Adverse drug reactions avoidance

The primary therapeutic outcomes for ED are improving the quantity and quality of penile erections suitable for intercourse and avoiding adverse drug reactions and drug interactions. 

Wilkins, M. R., What do we want from proteomics in the detection and avoidance of adverse drug reactions, Toxicol. Lett., 127, 245, 2002. 

However, the temptation to link glutathione (GSH) adducts to MBI must be avoided since the identification of metabolite adducts with GSH does not confirm MBI, albeit it may be an indicator of other adverse drug reactions (Walgren et al., 2005). By definition, exogenous nucleophiles such as GSH should offer no protection from MBI [161], and in principle, even when GSH adducts are formed from the same chemical entity responsible for MBI, the exogenous adducts themselves may not be related to the enzyme-inactivating species [174]. 

A number of terms are used to describe an adverse event, including adverse drug reaction (ADR), adverse experience, adverse effect, and albeit rarely, drug misadventure. In this paper, the term adverse event is used in most cases to avoid confusion. 

Adverse drug reactions constitute a major morbidity, causing deaths in some cases. About 6% of all hospital admissions are related to ADRs and about half of these are avoidable. There is also a substantial diagnostic problem since there is a limited way in which the body may respond patho-physiologically. This means that ADRs often masquerade as other diseases. Commonly reported ADRs are given in Table 1. 

Adverse drug reactions should be avoided, managed by dose reduction or withdrawal of the offending drug, replacement with another if necessary, but not treated by with other drugs unless essential. 

In addition to new reactions to new drugs there is a function of reporting which is even more important to public health. Many adverse drug reactions are avoidable. They may be due to ... 

In March 2007, a study commissioned by the FDA came out with similar conclusions to mine. The FDA had hoped the study would exonerate the agency, but instead it lamented the culture of conflict, avoidance, and waste inside the FDA when it comes to tracking adverse drug reactions (Mathews, 2007b). 

Based on their pharmacokinetic profile alone, the safest statins in chronic compensated liver disease and a history of decompensation are prohahly pravastatin and rosnvastatin. However, clinical experience with rosnvastatin in liver disease is lacking, and so it cannot be recommended. In addition, the true rate of post-marketing adverse drug reactions is not yet clear. Pravastatin is therefore the drug of choice in these patients, where treatment is deemed necessary. It should, however, be avoided in acute episodes until liver function or transaminases stabilise/return to normal. 

Adverse drug reactions can result from combining MAO inhibitors with tricyclic/tetracyclic antidepressants and related compounds, including carbamazepine, cyclobenzaprine, and mirtazapine, and should be avoided except by experts to treat difficult cases... 

French DG. Avoiding adverse drug reactions in the elderly patient Issues and strategies. Nurse Practitioner 1996 21 90, 96-7, 101-7. 

A medication error is any preventable event that may cause or lead to inappropriate medication use or patient harm while medication is in the control of a healthcare professional/ patient/ or consumer (6). Not all medication errors reach the patient. These are often referred to as "near misses." They are not usually considered to be ADEs only because no harm was done. Preventable ADEs are a subset of medication errors that cause harm to a patient (7). Figure 26.1 depicts the relationship between ADES/ medication errorS/ and adverse drug reactions (8). Because adverse drug reactions are generally unexpected/ they are not presently considered to be a reflection of medication use quality in a classic sense. However/ as genetic variances become a more prominent consideration in drug selection and monitoring/ it may be possible to predict and avoid some of the reactions that have been previously unexpected. This offers an opportunity to improve the quality of medication use. 

Continue therapy until apparent cure has been achieved most acute infections are treated for 5-10 days. There are many exceptions to this, such as typhoid fever, tuberculosis and infective endocarditis, in which relapse is possible long after apparent clinical cure and so the drugs are continued for a longer time, determined by comparative or observational trials. Otherwise, prolonged therapy is to be avoided because it increases costs and the risks of adverse drug reactions. 

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