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Adverse Drug Reactions is an untended noxious response occurring after the normal use of drug, which is

suspected to be associated with the drug.


Classified as:
[ Type A (Augmented) most common and related to the drugs pharmacological effect; dose dependent
[ Type B (Bizarre) which are rare & unpredictable; dose independent
According to World Health Organization (WHO) ADR is:
[ A response to a drug that is noxious and unintended and occurs at doses normally used in man for the
prophylaxis, diagnosis or therapy of disease, or for modification of physiological function.
ADR applies to the patients point of view.
Adverse effect applies to the drug
According to UKs Yellow Card Scheme:
[ A side effect is an unintended effect of a drug related to its pharmacological properties and can include
unexpected benefits of treatment.
Classification of ADR
Type of Reaction Features Example
Type A: Augmented Common
Predictable effect
Dose-dependent
Low morbidity
Low mortality
Bradycardia associated with
beta-adrenergic receptor
antagonist
Type B: Bizarre Uncommon
Unpredictable
Dose-independent
High morbidity
High mortality
Anaphylaxis associated with a
penicillin antibiotic
Type C: Chronic or Continuous Uncommon
Related to the cumulative dose
Hypothalamic pituitary
adrenal axis suppression by
corticosteroids
Type D: Delayed Uncommon
Usually dose related
Occurs or becomes apparent
sometime after use of the
drug
Carcinogenesis
Type E: End of Use Uncommon
Occurs soon after withdrawal
of the drug
Opiate withdrawal syndrome
Type F: Failure Common
Dose-related
Often caused by drug
interactions
Failure of oral contraceptive in
presence of enzyme inducer
Type G: Genetic or Genomic
reactions

Classifications of Immunological Reactions
Classification Mechanism (Enzyme) Symptoms/Signs & Examples
Type I (Immediate) IgE Pruritis, urticaria,
bronchoconstriction, angioedema,
hypotension, shock; eg. Penicillin,
anaphylaxis
Type II (Cytotoxic) IgG or IgM Haemolytic anaemia and
thrombocytopaenia; eg. Associated
with cephalosphorins, penicillins and
rifampicin
Type III (Immune Complex) IgG or IgM Cutaneous vasculitis, serum
sickness; eg. Associated with
chlorpromazine and sulphonamides
Type IV (Delayed type) T-cells Occur after 7 20 days. Macular
rashes and organ failure, including
Stevens-Johnson syndrome and toxic
epidermal necrolysis; eg. Associated
with neomycin and sulphonamides

G6PD (Erythrocyte glucose-6-phophatase dehydrogenase) Deficiency

I can do all things through Christ who strengthens me. Phil. 4:13

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