This document discusses adverse drug reactions and their classification. It defines key terms like adverse drug effects, adverse drug events, and adverse drug reactions. It describes different types of adverse reactions based on their mechanism, including type A reactions which are augmented and dose-related, and type B reactions which are idiosyncratic and non-predictable. Adverse reactions are also classified based on their severity as mild, moderate, severe or lethal. The document discusses various classification systems for adverse reactions from WHO and others and covers factors like preventability. It also lists different types of drug related adverse effects patients can experience.
Drug interaction is defined as the pharmacological activity of one drug is altered by the concomitant use of another drug or by the presence of some other substance.
1.Drug-drug interactions.
2.Drug-food interactions.
3.Chemical-drug interactions.
4.Drug-laboratory test interactions.
5.Drug-disease interactions.
Drug interaction is defined as the pharmacological activity of one drug is altered by the concomitant use of another drug or by the presence of some other substance.
1.Drug-drug interactions.
2.Drug-food interactions.
3.Chemical-drug interactions.
4.Drug-laboratory test interactions.
5.Drug-disease interactions.
Definition and scope of Pharmacoepidemiology ABUBAKRANSARI2
In these slides I shared the information of definition and scope of pharmacoepidemiology. Types of studies - cohort studies, cross-sectional studies etc.
pharmacoepidemiology is the study of use and effect of drugs in large number of population.
pharmacoepidemiology enhances or supplements the information from the preclinical studies.
breif notes on what is pharmacoepidemiology, why do we need pharmacoepidemiology, whats is its aim and its main applications, advantages and disadvantages
Introduction to dosage regimen and Individualization of dosage regimenKLE College of pharmacy
Introduction of Dosage regimen, Approaches for design of dosage regimen, Individualization, Advantages, Dosage in neonates, Geriatrics, Renal and Hepatic impaired Patients.
The presentation aims to give a basic understanding about the various drug reactions. It explains the mechanisms of ADR, Types, predisposing factors for ADR, and other common drug related adverse events
Definition and scope of Pharmacoepidemiology ABUBAKRANSARI2
In these slides I shared the information of definition and scope of pharmacoepidemiology. Types of studies - cohort studies, cross-sectional studies etc.
pharmacoepidemiology is the study of use and effect of drugs in large number of population.
pharmacoepidemiology enhances or supplements the information from the preclinical studies.
breif notes on what is pharmacoepidemiology, why do we need pharmacoepidemiology, whats is its aim and its main applications, advantages and disadvantages
Introduction to dosage regimen and Individualization of dosage regimenKLE College of pharmacy
Introduction of Dosage regimen, Approaches for design of dosage regimen, Individualization, Advantages, Dosage in neonates, Geriatrics, Renal and Hepatic impaired Patients.
The presentation aims to give a basic understanding about the various drug reactions. It explains the mechanisms of ADR, Types, predisposing factors for ADR, and other common drug related adverse events
Adverse Drug Reaction by Firoz Rosid.pptxFirozRosid1
Adverse 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.
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
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Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
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Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
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2 Case Reports of Gastric Ultrasound
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists
Adverse drug reaction for BPH
1. Adverse Drug
Reactions
For BPH 1st Year
Dr. Pravin Prasad
2nd Year Resident, MD Clinical Pharmacology
Maharajgunj Medical Campus
15th February, 2017 (5th Falgun, 2073),
Thursday
3. Adverse Drug Effects:
Terminologies
Adverse Drug Event:
Any untoward medical
occurrence that may present
during treatment with the
medicine, but which does not
necessarily have a causal
relationship with the treatment
5. Adverse Drug Effects:
Terminologies
Adverse Drug Reaction(ADR):
An appreciably harmful or unpleasant
reaction, resulting from an intervention
related to the use of a medicinal product,
which predicts hazard from future
administration and warrants prevention or
specific treatment, or alteration of the
dosage regimen, or withdrawal of the
product.
6. Adverse Effects: Classification
Type Mechanism Examples
A
Augmented,
dose related,
Predictable
• Postural
hypotension with
anti-hypertensives
• Hypoglycaemia with
oral hypoglycaemics
• Hypokalemia with
diuretics
7. Adverse Effects: Classification
Type Mechanism Examples
B
Bizzare,
idiosyncratic,
not dose
related, Non-
predictable
• Antibiotic induced
rash
• Phenytoin induced
Steven-Johnson
Syndrome/ Toxic
Epidermal
Necrolysis
8. Adverse Effects: Classification
Type Mechanism Examples
C
Chronic/cont
inuous, time
related
• Analgesic
Nephropathy
• Dyskinesia with
Levodopa
D Delayed
• Thalidomide
induced phocomelia
• Vaginal cancer due
to diethylstilbestrol
9. Adverse Effects: Classification
Type Mechanism Examples
E
End of
treatment
• Adrenocortical
insufficiency due to abrupt
corticosteroid withdrawal
• Opioid withdrawal causing
withdrawal syndrome
• Insomnia due to abrupt
benzodiazepam
withdrawal
Others: Type F, Type G
10. Adverse Effects: Classification
According to severity, as:
Mild
No therapy, antidote or prolongation of
hospitalization is required
Moderate
Requires change in drug therapy, specific
treatment or prolongs hospital stay by at
least one day
11. Adverse Effects: Classification
According to severity, as:
Severe
Potentially life threatening, causes
permanent damage or requires intensive
medical treatment
Lethal
Directly or indirectly contributes to death
of the patient
12. ADRs: WHO Classification
Temporal
relationship
Previous
Knowledg
e
De-
challenge
Re-
challenge
Explained by
disease or other
drugs
Definite
(plausible)
(plausible)
(Cannot be explained)
Probable
(reasonable)
(clinically
reasonable)
(Unlikely)
Possible
(reasonable)
(lacking or
unclear)
/
(Could be)
Unlikely /
(improbable)
(plausible)
Conditional/
Unclassified
More data for proper assessment needed; additional
data under examination
Unassessable
or
unclassifiable
Report suggestiong and adverse reaction; cannot be judged: information
insufficient or contradictory; data cannot be supplemented or verified
14. Adverse Drug Effects
Drug Related Patient Related
Side Effects Intolerance
Toxic Effects (Poisoning) Idiosyncracy
Photosensitivity
(Phototoxicity and Photoallergy)
Drug Allergy
Teratogenicity Drug Dependence
Mutagenicity and Carcinogenicity Drug Withdrawal Reactions
Prescriber’s related: Drug Induced Disease
Adverse Effects: any undesirable or unintended consequence of drug administration
Adverse Drug Event: any untoward medical occurance that may present during treatment with the medicine, but which does not necessarily have a causal relationship with the treatment
Side Effects: minor effects of type A events/effects
Adverse Drug Reaction: any noxious change which is suspected to be due to drug, occurs at doses normally used in man, requires treatment or decrease in dose, or indicates caution in future use of the same drug. Excludes trivial or expected side effects and poisoning or overdose
Adverse Effects: any undesirable or unintended consequence of drug administration
Adverse Drug Event: any untoward medical occurance that may present during treatment with the medicine, but which does not necessarily have a causal relationship with the treatment
Side Effects: minor effects of type A events/effects
Adverse Drug Reaction: any noxious change which is suspected to be due to drug, occurs at doses normally used in man, requires treatment or decrease in dose, or indicates caution in future use of the same drug. Excludes trivial or expected side effects and poisoning or overdose
Adverse effects: Any un-desireable or unintended consequence of drug administration
Type A: based on pharmacological properties of a drug, will occur in everyone if enough of the drug is given because they are due to excess of normal, predictable, dose-related, pharmacodynamic effects. Includes side effects, toxic effects, consequences of drug withdrawal (type E)??, mostly preventable and reversible. Eg
Type B: will occur only in some people, patient dependent, includes allergy and idiosyncracy, less common, non dose-related, generally more serious, requires withdrawal of drug, can be predicted and prevented if genetic basis is known and individual phenotype is identified. Accounts for most drug fatalities
Type E: ending of use reactions, discontinuation of chromnic therapy is too abrupt: corticosteroids withdrawal leading to rebound adrenocortical insufficiency, opiod causing withsrawal syndrome
Maximum score : +13
Atropine used as antisecretory for GA producing dryness of mouth, GTN used in Angina producing postural hypotension and throbbing headache
Anti-allergic promethazine producing sedation, Anti-ovulatory estrogen producing nausea
Constipation by codeine used for cough is m/a in traveller’s diarrhoea, AV conduction depression in AF is S/E when digoxin used in CHF
Functional alteration (high dose atropine causing delirium)
Drug induced tissue damage (hepatic necrosis form paracetamol overdosage)
Extension of therapeutic effects (coma by barbiturates, complete A-V block by digoxin, bleeding due to heparin)
Another action (analgesic morphine causing respiratory depression, antidepressant imipramine causing cardiac arrhythmia, antitubercular streptomycin causing vestibular damage)
Cutaenous reaction resulting from drug induced sensitization of the skin to ultraviolet (UV) radiation
Severe lesion with larger doses of drugs in phototoxicity
Phototoxicity: Accumulates in the skin, absorbs light and undergoes a photochemical reaction followed by a photobiological reaction resulting in local tissue damage (erythema, edema, blistering)
Photoallergy: Drugs and its metabolites induces a cell mediated immune response, on exposure to light produces a papular or eczematous contact dermatitis like picture
Thalidomide disaster (1958-1961) phocomelia (seal like limbs)
Capacity of the drug to cause foetal abnormality when administered to the pregnant mother
Drug effects on embryo are often irreversible
Foetal exposure depends on:
Blood level
Duration for which drug remains in maternal circulation
Direct interaction: modified DNA sequence codes for proto-oncogenes; proteins that inhibit transcription of proto-oncogenes
Indirect interaction: genetically damaged cells
Example:
Single dose of triflupromazine induces muscle dystonias in some individuals, specially children
Few doses of carbamazepine causing ataxia
Chloroquine causing abdominal pain and vomiting in an occasional patient
Example:
Barbiturates causing excitement and mental confusion in some individuals
Quinine/quinidine causing cramps, diarrhea, purpura, asthma, and vascular collapse in some patients
Chloramphenicol non dose related severe aplastic anaemia
Immunologically mediated reaction producing stereotype symptoms, unrelated to the pharmacodynamic profile of the drug
Smaller dose, different time course of onset and duration
Drug or its metabolite acts as antigen or hapten on combination with endogenous protein induces production of AB/ sensitized lymphocytes
Humoral
Type I: Anaphylactic reactions, IgE mediated.
Body on sensitization produces reaginic antibodies (IgE) that fixes on mast cells
Exposure to drug, Ag:Ab reaction – mediators release (histamine, 5-HT, leukotrienes, LT-C4 and D4, PG, PAF
Utricaria, itching, angioedema, bronchospasm, rhinitis, anaphylactic shock
Paresthesia, flushing, swelling, wheezing, palpitation anaphylaxis syncope
Stop Drug, Anti-histamines in milder cases, epinephrine and corticosteroids in severe cases
Type II: (Cytolytic)
Drug + Component of a tissue cell = Antigen
Antibodies: IgG, IgM; binds to target cells
Re-exposure Ag:Ab reaction complement activated cytolysis (thrombocytopenia, agranulocytosis, aplastic anaemia, hemolysis, organ damage (liver, kidney, muscle), SLE)
Type III: (retarded, Arthus)
Circulating antibodies (IgG, aka mopping AB)
Ag:Ab complexes bind to complement precipitate on vascular endothelium destructive imflammatory response
Rahses, serum sickness(fever, arthralgia, lymphadenopathy), polyarteritis nodosa, SJS (erythema multiforme, arthritis, nephritis, myocarditis, mental symptoms)
Subsides in 1-2 weeks
Type IV (delayed hypersensitivity):
Mediated through production of sensitized T-lymphocytes carrying receptors for Ag.
On binding, releases lymphokines attracts granulocytes inflammatory response
Contact dermatitis, rashes, fever, photosensitization
Generally takes >12 hrs to develop.
Drug capable of altering mood and feelings are liable to repetitive use to derive euphoria, recreation, withdrawal from reality, social adjustment
Psychological dependence: individual believes that optimal state of well being is achieved only through the actions of the drug; feels emotionally distressed if drug not taken; liking compulsion; intensity varies from desire craving
Reinforcement: ability of the drug to produce effects that user enjoys and which make him wish to take it again or to induce drug seeking behaviour Faster acting drugs (opiods, cocaine), inhaled/i.v. are strong re-inforcers, Slower acting drugs (BZDs) weak reinforcers are liable to repetitive use to derive euphoria, recreation, withdrawal from reality, social adjustment
Drug addiction: Pattern of compulsive drug use characterised by overwhelming involvement with the use of the drug; Procuring and using drug is prime concern; takes precedence over other activities; Tends to relapse after withdrawal; Can be produced by drugs not liable to produce physical dependence (amphetamines, cocaine, cannabis, LSD); Nalorphine: physical dependence without addiction (no drug seeking behaviour)
Drug habituation: less intensive involvement with the drug; withdrawal mild discomfort; tea, coffee, tobacco, social drinking; no physical dependence
Physical dependence: altered physiological state, which necessitates continued presence of drug to maintain physiological equilibrium; discontinuation withdrawal syndrome; aka neuroadaptation; eg opioids, barbiturates, alcohol, BZDs. Stimulant drugs (amphetamine, cocaine) little or no physical dependence
Drug Abuse: Use of a drug by self medication in a manner and amount that deviates from the approved medical and social patterns in a given culture at a given time; 2 patterns: continuous use (opioids, alcohol, sedatives) and occasional use (alcohol, cannabis, amphetamines, binge drinking cannabis, solvents)