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Miscellaneous Topics

 

  1. Adverse drug reaction (ADR)

TYPE A

Augmented effects (dose dependent & predictable)
            e.g.: hypoglycemia by insulin
 

TYPE B

Bizarre/idiosyncratic reaction
           e.g.: dose independent/allergic/unpredictable
 

TYPE C

Chronic effects
            e.g.: peptic ulcer by NSAIDS
 

TYPE D

Delayed effects
          e.g.: teratogenicity by thalidomide
 

TYPE E

End of treatment effects
         e.g.: withdrawal reaction
 

TYPE F

Failure of therapy
        e.g.: no effect produced/resistance

 

ADR reporting:

  • Part of Phase IV trial
  • Naranjo scale -- method of assessment on ADR sheets.
  • Submitted to Pharmacovigilance Center (IPC Ghaziabad)
  • Than To Uppsalla monitoring Center (Sweden)
  1. Therapeutic drug monitoring
    For drug of low safety margins/narrow therapeutic index/narrow window drugs    
    1. Measurement of drug conc. in plasma
    2. Maintain a strict dose range
    3. Avoidance of toxic reaction or no response

Methods:                        

 

Priori drug Monitoring

Posteriori drug monitoring

Demographic date                       
 Disease state                               
 Pharmacogenetic characters

Repeated drug measurement
Pharmakokinetic parameters.
 

 

E.g.:

  • Aminoglycoside (gentamicin)
  • Lithium (0.8 – 1.2 meq/L)
  • Antipsychotics
  • Theophylline
  • Antiepileptic (e.g. phenytoin)
  1. Branches of pharmacology
  • Pharmacy:  preparation, compounding & dispensing of drug
  • Pharmacognosy:  properties of drug in crude/unprepared form
  • Pharmacoeconomics :  lost of drugs, impact on unprepared form
  • Pharmacogenetics:  genetic variation in individual affects response & metabolism of drug.
  • Pharmagenomics:  drug designing based on genetic built of an individual
  • Pharmacoepidemiology:  study of drug impact on larger population
  • Pharmacovigilance: study & reporting of adverse drug reaction




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