Pharmacology Notes #2

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SIDE EFFECTS and ADVERSE REACTION Tolerance

Adverse drug reaction (ADR) - Decreased responsiveness to a drug as a result


of repeated drug administration
- Any reaction to a drug that is unexpected and
- Pharmacodynamic tolerance: The result of
undesirable
adaptive processes that occur in response to
- Occurs at therapeutic dosages
chronic receptor occupation; a familiar type of
Side effect tolerance due to long-term administration of
drugs such as morphine and heroin
- Unavoidable secondary drug effect produced at - Metabolic tolerance: a tolerance resulting from
therapeutic doses accelerated drug metabolism
- Generally predictable - Tachyphylaxis: A reduction in drug
- Expected as part of therapy responsiveness brought on by repeated dosing
- Examples: over a short time
 Drowsiness caused by antihistamine
 Gastric irritation caused by aspirin Placebo effect

Toxicity - A drug response is caused by a psychologic


factors and not by the biochemical and
- The degree of detrimental physiologic effects physiologic properties of the drug
caused by excessive drug dosing - Depends on the pt’s attitude towards the
- Examples: medicine
 Respiratory depression from overdose
of morphine
 Severe hypoglycemia from overdose of
insulin
LOADING DOSES and MAINTENANCE DOSES
Allergic reaction

- An immune response Loading dose


- The intensity of the allergic reactions is largely - A higher amount of drug
independent of the dosage - Often given only once or twice to “prime” the
- Examples: bloodstream with a sufficient level of drug
 Anaphylaxis Maintenance dose
 Mild to severe rashes
- To keep the plasma drug concentration in the
Paradoxical effect therapeutic range
- Opposite of the intended drug response
- Examples:
 Excitement and insomnia for pt given
with benzodiazepines for sedation

Teratogenic Effect

- A drug-induced birth defect

Idiosyncratic

- an uncommon drug response resulting from a


genetic predisposition
- Pharmacogenetics: a study of genetic variations
in drug response and focuses on single-gene
variations

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