Adverse, drug reactions classification systems

There have been several attempts over the years to classify adverse drug reactions, primarily based on the perception of what can and what cannot be predicted given knowledge of the pharmacology and toxicology of the drug. For example, Edwards and Aronson [13] proposed what is probably the most extensive classification system ... 

Drug-related problems can be defined as Any undesirable event experienced by the patient that involves or is suspected to involve drug therapy and that actually or potentially interferes with a desired patient outcome (Strand et al. 1990). This is a vital component of Pharmaceutical Care and Clinical Pharmacy and will be described more in detail in another chapter. It should however be noted that there are several definitions and classification systems for DRPs. A literature review (van Mil et al. 2004) identified fourteen classifications and their critical elements. In the presented definition a potential problem is a DRP but this is not the case in all definitions and classifications. This is also the case for unavoidable adverse drug reactions (e.g. with cytotoxic agents). 

The ABPI Code of Practice, in line with European Directive 75/319/EEC, calls for an efficient transfer of information on adverse drug reactions. In the case of defective medicines, an ABPI Batch Recall of Pharmaceutical Products system is in operation. In the ABPI Expanded Syllabus, batch recall is referred to in the Pharmaceutical Technology section and adverse drug reactions in the Pharmacology and Classification of Medicines and the Pharmaceutical Industry and the NHS sections. 

Several types of adverse drug reactions do not easily fit into Cell and Coomb s classification scheme. These include most cutaneous hypersensitivity reactions (such as toxic epidermal necrolysis), immune-allergic hepatitis and hypersensitivity pneumonitis. Another difficulty is that allergic drug reactions can occur via more than one mechanism picryl chloride in mice induces both type 1 and type IV responses. Although other classification schemes have been proposed. Cell and Coomb s system remains the most widely utilized scheme [4-7]. 

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