intro of adr.pptxGayatriBahatkar1Introduction to adverse drug reactions
Definitions and classification of ADRs
Detection and reporting
Methods in Causality assessment
Severity and seriousness assessment
Predictability and preventability assessment
Management of adverse drug reactions
Adverse Drug Reaction by Firoz Rosid.pptxFirozRosid1Adverse reaction of any drug is a major concerning issue in many countries. A medicine may act as poison without proper dosing as well as management. Sometimes, adverse drug reaction is life threatening. About 10% of diseased people are dying due to adverse reaction of drug. They even don't know why medicine is not being effective them well. So, to get proper medication, knowledge about adverse drug reaction is a must.
Adverse drug reactions.pdfShaikh AbusufyanFor all III YouTube Live Video lecture series of this topic click:
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ADR, Monitoring& Reporting.pptxMerlin Dinesh1) Adverse drug reactions can range from minor to lethal and are classified based on their severity and type. Types include augmented (dose-dependent), bizarre (unpredictable allergic reactions), chronic, delayed, end of use effects, and treatment failure.
2) Pharmacovigilance aims to detect, understand, and prevent adverse drug reactions through post-marketing surveillance, assessing causality of reactions, communicating findings to healthcare professionals, and monitoring methods like spontaneous reporting and surveys.
3) Serious or uncommon adverse drug reactions should be reported to local monitoring centers along with patient details, suspected drugs, reaction description, and management to allow for analysis and prevention of future harm.
Adverse drug reactionsVarshaBarethiya1. An adverse drug reaction (ADR) is an unwanted effect that occurs when taking a medication at normal doses. ADRs can be caused directly by the pharmacological properties of the drug.
2. Factors that contribute to more ADRs globally include an increasing number of drugs on the market, an aging population, and more frequent polypharmacy or use of multiple medications.
3. Monitoring and reporting of ADRs aims to help regulators and health programs identify risks to reduce ADRs, find safety issues with medications, and recognize risk factors for developing ADRs based on patient characteristics or drug interactions.
adverse drug rxn.pptSeema BansalThis document defines adverse drug reactions and discusses their epidemiology, classification, detection, and monitoring. It provides definitions of adverse drug reactions from WHO and other organizations. It describes the incidence, costs, and preventability of ADRs. It classifies ADRs into types A-F based on mechanisms and discusses methods to determine causality, including the Naranjo algorithm. It outlines the pharmacovigilance system in India including monitoring centers coordinated by AIIMS.
ADRs (VK)Dr. Abhavathi Vijay KumarThis document defines adverse drug reactions and discusses their epidemiology and risk factors. It states that adverse drug reactions are any unintended and harmful responses to a medication. It notes that 4% of hospital admissions, 1 in 1000 deaths in medical wards, and 10-20% of inpatients experience adverse drug reactions. Risk factors include simultaneous use of multiple drugs, advanced age, pregnancy, breastfeeding, hereditary factors, and disease states. Common culprit medications are anti-coagulants, NSAIDs, corticosteroids, antihypertensives, antibiotics, diuretics and insulin.
Main PostPharmacokinetics and PharmacodynamicsAs advance.docxwkyra78Main Post
Pharmacokinetics and Pharmacodynamics
As advanced practice nurses it is important that we understand pharmacokinetics and pharmacodynamics when caring for our patients. There are many factors to consider when prescribing medications because not one person is the same. Pharmacokinetics is the study of drug movement throughout the body, and has four basic processes: absorption, distribution, metabolism, and excretion (Rosenthal, 2021, p 13). Pharmacodynamics is the study of the biochemical and physiologic effects of drugs on the body and the molecular mechanisms by which those effects are produced (Rosenthal, 2021, p 22). In my experience I can not pinpoint one specific scenario in which pharmacokinetic and pharmacodynamic factors altered an anticipated response to a drug but multiple scenarios.
I can think of things to consider when prescribing medications like their medical history, medications they take, whether prescribed or over the counter, compliance, genetics, age, race, and family history. Other things to consider is the patients liver function and renal function, which affect the drugs absorption and excretion rate. One class of drugs that comes to mind are chemotherapy medications. Not everyone has the same outcome with chemotherapeutic agents when treating cancers. Another class of medications are psychotropic medications, some psych medications work better for others and do not work at all for some. And one of the most common ailments hypertension, antihypertensive drugs that work for some and not others. Immunosuppressed, CHF, renal failure, liver failure patients and patients with multiple ailments on multiple medications, all have to be prescribed medications carefully because of possible polypharmacy and drug interactions. A-fib patients prescribed coumadin needing their PT/INR checked to make sure their coumadin is therapeutic, educating them not to eat green leafy vegetables or drink grapefruit juice.
A patient’s genetics may play a role in whether the medication prescribed is going to work or not. It became evident in the 60’s that therapeutic doses of psychotropic medications vary markedly from person to person, with some patients failing to respond despite treatment with high dosages (Lerer, 2004, p158). Among many factors that may influence the drug response, hepatic function, and drug metabolism ae of great importance for nearly all medications used in psychiatry and even more importantly patient compliance with medication use (Lerer, 2004, p158). The CYP2D6 genetic polymorphism was discovered in late 1970’s and represents one of the most intensively studied monogenic variations in drug metabolism, approx. 7% of Caucasians are poor metabolizers of CYP2D6 substrates while the rest are considered as extensive metabolizers (Lerer, 2004, p160). CYP2D6 enzyme has particular significance for clinical psychiatry as it is involved in clearance of many psychotropic drugs such as tricyclic, antidepressants, selective.
Adverse drug reactionSMT. S.M. SHAH PHARMACY COLLEGE, AMASARAN1. An adverse drug reaction (ADR) is defined by the WHO as any unintended and harmful response to a drug that occurs at normal dosages.
2. ADRs are common, occurring in 5-30% of hospitalized patients and 3% of hospital admissions. They are more common in the elderly, young, and those taking multiple drugs.
3. ADRs can range from mild to severe or life-threatening. They can occur immediately after drug administration or after prolonged use. Common causes of ADRs include dose-related effects, allergic reactions, and idiosyncratic responses.
Scope of Pharmacology tuvidyumnay0586Pharmacology and toxicology are the study of the effects of drugs and chemicals on living organisms. A toxicologist examines how substances cause adverse health effects on humans, animals and the environment. The history of pharmacology involved early experimentation with animals to determine drug actions. Toxicologists work in various areas including mechanistic toxicology to understand disease mechanisms, descriptive toxicology for toxicity testing, regulatory toxicology for rulemaking, and translational toxicology applying basic research to patients. Their work assesses chemical risks and ensures product and environmental safety.
Handout adrJessica GutierrezThis document discusses medication errors and adverse drug reactions (ADRs). It defines medication errors as preventable events that may lead to inappropriate medication use or harm, and defines ADR harm. It then categorizes common types of medication errors and describes the differences between ADRs, drug interactions, and adverse drug events. It also discusses factors that can contribute to ADRs and lists different classifications of ADRs including by severity and type.
Adverse drug monitoringManjula MJAdverse drug reactions (ADRs) can occur when taking medications and include any harmful, unintended effects. ADRs are classified based on factors like onset, severity, mechanism and type. Common types include Type A reactions which are predictable and dose-dependent, Type B which are unpredictable immune reactions, and allergic reactions classified as Type I-IV. Monitoring and reporting of ADRs is important for patient safety and involves considering factors affecting reactions, clinical significance, and prevention through rational drug use and monitoring.
Adverse drug reaction monitoring and reportingTHUSHARA MOHANThis document discusses types of adverse drug reactions and factors influencing them. It describes types A-E reactions, which include augmented, bizarre, chemical, delayed and end of treatment reactions. Polypharmacy, age, drug characteristics, gender, race and genetic factors can influence susceptibility. Detection methods include pre-marketing studies, post-marketing surveillance, underreporting and communicating reactions. Healthcare professionals should monitor high-risk patients and gather information to assess causality between drugs and adverse events. Underreporting is common due to various barriers but can be addressed through improved reporting systems and education.
ToxicologyAsraful Islam RayhanToxicology
Principles of Toxicology
Dose-response relationship
Risk = Hazard X Exposure
Factors that influence toxicity
Drug Toxicology
Therapeutic index
Therapeutic window
Idiosyncrasy
Pharmcogenetics
Drug allergy
Test for prediction drug allergy
Toxicology is a branch of biology, chemistry, and medicine that concerned with the study of the adverse effects of chemicals on living organisms.
Personalized medicine pptIrene DanielThis document discusses personalized medicine, which aims to provide the right treatment for each individual patient based on their genetic profile. It defines personalized medicine as tailoring medical treatment to each patient's characteristics, needs and preferences. The development of genomic sequencing allows for more precise treatment by understanding how genetic variations impact drug metabolism and response. Pharmacogenomics studies how DNA and RNA variations affect drug effectiveness. Implementing personalized medicine through genetic testing can help reduce disease burden by improving prevention, treatment and healthcare costs while minimizing risks.
CLINICAL PHARMACY.pptxArchana ChavhanPOINTS TO BE INCLUDED
Definition, scope,
Technical definitions, common terminologies used in clinical
settings
Daily activities of clinical pharmacists
Ward round participation
Treatment Chart Review
Adverse drug reaction monitoring
Interprofessional collaboration
Personalized medicine and customized drug delivery systemLaniyaNasrinkIt includes personalized medicine, pharmacogenetics and customized drug delivery system as per M Pharm syllabus
Pharmacological implications of genetic polymorphism and PharmacogeneticsRumaMandal4Genetic polymorphism is applied to variants occuring at frequency >1%
Pharmacogenetics is study of genetic variation on drug response.
Pharmacogenetic traits may be Pharmacogenetics and pharmacodynamic types
ADR and pharmacovigillanceNesNalNiraula1This slide contains the description of ADR, its dissimilarities with Side effects and toxic effects, types of ADRs, risk Factors and the description of Pharmacovigilance program.
Adverse Drug Reaction.pptxBimal MagarThis document discusses adverse drug reactions (ADRs), including definitions from WHO and FDA, classification of ADRs as Type A or B reactions, factors affecting ADR incidence and severity, and methods for detecting and monitoring ADRs. It provides details on the national pharmacovigilance program in Nepal and the role pharmacists play in ADR monitoring and pharmacovigilance.
Drug idiosyncrasyNafeeyabanoThis document discusses drug idiosyncrasy and adverse drug reactions. It defines drug idiosyncrasy as an abnormal genetic response to a drug in some individuals. Idiosyncratic reactions are non-dose related and unpredictable. The document categorizes and classifies different types of adverse drug reactions and discusses methods of detection, including pre-marketing clinical trials and post-marketing surveillance. It emphasizes the importance of reporting suspected adverse drug reactions to help prevent future harm.
Adverse Drug Reactions Dr. Pawan Kumar BFactors such as age, weight, gender, and genetic variations can modify how individuals respond to drugs. Drug-related factors like dosage, interactions, and tolerance also impact outcomes. Adverse drug reactions may be predictable based on pharmacology or unpredictable due to immune or genetic factors. Close monitoring of drug therapy is needed to optimize benefits and prevent harm.
Pharmacogenetics and individual variation of drug responseNarasimha Kumar G VThis document discusses pharmacogenetics and individual variation in drug response. It begins by outlining how individuals can metabolize and respond to drugs differently due to genetic factors like polymorphisms. Three key discoveries in the 1950s helped establish the field of pharmacogenetics by showing how genetic differences can impact drug metabolism and efficacy. The document then examines specific genetic variations that influence drug pharmacokinetics and pharmacodynamics, such as differences in metabolizing enzymes and receptors. Understanding these genetic factors can help optimize drug therapy for each individual patient.
ADVERSE DRUG REACTIONS.pdfPawanSharma654041This document defines and classifies adverse drug reactions and drug-related harms. It discusses predictable and unpredictable reactions, side effects versus adverse effects, and different types of reactions including hypersensitivity, idiosyncrasy, toxicity and dependence. It also covers teratogenicity, pharmacovigilance, and methods for monitoring and reporting adverse drug reactions.
Geno toxicity, carcinogenicity and teratogenicity Manohar KuppalaThis document discusses genotoxicity, carcinogenicity, and teratogenicity. Genotoxicity is the ability of an agent to damage genetic material like DNA and RNA, which can result in mutations and cancer. Carcinogenicity is the ability of a chemical to induce tumors or increase tumor occurrence when inhaled, ingested, or applied to the skin. It discusses characteristics of carcinogens and studies done using chimeric and knockout animals. Teratogenicity is the ability of a drug to cause fetal abnormalities when administered to a pregnant mother. It discusses testing done using in vitro techniques like whole embryo culture tests in rodents and zebrafish embryos to evaluate teratogenic effects.
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Main PostPharmacokinetics and PharmacodynamicsAs advance.docxwkyra78Main Post
Pharmacokinetics and Pharmacodynamics
As advanced practice nurses it is important that we understand pharmacokinetics and pharmacodynamics when caring for our patients. There are many factors to consider when prescribing medications because not one person is the same. Pharmacokinetics is the study of drug movement throughout the body, and has four basic processes: absorption, distribution, metabolism, and excretion (Rosenthal, 2021, p 13). Pharmacodynamics is the study of the biochemical and physiologic effects of drugs on the body and the molecular mechanisms by which those effects are produced (Rosenthal, 2021, p 22). In my experience I can not pinpoint one specific scenario in which pharmacokinetic and pharmacodynamic factors altered an anticipated response to a drug but multiple scenarios.
I can think of things to consider when prescribing medications like their medical history, medications they take, whether prescribed or over the counter, compliance, genetics, age, race, and family history. Other things to consider is the patients liver function and renal function, which affect the drugs absorption and excretion rate. One class of drugs that comes to mind are chemotherapy medications. Not everyone has the same outcome with chemotherapeutic agents when treating cancers. Another class of medications are psychotropic medications, some psych medications work better for others and do not work at all for some. And one of the most common ailments hypertension, antihypertensive drugs that work for some and not others. Immunosuppressed, CHF, renal failure, liver failure patients and patients with multiple ailments on multiple medications, all have to be prescribed medications carefully because of possible polypharmacy and drug interactions. A-fib patients prescribed coumadin needing their PT/INR checked to make sure their coumadin is therapeutic, educating them not to eat green leafy vegetables or drink grapefruit juice.
A patient’s genetics may play a role in whether the medication prescribed is going to work or not. It became evident in the 60’s that therapeutic doses of psychotropic medications vary markedly from person to person, with some patients failing to respond despite treatment with high dosages (Lerer, 2004, p158). Among many factors that may influence the drug response, hepatic function, and drug metabolism ae of great importance for nearly all medications used in psychiatry and even more importantly patient compliance with medication use (Lerer, 2004, p158). The CYP2D6 genetic polymorphism was discovered in late 1970’s and represents one of the most intensively studied monogenic variations in drug metabolism, approx. 7% of Caucasians are poor metabolizers of CYP2D6 substrates while the rest are considered as extensive metabolizers (Lerer, 2004, p160). CYP2D6 enzyme has particular significance for clinical psychiatry as it is involved in clearance of many psychotropic drugs such as tricyclic, antidepressants, selective.
Adverse drug reactionSMT. S.M. SHAH PHARMACY COLLEGE, AMASARAN1. An adverse drug reaction (ADR) is defined by the WHO as any unintended and harmful response to a drug that occurs at normal dosages.
2. ADRs are common, occurring in 5-30% of hospitalized patients and 3% of hospital admissions. They are more common in the elderly, young, and those taking multiple drugs.
3. ADRs can range from mild to severe or life-threatening. They can occur immediately after drug administration or after prolonged use. Common causes of ADRs include dose-related effects, allergic reactions, and idiosyncratic responses.
Scope of Pharmacology tuvidyumnay0586Pharmacology and toxicology are the study of the effects of drugs and chemicals on living organisms. A toxicologist examines how substances cause adverse health effects on humans, animals and the environment. The history of pharmacology involved early experimentation with animals to determine drug actions. Toxicologists work in various areas including mechanistic toxicology to understand disease mechanisms, descriptive toxicology for toxicity testing, regulatory toxicology for rulemaking, and translational toxicology applying basic research to patients. Their work assesses chemical risks and ensures product and environmental safety.
Handout adrJessica GutierrezThis document discusses medication errors and adverse drug reactions (ADRs). It defines medication errors as preventable events that may lead to inappropriate medication use or harm, and defines ADR harm. It then categorizes common types of medication errors and describes the differences between ADRs, drug interactions, and adverse drug events. It also discusses factors that can contribute to ADRs and lists different classifications of ADRs including by severity and type.
Adverse drug monitoringManjula MJAdverse drug reactions (ADRs) can occur when taking medications and include any harmful, unintended effects. ADRs are classified based on factors like onset, severity, mechanism and type. Common types include Type A reactions which are predictable and dose-dependent, Type B which are unpredictable immune reactions, and allergic reactions classified as Type I-IV. Monitoring and reporting of ADRs is important for patient safety and involves considering factors affecting reactions, clinical significance, and prevention through rational drug use and monitoring.
Adverse drug reaction monitoring and reportingTHUSHARA MOHANThis document discusses types of adverse drug reactions and factors influencing them. It describes types A-E reactions, which include augmented, bizarre, chemical, delayed and end of treatment reactions. Polypharmacy, age, drug characteristics, gender, race and genetic factors can influence susceptibility. Detection methods include pre-marketing studies, post-marketing surveillance, underreporting and communicating reactions. Healthcare professionals should monitor high-risk patients and gather information to assess causality between drugs and adverse events. Underreporting is common due to various barriers but can be addressed through improved reporting systems and education.
ToxicologyAsraful Islam RayhanToxicology
Principles of Toxicology
Dose-response relationship
Risk = Hazard X Exposure
Factors that influence toxicity
Drug Toxicology
Therapeutic index
Therapeutic window
Idiosyncrasy
Pharmcogenetics
Drug allergy
Test for prediction drug allergy
Toxicology is a branch of biology, chemistry, and medicine that concerned with the study of the adverse effects of chemicals on living organisms.
Personalized medicine pptIrene DanielThis document discusses personalized medicine, which aims to provide the right treatment for each individual patient based on their genetic profile. It defines personalized medicine as tailoring medical treatment to each patient's characteristics, needs and preferences. The development of genomic sequencing allows for more precise treatment by understanding how genetic variations impact drug metabolism and response. Pharmacogenomics studies how DNA and RNA variations affect drug effectiveness. Implementing personalized medicine through genetic testing can help reduce disease burden by improving prevention, treatment and healthcare costs while minimizing risks.
CLINICAL PHARMACY.pptxArchana ChavhanPOINTS TO BE INCLUDED
Definition, scope,
Technical definitions, common terminologies used in clinical
settings
Daily activities of clinical pharmacists
Ward round participation
Treatment Chart Review
Adverse drug reaction monitoring
Interprofessional collaboration
Personalized medicine and customized drug delivery systemLaniyaNasrinkIt includes personalized medicine, pharmacogenetics and customized drug delivery system as per M Pharm syllabus
Pharmacological implications of genetic polymorphism and PharmacogeneticsRumaMandal4Genetic polymorphism is applied to variants occuring at frequency >1%
Pharmacogenetics is study of genetic variation on drug response.
Pharmacogenetic traits may be Pharmacogenetics and pharmacodynamic types
ADR and pharmacovigillanceNesNalNiraula1This slide contains the description of ADR, its dissimilarities with Side effects and toxic effects, types of ADRs, risk Factors and the description of Pharmacovigilance program.
Adverse Drug Reaction.pptxBimal MagarThis document discusses adverse drug reactions (ADRs), including definitions from WHO and FDA, classification of ADRs as Type A or B reactions, factors affecting ADR incidence and severity, and methods for detecting and monitoring ADRs. It provides details on the national pharmacovigilance program in Nepal and the role pharmacists play in ADR monitoring and pharmacovigilance.
Drug idiosyncrasyNafeeyabanoThis document discusses drug idiosyncrasy and adverse drug reactions. It defines drug idiosyncrasy as an abnormal genetic response to a drug in some individuals. Idiosyncratic reactions are non-dose related and unpredictable. The document categorizes and classifies different types of adverse drug reactions and discusses methods of detection, including pre-marketing clinical trials and post-marketing surveillance. It emphasizes the importance of reporting suspected adverse drug reactions to help prevent future harm.
Adverse Drug Reactions Dr. Pawan Kumar BFactors such as age, weight, gender, and genetic variations can modify how individuals respond to drugs. Drug-related factors like dosage, interactions, and tolerance also impact outcomes. Adverse drug reactions may be predictable based on pharmacology or unpredictable due to immune or genetic factors. Close monitoring of drug therapy is needed to optimize benefits and prevent harm.
Pharmacogenetics and individual variation of drug responseNarasimha Kumar G VThis document discusses pharmacogenetics and individual variation in drug response. It begins by outlining how individuals can metabolize and respond to drugs differently due to genetic factors like polymorphisms. Three key discoveries in the 1950s helped establish the field of pharmacogenetics by showing how genetic differences can impact drug metabolism and efficacy. The document then examines specific genetic variations that influence drug pharmacokinetics and pharmacodynamics, such as differences in metabolizing enzymes and receptors. Understanding these genetic factors can help optimize drug therapy for each individual patient.
ADVERSE DRUG REACTIONS.pdfPawanSharma654041This document defines and classifies adverse drug reactions and drug-related harms. It discusses predictable and unpredictable reactions, side effects versus adverse effects, and different types of reactions including hypersensitivity, idiosyncrasy, toxicity and dependence. It also covers teratogenicity, pharmacovigilance, and methods for monitoring and reporting adverse drug reactions.
Geno toxicity, carcinogenicity and teratogenicity Manohar KuppalaThis document discusses genotoxicity, carcinogenicity, and teratogenicity. Genotoxicity is the ability of an agent to damage genetic material like DNA and RNA, which can result in mutations and cancer. Carcinogenicity is the ability of a chemical to induce tumors or increase tumor occurrence when inhaled, ingested, or applied to the skin. It discusses characteristics of carcinogens and studies done using chimeric and knockout animals. Teratogenicity is the ability of a drug to cause fetal abnormalities when administered to a pregnant mother. It discusses testing done using in vitro techniques like whole embryo culture tests in rodents and zebrafish embryos to evaluate teratogenic effects.
Limitations of animal models part 2Manohar KuppalaThis document discusses alternative models that can be used to reduce animal testing. It outlines several options such as cell culture, human tissue samples, in chemico testing, organ chips, computer models, microdosing, volunteer studies, and population research. The document emphasizes the need to find alternatives to animal testing.
Limitations of animal models part 1 Manohar KuppalaAnimal studies have several limitations for predicting human outcomes, including interspecies differences in disease susceptibility, pharmacokinetics, and responses to stress. Studies in stressful laboratory environments and using chronic high doses can distort results. Alternatives to animal testing are needed and should incorporate the principles of reduction, replacement, and refinement. These include addressing methodological issues in animal experiments like small sample sizes, lack of randomization and blinding, and conflicts of interest. The external validity of animal models is reduced due to differences between young, healthy research animals and elderly, comorbid human patients.
Common laboratory animals part 2 Manohar KuppalaCommon laboratory animals used in drug development include rodents like mice and rats as well as non-rodents. Non-rodent models discussed in the document include rabbits, monkeys, cats, dogs, frogs, zebrafish, chickens, and pigeons. Rabbits are used for pyrogen testing due to their resistance to atropine. Monkeys such as rhesus monkeys and squirrel monkeys are used due to their similarity to humans, though squirrel monkeys are smaller making them easier to handle. Cats and dogs are also used for research due to their similarities to humans. Frogs have provided a new class of antibiotic compounds and zebrafish are used for genetic research due to external fertilization. Chick
common laboratory animals part 1 Manohar KuppalaThis document discusses common laboratory animals used in drug development research. It begins by introducing the importance of animal models that share physiological and anatomical similarities with humans. It then classifies disease models and research types that utilize animal subjects. The majority of the document focuses on describing specific rodent animal models commonly used - rats, mice, guinea pigs, gerbils, and hamsters. Details provided include typical strains, applications in research, anatomical features, life cycles, and other relevant information. A brief overview of non-rodent models like rabbits, monkeys, cats, and dogs is also presented.
Cell lines BasicsManohar KuppalaThis work is done in IIT-M (Indian Institute of Technology- Madras) with help of Indian Academy of Science during June 2011-Oct 2011 under Dr Karunagaran Devarajan sir
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Session | The Neurological Levels of Team-working: Harmony and Tensions
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2. 1. Introduction- Definition of PV – D, A, U, P
2. History, Examples of failure in PV
3. Need for Pharmacovigilence
4. Types of ADRs
5. Drug discovery process
6. Limitations of clinical studies
7. Reporting and Governing stricture
9. Adverse Drug Reactions
A response to a drug which is noxious and unintended,
and which occurs at doses normally used in man for
the prophylaxis, diagnosis, or therapy of disease, or
for the modifications of physiological function.
10. Scope of Pharmacovigilance
• ADRs event
• Medication errors
• Substandard medication
• Lack of efficacy of medicine
• Misuse and abuse of drugs
• Interaction between
medications
13. Type A: Predictable, related to mechanism of action
Type B: Unpredictable, not related to known
mechanism
Type A Type B
Dose dependency Yes No
Predictable from
known pharmacology
Yes No
Predisposing factor Co-
morbidities
Genetic, Immunological,
Frequency Common Uncommon
Seriousness Variable Serous
14. Mechanisms of action of ADRs
Pharmacodynamics- PD
• Mechanism of action
• Targets
• Specificity
Pharmacokinetics- PK
• Drug absorption
• Drug distribution
• Drug metabolism
• Drug excretion
15. Reasons for Type A reactions
PK variability
• Bioavailability
• Excretion
• Interactions with drug/food
• Genetic
Concentration abnormal!
PD variability
• Individual susceptibility due to altered target
organ sensitivity
• Interactions
• Additive
• Synergistic
• Genetic
16. Type B – Immunologic reactions
Drug allergies – 4 pathophysiological types
I. Anaphylaxis
II. Antibody-mediated cytotoxic reactions
III. Immune complex-mediated reactions
IV. Delayed type hypersensitivity
17. Drug factors associated with ADRs
Narrow therapeutic index
• anticoagulants
• immuno suppressants
Effects at multiple targets (“dirty drugs”)
• antipsychotics
• Corticosteroids
Toxic effects in one organ
• Aminoglycoside ototoxicity
• Chloroquine retinopathy
24. Drug Drug used for Side Effect Year
of ban
Avandia Type-2 Diabetes Increased risk of heart
attacks
2010
Chantix Quit smoking
tobacco products
Serious
hypersensitivity
2021
Vioxx
rofecoxib
NSAID Risk of heart attacks
and strokes
2007
Baycol Blocks LDL
cholesterol
Muscle tissue breaks
down
2001
Tysabri Multiple
sclerosis
Multifocal
leukoencephalopathy
2005