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Support the use of medication in social care settings:
Adverse drug reaction
Sheena Helyer
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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.
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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?
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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
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•
•
•
Allergic response
Self medication
Not following instructions
Reactions to other medication or remedies
• Substandard or counterfeit medication
Adverse drug reactions
Anaphylaxis
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Adverse drug reactions
Anaphylaxis
Hives
Medical alert bracelet
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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
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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
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Adverse drug reactions
Improving
medication
safety
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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