Ch. 3: Adverse Reactions

the drug-receptor interaction produces desired physical or behavioral changes

therapuetic effects

a general term for any undesirable effects that are a direct response to one or more drugs.

adverse effects

What is an adverse drug reaction?

undesirable response to a drug

potentially harmful

occurs at usual therapuetic doses

What are the 5 different catregories of adverse drugs reactions?

toxic reaction

side effect

idiosyncratic reaction

drug allergy

interference with natural defense mechanisms

exaggeration of desired effect

toxic reaction

not part of desired outcome

side effect

genetically related abnormal response

idiosyncratic reaction

immunologic response

drug allergy

immunity issues

interference with natural defense mechanisms

What are the different clinical manifestations of adverse reactions?

exaggerated effect on target tissues

effect on nontarget tissues

teratogenic effect

local effect

drug interactions

hypersensitivity

idiosyncrasy

interference with natural defense mechanisms

What can cause an exaggerated effect on target tissues?

an overreaction of a sensitive pt

a dose that is too large for that pt

What change might reduce the effects when there is an effect on the nontarget tissues?

a reduction in dose can reduce these adverse reactions

What types of drugs can cause a local effect?

injectable drugs

topically applied drugs

drugs taken orally

occur when the effect of one drug is altered by another drug

may result in toxicity or lack of effectiveness

drug interactions

What categories of drugs used in dentistry are contraindicated during pregnancy?

teratogens

type C or D drugs

If a pregnant women needs an antibiotic, what is the safest drug?

Penicillin

What are the three different types of drug interactions?

drug-drug

drug-food

drug-disease

anaphylactic shock (hypotension, bronchospasm, laryngeal edema, cardiac arrhythmias)

rhinitis/asthma

urticaria/dermatitis

occurs within a few min up to less than an hour after administration

type I - immediate/anaphylactic

complement-dependtent reactions involving either IgG or IgM antibodies

type II - cytotoxic/cytolytic

involves aggregations of antigens and antibodies deposited in the tissues

serum sickness

urticarial skun reactions (welts, rash)

arthralgia

arthritis

lymphadenopathy

fever

type III - imunne complex/arthus

reactions are mediated by sensitized T lymphocytes and macrophages

type IV - delayed hypersensitivity

a reaction that is neither the drug’s side effects nor an allergic reaction

some have been determined to be a genetically abnormal reaction

idiosyncrasy

dosage or blood concentration range where a drug works safely without causing severe side effects

therapeutic index/window of a drug

What are the roles of the RDH when dealing with dverse drug reactions?

know the difference between side effect, toxic effect, and allergic reaction

allergic to one drug usually means alos allergic to drugs in the same chemical class

make sure pt knows how to take the drug

educate pt about possible adverse drug effects and what should be done fi they occur

ask if pt may be pregnant