METHODS FOR DETECTING ADVERSE DRUG REACTIONS:-

Many factors are responsible for the adverse effects of drugs in patients receiving it.
The adverse effects of the drug depend on its dose, duration, toxicity and other individual factors
such as sex, age, genetics, compliance of patients and total number of drugs administered.

Spontaneous Case Reports:-

• It is the common method of affecting doubts about drug related diseases;
• A prescriber suspects that a condition arising in a patient may be drug related.
• He therefore reports either in a letter to the medical journals or to the manufacturer of drug.
• By this means other prescribers are alerted to the possibility of drug-disease relationship. "

Record Linkage Studies:-

• The details of cause of death or of hospitalization are routinely collected and analysed.
• It gives early warning of an epidemic of drug related disease.
• Record linkage studies may be used to great effect in the search for drug-induced disease.

Cohort Studies:-
• The "Cohort" means identifying a group of recipients of drug of interest and observing these
patients for varying lengths of time for what happens to them.
• This type of study is used for short term clinical trial of new drug.
• Thus,this method is of great value for detecting predictable adverse effects due to excessive
pharmacotogical effects arising during/ immediately after short term treatment.

Case Control Studies:-

• It Involves the comparison of group of patients with a disease which is thought to be due to
drug (the 'cases’) with the group of patients who do not have the disease (the ‘control).
• The drug histories of the cases and controls are obtained and compared, if a drug is causing the
disease then its use amongst the cases will be far in excess of that found in the controls.
• Case control studies can be conducted rapidly and efficiently at relatively low cost,
• However, It must be conducted correctly and resulting data must be interpreted correctly.

REPORTING AND MANAGEMENT OF ADVERSE DRUG REACTION:-

• Life threatening emergencies like haemorrhage, hypoglycemic coma, cardiac arrhythmias,
convulsion or hypertensive crisis may occur.
It is important to recognize and prevent such catastrophies, for which certain guidelines would be
helpful.
1)The more potent the drug, higher is the risk of toxicity.
2) Authentic manuals on drug interactions must be readily available for consultation.

Pharmacist should involve in the following steps of identifcation and monitoring of adverse drug
reactions.

Patient History:-
• Pharmacist should check whether the patient have a history of allergic disorder. It is anticipated
that 10% to 25% of patient’s population is hypetsensitive to one drug or another.
• The pharmacist may reduce the likelihood of these reactions by asking the patient whether or
not he has ever experienced an allergic reaction to a drug.
• If the answer is "yes", the pharmacist should then inquire as to the type of ADR and the drug
that supposed induced it.
Drug Profile Records:-
• The patient profile or complete family health record can assist in controlling and preventing
adverse drug reactions.
• The pharmacist is capable of knowing all of the medications used by these patients by
maintaining a health Real records.

Literature Review:-
• Pharmacist and physician should check properly published literature and package insert
information of drugs and given the proper attention regarding the suspected adverse drug
effect of drugs.

Drug Level Studies:-

• If the adverse drug reaction is dose dependent then the pharmacist should check the drug levels
in biological fluids.
• Computer software's can be used for checking drug levels as well as drug-drug. drug-diet and
drug-disease interaction.

Therapeutic Decision Making:-

• The advice of the pharmacist is very valuable regarding the immediate discontinuation of
therapy in case of ADRs.
• Pharmacist should check the risk/benefit ratio of the continued administration of drug against
the availability of other drugs.