Lecture 17 - Chemical Basis for Drug Hypersensitivity, Mutagenicity, and Teratogenicity

A series of flashcards aimed at reviewing concepts related to adverse drug events, their classification, mechanisms of hypersensitivity reactions, mutagenicity, and teratogenicity.

An adverse drug event (ADE) is defined as __.

An injury resulting from the use of a drug.

Adverse drug reactions (ADRs) can be categorized as or .

predictable (type A) and unpredictable (type B).

Hypersensitivity reactions can be grouped as type I (), type II (), type III (), and type IV ().

anaphylaxis, cytotoxic, Immune complex, Delay.

Functional groups in drugs capable of covalent bonding include __, __, __, __, and __.

β-lactams, epoxides, α,β-unsaturated carbonyl, aromatic amines, sulfhydryl.

Mutagens cause and changes in DNA.

irreversible and heritable.

A teratogen is any agent that causes __ during pregnancy.

congenital deformities.

Approximately __% of birth defects are caused by exposure to a teratogen.

5%.

The period of organogenesis is most critical during __ of pregnancy.

day 20 to the end of the first trimester.

Penicillin hypersensitivity is caused by __ bonding to proteins.

covalent.

Types of drug allergic reactions include __, __, __, and __.

IgE mediated, Cytotoxic, Immune complex, Delayed type hypersensitivity.

ADRs in the U.S. account for __% of all hospitalizations.

3 to 7%.

An example of an anticoagulant that can lead to ADEs is __.

bleeding.

can cause hypoglycemia as an adverse drug event.

Diabetes agents.

Drug-related overdoses can result from usage of drugs.

improper; Opioids.

Immediate hypersensitivity reactions are mediated by __.

IgE antibodies.

Covalent bonding to macromolecules can trigger immune-mediated drug hypersensitivity reactions due to the __ produced.

hapten.

ARBs, ACE inhibitors, and __ are associated with higher risks of ADRs.

calcium channel blockers.

In the context of ADEs, __ refers to the overuse or misuse of medications.

Medication errors.

Haptenation is predominantly important for which type of hypersensitivity reaction? __.

Type IV.

The term __ refers to drugs that can interfere with normal fetal development.

teratogens.

Mutagenic agents include __, __, and __.

epoxides, alkylating agents, analogs to DNA bases.

Covalent bonding to __ is one of the mechanisms leading to drug hypersensitivity.

sulfhydryl groups.

The __ isomers of thalidomide has been found to be teratogenic.

S'.

ADRs can occur during __% of hospitalizations.

10 to 20%.

The principal health issues connected with the use of __ involves polysystemic reactions.

opioids.

The overall __ of adverse drug reactions tends to increase in advanced age and with polypharmacy.

incidence.

Drug allergies can manifest as __, __, and __ reactions.

urticaria, bronchospasm, anaphylaxis.

Clinical manifestations of drug hypersensitivity include __, __, fever, and malaise.

cutaneous symptoms, respiratory issues.

The __ effect refers to the generation of adverse drug reactions due to genetic factors.

idiosyncratic.

In adults, exposure to teratogens can lead to __ defects in newborns.

congenital.

Drug molecules often activate immune responses by forming __ with proteins.

covalent bonds.

Small reactive molecules involved in immune reactions are often referred to as __.

haptens.

An important factor in the classification of adverse events is the __ of the drug involved.

dosage.

Polypharmacy increases the risk of __ and possible adverse reactions.

drug interactions.

The main therapeutic application of thalidomide today is in treating complications of __.

leprosy.

Most drugs have the potential to cause __, regardless of their therapeutic effects.

adverse drug reactions.

Antibodies involved in hypersensitivity reactions are primarily __.

IgE.

The __ Action Plan aims to address common and preventable ADEs.

ADE.

High-risk populations for ADEs often include patients on __, __, and __.

anticoagulants, diabetes agents, opioids.

Examples of __ adverse reactions include allergic reactions and other hypersensitivity events.

predictable.

Drug Hypersensitivity Reactions that are immediate are predominantly mediated by __ cells.

mast.

True or false: All drugs have the potential for causing ADRs regardless of their intended effects. __

True.

Anaphylactic reactions are classified as __ hypersensitivity reactions.

Type I.

Antigen presenting cells play a vital role in the __ of hypersensitivity reactions.

activation.

Severe ADRs may be expressed overnight leading to __.

serious morbidity.

Examples of antigens that can mediate drug allergies include __.

proteins.

Drugs that covalently bond with proteins can sometimes lead to generation of a __ response.

humoral.

A higher incidence of ADRs has been noted with __ and certain drug classes like those involved in chronic management conditions.

polypharmacy.

The __ reaction is often observed in beta-lactam antibiotic hypersensitivity.

cytotoxic.

The risk of ADRs increases with the __ of medication administration.

duration.

Medication safety practices aim to minimize things like and errors.

prescribing; monitoring.

Different therapeutic classes of drugs yield different __ for reactions based on usage.

risk factors.

Examples of __ adverse drug reactions include those that activate the immune response.

unpredictable.

Penicillin is associated with a higher incidence of __ compared to non-beta-lactams.

drug allergies.

Therapeutic management of patients involves monitoring for __ after medication administration.

adverse reactions.

The involvement of __ in allergic reactions can exacerbate the response to drug exposure.

genetic predisposition.

Covalent modifications of proteins that lead to hypersensitivity reactions are often referred to as __.

haptenation.

The timing of hypersensitivity reactions can vary, with immediate reactions typically manifesting within __ after exposure.

minutes.

Progressive symptoms of hypersensitivity can lead to __, making recognition essential.

anaphylaxis.

A drug that influences the immune system or alters immune responses is termed an __ modifier.

immunological.

Drugs that interact with cell-surface receptors can potentially lead to a __ response.

cell-mediated.

The analysis of __ for ADR susceptibility is becoming increasingly relevant in clinical practices.

pharmacogenomics.

Adverse drug reactions can complicate the clinical management of patients with __ or multiple conditions due to complexity.

comorbidities.

Histamine release is a critical step in the response to __ reactions.

Type I hypersensitivity.

Reactions to certain drugs might be enhanced by previously existing __ to them due to prior exposures.

sensitization.

The __ of adverse drug events can lead to significant healthcare costs.

prevalence.

A major consideration in understanding teratogenicity is the timing and __ of exposure during pregnancy.

duration.

True or false: Mutagens cause irreversible changes to DNA which can affect future generations. __

True.

Teratogenic agents create potential __ for developing abnormalities in embryos.

risk factors.

The presence of drug-specific antibodies indicates prior __ to that specific medication.

exposure.

Incidence of drug-induced hypersensitivity often correlates to __ factors such as dosage and genetic disposition.

external.

Research in drug discovery often focuses on elucidating the mechanisms of __ related to hypersensitivity.

toxicity.

Post-marketing surveillance is essential for detecting previously unknown __ drugs.

safe.

Pharmacovigilance encompasses all activities related to the detection, assessment, understanding, and prevention of __.

adverse effects.

Chronic exposure to teratogens can lead to long-lasting __ in affected individuals.

health impacts.

Adequate monitoring and risk assessment are crucial for __ populations and concurrent medication utilizations.

at-risk.

Drug patch tests can assist in assessing __ to specific medications in patients.

allergies.

Type II hypersensitivity is also known as __ hypersensitivity.

cytotoxic.

Prescribing errors can occur at any point in the __ process including post-marketing.

prescribing.

Therapeutic decision-making must take into account a patient’s potential for __.

allergic reactions.

Contention around drug safety is high regarding __ reactions and their potential for harm.

adverse.

The establishment of reverse transcriptase in HIV therapeutics demonstrates a fine balance between efficacy and __.

toxicity.

Genetic testing can inform clinicians about potential __ or expressions affecting drug metabolism.

polymorphisms.

Olanzapine is one of several medications implicated in __ reactions leading to ADRs in psychiatric settings.

adverse.

Substantial literature exists concerning the __ for hereditary predispositions to ADRs.

in-depth analysis.

Antigenic cross-reactivity in drug allergies can lead to subsequent __ in treatment effectiveness.

loss.

Recombinant technology can help in synthesizing __ that mimic human proteins to minimize reactions.

medications.

Figures from different studies show that certain age groups experience higher rates of __ after medication exposure.

reactions.

Multidisciplinary approaches are necessary to properly address __ associated with drug therapies.

responses.

Pharmacovigilance systems are meant to proactively diminish adverse __ outcomes in medications.

therapeutic.

Public health campaigns highlight awareness of drug-induced __ to improve patient safety.

allergies.

Biologics often show a unique profile concerning the incidence of __ among treated populations.

reactions.

Histological techniques study drug-induced __, providing insights into their potential causes.

changes.

Responsive measures regarding drug allergies include clear labeling and __ mechanisms for patient education.

communication.

Histamine release due to drug exposure can lead to __ and hypotension as potential outcomes.

anaphylaxis.

Research in drug safety increasingly involves studying the __ profiles of medications to determine risk.

adverse effect.

Current pharmacological strategies stress the importance of allergy history assessment prior to new drug __.

administration.

Patient education on potential drug side effects can enhance __ and adherence to treatment regimens.

safety.

Drug companies are often required to submit post-market studies to evaluate __ related to medications.

safety issues.

In-depth research on drug interactions can better inform clinicians about the potential for __ with certain agents.

reactions.