Chapter 211: Adverse Drug Reactions

Chapter 211: Adverse Drug Reactions is a topic covered in the Harrison's Manual of Medicine.

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Adverse drug reactions are among the most frequent problems encountered clinically and represent a common cause for hospitalization. They occur most frequently in pts receiving multiple drugs and are caused by:

  • Errors in self-administration of prescribed drugs (quite common in the elderly);
  • Exaggeration of intended pharmacologic effect (e.g., hypotension in a pt given antihypertensive drugs);
  • Concomitant administration of drugs with synergistic effects (e.g., aspirin and warfarin);
  • Cytotoxic reactions (e.g., hepatic necrosis due to acetaminophen);
  • Immunologic mechanisms (e.g., quinidine-induced thrombocytopenia, hydralazine-induced SLE);
  • Genetically determined enzymatic defects (e.g., primaquine-induced hemolytic anemia in G6PD deficiency); or
  • Idiosyncratic reactions (e.g., chloramphenicol-induced aplastic anemia).

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