dmi
nis
tra
ti
oni
sgi
veni
ntr
ave
nous
ly
 De
ter
ior
ate
ddr
uge
rror
:Thi
ser
roroc
cur
swhe
ndr
ugsa
rea
dmi
nis
ter
edt
ha vee
tha xpi
redorha
ve
de
ter
ior
ate
dpr
ema
tur
elyduet
oimpr
ope
rst
ora
gec
ondi
ti
ons
.
 Moni
tor
inge
rror
:The
see
rror
soc
curwhe
npa
ti
e sa
nt r
enotmoni
tor
eda
ppr
opr
iat
elye
it
hera
fte
rthe
yha
ve
r
ece
ive
dadr
ugorbe
for
ethe
yre
cei
vedadr
ug.

 Compl
ianc
eer
ror
:Thi
stypeofe
rroroc
cur npa
swhe tie
ntsus
eme
dic
ati
onsi
nappr
opr
iat
ely.Pr
ope
rpa
ti
ent
e
duc
ati
ona
ndf
oll
ow-
upma
ypl
ayas
igni
fi
cantr
olei
nmi
nimi
zi
ngt
hist
ypeofe
rror
.
 CLASSI
FICATI
ONOFMEDI
CATI
ONERRORS

2
-se
ver
it
yorout
come

1.NOERROR:

 Ca
tegor
yA:Ci
rcums
tanc
esore
vent
stha
tha
vet
hec
apa
cit
ytoc
aus
eer
ror
2.ERROR,NOHARM

Ca
tegor
yB:Ane
rroroc
cur
red,butt
heme
dic
ati
ondi
dnotr
eac
hthepa
ti
ent
.

Ca
tegor
yC:Ane
rroroc
cur
redt
hatr
eac
hedt
hepa
ti
ent
,butdi
dnotc
aus
ethepa
ti
entha
rm.

 Ca
tegor
yD:Ane
rroroc
cur
redt
hatr
esul
te
dint
hene
edf
ori
ncr
eas
edpa
ti
entmoni
tor
ing,butc
aus
edno
pa
ti
entha
rm
3.ERROR,HARM

 Ca
tegor
yE:Ane
rroroc
cur
redt
hatr
esul
te
dint
hene
edf
ort
rea
tme
ntori
nte
rve
nti
ona
ndc
aus
edt
empor
ary
pa
ti
entha
rm.

Ca
tegor
yF:Ane
rroroc
cur
redt
hatr
esul
te
dini
nit
ia
lorpr
olonge
dhos
pit
al
iz
ati
ona
ndc
aus
edt
empor
ary
pa
ti
entha
rm.

Ca
tegor
yG:Ane
rroroc
cur
redt
hatr
esul
te
dinpe
rma
nentpa
ti
entha
rm.

 Ca
tegor
yH:Ane
rroroc
cur
redt
hatr
esul
te
dinane
ar-
dea
the
vent(
e.g.
,ana
phyl
axi
sandc
ardi
aca
rre
st)
.

4
.ERROR,DEATH

 Ca
tegor
yI:Ane
rroroc
cur
redr
esul
ti
ngi
npa
ti
entde
ath.