SlideShare una empresa de Scribd logo
1 de 16
Descargar para leer sin conexión
Project on
Adverse drug reaction
Submitted to:
Consumer education & research centre
1st
December 2015
BY:
NISHU P. VORA
DARSHAN R. KABRA
HARSHUL N. VAGHELA
* AMBULATORY PATIENTS – Patientswhoare not bedriddenORthose whocanwalk.
ADVERSE DRUG REACTION
 INTRODUCTION
Adverse Drug Reaction is the harm caused due to use of given
medicines OR unwanted or harmful reaction experienced after the
administration of a drug or combination of drugs under normal
conditions of use.
Thus, simply speaking ADRs are inevitable consequences of
pharmacotherapy (Pharmaceutical Drugs). It is well known that all
drugs carry the potential to produce desirable and undesirable
effects. No drug is absolutely safe under all circumstances of use
or in all patients except Ayurvedic & Homeopathic drugs and
ADRs may occur even if a drug is correctly selected and dosed.
The Adverse Drug Reaction classified on the basis of Edward and
Aronson classification system were found to be of 6 types –
1. Type A (Augmented Pharmacologic Effects) -
a) Related to pharmacological action of drug
b) Predictable
c) Dose dependent
d) Common
Different classes: 1) Toxicity of overdose (Drug overdose)
2) Side Effects
3) Secondary Effects
4) Drug Interactions
2. Type B (Bizarre Effects) –
a) Unrelated to pharmacological actions
b) Unpredictable
c) Unrelated to dose
Different Classes: 1) Drug Intolerance
2) Hypersensitivity
3) Pseudo allergic reactions
4) Idio syncratic reactions
3. Type C (Chronic Effects) –
a) Associated with long term drug therapy
b) Well known and can be anticipated
c) Eg : Opoids , Alcohol , Barbiturates
4. Type D (Delayed Effects) –
a) Carcinogenic (Medication lead to cancer; take >20 y to develop)
& teratogenic (Drug- induced birth defects) effects
b) Very Rare
5. Type E (End of Treatment Effects)
6. Type F (Failure of Therapy)
 ITEMS THAT COULD CAUSE ADVERSE DRUG
REACTION:
1) Drugs prescribed by a doctor
2) Drugs bought over the counter
3) Pain medications
4) Antibiotics
5) Vitamins
6) Some food and drink such as alcohol and caffeine
 SIGNS AND SYMPTOMS OF ADVERSE DRUG REACTION
The symptoms involved in an Adverse Drug Reaction will depend
upon the age of an individual and dosage taken. Some of the most
common symptoms are:
1) Mild , Moderate , Severe or Lethal
2) Sign & symptoms manifest soon after 1st dose or only after
chronic use
E.g., Allergic reactions occur soon after drug is taken usually
2nd time (itching, rash, eruption, upper or lower airwayedema with
dyspnea & hypotension).
3) Irritation to the skin
4) Bleeding
5) Nausea
6) Vomiting
7) Diarrhea
8) Breathing Problems
 RESULTS AND FINDINGS
Adverse Drug Reaction is most common in:
1) Women
2) Elders (above 60 years)
3) Very young (1-4 years)
4) Patients taking more than 1 drug
Also as per the surveys and findings it has been found that there is a
correlation between increasing age and adverse drug reaction (ADR)
rate, at least for some medical conditions. More than 80% of ADRs
causing admission or occurring in hospital are type A (dose-related) in
nature, and thus predictable from the known pharmacology of the drug
and therefore potentially avoidable. Antibiotics, anticoagulants, digoxin,
diuretics, hypoglycaemic agents, antineoplastic agents and nonsteroidal
anti-inflammatory drugs (NSAIDs) are responsible for 60% of ADRs
leading to hospital admission and 70% of ADRs occurring in hospital.
These are generally drugs with a low therapeutic ratio (ratio between the
average therapeutic and toxic dose). In addition, they all figure highly in
lists of medicines most likely to be used in the elderly, and likely to be
associated with adverse drug interactions. It has been suggested that type
A ADRs are more common in the elderly and the unpredictable type B
(‘bizarre’ or idiosyncratic reactions) less common. However, some
important and occasionally serious examples of type B toxicity (e.g.
hepatotoxicity in association with the antibiotic flucloxacillin or the
antibiotic combination, coamoxiclav) appear to be commoner in elderly
than younger individuals.
MEDICINES REACTIONS
Amidopyrine (for inflammation) white blood cell disorder
Clioquinol (for skin infections) visual impairment
Erythromycin-estolate
(antibacterial)
hepatitis (liver disorder)
Oral contraceptives thromboembolism (blood clots)
Statins (for controlling cholesterol) muscle degeneration
Thalidomide (for managing
morning sickness)
phocomelia (disfigured infants)
9 REASONS WHY OLDER ADULTS ARE MORE LIKELY
THAN YOUNGER ADULTS TO SUFFER ADRs –
1. Smaller bodies and different body composition
2. Decreased ability of the liver to process drugs
3. Decreased ability of the drugs to clear drugs out of the body
4. Increased sensitivity to drugs
5. Decreased Blood-Pressure maintain ability
6. Decreased Temperature compensation
7. More diseases that affect the response to drugs
8. More drugs, and therefore more ADRs
9. Inadequate testing of drugs on older adults before approval
 SOME FACTS ON ADVERSE DRUG REACTIONS
1. Patients who experienced Adverse Drug Events (ADEs) were
hospitalized an average of 8-12 days longer than the patients
who didn’t suffer ADEs and their hospitalization costs $16000
to $24000 more.
2. Anywhere from 28%-95% of ADEs can be prevented by
reducing medication errors through computerized monitoring
systems. (Medication Error - It is any preventable event that may cause
or lead to inappropriate medication use or patient harm while the
medication is in the control of the health care professional, patient, or
consumer; Computerized Monitoring System - The system integrates
computerized data on each hospital patient (medications, clinical
laboratory, blood gas, ECG, allergies, diagnosis, etc.) and returns to the
pharmacist warning messages and suggestions regarding patient drug
therapy).
3. Computerized medication order entry has the potential to
prevent an estimated 84 percent of dose, frequency and route
errors.
4. Hospitals can save as much as $500000 annually in direct costs
(Stationary Costs) by using computerized systems.
5. Over 770000 people are injured or die each year in hospitals
from ADEs which may cost upto $5.6 million each year per
hospital depending on hospital size.
6. National hospital expenses to treat patients who suffer ADEs
during hospitalization are estimated at between $1.56 and $5.6
billion annually.
7. Medication errors associated with ADRs are as follows:
 Missed dose - 7% (medicine to be taken but not taken)
 Wrong technique – 6% (taken inappropriately)
 Illegible order – 6% (Unreadable prescription which led to
giving of different drug by pharmacist)
 Duplicate therapy – 5% (Wrong treatment by doctor due to
unclear history of the patient OR patient’s lack of knowledge)
 Drug-Drug interaction – 3-5% (Risk increases as many drugs
are administered at the same time to the patient)
 Equipment failure - 1%
 Inadequate monitoring – 1% (Inappropriate follow-up)
 Preparation error – 1%
8. Studies indicate that anywhere from 28-95% of ADEs can be
prevented.
 MECHANISM AFTER ADVERSE DRUG REACTION
(Authorities, Reporting and future course of action)
The Central Drugs Standard Control Organisation (CDSCO), New
Delhi, under the aegis of Ministry of Health & Family Welfare,
Government of India has initiated a nation-wide
pharmacovigilance programme in July, 2010, with the All India
Institute of Medical Sciences (AIIMS), New Delhi as the National
Coordinating Centre (NCC) for monitoring Adverse Drug
Reactions (ADR) in the country to safe-guard Public Health. In
year 2010, 22 ADR monitoring centres (AMCs) including AIIMS,
New Delhi had been set up under this Programme. To ensure
implementation of this programme in a more effective way, the
National Coordinating Centre was then shifted from the All India
Institute of Medical Sciences (AIIMS), New Delhi to the Indian
Pharmacopoeia Commission (IPC), Ghaziabad, (U.P.) in April,
2011.
Thus, the Pharmacovigilance Program of India (PvPI) was
launched with a broad objective to safe guard the health of people
of India. Adverse drug Reactions (ADRs) are reported from all
over the country to NCC-PvPI, which also work in collaboration
with the global ADR monitoring centre (WHO-UMC), Sweden to
contribute in the global ADRs data base. NCC-PvPI monitors the
ADRs among Indian population and helps the regulatory authority
of India (CDSCO) in taking decision for safe use of medicines.
PURPOSE
The purpose of the PvPI is to collate data, analyze it and use the
inferences to recommend informed regulatory interventions,
besides communicating risks to healthcare professionals and the
public. The broadened patient safety scope of pharmacovigilance
includes the detection of medicines of substandard quality as well
as prescribing, dispensing and administration errors.
Counterfeiting, antimicrobial resistance, and the need for real time
surveillance in mass vaccinations are other pharmacovigilance
challenges which need to be addressed.
REPORTING
To report suspected ADRs, filled ADR form can be sent to the
nearest monitoring centre.
The form for ADR reporting is available on the site of PvPI
( http://www.ipc.gov.in/PvPI/pv_adr.html ).
Adverse drug reaction Type of drug Examples
Anemia (resulting from
decreased production or
increased destruction of red
blood cells)
Certain antibiotics Chloramphenicol
Angioedema (swelling of the
lips, tongue, and throat causing
difficulty breathing)
ACE inhibitors Captopril , Enalapril
Bone fractures Bone fractures Esomeprazole,Lansoprazole
Confusion and drowsiness Sedatives, including many
antihistamines
Diphenhydramine
Decreased production of white
blood cells, with increased risk
of infection
Certain antipsychotic drugs Clozapine
Kidney damage NSAIDs (repeated use of
excessive doses)
Ibuprofen,Ketoprofen
Liver damage Some analgesics Acetaminophen (use of
excessive doses)
Muscle tissue destruction
(rhabdomyolysis)
Statins Atorvastatin
Stomach or intestinal ulcers
(with or without bleeding)
NSAIDs Aspirin
Toxic epidermal necrolysis
(see Stevens-Johnson
Syndrome (SJS) and Toxic
Epidermal Necrolysis)
Some antibiotics Penicillins
Blood clots Birth control drugs (all forms
including patches and pills)
Drospirenone/ethinyl
estradiol
CONCLUSION
The above detailed report is on the topic – Adverse Drug Reaction
which is basically the bad reactions caused due to consumption of drugs
(mostly allopathy). Also, we have understood that Ayurvedic &
Homeopathic medicines are far better than Allopathic because the earlier
medicines have no side effects and it is so because Ayurvedic and
homeopathic medicines are left sided medicines which our human body
also accepts. However, Allopathic medicines are right sided and thus
cause ADR.
At this juncture it would be necessary to refer to thoughts of Dr B. M
Hegde penned by him in his book titled " Douglas C Wallace, a noted
American professor of genetics, in his classic, Mitochondria as Chi, in
the journal, Genetics (2008; 179: 727-735) has shown that all
reductionist chemical molecules used in our therapeutics being
dextrorotatory, while the body molecules are levorotatory, destroy body
cells. Whereas all the Eastern herbal drugs are accepted by the body as
food (they are also levorotatory) and help the system!"
SUMMARY
This report contains definitions, causes, facts, cures and reporting
procedures after ADEs. Also, Adverse Drug Reaction depends upon the
individual’s age and dosage taken. Some of the eye opening facts are
also mentioned. Many of us believe that there is a pill for every ill. This
concept is not only naïve but dangerous. While certainly there is no pill
for every ill, there is an illness following every pill. This concept can
easily be understood after reading this project/report. After completing
the report, we have understood that one of the leading causes of deaths
in the world is due to Adverse Drug Reaction.
“The Jem cannot be polished without friction, nor medicines
perfected without trials”.
- Chinese Proverb
BIBLIOGRAPHY
1. http://www.ipc.gov.in/PvPI/pv_home.html
2. http://www.wiredhealthresources.net/resources/NA/WHO-
FS_MedicinesSafetyAdverseReactions.pdf
3. http://icmr.nic.in/ijmr/2012/september/0907.pdf
4. http://www.msdmanuals.com/home/drugs/adverse-drug-
reactions/overview-of-adverse-drug-reactions
5. http://pubmedinfo.com/pdf/Full%20Book_Final.pdf
6. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1884428/
7. http://archive.ahrq.gov/research/findings/factsheets/errors-
safety/aderia/ade.html#Introduction
8. “Prophetic thoughts and articles on health & disease – body and
mind” by Dr. B. M. Hegde.

Más contenido relacionado

La actualidad más candente

Advesre drug reaction- Types, Reporting, Evaluation, Monitoring, Preventing &...
Advesre drug reaction- Types, Reporting, Evaluation, Monitoring, Preventing &...Advesre drug reaction- Types, Reporting, Evaluation, Monitoring, Preventing &...
Advesre drug reaction- Types, Reporting, Evaluation, Monitoring, Preventing &...Suhas Reddy C
 
Pharmacodynamics (Mechanisn of drug action)
Pharmacodynamics (Mechanisn of drug action) Pharmacodynamics (Mechanisn of drug action)
Pharmacodynamics (Mechanisn of drug action) http://neigrihms.gov.in/
 
Adverse drug reaction
Adverse   drug  reactionAdverse   drug  reaction
Adverse drug reactionViraj Shinde
 
Adverse drug reactions
Adverse drug reactions Adverse drug reactions
Adverse drug reactions Faiza Waseem
 
Classification of Antidepressants & “Diagnosis & Pathophysiology of Depression”
Classification of Antidepressants & “Diagnosis & Pathophysiology of Depression”Classification of Antidepressants & “Diagnosis & Pathophysiology of Depression”
Classification of Antidepressants & “Diagnosis & Pathophysiology of Depression”Sawsan Aboul-Fotouh
 
Class adverse drug reaction
Class adverse drug reactionClass adverse drug reaction
Class adverse drug reactionRaghu Prasada
 
Pharmacodynamics part 4
Pharmacodynamics part 4Pharmacodynamics part 4
Pharmacodynamics part 4Pravin Prasad
 
Adverse Drug Reactions (ADR’s)
Adverse Drug Reactions (ADR’s)Adverse Drug Reactions (ADR’s)
Adverse Drug Reactions (ADR’s)Dikshakaushal8
 
Adverse Drug Reactions
Adverse Drug ReactionsAdverse Drug Reactions
Adverse Drug ReactionsKajal Rajdev
 

La actualidad más candente (20)

Adverse drug reactions
Adverse drug reactionsAdverse drug reactions
Adverse drug reactions
 
Adverse Drug Reaction
Adverse Drug ReactionAdverse Drug Reaction
Adverse Drug Reaction
 
Advesre drug reaction- Types, Reporting, Evaluation, Monitoring, Preventing &...
Advesre drug reaction- Types, Reporting, Evaluation, Monitoring, Preventing &...Advesre drug reaction- Types, Reporting, Evaluation, Monitoring, Preventing &...
Advesre drug reaction- Types, Reporting, Evaluation, Monitoring, Preventing &...
 
Pharmacodynamics (Mechanisn of drug action)
Pharmacodynamics (Mechanisn of drug action) Pharmacodynamics (Mechanisn of drug action)
Pharmacodynamics (Mechanisn of drug action)
 
Adverse drug reaction
Adverse   drug  reactionAdverse   drug  reaction
Adverse drug reaction
 
Adverse drug reactions
Adverse drug reactionsAdverse drug reactions
Adverse drug reactions
 
Adverse drug reactions
Adverse drug reactions Adverse drug reactions
Adverse drug reactions
 
PHARMA-PHARMACODYNAMICS
PHARMA-PHARMACODYNAMICSPHARMA-PHARMACODYNAMICS
PHARMA-PHARMACODYNAMICS
 
Classification of Antidepressants & “Diagnosis & Pathophysiology of Depression”
Classification of Antidepressants & “Diagnosis & Pathophysiology of Depression”Classification of Antidepressants & “Diagnosis & Pathophysiology of Depression”
Classification of Antidepressants & “Diagnosis & Pathophysiology of Depression”
 
Class adverse drug reaction
Class adverse drug reactionClass adverse drug reaction
Class adverse drug reaction
 
Pharmacodynamics part 4
Pharmacodynamics part 4Pharmacodynamics part 4
Pharmacodynamics part 4
 
Adverse drug reaction
Adverse drug reactionAdverse drug reaction
Adverse drug reaction
 
Antileprotic drugs
Antileprotic drugsAntileprotic drugs
Antileprotic drugs
 
ADR
ADR ADR
ADR
 
Adverse Drug Reactions (ADR’s)
Adverse Drug Reactions (ADR’s)Adverse Drug Reactions (ADR’s)
Adverse Drug Reactions (ADR’s)
 
Antitubercular drugs
Antitubercular drugsAntitubercular drugs
Antitubercular drugs
 
Adverse Drug Reactions
Adverse Drug ReactionsAdverse Drug Reactions
Adverse Drug Reactions
 
Adverse Drug Reaction
Adverse Drug ReactionAdverse Drug Reaction
Adverse Drug Reaction
 
Adverse drug reactions
Adverse drug reactionsAdverse drug reactions
Adverse drug reactions
 
Pharmacotherapy of ibd
Pharmacotherapy of ibdPharmacotherapy of ibd
Pharmacotherapy of ibd
 

Similar a Adverse Drug Reaction

PHARMACOVIGILANCE - A Worldwide masterkey for Drug Monitoring
PHARMACOVIGILANCE - A Worldwide masterkey for Drug MonitoringPHARMACOVIGILANCE - A Worldwide masterkey for Drug Monitoring
PHARMACOVIGILANCE - A Worldwide masterkey for Drug MonitoringVenugopal N
 
Pharmacovigilance AN
Pharmacovigilance ANPharmacovigilance AN
Pharmacovigilance ANAhmed Nouri
 
ADVERSE DRUG REACTION | PHARMACY PRACTICE | PDF | SHIVAM DUBEY B PHARMA | PHA...
ADVERSE DRUG REACTION | PHARMACY PRACTICE | PDF | SHIVAM DUBEY B PHARMA | PHA...ADVERSE DRUG REACTION | PHARMACY PRACTICE | PDF | SHIVAM DUBEY B PHARMA | PHA...
ADVERSE DRUG REACTION | PHARMACY PRACTICE | PDF | SHIVAM DUBEY B PHARMA | PHA...MrHotmaster1
 
Pharmacovigilance & Adverse drug reaction
Pharmacovigilance & Adverse drug reactionPharmacovigilance & Adverse drug reaction
Pharmacovigilance & Adverse drug reactionRahul Bhati
 
pharmacovigilance-111031093044-phpapp01.pdf
pharmacovigilance-111031093044-phpapp01.pdfpharmacovigilance-111031093044-phpapp01.pdf
pharmacovigilance-111031093044-phpapp01.pdfdabloosaha
 
Rational use of drugs -1
Rational use of drugs -1Rational use of drugs -1
Rational use of drugs -1Muhammad Saalim
 
Pharmacovigilance STUDY
Pharmacovigilance STUDYPharmacovigilance STUDY
Pharmacovigilance STUDYSuvarta Maru
 
1591115199267_Pharmacovigilance.pptx
1591115199267_Pharmacovigilance.pptx1591115199267_Pharmacovigilance.pptx
1591115199267_Pharmacovigilance.pptxDrAniqaSundas
 
ADRppt.pptx
ADRppt.pptxADRppt.pptx
ADRppt.pptxNiyasp8
 
profile of adverse drug reactions in a rural tertiary care hospital
profile of adverse drug reactions in a rural tertiary care hospital profile of adverse drug reactions in a rural tertiary care hospital
profile of adverse drug reactions in a rural tertiary care hospital Naser Tadvi
 
Pharmacovigilance by bishnu koirala
Pharmacovigilance by bishnu koiralaPharmacovigilance by bishnu koirala
Pharmacovigilance by bishnu koiralaBishnu Koirala
 
Pharmacovigilance-an overview
Pharmacovigilance-an overviewPharmacovigilance-an overview
Pharmacovigilance-an overviewDr. Pramod Kumar
 
Future challenges for PV in the monitoring of adverse drug reactions
Future challenges for PV in the monitoring of adverse drug reactionsFuture challenges for PV in the monitoring of adverse drug reactions
Future challenges for PV in the monitoring of adverse drug reactionsSollers College
 

Similar a Adverse Drug Reaction (20)

Adverse drug reactions
Adverse drug reactionsAdverse drug reactions
Adverse drug reactions
 
PHARMACOVIGILANCE - A Worldwide masterkey for Drug Monitoring
PHARMACOVIGILANCE - A Worldwide masterkey for Drug MonitoringPHARMACOVIGILANCE - A Worldwide masterkey for Drug Monitoring
PHARMACOVIGILANCE - A Worldwide masterkey for Drug Monitoring
 
Pharmacovigilance and adr
Pharmacovigilance and adrPharmacovigilance and adr
Pharmacovigilance and adr
 
Pharmacovigilance AN
Pharmacovigilance ANPharmacovigilance AN
Pharmacovigilance AN
 
ADVERSE DRUG REACTION | PHARMACY PRACTICE | PDF | SHIVAM DUBEY B PHARMA | PHA...
ADVERSE DRUG REACTION | PHARMACY PRACTICE | PDF | SHIVAM DUBEY B PHARMA | PHA...ADVERSE DRUG REACTION | PHARMACY PRACTICE | PDF | SHIVAM DUBEY B PHARMA | PHA...
ADVERSE DRUG REACTION | PHARMACY PRACTICE | PDF | SHIVAM DUBEY B PHARMA | PHA...
 
Pharmacovigilance
PharmacovigilancePharmacovigilance
Pharmacovigilance
 
Pharmacovigilance
PharmacovigilancePharmacovigilance
Pharmacovigilance
 
Pharmacovigilance
PharmacovigilancePharmacovigilance
Pharmacovigilance
 
Pharmacovigilance System
Pharmacovigilance SystemPharmacovigilance System
Pharmacovigilance System
 
Pharmacovigilance & Adverse drug reaction
Pharmacovigilance & Adverse drug reactionPharmacovigilance & Adverse drug reaction
Pharmacovigilance & Adverse drug reaction
 
pharmacovigilance-111031093044-phpapp01.pdf
pharmacovigilance-111031093044-phpapp01.pdfpharmacovigilance-111031093044-phpapp01.pdf
pharmacovigilance-111031093044-phpapp01.pdf
 
Rational use of drugs -1
Rational use of drugs -1Rational use of drugs -1
Rational use of drugs -1
 
Pharmacovigilance STUDY
Pharmacovigilance STUDYPharmacovigilance STUDY
Pharmacovigilance STUDY
 
1591115199267_Pharmacovigilance.pptx
1591115199267_Pharmacovigilance.pptx1591115199267_Pharmacovigilance.pptx
1591115199267_Pharmacovigilance.pptx
 
ADRppt.pptx
ADRppt.pptxADRppt.pptx
ADRppt.pptx
 
Hospital pharmacy
Hospital pharmacyHospital pharmacy
Hospital pharmacy
 
profile of adverse drug reactions in a rural tertiary care hospital
profile of adverse drug reactions in a rural tertiary care hospital profile of adverse drug reactions in a rural tertiary care hospital
profile of adverse drug reactions in a rural tertiary care hospital
 
Pharmacovigilance by bishnu koirala
Pharmacovigilance by bishnu koiralaPharmacovigilance by bishnu koirala
Pharmacovigilance by bishnu koirala
 
Pharmacovigilance-an overview
Pharmacovigilance-an overviewPharmacovigilance-an overview
Pharmacovigilance-an overview
 
Future challenges for PV in the monitoring of adverse drug reactions
Future challenges for PV in the monitoring of adverse drug reactionsFuture challenges for PV in the monitoring of adverse drug reactions
Future challenges for PV in the monitoring of adverse drug reactions
 

Último

Red Blood Cells_anemia & polycythemia.pdf
Red Blood Cells_anemia & polycythemia.pdfRed Blood Cells_anemia & polycythemia.pdf
Red Blood Cells_anemia & polycythemia.pdfMedicoseAcademics
 
Pharmacokinetic Models by Dr. Ram D. Bawankar.ppt
Pharmacokinetic Models by Dr. Ram D.  Bawankar.pptPharmacokinetic Models by Dr. Ram D.  Bawankar.ppt
Pharmacokinetic Models by Dr. Ram D. Bawankar.pptRamDBawankar1
 
ANATOMICAL FAETURES OF BONES FOR NURSING STUDENTS .pptx
ANATOMICAL FAETURES OF BONES  FOR NURSING STUDENTS .pptxANATOMICAL FAETURES OF BONES  FOR NURSING STUDENTS .pptx
ANATOMICAL FAETURES OF BONES FOR NURSING STUDENTS .pptxWINCY THIRUMURUGAN
 
DNA nucleotides Blast in NCBI and Phylogeny using MEGA Xi.pptx
DNA nucleotides Blast in NCBI and Phylogeny using MEGA Xi.pptxDNA nucleotides Blast in NCBI and Phylogeny using MEGA Xi.pptx
DNA nucleotides Blast in NCBI and Phylogeny using MEGA Xi.pptxMAsifAhmad
 
Neurological history taking (2024) .
Neurological  history  taking  (2024)  .Neurological  history  taking  (2024)  .
Neurological history taking (2024) .Mohamed Rizk Khodair
 
"Radical excision of DIE in subferile women with deep infiltrating endometrio...
"Radical excision of DIE in subferile women with deep infiltrating endometrio..."Radical excision of DIE in subferile women with deep infiltrating endometrio...
"Radical excision of DIE in subferile women with deep infiltrating endometrio...Sujoy Dasgupta
 
Male Infertility Panel Discussion by Dr Sujoy Dasgupta
Male Infertility Panel Discussion by Dr Sujoy DasguptaMale Infertility Panel Discussion by Dr Sujoy Dasgupta
Male Infertility Panel Discussion by Dr Sujoy DasguptaSujoy Dasgupta
 
PAIN/CLASSIFICATION AND MANAGEMENT OF PAIN.pdf
PAIN/CLASSIFICATION AND MANAGEMENT OF PAIN.pdfPAIN/CLASSIFICATION AND MANAGEMENT OF PAIN.pdf
PAIN/CLASSIFICATION AND MANAGEMENT OF PAIN.pdfDolisha Warbi
 
CONNECTIVE TISSUE (ANATOMY AND PHYSIOLOGY).pdf
CONNECTIVE TISSUE (ANATOMY AND PHYSIOLOGY).pdfCONNECTIVE TISSUE (ANATOMY AND PHYSIOLOGY).pdf
CONNECTIVE TISSUE (ANATOMY AND PHYSIOLOGY).pdfDolisha Warbi
 
pA2 value, Schild plot and pD2 values- applications in pharmacology
pA2 value, Schild plot and pD2 values- applications in pharmacologypA2 value, Schild plot and pD2 values- applications in pharmacology
pA2 value, Schild plot and pD2 values- applications in pharmacologyDeepakDaniel9
 
BENIGN BREAST DISEASE
BENIGN BREAST DISEASE BENIGN BREAST DISEASE
BENIGN BREAST DISEASE Mamatha Lakka
 
SGK ĐIỆN GIẬT ĐHYHN RẤT LÀ HAY TUYỆT VỜI.pdf
SGK ĐIỆN GIẬT ĐHYHN        RẤT LÀ HAY TUYỆT VỜI.pdfSGK ĐIỆN GIẬT ĐHYHN        RẤT LÀ HAY TUYỆT VỜI.pdf
SGK ĐIỆN GIẬT ĐHYHN RẤT LÀ HAY TUYỆT VỜI.pdfHongBiThi1
 
Different drug regularity bodies in different countries.
Different drug regularity bodies in different countries.Different drug regularity bodies in different countries.
Different drug regularity bodies in different countries.kishan singh tomar
 
Male Infertility, Antioxidants and Beyond
Male Infertility, Antioxidants and BeyondMale Infertility, Antioxidants and Beyond
Male Infertility, Antioxidants and BeyondSujoy Dasgupta
 
Adenomyosis or Fibroid- making right diagnosis
Adenomyosis or Fibroid- making right diagnosisAdenomyosis or Fibroid- making right diagnosis
Adenomyosis or Fibroid- making right diagnosisSujoy Dasgupta
 
Mental health Team. Dr Senthil Thirusangu
Mental health Team. Dr Senthil ThirusanguMental health Team. Dr Senthil Thirusangu
Mental health Team. Dr Senthil Thirusangu Medical University
 
How to cure cirrhosis and chronic hepatitis naturally
How to cure cirrhosis and chronic hepatitis naturallyHow to cure cirrhosis and chronic hepatitis naturally
How to cure cirrhosis and chronic hepatitis naturallyZurück zum Ursprung
 
SGK LEUKEMIA KINH DÒNG BẠCH CÂU HẠT HAY.pdf
SGK LEUKEMIA KINH DÒNG BẠCH CÂU HẠT HAY.pdfSGK LEUKEMIA KINH DÒNG BẠCH CÂU HẠT HAY.pdf
SGK LEUKEMIA KINH DÒNG BẠCH CÂU HẠT HAY.pdfHongBiThi1
 
power point presentation of Clinical evaluation of strabismus
power point presentation of Clinical evaluation  of strabismuspower point presentation of Clinical evaluation  of strabismus
power point presentation of Clinical evaluation of strabismusChandrasekar Reddy
 

Último (20)

Red Blood Cells_anemia & polycythemia.pdf
Red Blood Cells_anemia & polycythemia.pdfRed Blood Cells_anemia & polycythemia.pdf
Red Blood Cells_anemia & polycythemia.pdf
 
Pharmacokinetic Models by Dr. Ram D. Bawankar.ppt
Pharmacokinetic Models by Dr. Ram D.  Bawankar.pptPharmacokinetic Models by Dr. Ram D.  Bawankar.ppt
Pharmacokinetic Models by Dr. Ram D. Bawankar.ppt
 
ANATOMICAL FAETURES OF BONES FOR NURSING STUDENTS .pptx
ANATOMICAL FAETURES OF BONES  FOR NURSING STUDENTS .pptxANATOMICAL FAETURES OF BONES  FOR NURSING STUDENTS .pptx
ANATOMICAL FAETURES OF BONES FOR NURSING STUDENTS .pptx
 
DNA nucleotides Blast in NCBI and Phylogeny using MEGA Xi.pptx
DNA nucleotides Blast in NCBI and Phylogeny using MEGA Xi.pptxDNA nucleotides Blast in NCBI and Phylogeny using MEGA Xi.pptx
DNA nucleotides Blast in NCBI and Phylogeny using MEGA Xi.pptx
 
Neurological history taking (2024) .
Neurological  history  taking  (2024)  .Neurological  history  taking  (2024)  .
Neurological history taking (2024) .
 
"Radical excision of DIE in subferile women with deep infiltrating endometrio...
"Radical excision of DIE in subferile women with deep infiltrating endometrio..."Radical excision of DIE in subferile women with deep infiltrating endometrio...
"Radical excision of DIE in subferile women with deep infiltrating endometrio...
 
Immune labs basics part 1 acute phase reactants ESR, CRP Ahmed Yehia Ismaeel,...
Immune labs basics part 1 acute phase reactants ESR, CRP Ahmed Yehia Ismaeel,...Immune labs basics part 1 acute phase reactants ESR, CRP Ahmed Yehia Ismaeel,...
Immune labs basics part 1 acute phase reactants ESR, CRP Ahmed Yehia Ismaeel,...
 
Male Infertility Panel Discussion by Dr Sujoy Dasgupta
Male Infertility Panel Discussion by Dr Sujoy DasguptaMale Infertility Panel Discussion by Dr Sujoy Dasgupta
Male Infertility Panel Discussion by Dr Sujoy Dasgupta
 
PAIN/CLASSIFICATION AND MANAGEMENT OF PAIN.pdf
PAIN/CLASSIFICATION AND MANAGEMENT OF PAIN.pdfPAIN/CLASSIFICATION AND MANAGEMENT OF PAIN.pdf
PAIN/CLASSIFICATION AND MANAGEMENT OF PAIN.pdf
 
CONNECTIVE TISSUE (ANATOMY AND PHYSIOLOGY).pdf
CONNECTIVE TISSUE (ANATOMY AND PHYSIOLOGY).pdfCONNECTIVE TISSUE (ANATOMY AND PHYSIOLOGY).pdf
CONNECTIVE TISSUE (ANATOMY AND PHYSIOLOGY).pdf
 
pA2 value, Schild plot and pD2 values- applications in pharmacology
pA2 value, Schild plot and pD2 values- applications in pharmacologypA2 value, Schild plot and pD2 values- applications in pharmacology
pA2 value, Schild plot and pD2 values- applications in pharmacology
 
BENIGN BREAST DISEASE
BENIGN BREAST DISEASE BENIGN BREAST DISEASE
BENIGN BREAST DISEASE
 
SGK ĐIỆN GIẬT ĐHYHN RẤT LÀ HAY TUYỆT VỜI.pdf
SGK ĐIỆN GIẬT ĐHYHN        RẤT LÀ HAY TUYỆT VỜI.pdfSGK ĐIỆN GIẬT ĐHYHN        RẤT LÀ HAY TUYỆT VỜI.pdf
SGK ĐIỆN GIẬT ĐHYHN RẤT LÀ HAY TUYỆT VỜI.pdf
 
Different drug regularity bodies in different countries.
Different drug regularity bodies in different countries.Different drug regularity bodies in different countries.
Different drug regularity bodies in different countries.
 
Male Infertility, Antioxidants and Beyond
Male Infertility, Antioxidants and BeyondMale Infertility, Antioxidants and Beyond
Male Infertility, Antioxidants and Beyond
 
Adenomyosis or Fibroid- making right diagnosis
Adenomyosis or Fibroid- making right diagnosisAdenomyosis or Fibroid- making right diagnosis
Adenomyosis or Fibroid- making right diagnosis
 
Mental health Team. Dr Senthil Thirusangu
Mental health Team. Dr Senthil ThirusanguMental health Team. Dr Senthil Thirusangu
Mental health Team. Dr Senthil Thirusangu
 
How to cure cirrhosis and chronic hepatitis naturally
How to cure cirrhosis and chronic hepatitis naturallyHow to cure cirrhosis and chronic hepatitis naturally
How to cure cirrhosis and chronic hepatitis naturally
 
SGK LEUKEMIA KINH DÒNG BẠCH CÂU HẠT HAY.pdf
SGK LEUKEMIA KINH DÒNG BẠCH CÂU HẠT HAY.pdfSGK LEUKEMIA KINH DÒNG BẠCH CÂU HẠT HAY.pdf
SGK LEUKEMIA KINH DÒNG BẠCH CÂU HẠT HAY.pdf
 
power point presentation of Clinical evaluation of strabismus
power point presentation of Clinical evaluation  of strabismuspower point presentation of Clinical evaluation  of strabismus
power point presentation of Clinical evaluation of strabismus
 

Adverse Drug Reaction

  • 1. Project on Adverse drug reaction Submitted to: Consumer education & research centre 1st December 2015 BY:
  • 2. NISHU P. VORA DARSHAN R. KABRA HARSHUL N. VAGHELA
  • 3. * AMBULATORY PATIENTS – Patientswhoare not bedriddenORthose whocanwalk.
  • 4. ADVERSE DRUG REACTION  INTRODUCTION Adverse Drug Reaction is the harm caused due to use of given medicines OR unwanted or harmful reaction experienced after the administration of a drug or combination of drugs under normal conditions of use. Thus, simply speaking ADRs are inevitable consequences of pharmacotherapy (Pharmaceutical Drugs). It is well known that all drugs carry the potential to produce desirable and undesirable effects. No drug is absolutely safe under all circumstances of use or in all patients except Ayurvedic & Homeopathic drugs and ADRs may occur even if a drug is correctly selected and dosed. The Adverse Drug Reaction classified on the basis of Edward and Aronson classification system were found to be of 6 types – 1. Type A (Augmented Pharmacologic Effects) - a) Related to pharmacological action of drug b) Predictable c) Dose dependent d) Common Different classes: 1) Toxicity of overdose (Drug overdose) 2) Side Effects 3) Secondary Effects 4) Drug Interactions
  • 5. 2. Type B (Bizarre Effects) – a) Unrelated to pharmacological actions b) Unpredictable c) Unrelated to dose Different Classes: 1) Drug Intolerance 2) Hypersensitivity 3) Pseudo allergic reactions 4) Idio syncratic reactions 3. Type C (Chronic Effects) – a) Associated with long term drug therapy b) Well known and can be anticipated c) Eg : Opoids , Alcohol , Barbiturates 4. Type D (Delayed Effects) – a) Carcinogenic (Medication lead to cancer; take >20 y to develop) & teratogenic (Drug- induced birth defects) effects b) Very Rare 5. Type E (End of Treatment Effects) 6. Type F (Failure of Therapy)
  • 6.  ITEMS THAT COULD CAUSE ADVERSE DRUG REACTION: 1) Drugs prescribed by a doctor 2) Drugs bought over the counter 3) Pain medications 4) Antibiotics 5) Vitamins 6) Some food and drink such as alcohol and caffeine
  • 7.  SIGNS AND SYMPTOMS OF ADVERSE DRUG REACTION The symptoms involved in an Adverse Drug Reaction will depend upon the age of an individual and dosage taken. Some of the most common symptoms are: 1) Mild , Moderate , Severe or Lethal 2) Sign & symptoms manifest soon after 1st dose or only after chronic use E.g., Allergic reactions occur soon after drug is taken usually 2nd time (itching, rash, eruption, upper or lower airwayedema with dyspnea & hypotension). 3) Irritation to the skin 4) Bleeding 5) Nausea 6) Vomiting 7) Diarrhea 8) Breathing Problems  RESULTS AND FINDINGS Adverse Drug Reaction is most common in: 1) Women 2) Elders (above 60 years) 3) Very young (1-4 years) 4) Patients taking more than 1 drug
  • 8. Also as per the surveys and findings it has been found that there is a correlation between increasing age and adverse drug reaction (ADR) rate, at least for some medical conditions. More than 80% of ADRs causing admission or occurring in hospital are type A (dose-related) in nature, and thus predictable from the known pharmacology of the drug and therefore potentially avoidable. Antibiotics, anticoagulants, digoxin, diuretics, hypoglycaemic agents, antineoplastic agents and nonsteroidal anti-inflammatory drugs (NSAIDs) are responsible for 60% of ADRs leading to hospital admission and 70% of ADRs occurring in hospital. These are generally drugs with a low therapeutic ratio (ratio between the average therapeutic and toxic dose). In addition, they all figure highly in lists of medicines most likely to be used in the elderly, and likely to be
  • 9. associated with adverse drug interactions. It has been suggested that type A ADRs are more common in the elderly and the unpredictable type B (‘bizarre’ or idiosyncratic reactions) less common. However, some important and occasionally serious examples of type B toxicity (e.g. hepatotoxicity in association with the antibiotic flucloxacillin or the antibiotic combination, coamoxiclav) appear to be commoner in elderly than younger individuals. MEDICINES REACTIONS Amidopyrine (for inflammation) white blood cell disorder Clioquinol (for skin infections) visual impairment Erythromycin-estolate (antibacterial) hepatitis (liver disorder) Oral contraceptives thromboembolism (blood clots) Statins (for controlling cholesterol) muscle degeneration Thalidomide (for managing morning sickness) phocomelia (disfigured infants) 9 REASONS WHY OLDER ADULTS ARE MORE LIKELY THAN YOUNGER ADULTS TO SUFFER ADRs – 1. Smaller bodies and different body composition 2. Decreased ability of the liver to process drugs 3. Decreased ability of the drugs to clear drugs out of the body 4. Increased sensitivity to drugs 5. Decreased Blood-Pressure maintain ability 6. Decreased Temperature compensation 7. More diseases that affect the response to drugs 8. More drugs, and therefore more ADRs 9. Inadequate testing of drugs on older adults before approval
  • 10.  SOME FACTS ON ADVERSE DRUG REACTIONS 1. Patients who experienced Adverse Drug Events (ADEs) were hospitalized an average of 8-12 days longer than the patients who didn’t suffer ADEs and their hospitalization costs $16000 to $24000 more. 2. Anywhere from 28%-95% of ADEs can be prevented by reducing medication errors through computerized monitoring systems. (Medication Error - It is any preventable event that may cause or lead to inappropriate medication use or patient harm while the medication is in the control of the health care professional, patient, or consumer; Computerized Monitoring System - The system integrates computerized data on each hospital patient (medications, clinical laboratory, blood gas, ECG, allergies, diagnosis, etc.) and returns to the pharmacist warning messages and suggestions regarding patient drug therapy). 3. Computerized medication order entry has the potential to prevent an estimated 84 percent of dose, frequency and route errors. 4. Hospitals can save as much as $500000 annually in direct costs (Stationary Costs) by using computerized systems. 5. Over 770000 people are injured or die each year in hospitals from ADEs which may cost upto $5.6 million each year per hospital depending on hospital size. 6. National hospital expenses to treat patients who suffer ADEs during hospitalization are estimated at between $1.56 and $5.6 billion annually. 7. Medication errors associated with ADRs are as follows:  Missed dose - 7% (medicine to be taken but not taken)  Wrong technique – 6% (taken inappropriately)
  • 11.  Illegible order – 6% (Unreadable prescription which led to giving of different drug by pharmacist)  Duplicate therapy – 5% (Wrong treatment by doctor due to unclear history of the patient OR patient’s lack of knowledge)  Drug-Drug interaction – 3-5% (Risk increases as many drugs are administered at the same time to the patient)  Equipment failure - 1%  Inadequate monitoring – 1% (Inappropriate follow-up)  Preparation error – 1% 8. Studies indicate that anywhere from 28-95% of ADEs can be prevented.  MECHANISM AFTER ADVERSE DRUG REACTION (Authorities, Reporting and future course of action) The Central Drugs Standard Control Organisation (CDSCO), New Delhi, under the aegis of Ministry of Health & Family Welfare, Government of India has initiated a nation-wide pharmacovigilance programme in July, 2010, with the All India Institute of Medical Sciences (AIIMS), New Delhi as the National Coordinating Centre (NCC) for monitoring Adverse Drug Reactions (ADR) in the country to safe-guard Public Health. In year 2010, 22 ADR monitoring centres (AMCs) including AIIMS, New Delhi had been set up under this Programme. To ensure implementation of this programme in a more effective way, the National Coordinating Centre was then shifted from the All India Institute of Medical Sciences (AIIMS), New Delhi to the Indian Pharmacopoeia Commission (IPC), Ghaziabad, (U.P.) in April, 2011.
  • 12. Thus, the Pharmacovigilance Program of India (PvPI) was launched with a broad objective to safe guard the health of people of India. Adverse drug Reactions (ADRs) are reported from all over the country to NCC-PvPI, which also work in collaboration with the global ADR monitoring centre (WHO-UMC), Sweden to contribute in the global ADRs data base. NCC-PvPI monitors the ADRs among Indian population and helps the regulatory authority of India (CDSCO) in taking decision for safe use of medicines. PURPOSE The purpose of the PvPI is to collate data, analyze it and use the inferences to recommend informed regulatory interventions, besides communicating risks to healthcare professionals and the public. The broadened patient safety scope of pharmacovigilance includes the detection of medicines of substandard quality as well as prescribing, dispensing and administration errors. Counterfeiting, antimicrobial resistance, and the need for real time surveillance in mass vaccinations are other pharmacovigilance challenges which need to be addressed. REPORTING To report suspected ADRs, filled ADR form can be sent to the nearest monitoring centre. The form for ADR reporting is available on the site of PvPI ( http://www.ipc.gov.in/PvPI/pv_adr.html ).
  • 13. Adverse drug reaction Type of drug Examples Anemia (resulting from decreased production or increased destruction of red blood cells) Certain antibiotics Chloramphenicol Angioedema (swelling of the lips, tongue, and throat causing difficulty breathing) ACE inhibitors Captopril , Enalapril Bone fractures Bone fractures Esomeprazole,Lansoprazole Confusion and drowsiness Sedatives, including many antihistamines Diphenhydramine Decreased production of white blood cells, with increased risk of infection Certain antipsychotic drugs Clozapine Kidney damage NSAIDs (repeated use of excessive doses) Ibuprofen,Ketoprofen Liver damage Some analgesics Acetaminophen (use of excessive doses) Muscle tissue destruction (rhabdomyolysis) Statins Atorvastatin Stomach or intestinal ulcers (with or without bleeding) NSAIDs Aspirin Toxic epidermal necrolysis (see Stevens-Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis) Some antibiotics Penicillins Blood clots Birth control drugs (all forms including patches and pills) Drospirenone/ethinyl estradiol
  • 14. CONCLUSION The above detailed report is on the topic – Adverse Drug Reaction which is basically the bad reactions caused due to consumption of drugs (mostly allopathy). Also, we have understood that Ayurvedic & Homeopathic medicines are far better than Allopathic because the earlier medicines have no side effects and it is so because Ayurvedic and homeopathic medicines are left sided medicines which our human body also accepts. However, Allopathic medicines are right sided and thus cause ADR. At this juncture it would be necessary to refer to thoughts of Dr B. M Hegde penned by him in his book titled " Douglas C Wallace, a noted American professor of genetics, in his classic, Mitochondria as Chi, in the journal, Genetics (2008; 179: 727-735) has shown that all reductionist chemical molecules used in our therapeutics being dextrorotatory, while the body molecules are levorotatory, destroy body cells. Whereas all the Eastern herbal drugs are accepted by the body as food (they are also levorotatory) and help the system!"
  • 15. SUMMARY This report contains definitions, causes, facts, cures and reporting procedures after ADEs. Also, Adverse Drug Reaction depends upon the individual’s age and dosage taken. Some of the eye opening facts are also mentioned. Many of us believe that there is a pill for every ill. This concept is not only naïve but dangerous. While certainly there is no pill for every ill, there is an illness following every pill. This concept can easily be understood after reading this project/report. After completing the report, we have understood that one of the leading causes of deaths in the world is due to Adverse Drug Reaction. “The Jem cannot be polished without friction, nor medicines perfected without trials”. - Chinese Proverb
  • 16. BIBLIOGRAPHY 1. http://www.ipc.gov.in/PvPI/pv_home.html 2. http://www.wiredhealthresources.net/resources/NA/WHO- FS_MedicinesSafetyAdverseReactions.pdf 3. http://icmr.nic.in/ijmr/2012/september/0907.pdf 4. http://www.msdmanuals.com/home/drugs/adverse-drug- reactions/overview-of-adverse-drug-reactions 5. http://pubmedinfo.com/pdf/Full%20Book_Final.pdf 6. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1884428/ 7. http://archive.ahrq.gov/research/findings/factsheets/errors- safety/aderia/ade.html#Introduction 8. “Prophetic thoughts and articles on health & disease – body and mind” by Dr. B. M. Hegde.