ADVERSE DRUG REACTION
REPORT
PRESENTED TO –
DR REENA BHARDWAJ
HOD of DEPARTMENT OF
PHARMACOLOGY
VCSG GIMS&R SRINAGAR
UTTARAKHAND
PRESENTED BY AKANKSHA BISHT
ROLL NO.-08
2ND PROF MBBS
ADVERSE DRUG REACTION REPORT
Patient develop rashes over thigh foot and itching after intake of
following drugs.dicyclomine
.ondansetron
.famotidine
PATIENT DETAILS
NAME
-
GAURANSH
AGE
-
9 YEARS
RESIDENCE – SRINAGAR
OCCUPATION - STUDENT
DEPARTMENT -PEDIATRICS
HISTORY OF PRESENT ILLNESS
Patient was asymptomatic 4 days back when he develops abdominal pain and vomiting. on self medication he takedicyclomine
ondansetron
paracetamol
famotidine
he presented to pediatric department and on examination it was found –
- rashes over thighs and foot
- itching
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HISTORY OF PAST ILLNESS
patient has no allergic
drugs in the past.
however he sometimes
abdominal pain.
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reaction to the
develop
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DRUGS INTAKE
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ABOUT THE DRUGS
DICYCLOMINE – It is an antispasmodic and
anticholinergic drug. It relieves smooth muscle
spasm of gastro intestinal tract. This action is
achieved via dual action:
1. it produces specific anticholinergic effect
acetylcholine receptor site.
2. By direct effect on the smooth muscle
ONDANSETRON – it is 5HT3 receptor blocker. the
use of ondansetron to reduce vomiting associated
with gastroenteritis and dehydration.
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ABOUT THE DRUGS
FAMOTIDINE - is H2 receptor blocker medication
that decreases stomach acid production. It is
used
to
treat
peptic
ulcer
disease,
gastroesophageal reflux disease
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WHO CAUSALITY SCALE
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CAUSALITY ASSESSMENT
the reaction caused by the drug intake was found to be associated
with –
. event abnormality with reasonable time relationship to the drug
intake.
. could also be explain by disease or other drug .
. information on drug withdrawal is present.
. after considering all the above information,we can say
that according to who scale,
. the reaction can “possible” by dicyclomine,ondansetron and
famotidine
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MANAGEMENT FOR THE ADR
Stoped the drugs taken by the patient.
Following drugs given for treatment of adrTab.paracetamol 500 mg 1bd
Tab. Cetrizine
10mg
1 od
Tab. Drotin ( Drotaverine and Aceclofenac) 1
sos
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Tab. Amoxyclav 625mg. 1bd
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.
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MECHANISM OF DRUG REACTION
drug combines with carrier to produce allergen
apc presents it to th2 cell
antigen is recognised by th2 cell
IL-3,IL-5(Eosinophil
activation)
IL-4
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IL-4
RELEASE OF MEDIATORS
class switching of b cell
plasma cell
CYTOKINES (TNF VASOACTIVE AMINESPROTEASES PROSTAGLANDINS
(HISTAMINE)
alpha)
inc. ige production
binding of ige to mast
cell receptors
RECRUITMENT OF
EOSINOPHILS
,NEUTROPHILS
VASODILATION
,SMOOTH MUSCLE
CONTRACTION
TISSUE
DAMAGE
VASODILATION
LATE PHASE
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REFERENCES
-kd tripathi essential of medical pharmacology
-7 th edition new dehli; jaypee brothers medical
publisher (p)limited
-martindale :the complete drug reference 34th
edition
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Thank you