Preventable Adverse Drug Reactions

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Learning Objectives

Learning Module

Torsades de Pointes

Ventricular Arrhythmia (Torsades de Pointes)
Occurring in Association with Terfenadine Use


Why Learn about
Adverse Drug Reactions (ADR)?

Costs Associated with ADRs

Why Are There So Many ADRs?

Characterization of New Drug’s Safety Profile Before Marketing

about ADR Reporting

Drugs Removed from or Restricted in the U.S. Market Because of Drug Interactions

Primary Worries in Primary Care:
1008 Patients

Contribution of Drug Interactions to the Overall Burden of Preventable ADRs

Systems Interventions and
Their Limitations

Prescribing to Avoid
Adverse Drug Reactions

Interactions Before Administration

In the GI Tract

Interactions in the Serum

Spectrum of Consequences
of Drug Metabolism

Microsomal Enzymes

Phases of Drug Metabolism

Drug Interactions Due to Hepatic Metabolism

Phase I Drug Oxidation

Cytochrome P450 Isoforms

Cytochrome P450 Nomenclature,
e.g. for CYP2D6


Polymorphic Distribution

Cytochrome P450 3A

CYP3A Inhibitors

CYP3A Inducers

Cytochrome P450 2D6

Cytochrome P450 2C9

Cytochrome P450 2C19

Cytochrome P450 1A2

Drug-Disease Interactions

Drug-Food Interactions

Effects of grapefruit juice on felodipine pharmacokinetics and pharmacodynamics.

Drug-Herbal Interactions

Mean plasma concentration time course of indinavir.

"FDA program initiated in 1993"

Drug-Drug Interactions:
A Stepwise Approach

A Good Medication History:
AVOID Mistakes

This completes the ADR learning module. 
Please check the following web sites for more learning tools.

Clinical Pharmacology: The Science of Pharmacology and Therapeutics