Adverse drug reactions detection methods

Post marketing surveillance conducted by drug regulators, the manufacturers and the medical community may be the preferred method of collecting information for the appropriate use of drugs. These adverse drug reactions may be detected shortly after ini-... 

Despite important progress in evaluating adverse drug reactions, there is still no reliable method to identify potential delayed events that might occur well after the original course of therapy. For example Medwatch system did not detect the identification of diethyl stilbesterol (DES) associated clear-cell adenocarcinoma in female fetuses exposed in utero [3]. 

Given the perceived failure of spontaneous reporting systems and the paucity of ADR reports/ some institutions have instituted more active methods of ADR detection to supplement spontaneous reports. Medication order screening has become a common practice in U.S. hospitals. Manual chart reviews and audits and computer programs are used for retrospective/ concurrent/ and prospective medication utilization evaluation. Certain events often prompt an evaluation of a suspected adverse reaction. These include abrupt discontinuation of a medication/ abrupt dosage reduction/ orders for antidotes and emergency medications/ orders for special tests or serum drug concentration measurements/ and abnormal results from laboratory tests and medical procedures. 

As a consequence of the toxicity related to the presence of aristolochic acid in plant preparations, several health institutions, such as the US Food and Drug Administration, Therapeutic Goods Administration have recently published safety information to prevent further cases of intoxication (information available at web address http //www.cfsan.fda. gov/ dms/ds-bot.html) [471], So detecting aristolochic acids in plant species that could be used in herbal remedies, and also in herbal preparations of uncertain composition, has attracted great priority in recent years to help prevent future adverse reactions. Aristolochic acids present in medicinal plants or herbs are analyzed by soxhlet extraction followed by TLC in the Chinese pharmacopoeia [412]. Another report used multiple ultrasonic extraction followed by HPLC analysis [472]. Ong s laboratory reported a method using a home made pressurized liquid extraction (PLE) system in dynamic mode to extract aristolochic acid in medicinal plants, followed by gradient elution HPLC [473]. Several scientific communities described various analytical methods for... 

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