Otolaryngology Book

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Adverse Drug Reaction

Aka: Adverse Drug Reaction, Medication Hypersensitivity, Drug Reaction
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  1. See Also
    1. Hypersensitivity Reaction
    2. Anaphylaxis
    3. Penicillin Allergy
    4. Gell and Coombs Classification
    5. Fixed Drug Eruption
  2. Types: Medication-induced Hypersensitivity Reaction
    1. See Gell and Coombs Classification
  3. Differential Diagnosis: Non-immune mediated Drug Reaction
    1. Medication withdrawal (examples)
      1. Antidepressant Withdrawal
      2. Clonidine
    2. Medication intolerance
      1. Significant gastrointestinal upset with codeine
    3. Idiosyncratic reaction (examples)
      1. G6PD Deficiency
    4. Pseudoallergic reaction (direct mast cell activation)
      1. Intravenous Contrast anaphylactoid reaction
    5. Drug Interactions
      1. See Cytochrome P-450
      2. Example: Drug Interactions with Coumadin
    6. Medication Overdose (examples)
      1. Medication Dosing Errors in Children
      2. Dilantin Toxicity
      3. Digoxin Toxicity
    7. Medication toxicity (examples)
      1. Medication Causes of Marrow Toxicity
      2. Medication Causes of Myositis
      3. Nephrotoxic Drugs
      4. Hepatotoxic Medication
      5. Ototoxic Drugs
    8. Medication specific adverse effect (examples)
      1. Medication Causes of Abnormal Uterine Bleeding
      2. Medication Causes of Constipation
      3. Medication Causes of Depression
      4. Medication Causes of Dyspepsia
      5. Medication Causes of Dyspnea
      6. Medication Causes of Edema
      7. Medication Causes of Galactorrhea
      8. Medication Causes of Headache
      9. Medication Causes of Hemolytic Anemia
      10. Medication Causes of Hyperpigmentation
      11. Medication Causes of Impotence
      12. Medication Causes of Jaundice
      13. Medication Causes of Lymphadenopathy
      14. Medication Causes of Macrocytic Anemia
      15. Medication Causes of Myositis
      16. Medication Causes of Neutropenia
      17. Medication Causes of Nightmares
      18. Medication Causes of Phototoxic Reaction
      19. Medication Causes of Pruritus
  4. Risk factors: Immune-mediated Drug Reaction
    1. Drug Hypersensitivity Reaction to related medication
    2. Adults (especially women)
    3. Concurrent viral infection
    4. Comorbid condition
      1. HIV Infection
      2. Asthma
      3. Systemic Lupus Erythematosus
      4. Beta Blocker use
    5. Medications with larger more complicated structure
      1. Non-human proteins
      2. Streptokinase
      3. Insulin
  5. Findings: Suggestive of drug hypersensitivity
    1. Anaphylaxis
    2. Angioedema
    3. Urticaria
    4. Morbilliform rash (1-3 weeks after exposure)
    5. Bullous Disease
      1. Erythema Multiforme
      2. Toxic Epidermal Necrolysis
  6. Management
    1. Avoid drug responsible for adverse reaction
    2. Consider testing for allergy if suspect immune-mediated
      1. Type 1 Hypersensitivity Reaction
        1. Skin Testing
        2. RAST Testing
      2. Type 2 Hypersensitivity Reaction
        1. Coombs' Test positive
        2. Complete Blood Count
          1. Hemolytic Anemia
          2. Thrombocytopenia
          3. Neutropenia
      3. Type 3 Hypersensitivity Reaction
        1. Erythrocyte Sedimentation Rate (ESR) increased
      4. Type 4 Hypersensitivity Reaction
        1. Patch Testing
    3. Consider desensitization to offending agent
    4. Consider specific agent management
      1. Penicillin Adverse Drug Reaction
      2. Intravenous Contrast
  7. References
    1. Diasio in Goldman (2000) Cecil Medicine, p. 100-1
    2. Gruchalla (2003) J Allergy Clin Immunol 111:548-59
    3. Riedl (2003) Am Fam Physician 68:1781-90

Adverse reaction to drug (C0041755)

Definition (MEDLINEPLUS)

Most of the time, medicines make our lives better. They reduce aches and pains, fight infections, and control problems such as high blood pressure or diabetes. But medicines can also cause unwanted reactions.

One problem is interactions, which may occur between

  • Two drugs, such as aspirin and blood thinners
  • Drugs and food, such as statins and grapefruit
  • Drugs and supplements, such as gingko and blood thinners
  • Drugs and diseases, such as aspirin and peptic ulcers

Interactions can change the actions of one or both drugs. The drugs might not work, or you could get side effects.

Side effects are unwanted effects caused by the drugs. Most are mild, such as a stomach aches or drowsiness, and go away after you stop taking the drug. Others can be more serious.

Drug allergies are another type of reaction. They can be mild or life-threatening. Skin reactions, such as hives and rashes, are the most common type.

When you start a new prescription or over-the-counter medication, make sure you understand how to take it correctly. Know which other medications and foods you need to avoid. Ask your healthcare provider or pharmacist if you have questions.

Definition (SNOMEDCT) All noxious and unintended responses to a medicinal product related to any dose should be considered adverse drug reactions (from US FDA 'Guideline for Industry, Clinical Safety Data Management: Definitions and Standards for Expedited Reporting').
Definition (PSY) Acute or chronic and often undesirable effects of drugs occurring in addition to the intended or therapeutic objective.
Definition (CSP) unintended, deleterious effects of otherwise licit, therapeutic, properly administered drugs; for effects of illicit and abused drugs, or of environmental chemicals, see TOXICOLOGY or POISONING.
Concepts Injury or Poisoning (T037)
MSH D004362
ICD10 T88.7
SnomedCT 158060007, 219105008, 62014003, 264519003, 212996000
DSM4 995.2
English Drug, adverse effect, drug adverse effect, Adverse Effects of Medication NOS, DRUG REACTION, Drug Side Effects, Adverse drug effect, NOS, Adverse drug reaction, NOS, Drug reaction, NOS, Adverse reaction to drug NOS, Drug side effect, Adverse drug reaction NOS, adverse reaction to drug therapy, adverse drug effect, adverse drug event, side effect (drug), adverse reaction to drug therapy (diagnosis), adverse drug reaction, adverse effect of drug therapy, Adverse reaction to drug, Adverse reaction to drug NOS (disorder), Adverse Drug Event, Drug Reactions, Adverse, Reaction, Adverse Drug, Event, Adverse Drug, Drug Reaction, Adverse, Reactions, Adverse Drug, Adverse Drug Reactions, Adverse Drug Events, Adverse Drug Reaction, Events, Adverse Drug, Drug Event, Adverse, Drug Events, Adverse, MEDICATION REACTION, Drug reaction NOS, medication side-effect, Adverse effect;medication, drug side effect, Side-effect;medication, medication adverse effects, medication side effect, medication side effects, adverse drug reactions, medications side effect, drug adverse reaction, medication reactions, medications reaction, medications reactions, reaction medication, drug adverse reactions, drug side effects, adverse drug effects, adverse drug events, Drug Reactions, Adverse drug effect, Drug reaction, ADR - Adverse drug reaction, Adverse drug reaction, Drug reaction (qualifier value), Adverse reaction to drug (disorder), drug; adverse effect, drug; reaction, drug; use, adverse effect, drugs; adverse effect, adverse effect; drugs, reaction; drug, Adverse reaction to drug NOS (finding), Side Effects (Drug), Drug Adverse Reactions, drug reaction, medication reaction, side-effect of medication
Italian Reazione avversa da farmaci, Reazione avversa da farmaci, NAS, Effetto collaterale di farmaco
Dutch geneesmiddelenbijwerking NAO, geneesmiddelbijwerking, drug; reactie, drugs; ongewenst gevolg, geneesmiddel; gebruik, ongewenst gevolg, geneesmiddel; gevolg, ongewenst gevolg; drugs, reactie; geneesmiddel of drug, geneesmiddelenbijwerking
French Réaction indésirable à un médicament SAI, Effet secondaire médicamenteux, Événement iatrogène médicamenteux, Pathologie iatrogène médicamenteuse, Manifestation pathologique iatrogène, Événement iatrogène d'origine médicamenteuse, Iatropathologie, Réaction indésirable à un médicament
German unerwuenschte Arzneimittelwirkung NNB, Medikamentennebeneffekt, Unerwuenschte Arzneimittelreaktion, Unerwuenschte Arzneimittelwirkung, Unerwünschte Arzneimittelwirkung, Arzneimittelnebenwirkung, Nebenwirkung, Unerwünschte Arzneimittelreaktion, unerwuenschte Arzneimittelwirkung
Portuguese Reacção adversa a fármacos NE, Efeito secundário de fármaco, Reações Adversas a Medicamentos, Reacção adversa a fármacos
Spanish Reacción adversa a drogas NEOM, Efecto secundario de un fármaco, Reacciones Adversas a Medicamentos, Adverse reaction to drug NOS, efecto adverso de una droga, reacción adversa a fármaco, SAI, reacción adversa a un fármaco (trastorno), reacción adversa a un fármaco, reacción medicamentosa (calificador), reacción medicamentosa, Reacción adversa a fármacos, reacción adversa a fármaco, SAI (hallazgo), reacción adversa a fármaco, SAI (trastorno)
Japanese 医薬品副作用ＮＯＳ, 医薬品副作用, ｲﾔｸﾋﾝﾌｸｻﾖｳ, ｲﾔｸﾋﾝﾌｸｻﾖｳNOS
Czech Nežádoucí účinek léku NOS, Nežádoucí účinek léku, Postranní účinek léku
Hungarian Gyógyszer-mellékhatás k.m.n., Gyógyszer mellékhatás
Sources
Derived from the NIH UMLS (Unified Medical Language System)


Drugs, medicines and biological substances causing adverse effects in therapeutic use (C0178359)

Concepts Injury or Poisoning (T037)
ICD9 E930-E949.9
SnomedCT 158007008, 218256004
English Adv reac drug/medic/biol subs, Adverse reaction to drugs/medicines/biological substances, Drugs, medicines and biological substances causing adverse effects in therapeutic use, Drugs, medicines and biological substances causing adverse effects in therapeutic use (event), Drugs, medicines and biological substances causing adverse effects in therapeutic use (finding), DRUGS, MEDICINAL AND BIOLOGICAL SUBSTANCES CAUSING ADVERSE EFFECTS IN THERAPEUTIC USE
Spanish Drugs, medicines and biological substances causing adverse effects in therapeutic use, fármacos, medicamentos y sustancias biológicas que producen efectos adversos durante la utilización terapéutica (hallazgo), fármacos, medicamentos y sustancias biológicas que producen efectos adversos durante la utilización terapéutica
Sources
Derived from the NIH UMLS (Unified Medical Language System)


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