Adverse Effects, Adverse Reactions, and Drug Interactions
David J. Owen in The Herbal Internet Companion, 2001
The increased use of herbal preparations is causing concern among doctors and pharmacists due to the widespread misconception among the American public that because herbal remedies are “natural,” they are free from the adverse effects or reactions associated with conventional drugs. Adverse effects, adverse reactions, and drug interactions are all areas of concern. An adverse effect is “[a]ny unintended effect of a pharmaceutical product occurring at doses normally used in man which is related to the pharmacological properties of the drug,” while an adverse reaction, is “[a] response to a drug which is noxious and unintended, and which occurs at doses normally used in man for the prophylaxis, diagnosis, or therapy of disease, or for the modification of physiological function.”1
Assessment of the psychiatric patient
Peter Kopelman, Dame Jane Dacre in Handbook of Clinical Skills, 2019
Enquiries should include: The substance used, the duration of first use, route of administration and (if intravenous use) safe injecting practice.The amount used. This is sometimes difficult to clarify. Ask how much was used in the previous day, and work backwards to build up an initial picture of use during the previous week. Ask how much money is spent and how the habit is funded.Evidence of dependence, the longest period of abstinence and withdrawal effects (e.g. alcohol – morning nausea or shaking, delirium tremens or fits).Adverse effects – psychological, physical and social (e.g. criminality and family or work problems).Treatments – for example outpatient/inpatient detoxification, rehabilitation or attendance at Alcoholics Anonymous or similar groups.
Medications and Older People
Claire Welford in Nursing & Health Survival Guide, 2014
There is also the Prescribing Optimisation Method (POM) which uses six questions to assist the healthcare provider in reducing polypharmacy: Is under-treatment present and is addition of medication indicated?Does the patient adhere to his or her medication schedule?Which drug(s) can be withdrawn or are inappropriate?Which adverse effects are present?Which clinically relevant interactions are to be expected?Should the dose, dose frequency and/or form of drug be adjusted?
Comparison of adverse events of biologicals for treatment of juvenile idiopathic arthritis: a systematic review
Published in Expert Opinion on Drug Safety, 2019
C Diener, G Horneff
Adverse effects were defined as any untoward medical occurrence in a patient administered a pharmaceutical product and which does not necessarily have a causal relationship with this treatment. A serious AE is commonly defined as death, any event that was life-threatening, required hospitalization or prolongation of existing hospitalization, resulted in persistent disability, congenital anomaly, or required medical or surgical intervention to prevent another serious outcome. If an infection leads to hospitalization, it is considered a serious infection. An opportunistic infection is defined as an infection which occurs more frequently or severely in people with a weakened immune system than in people with a healthy immune system. If an AE is caused by auto-antibodies or self-reactive T cells, we defined it as an autoimmune event.
Tocilizumab in COVID-19: a study of adverse drug events reported in the WHO database
Published in Expert Opinion on Drug Safety, 2021
Jaykaran Charan, Siddhartha Dutta, Rimplejeet Kaur, Pankaj Bhardwaj, Praveen Sharma, Sneha Ambwani, Iffat Jahan, Abdullahi Rabiu Abubakar, Salequl Islam, Timothy Craig Hardcastle, Nor Azlina A Rahman, Halyna Lugova, Mainul Haque
Tocilizumab appears to be a relatively safe drug based on the WHO database’s available data, with small overall numbers of ADEs, reported. Neutropenia, elevated liver enzymes, superinfections, pneumonia, reactivation of herpes simplex, tuberculosis or hepatitis, hypertriglyceridemia, acute kidney injury, pulmonary embolism, rash, and cardiac abnormalities are prevalent ADEs in patients with COVID-19 infection, mostly in mild cases. Therefore, to generate evidence, long-term follow-up studies with a large sample size will enlighten medical science about unknown ADEs associated with tocilizumab in COVID-19 patients. According to this study, the findings suggest there are numerous adverse effects. Reports from randomized, double-blind controlled clinical trials will provide more safety information to enable evidence-based decision-making on the use of tocilizumab to treat patients with COVID-19.
The need for contraception in patients taking prescription drugs: a review of FDA warning labels, duration of effects, and mechanisms of action
Published in Expert Opinion on Drug Safety, 2018
Zhanhu Zhang, Lili Xu, Zhenyu Zhang, Hongxia Ding, Elizabeth R. Rayburn, Haibo Li
Several mechanisms of teratogenicity associated with medication use have been described, including folate antagonism, neural crest cell disruption, endocrine disruption, the induction of oxidative stress, vascular disruption, and specific receptor- or enzyme-mediated teratogenesis [9–11]. As noted above, adverse effects may be due to the intended effects of the drug or to indirect/side effects. For example, several chemotherapeutic agents are anti-folates (e.g. pemetrexed) that can inhibit cell division, DNA and/or RNA synthesis, and/or DNA repair and protein synthesis. While targeting these processes helps to eliminate rapidly growing malignant cells, their inhibition is also harmful to a rapidly growing fetus. It has been suggested that a reduction in folate via various mechanisms may underlie the teratogenicity of many prescription drugs [9].
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