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PHARMACOLOGY

Learn about the different types of adverse drug reactions (ADR), including predictable and unpredictable reactions, chronic use reactions, delayed reactions, and more. Discover common side effects, toxic effects, poisoning, drug allergies, and drug dependence. Understand the teratogenicity and iatrogenicity of drugs, as well as their carcinogenic potential.

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PHARMACOLOGY

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  1. PHARMACOLOGY

  2. ADVERSE DRUG REACTIONS

  3. Adverse Drug Reactions (ADR) • Any harmful effect which is suspected to be due to a drug, occurs at doses normally used in man, requires treatment or decrease in dose or indicates caution in the future use of the same drug

  4. Types of ADRs: • Type A, pharmacologically predictable • Type B, bizarre and unpredictable • Type C, arising from chronic use • Type D, delayed reaction • Type E, end of dose reaction • Type F, Failure of therapy

  5. Side Effect • Unwanted but often unavoidable pharmacodynamic effects that occur at therapeutic doses

  6. Morphine  constipation • Atropine  dry mouth • Promethazine  sedation

  7.  blockers  alopecia • Hydralazine  headache • Digitalis  diarrhea

  8. Anticancer drugs  vomiting • Cimetidine  confusion

  9. Toxic Effects • Excessive pharmacological action of a drug due to over dosage or prolonged use. • Morphine respiratory failure • Streptomycin renal failure • Heparin  bleeding

  10. Poisoning • Poison is a substance which endangers life by severely affecting one or more vital functions • Poisoning may result from large doses of drugs • organophosphurus

  11. Intolerance • Appearance of characteristic toxic effects in an individual at therapeutic doses • E.g. one tablet of Chloroquine may cause vomiting and abdominal pain in in some patients

  12. Idiosyncrasy • Genetically determined abnormal reactivity to a chemical • E.g. barbiturates cause excitement in some individuals

  13. Drug allergy • Drug allergy is defined as an immune-mediated response to a drug agent in a sensitized patient.

  14. Type I allergic reaction( Anaphylactic reaction) drug ( antigen) ↓ antibody ( IgE) ↓ attached to mast cells ↓ AG:AB reaction ↓ release of mediators( histamine,LTs) ↓ Penicillin Streptokinase heparin Second exposure Urticaria Itching Angioedema Asthma hypotension

  15. Treatment • Adrenaline IM (0.5 mg) • H1 antihistaminics • Glucocorticoid IV

  16. Type II allergic reaction( Cytolytic reactions) drug+ protein ( antigen) ↓ antibody (IgG ; IgM) ↓ AG:AB reaction ↓ Cytolysis ↓ Sulfonamides Methyldopa chloramphenicol Second exposure Thrombocytopenia Aplastic anemia Haemolysis Organ damage

  17. Type III allergic reaction( Arthus reactions) drug ( antigen)+ IgG (antibody) ↓ deposited in vessel wall ↓ AG:AB reaction ↓ inflammatory response ↓ vasculitis ↓ Sulfonamide Phenytoin Rashes Fever Lymphadenopathy Steven Johnson syndrome

  18. Type IV allergic reaction( Delayed hypersensitivity reactions) drug ( antigen) + T-lymphocyte ↓ Lymphokines ↓ Inflammatory reaction ↓ sulfonamide Contact dermatitis Rashes Fever

  19. Drug Dependence drug dependence is a state in which use of drugs for personal satisfaction is accorded a higher priority than other basic needs, often in the face of known risks to health

  20. Psychological Dependence • It is said to have developed when the individual believes that optimal state of well being is achieved only through the action of the drug • Compulsive drug seeking behavior • Nicotine, Amphetamine

  21. Physical Dependence • It is an altered physiological state produced by repeated administration of a drug which necessitates the continued presence of the drug to maintain physiological equilibrium • Discontinuation of drug  withdrawal syndrome • Morphine, Alcohol, Barbiturates

  22. Teratogenicity Capacity of a drug to cross placenta & cause foetal abnormality when administered to a pregnant women

  23. Alcohol  foetal alcohol syndrome

  24. Thalidomide  phocomelia • Corticosteroid cleft palate

  25. Phenytoin  foetal hydantoin syndrome

  26. Iatrogenicity • Drug induced / physician induced disease • Aspirin Peptic ulcer • Antipsychotis parkinsonism

  27. Carcinogenicity Capacity of a drug to cause cancer E.g. anticancer drugs radioisotope

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