Monitoring of Suspected Adverse Drug Reactions in Oncology Unit ...

International Journal of Research in Pharmaceutical and Biomedical Sciences ISSN: 2229-3701
e.g. Fetal hydantoin syndrome and phenytoin.
Types of allergic reactions [Guglielmi L, et al, 2006; Gruchalla R, 2000]
Type I Immediate, anaphylactic.
e.g. Anaphylaxis with penicillins.
Type II : Antibody (IgG, IgM) dependent cellular toxicity.
e.g. Methyldopa and hemolytic anemia.
Type III : Serum sickness type; mediated by deposition of antigen antibody complex.
e.g. Procainamide and drug-induced lupus.
Type IV : Delayed hypersensitivity type.
e.g. Contact dermatitis.
Serious adverse drug reaction [Knowles S & Shapiro L, 1997]
Any adverse experience that results in one of the following outcomes: death, a life-threatening
experience, in-patient hospitalization or prolongation of existing hospitalization, a persistent or significant
disability/incapacity, or a congenital anomaly/birth defect. Important medical events that may not result in
death, be life-threatening or require hospitalization may be considered as serious adverse event when, based
upon appropriate medical judgment, they may jeopardize the subject and may require intervention to
prevent one of the outcomes listed.
Delayed adverse effects of drugs
A number of adverse effects may only become apparent after long-term treatment, such as the relatively
harmless melanin deposits in the lens and cornea that are seen after years of phenothiazine treatment (and
which should be distinguished from pigmentary retinopathy). Other examples include the development of
vaginal carcinoma in the daughters of women given diethylstilbestrol during pregnancy for the treatment of
threatened abortion; and immunosuppressives and chemotherapeutic agents which can induce malignancies
that may not be apparent until years after treatment has been given.
Adverse effects associated with drug withdrawal
Some drugs cause symptoms when treatment is stopped abruptly, for example the benzodiazepine
withdrawal syndrome, rebound hypertension following discontinuation of antihypertensives such as
clonidine, and the acute adrenal insufficiency that may be precipitated by the abrupt withdrawal of
corticosteroids. These are all Type A reactions.
Common therapeutic groups causing adverse drug reactions
These are as follows:
• Antibiotics
• Antineoplastics
• Anticoagulants
• Antiarrythmics
• Oral hypoglycemics
• Antihypertensives
• Non-steroidal anti-inflammatory drugs (NSAIDs) / Analgesics
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