HSC 3047 :Part 3 Support the use of medication in social care settings: Adverse drug reaction Sheena Helyer 1.2013 Pictures provided by cadista.com

What is an adverse drug reaction? An adverse drug reaction (ADR) is an unwanted or harmful reaction experienced following the administration of a drug or combination of drugs. The reaction may be a known side effect of the drug or it may be new and previously unrecognised. Has anyone in the group ever had an adverse reaction to a drug? Adverse drug reactions

Is it a reaction or an event? An adverse reaction is any undesirable experience that has happened to the patient while taking the drug that is suspected to be caused by the drug. i.e. the person develops a severe headache. An adverse event is an undesirable event which happens to a person whilst taking medication, regardless of whether or not the medicine is suspected to be related to the event .i.e. the person trips and falls. Pictures provided by apexheadacheclinic.co.uk Besthomecaren.com Adverse drug reactions

Type A reactions Type A (augmented).The reaction results from an exaggeration of the drug’s normal pharmacological actions when given at the usual dose. Examples include: Low blood pressure with an antihypertensive. Low blood sugar with insulin. Give other examples if the group needs further clarification Adverse drug reactions

Type B reactions Type B (bizarre). The reaction is a novel response that is not expected from the known pharmacological actions of the drug. Examples include: Anaphylaxis with penicillin Skin rashes with antibiotics. Adverse drug reactions

How common are ADRs? 5% of hospital admissions were related to ADRs. Projected annual cost to the NHS is over £1 billion 2% of patients admitted with ADRs died. Most cases of ADRs were due to predictable causes and therefore preventable Common causes: low dose aspirin, diuretics, warfarin, non-steroidal anti-inflammatory medication (Adverse drug reactions as cause of admission to hospital: Munir Pirmohamed et al 2004) Adverse drug reactions

Drugs which commonly cause ADRs Aspirin: Given in high doses for colds flus and pain, and in low doses for prevention of strokes and heart attacks. Risk of gastric irritation, stomach ulcers and bleeding Diuretics: Given to expel excess fluid from the body which has been causing oedema/swelling and/or breathlessness Risk of blood chemical imbalance which causes confusion weakness and abnormal heart rhythms. Non-steroidal anti inflammatory drugs NSAIDs: Given to reduce the pain of conditions such as arthritis. Risk of stomach irritation and bleeding so must be given with or after food. Warfarin: Given to inhibit clotting. Risk of bruising and bleeding. Levels must be carefully controlled Ask the group if they know what the common side effects are for these drugs Adverse drug reactions

Causes of ADRs Wrong diagnosis Wrong drug or dose Allergic response Self medication Not following instructions Reactions to other medication or remedies Substandard or counterfeit medication Adverse drug reactions

Anaphylaxis Adverse drug reactions Ask the group if they know of anyone who experiences severe allergic responses….have they aver seen a case of anaphylaxis? Pictures provided by healthcentral.com thejrexperiment.com Adverse drug reactions

Anaphylaxis Hives Medical alert bracelet Pictures provided by virtualmedicalcentre.com Latexsens.com Adverse drug reactions

Anaphylaxis Anaphylaxis is a sudden onset allergic reaction Skin and mucosal changes. Hives. Airway and lung problems. Difficulty breathing. Collapse of circulation. Tachycardia. Anaphylaxis can result in DEATH Stress that quick action is vital in the case of severe anaphylaxis Adverse drug reactions

Treatment of Anaphylaxis Call 999 The person needs to receive:- Adrenaline Antihistamine May need resuscitation Adverse drug reactions

Triggers Food Medication Venom Nuts Antibiotics Bee/wasp sting Pulses Opioids Shell fish NSAIDs Eggs Milk What common allergies is the group aware of? Pictures provided by maloneyperformance.com sinusitisunderstoodblogspot.com solent-bee-keepers.co.uk Adverse drug reactions

Reporting of adverse reactions The person’s GP must be told of any adverse reaction. All adverse reactions to medication should be reported to the MHRA using the yellow card scheme. Yellow Card Centre West Midlands: City Hospital, Dudley Road, Birmingham, B18 7QH Tel: 0121 507 5672 Patients may now complete reports directly to the yellow card centre Adverse drug reactions

Yellow card scheme Adverse drug reactions Pictures provided by article.wn.com Adverse drug reactions

Improving medication safety This flow chart shows the improvements in reporting systems which have been introduced since the thalidomide tragedy in the late 50s and early 60s. Explain to the younger members of the group what happened when Thalidomide was introduced first as a sleeping tablet and then to reduce sickness in pregnancy. Pictures provided by mhra.gov.uk Adverse drug reactions

Preventing Adverse Drug Reactions Known drug allergies must be brought to the attention of all the people who prescribe and administer medication. Everyone involved with the process must understand what the medication is for and what the common side effects might be. Special care should be taken with new medication which is identified by a black triangle. Action must be taken at an early stage to prevent deterioration. People taking multiple medicines should be reviewed at regular intervals by their GPs. Ask the learners what they think should be done to prevent ADRs Adverse drug reactions

The following outcome has been covered:- Outcome 2 The learner can describe changes to an individual’s physical or mental well-being that may indicate an adverse reaction to a medication. Adverse drug reactions