1. HSC 3047 :Part 3 Support the use of medication in social care settings: Adverse drug reaction
Sheena Helyer
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2. 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

3. 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.
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Adverse drug reactions

4. 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

5. 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

6. 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

7. 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

8. 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

9. 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?
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Adverse drug reactions

10. Anaphylaxis Hives Medical alert bracelet
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Adverse drug reactions

11. 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

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

13. Triggers
Food Medication Venom Nuts Antibiotics Bee/wasp sting Pulses Opioids Shell fish NSAIDs Eggs Milk
What common allergies is the group aware of?
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Adverse drug reactions

14. 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:
Patients may now complete reports directly to the yellow card centre
Adverse drug reactions

15. Yellow card scheme Adverse drug reactions
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Adverse drug reactions

16. 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.
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Adverse drug reactions

17. 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

18. 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