Complete notes on a adverse drug reaction and drug withdrawal,causes,symptoms and treatment and examples of ADR. Genotoxicity.

1. Adverse drug reactions and Drug withdrawal &
Toxicity
Presented by:
Mr. G.p Kashyap
(Asst .Professor)
M.Pharm (QA)
Siddhi Vinayaka Inst. of
Technology & Sciences
Bilaspur(C.G)

2. Adverse Drug reaction
& Drug withdrawal
I. Excessive pharmacological effects
II. Secondary pharmacological effects
(TYPE-A)
III.Iodiosyncracy (type-b)
IV.ALLERGIC DRUG REACTIONS

3. Definition:
An adverse drug reaction (ADR) is an
unwanted or harmful reaction experienced
following the administration of a drug or
combination of drugs under normal
conditions of use and is suspected to be
related to the drug. An ADR will usually
require the drug to be discontinued or the
dose reduced.

4. 1. Excessive pharmacological effects
It is common effects of patients those are
receiving like cardio agent, CNS depressants,
hypotensive agents and hypoglycemic agents.
Associated from pharmacological properties
of the drugs.

5. If any patients are given excess form of such
drugs will cause such type of reaction.
It is predictable, dose dependent, undesirable
the goal of therapy.
EXAMPLES:
1.Benzodiazepines- sedation
2.Insulin- Hypoglycemia
3.Warfarin- Bleeding

6. 2. Secondary pharmacological effects
Studies on the mode of action and or effects of
a substances not related to its desired
therapeutic effect target.
This are also called as TYPE-A / PREDICTABLE.
• Drug reactions which is based on
pharmacological properties.

7. EXAMPLES:
1.Propranolol- Bradycardia(Primary
pharmacological adverse reaction)
Bronchospasm – Secondary pharmacological
ADR.
2.Antihistamines-Allergic rxn, anti nausea. To
hospitalized patients it cause drowsiness but
given to the bus driver it may harmful or
disastrous.

8. EXAMPLES:
1.Long term therapy with
immunosuppressant like azathioprine and
cyclophosphamide may induce lymphoid
tumors.
2. Analgesics may induce tumors of kidney

9. 3. Idiosyncracy
 It is also called TYPE-B Adverse reaction
 Characterstics-
• It occurs in genetically abnormal subjects
• It arises for few days
• Priore drug exposer
• Its response is dose dependent
• Its mechanism explained by drug receptor
intraction

10. 4.Allergic drug reaction
• An allergic drug reaction is one involving the
special biochemical mechanisms involved in
immunologic amplification.
• Anaphylaxis, a potentially life-threatening
reaction that can simultaneously affect two or
more organ systems (for example, when there
is both a rash and difficulty breathing)

11. Drug Allergy Symptoms
Skin rash or hives
Itching
Wheezing
or other breathing problems
Swelling

12. Common Triggers of Drug Allergies
Penicillin and related antibiotics
Antibiotics containing sulfonamides (sulfa
drugs)
Anticonvulsants
Aspirin, ibuprofen and other nonsteroidal
anti-inflammatory drugs (NSAIDs)
Chemotherapy drugs

13. Genotoxicity
 In genetics, Genotoxicity describes the property
of chemical agents that damages the genetic
information within a cell causing mutations, which
may lead to cancer.
While Genotoxicity is often confused with
mutagenicity, all mutagens are genotoxic, whereas
not all genotoxic substances are mutagenic.

15. The alteration can have direct or indirect
effects on the DNA: the induction of
mutations, mistimed event activation, and
direct DNA damage leading to mutations.
The permanent, heritable changes can affect
either somatic cells of the organism or germ
cells to be passed on to future generations.
Cells prevent expression of the genotoxic
mutation by either DNA repair or apoptosis.

17. Drug withdrawal
• Withdrawal is the combination of physical and
mental effects that a person experiences after
they stop using or reduce their intake of a
substance such as alcohol and prescription or
recreational drugs.
• The characteristics of withdrawal depend on
what drug is being discontinued.

18. Symptoms
Withdrawal symptoms vary depending on the type of drug you were taking. Some
symptoms commonly associated with withdrawal include:
•Changes in appetite
•Changes in mood
•Congestion
•Fatigue
•Irritability
•Muscle pain
•Nausea
•Restlessness
•Runny nose
•Shakiness
•Sleeping difficulties
•Sweating
•Tremors
•Vomiting

19. Identifying Withdrawal
• People may recognize symptoms of withdrawal
when they stop taking or cut back on a
substance. Missing your usual morning cup of
coffee, for example, might result in symptoms of
caffeine withdrawal such as fatigue, headache,
and irritability.
Withdrawal symptoms are often the opposite of the
effects of the substance. For example, alcohol is a
depressant, so if you suddenly stop consuming alcohol,
you might experience symptoms of overstimulation such
as anxiety or restlessness.

20. Causes
• The body and brain work to maintain a state
of balance known as homeostasis. Taking a
substance changes that balance, so your body
has to take steps to adjust including changing
the levels of certain neurotransmitters.
• These substances act on your brain's reward
system, triggering the release of chemicals.

21. When you regularly take a substance for a period
of time, your body may build a tolerance and
dependence on that substance.
Tolerance means that it takes larger doses of the
substance to achieve the same effects that you initially
experienced.
dependence means that your body requires the
substance in order to avoid experiencing withdrawal
effects.
Homeostasis, refers to an organism's ability to
regulate various physiological processes to keep
internal states steady and balanced.

22. Types
 The specific withdrawal symptoms you experience depends
on the type of drug you were taking. There are a number of
different drug types that can result in withdrawal, including
the following:
• Antidepressants
• Barbiturates
• Cannabis
• Depressants
• Hallucinogens
• Inhalants
• Opioids
• Stimulants

23. Examples of drug withdrawal
• Alcohol: Not everyone who stops drinking alcohol has
withdrawal symptoms, but most people who quit
suddenly after drinking enough alcohol for any length of
time can experience a wide range of symptoms. Many
times those symptoms will trigger a relapse.
• Heroin: Those who have become addicted to heroin
experience some particularly intense withdrawal
symptoms, but even the worst of those symptoms will
subside in five to seven days. However, for some, post-
acute withdrawal syndrome (PAWS) can last for weeks
or even months.

24. Marijuana: Compared to alcohol and other drugs, the
withdrawal symptoms some marijuana users experience
when they try to quit are on the mild side. But, some of
those symptoms are unpleasant enough for some that
they decide to go back to using the drug.
Nicotine: Not everyone experiences all of the same
symptoms of nicotine withdrawal. As many who smoke
know, symptom of nicotine withdrawal can make it
difficult to give up cigarettes. There are steps you can
take to reduce those symptoms, too.