Classical examples of drug-induced idiosyncratic reactions
- Epidermal necrosis and detachment
- Mucous membrane erosions
- "Target" lesions
What are initial reactions?
initial reaction. Examples have not been reviewed. The initial reaction of some local leaders was cautious and critical. La reacción inicial de algunos dirigentes locales fue cautelosa y crítica. The initial reaction of both administering Powers had been positive. La primera reacción de las dos Potencias administradoras ha sido positiva.
What is a non redox reaction?
What is non-redox reaction? The reaction in which neither oxidation or reduction takes or no species either gains or loses electrons are called non-redox reactions, e.g., (i) HCl(aq) + NaOH(aq) NaCl(aq) + H2O(l)
What are examples of idiosyncrasies?
Example: The professor swore he developed a rash when his students didn’t do their homework – an idiosyncrasy that plagued him for years. Origin The word idiosyncrasy comes to us from the Greek idiosynkrasia , meaning “an unusual nature or disposition” belonging to any particular person or thing.
What type of reaction is an acid-base reaction?
The reaction of an acid with a base is called a neutralization reaction. The products of this reaction are a salt and water. acid + base → salt + water In this traditional representation an acid–base neutralization reaction is formulated as a double-replacement reaction.
What is an idiosyncratic reaction?
The term idiosyncratic drug reaction (IDR) has been used in various ways and has no clear definition, but the term is used in this review to designate an adverse reaction that does not occur in most patients treated with a drug and does not involve the therapeutic effect of the drug.
What is idiosyncrasy of drug?
"Drug idiosyncrasy" refers to untoward reactions to drugs that occur in a small fraction of patients and have no obvious relationship to dose or duration of therapy.
What is another name for an idiosyncratic reaction?
Idiosyncratic drug reactions, also known as type B reactions, are drug reactions that occur rarely and unpredictably amongst the population. This is not to be mistaken with idiopathic, which implies that the cause is not known.
What is an example of an idiosyncrasy?
Putting salt in your hot chocolate or needing the light on to sleep or tapping your head while you think are all idiosyncrasies. A machine such as a DVD player has an idiosyncrasy if you have to do something weird to it to make it work like having to bang it on the back left-hand side to stop it from skipping.
What is an example of drug idiosyncrasy?
Idiosyncratic reactions are unpredictable and not explained by the pharmacologic properties of the drug. An example is the individual with infectious mononucleosis who develops a rash when given ampicillin.
What is an example of an adverse drug reaction?
Examples of such adverse drug reactions include rashes, jaundice, anemia, a decrease in the white blood cell count, kidney damage, and nerve injury that may impair vision or hearing. These reactions tend to be more serious but typically occur in a very small number of people.
What type of ADR is idiosyncrasy?
WHAT IS AN IDIOSYNCRATIC ADR? Idiosyncratic ADRs are unpredictable and difficult to prevent, if risk factors for occurrence are unknown. Idiosyncratic ADRs do not occur in most patients, may be unrelated to both the dose and the pharmacology of the drug, and can be potentially life-threatening.
What are the most common idiosyncratic drug reactions?
The most common idiosyncratic drug reactions involve the following: The skin, which can experience something like a mild rash, hives, or serious sloughing off the skin. The liver, whereupon liver cells will die. The blood cells, including white blood cells, platelets, and red blood cells.
What organs are affected by idiosyncratic reactions?
Virtually any organ of your body can be affected by an idiosyncratic reaction. However, it's the skin, liver, and blood cells that are most commonly affected. Some of the idiosyncratic reactions will target a specific organ, while others can affect many organs at the same time.
What is idiosyncrasy in medicine?
In pharmacology, idiosyncrasy refers to an idiosyncratic reaction, which is an adverse effect to an agent, such as a drug, which doesn't occur in most patients who've used the same agent. ...
Why is the liver a site of idiosyncratic reactions?
The reason the liver is a common site of idiosyncratic reactions is because it is the place where drugs are converted into an active form, prior to entering your general circulation.
Is it possible to predict idiosyncratic reactions?
To be clear, an idiosyncratic reaction is abnormal in nature and is therefore not possible to predict who may develop one, when, or what specific form it will take ahead of time. While the good news is that idiosyncratic reactions aren't all that common, the bad news is that when they do occur, many tend to be life-threatening in nature.
Can idiosyncratic reactions kill off white blood cells?
Finally, an idiosyncratic reaction may kill off certain white blood cells, which will make it more likely a person will get sick from an infectious cause. Or it may incapacitate a person's platelets, making it more likely they'll suffer serious bleeding even from a minor cut.
What is idiosyncrasy in pharmacology?
The definition from Textbook of Pharmacology by Seth is: "an unusual response or a highly exaggerated usual response to usual doses to some drugs in few individuals". That's probably as good as it gets.
What is the definition of idiosyncrasy?
That is quite different from Goodman & Gillman: "Idiosyncrasy is an abnormal reactivity to a chemical that is peculiar to a given individual". This definition is probably the most suitable because it is short and generic.
What is an abnormally exaggerated response?
It could be: An abnormally exaggerated response, or an abnormal lack of response. A response unusual because it requires an unusually small or unusually large dose. An extension of the normal physiological drug effect. A reaction which is unrelated to the expected physiological effect.
Is idiosyncratic drug reaction immune mediated?
Pathophysiology of idiosyncratic drug reactions. Idiosyncratic reactions are generally thought to be immune-mediated. There is no agreement on their precise mechanism, and there are many exceptions to contradict every hypothesis. In summary: Either the drug itself, or a reactive metabolite, binds to a protein.
Is idiosyncrasy a drug allergy?
Idiosyncrasy is not a drug allergy, but both are forms of adverse drug reaction. Idiosyncratic drug reactions are unrelated to the dose of the drug. Common lifethreatening idiosyncratic drug reactions include DRESS syndrome, toxic epidermal necrolysis and Stevens-Johnson syndrome.
What are idiosyncratic reactions?
Many idiosyncratic drug reactions are believed to be immune-mediated. Neoantigens may result from adducts formed from the interaction of reactive drug metabolites with cellular proteins. These neoantigens may be processed by Kupffer cells or other antigen-presenting cells, transported to the cell surface, and presented as antigens. A cell- and antibody-mediated immune response may cause severe liver damage. Various drugs are believed to cause immune- mediated idiosyncratic reactions in humans, including halothane, diclofenac, phenytoin, and sulfonamides (Sturgill and Lambert, 1997; Watkins et al., 1999; Zimmerman et al., 1999; Treinen-Moslen and Klaasen, 2001 ).
What is the problem with idiosyncratic drug reactions?
This is second only to acetaminophen (paracetamol)-induced liver failure, but at least in principle it should be possible to prevent acetaminophen-induced liver failure. In addition, IDILI is a major problem for drug development because it is a major cause of withdrawal of drugs from the market [2]. This adds significantly to the cost and uncertainty of drug development for several reasons: a significant effort is made to screen candidates for their potential to cause IDRs, but such efforts are mostly unsuccessful. There are often signals, both in animal testing and clinical trials of drug candidates, that suggest a candidate may cause IDILI. Most of these signals turn out to be false-positives, but investigation of these signals further delays drug approval, which significantly adds to the cost of drug development. On the other hand, if a drug has to be withdrawn from the market because it is found to be associated with an unacceptable incidence of IDILI or some other IDRs, the loss of revenue, the cost of litigation, and the time and effort spent dealing with the problem can paralyze a company and ultimately lead to its failure. Therefore, solving the issue of IDRs would greatly facilitate drug development, as well as improve drug safety. This will be difficult to accomplish without a much better mechanistic understanding of IDILI and other IDRs. Our current mechanistic understanding of IDRs is superficial and a subject of significant debate. Given the current controversies about the mechanisms of IDRs, specifically IDILI, it is important to review their characteristics; any mechanistic hypothesis should be consistent with these characteristics.
Why do some drugs dampen the immune system?
Some dampen the immune response to treat immune-mediated diseases and others are designed to stimulate the immune system or impair immune tolerance to treat cancer. These agents can also cause IDRs similar to small molecules, and in many cases, the IDR was not predicted based on the target of the drug.
How long does it take for a drug to cause idiosyncratic dili?
Idiosyncratic DILI typically occurs 1–3 months after initiation of a drug but varies among drugs and patients. This latency between initiation of therapy and the onset of liver disease is a component of the signature of reactions to specific drugs and provides some clues to the pathogenesis.
How many people are exposed to idiosyncratic drugs?
Idiosyncratic drug reaction occurs in very few individuals exposed to drugs that are known to be hepatotoxic. It occurs in 1 in 1000 to 1 in 50 000 individuals who take the drug.
What is the significance of IDRs?
IDRs represent a significant source of patient morbidity and mortality, and they also significantly increase the risk of drug development . Mechanistic studies are very difficult to perform and little is known with certainty about their mechanisms.
Which drug class is most likely to cause idiosyncratic reactions?
This is still a high rate of injury compared to other idiosyncratic drug reactions, yet the usefulness of the drug has precluded its withdrawal. Apart from isoniazid, antibiotics, nonsteroidals, and anticonvulsants are the most commonly associated drug class capable of inducing idiosyncratic reactions.
