What is an adverse drug reaction?
An adverse drug reaction (ADR) is an injury caused by taking medication.ADRs may occur following a single dose or prolonged administration of a drug or result from the combination of two or more drugs. The meaning of this term differs from the term "side effect" because side effects can be beneficial and detrimental. The study of ADRs is the concern of the field known as pharmacovigilance. An adverse drug event (ADE) refers to any injury occurring at the time a drug is used, whether or not it is identified as a cause of the injury. An ADR is a particular type of ADE in which a causative relationship can be shown. ADRs are only one type of medication-related harm, as harm can also be caused by omitting to take indicated medications.
What are the signs and symptoms of an adverse drug reaction?
- Mild symptoms include red, itchy, flaky, or swollen skin. You may have a flat, red area on your skin covered with small bumps. You may also have hives.
- Severe symptoms include skin that blisters or peels, vision problems, and severe swelling or itching. Severe reactions include conditions such as toxic epidermal necrolysis (TEN). Ask your healthcare provider for more information on TEN and other severe conditions.
- Anaphylaxis symptoms include throat tightness, trouble breathing, tingling, dizziness, and wheezing. Anaphylaxis is a sudden, life-threatening reaction that needs immediate treatment. Anaphylaxis may occur if you exercise after exposure to another trigger, such as after you take an antibiotic.
How is an adverse drug reaction diagnosed?
Your healthcare provider will ask about your medical history and allergies. You may need additional testing if you developed anaphylaxis after you were exposed to a trigger and then exercised. This is called exercise-induced anaphylaxis. Medicines can be a trigger. You may also need any of the following:
- A patch test means a small amount of the drug is put on your skin. The area is covered with a patch that stays on for 2 days. Then, your healthcare provider will check your skin for a reaction.
- A skin prick test means a small drop of the drug is put on your forearm, and your skin is pricked with a needle. Your healthcare provider will watch for a reaction.
- An intradermal test means a small amount of liquid containing the drug is put under the surface of your skin. Your healthcare provider will watch for a reaction.
- A drug provocation test is also known as a challenge test. Your healthcare provider gives you increasing doses of the drug and watches for a reaction.
How is an adverse drug reaction treated?
For dose-related adverse drug reactions, modifying the dose or eliminating or reducing precipitating factors may suffice. Increasing the rate of drug elimination is rarely necessary. For allergic and idiosyncratic ADRs, the drug usually should be discontinued and not tried again. Switching to a different drug class is often required for allergic ADRs and sometimes needed for dose-related ADRs.
- Antihistamines decrease mild symptoms such as itching or a rash.
- Epinephrine is a medicine used to treat severe allergic reactions such as anaphylaxis.
- Steroids reduce inflammation.
- Desensitization may be done after you have a reaction if you need to be treated with the drug again. Your healthcare provider will give you small doses of the drug over a few hours. He will treat any allergic reaction that you have. The dose is increased a little at a time until the full dose is reached and the drug stops causing an allergic reaction.
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