HSC 3047 :Part 3
Support the use of medication in social care settings:
Adverse drug reaction
Sheena Helyer
Pictures provided by cadista.com
1.2013
What is an adverse drug reaction?
• An adverse drug reaction (ADR) is an unwanted or harmful
reaction experienced following the administration of a drug
or combination of drugs.
• The reaction may be a known side effect of the drug or it
may be new and previously unrecognised.
Adverse drug reactions
Is it a reaction or an event?
• An adverse reaction is any undesirable
experience that has happened to the patient
while taking the drug that is suspected to be
caused by the drug. i.e. the person develops
a severe headache.
• An adverse event is an undesirable event
which happens to a person whilst taking
medication, regardless of whether or not
the medicine is suspected to be related to
the event .i.e. the person trips and falls.
Pictures provided by apexheadacheclinic.co.uk
Besthomecaren.com
Adverse drug reactions
Type A reactions
Type A (augmented).The reaction results from an exaggeration
of the drug’s normal pharmacological actions when given at the
usual dose.
Examples include:
• Low blood pressure with an antihypertensive.
• Low blood sugar with insulin.
Adverse drug reactions
Type B reactions
Type B (bizarre). The reaction is a novel response that is not
expected from the known pharmacological actions of the drug.
Examples include:
• Anaphylaxis with penicillin
• Skin rashes with antibiotics.
Adverse drug reactions
How common are ADRs?
•
•
•
•
5% of hospital admissions were related to ADRs.
Projected annual cost to the NHS is over £1 billion
2% of patients admitted with ADRs died.
Most cases of ADRs were due to predictable causes and
therefore preventable
• Common causes: low dose aspirin, diuretics, warfarin, nonsteroidal anti-inflammatory medication
(Adverse drug reactions as cause of admission to hospital: Munir Pirmohamed et al 2004)
Adverse drug reactions
Drugs which commonly cause ADRs
• Aspirin: Given in high doses for colds flus and pain, and in
low doses for prevention of strokes and heart attacks.
Risk of gastric irritation, stomach ulcers and bleeding
• Diuretics: Given to expel excess fluid from the body which
has been causing oedema/swelling and/or breathlessness
Risk of blood chemical imbalance which causes confusion weakness
and abnormal heart rhythms.
• Non-steroidal anti inflammatory drugs NSAIDs: Given
to reduce the pain of conditions such as arthritis.
Risk of stomach irritation and bleeding so must be given with or
after food.
• Warfarin: Given to inhibit clotting.
Risk of bruising and bleeding. Levels must be carefully controlled
Adverse drug reactions
Causes of ADRs
• Wrong diagnosis
• Wrong drug or dose
•
•
•
•
Allergic response
Self medication
Not following instructions
Reactions to other medication or remedies
• Substandard or counterfeit medication
Adverse drug reactions
Anaphylaxis
Pictures provided by healthcentral.com
thejrexperiment.com
Adverse drug reactions
Anaphylaxis
Hives
Medical alert bracelet
Pictures provided by virtualmedicalcentre.com
Latexsens.com
Adverse drug reactions
Anaphylaxis
Anaphylaxis is a sudden onset allergic reaction
• Skin and mucosal changes. Hives.
• Airway and lung problems. Difficulty breathing.
• Collapse of circulation. Tachycardia.
• Anaphylaxis can result in DEATH
Adverse drug reactions
Treatment of Anaphylaxis
• Call 999
• The person needs to receive:-
– Adrenaline
– Antihistamine
– May need resuscitation
Adverse drug reactions
Triggers
Food
Nuts
Pulses
Shell fish
Medication
Antibiotics
Opioids
NSAIDs
Venom
Bee/wasp sting
Eggs
Milk
Pictures provided by maloneyperformance.com
sinusitisunderstoodblogspot.com solent-beekeepers.co.uk
Adverse drug reactions
Reporting of adverse reactions
• The person’s GP must be told of any adverse reaction.
• All adverse reactions to medication should be reported to
the MHRA using the yellow card scheme.
Yellow Card Centre West Midlands:
City Hospital, Dudley Road, Birmingham, B18 7QH
Tel: 0121 507 5672
Adverse drug reactions
Yellow card scheme
Pictures provided by article.wn.com
Adverse drug reactions
Improving
medication
safety
Pictures provided by mhra.gov.uk
Adverse drug reactions
Preventing Adverse Drug Reactions
• Known drug allergies must be brought to the attention of all
the people who prescribe and administer medication.
• Everyone involved with the process must understand what
the medication is for and what the common side effects might
be.
• Special care should be taken with new medication which is
identified by a black triangle.
• Action must be taken at an early stage to prevent
deterioration.
• People taking multiple medicines should be reviewed at
regular intervals by their GPs.
Adverse drug reactions
The following outcome has been covered:Outcome 2
The learner can describe changes to an individual’s physical or
mental well-being that may indicate an adverse reaction to a
medication.
Adverse drug reactions