Adverse, drug reactions assessment

Pere JC, Begaud B, Haramburu F, Albin H. Computerized comparison of six adverse drug reaction assessment procedures. Clin Pharmacol Ther 1986 40 451-61. 

The ongoing assessment involves careful observation of the patient every 2 to 4 hours for adverse drug reactions when the antifungal drug is given by the oral or parenteral route. When these dru are applied topically to the skin, the nurse inspects the area at the time of each application for localized skin reactions. When these dm i are administered vaginally, the nurse questions the patient regarding any discomfort or other sensations... 

As part of the ongoing assessment during the administration of naloxone, the nurse monitors the blood pressure, pulse, and respiratory rate at frequent intervals, usually every 5 minutes, until the patient responds. After the patient has shown response to the drug, the nurse monitors vital signs every 5 to 15 minutes. The nurse should notify tlie primary healdi care provider if any adverse drug reactions occur because additional medical treatment may be needed. The nurse monitors die respiratory rate, rhydun, and depdi pulse blood pressure and level of consciousness until the effects of die narcotics wear off. 

MYASTHENIA GRAVIS. Once dierapy is under way, the nurse must document any increase in the symptoms of die disease or adverse drug reactions before giving each dose of the drug. The nurse assesses the patient for the presence or absence of die symptoms of myasdienia gravis before each drug dose In patients witii severe... 

Continual cardiac monitoring assists the nurse in assessing the patient for adverse drug reactions. If the patient is acutely ill or is receiving one of these drugs par-enterally, the nurse measures and records the fluid intake and output. The primary health care provider may order subsequent laboratory tests to monitor the patient s progress for comparison with tests performed in the preadministration assessment, such as an ECG, renal and hepatic function tests, complete blood count, serum enzymes, and serum electrolytes. The nurse reports to the primary care provider any abnormalities or significant... 

ASSESSMENT OF THE HOSPITALIZED PATIENT The hospitalized patient receiving a female hormone requires careful monitoring. The nurse takes the vital signs daily or more often, depending on the patient s physical condition and the reason for drug use. The nurse observes the patient for adverse drug reactions, especially those related to the liver (the development of jaundice) or the cardiovascular system (thromboembolism). The nurse weighs the patient weekly or as ordered by the primary health care provider. The nurse... 

Patients should be monitored to assess for drug effectiveness, adverse drug reactions, and potential drug-drug interactions. Patients should be assessed for adherence to their pharma-cotherapeutic regimens and lifestyle modifications. 

Evaluate the patient to assess for adverse drug reactions, drug intolerance, and drug interactions. 

Evaluate the patient s medical record and medication history, and conduct a patient interview to assess for the presence of drug allergies, adverse drug reactions, and drug interactions. 

Assess the patient for adverse drug reactions and drug-drug interactions. 

Assess the patient daily for any new signs or symptoms of infection. Evaluate the patient for adverse drug reactions, drug allergies, and drug interactions. Have all antibiotics been dose adjusted for renal or hepatic dysfunction ... 

At each follow-up visit, compliance with a healthy lifestyle should be determined, as well as measurement of physical parameters, including weight, blood pressure, and heart rate. Waist circumference should be measured intermittently. A complete assessment also would include identification of adverse drug reactions or drug interactions if weight-loss medications have been initiated. 

Hutchinson, T.A. (1992). Causality assessments of suspected adverse drug reactions. In Detection of New Adverse Drug Reactions (Stephens, M.B.D., Ed.). Macmillan, Press, London. 

Snidermann, O.A. (2000). The need for greater involvement of regulatory agencies in assessing adverse drug reactions. CMAJ162 209-210. 

CIOMS. Standardisation of definitions and criteria of causality assessment of adverse drug reactions -drug-induced cytopenia. Int J Clin Pharmacol Tker Toxicol 1991 29 75-81. 

Lane DA, Kramer MS, Hutchinson TA, et al. The causality assessment of adverse drug reactions using a Bayesian approach. Pharm Med 1987 2 265-83. 

Hutchinson TA, Lane DA. 1989. Assessing methods for causahty assessment of suspected adverse drug reactions. J Clin Epidemiol 42 5-16. 

Serum chemistry markers play an important role in hepatotoxicity evaluation in human and animal safety studies. The classic markers of hepatotoxicity are alanine aminotransferase (ALT), aspartate aminotrasnferase (AST) and alkaline phosphatase (ALP) [124—127]. Drug-induced hepatotoxicity can be difficult to assess in some circumstances. Hepatotoxic responses can be intrinsic (predictable, dose-related) or idiosyncratic (unpredictable, non-dose-related). ALT, AST and ALP are generally not useful for predicting idiosyncratic responses. The administration of some drugs, such as isoniazid, can lead to a high incidence of ALT elevation, but are tolerated by most patients without severe hepatotoxicity. Adverse drug reactions can be masked... 

Spielberg SP (1992) Anticonvulsant adverse drug reactions Age dependent and age independent. In Guzelian PS, Henry CJ, Olin SS eds. Similarities and differences between children and adults Implication for risk assessment. Washington, DC, International Life Sciences Institute, ILSI Press, pp 104-106. 

RI Tallarida. A scale for assessing the severity of diseases and adverse drug reactions. Application to drug benefit and risk. Clin Pharmacol Ther 25 381-390, 1979. 

World Health Organization Definitions—Causality Assessment of Suspected Adverse Drug Reactions... 

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