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Related Concept Videos

Allergic Drug Reactions01:27

Allergic Drug Reactions

1.5K
Allergic reactions related to drugs are hypersensitivity responses driven by the immune system and bear no connection to the drug's therapeutic action. While drugs in isolation do not trigger an immune response, they can interact with endogenous proteins to form antigens. These antigens stimulate lymphocytes to produce antibodies. IgE-type antibodies attach themselves to mast cells. Upon subsequent exposure to the same stimulus, the antigen-antibody interaction is initiated, unleashing...
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Drug Toxicity: Allergic Reactions01:30

Drug Toxicity: Allergic Reactions

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Drug-related allergies are immune-mediated responses triggered by the administration of pharmacological agents. These hypersensitivity reactions are classified based on the immune mechanisms involved. The four primary types—Type I, II, III, and IV—are mediated by different immunological pathways and exhibit distinct clinical manifestations.Type I Hypersensitivity/ IgE-Mediated Reactions: Immunoglobulin E (IgE) immediately mediates Type I hypersensitivity reactions. Upon initial...
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Drug Metabolism: Phase I Reactions01:17

Drug Metabolism: Phase I Reactions

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A phase I reaction is a biochemical process that introduces a functionally reactive polar group to a substance. This transformation predominantly occurs in the liver, facilitated by the cytochrome P450 system of hemoproteins situated in the lipophilic endoplasmic reticulum of cells. The metabolite generated through this process can have varying polarities. If it is sufficiently polar, it can be easily excreted in the urine due to its water compatibility. However, if the metabolite is nonpolar,...
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Drug Metabolism: Phase II Reactions01:14

Drug Metabolism: Phase II Reactions

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Phase II reactions are essential for the detoxification and elimination of drugs from the body. These reactions involve the conjugation of parent drugs or their phase I metabolites with endogenous molecules, resulting in more hydrophilic drug conjugates. The primary conjugation reactions in this phase are sulfation and glucuronidation. Both sulfation and glucuronidation typically produce biologically inactive metabolites. However, in some cases involving prodrugs, active metabolites may be...
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Drug toxicity: Idiosyncratic Reactions01:16

Drug toxicity: Idiosyncratic Reactions

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Idiosyncratic drug reactions represent abnormal chemical responses that vary significantly among individuals, ranging from extreme sensitivity to low doses to insensitivity to high doses. These reactions often occur due to the drug's covalent binding with serum proteins, forming a foreign hapten that triggers an immunotoxicological response. The variability in drug reactions has a strong pharmacogenetic foundation, with genetic differences crucial in how individuals metabolize drugs. For...
21
Drug Toxicity: Dose-Dependent Reactions01:24

Drug Toxicity: Dose-Dependent Reactions

19
Drug toxicities can be stratified into pharmacological, pathological, or genotoxic based on their mechanisms. The incidence and severity of these toxicities generally increase with the drug's concentration in the body and exposure time.Pharmacological toxicity is evident when the therapeutic effects of drugs overshoot into adverse reactions in a predictable, dose-dependent manner. Central nervous system (CNS) depression from barbiturates is a classic example, with effects escalating from...
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Related Experiment Video

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Author Spotlight: A Novel Protocol for Intracameral Injections to Enhance Precision in Rodent Ophthalmology
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Adverse drug reactions.

K Patton1, D C Borshoff2

  • 1Department of Anaesthesia, University Hospital Bristol, Bristol, UK.

Anaesthesia
|January 10, 2018
PubMed
Summary

Anaphylaxis during anesthesia poses significant risks, with diagnosis and treatment complicated by drug variety and patient presentation. Vigilance for patient factors and updated knowledge are crucial for anesthesiologists to minimize severe adverse drug reactions.

Keywords:
adverse drug reactionsaetiologyanaphylaxisdiagnosis and treatmentperi-operative anaphylaxis

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Area of Science:

  • Anesthesiology
  • Pharmacology
  • Immunology

Background:

  • Adverse drug reactions (ADRs) are a major cause of patient morbidity and mortality, and a significant financial burden on healthcare systems.
  • Anaphylaxis and malignant hyperthermia are particularly concerning ADRs for anesthesiologists.
  • Diagnosing and treating anaphylaxis in anesthetized patients is challenging due to diverse peri-operative drugs and variable clinical presentations.

Purpose of the Study:

  • To highlight the challenges in diagnosing and treating anaphylaxis under anesthesia.
  • To emphasize the importance of anesthesiologists staying updated on newer anesthetic drugs and potential causative agents.
  • To underscore the need for vigilance regarding patient characteristics, including pharmacogenetic variations, that may increase ADR risk.

Main Methods:

  • Review of current literature on peri-operative anaphylaxis.
  • Analysis of changing trends in causative anesthetic agents.
  • Discussion of diagnostic challenges beyond IgE-mediated mechanisms.

Main Results:

  • Anaphylaxis incidence under anesthesia is difficult to determine but common enough for most anesthesiologists to encounter.
  • Identifying causative agents can be difficult due to non-IgE mediated reactions and the wide array of peri-operative drugs.
  • Increasing reports of anaphylaxis to newer agents like sugammadex necessitate updated awareness.

Conclusions:

  • Anesthesiologists must remain current on anesthetic drug ADRs and diagnostic complexities.
  • Vigilance for patient predispositions, such as pharmacogenetic factors, is essential for risk minimization.
  • Despite advances, severe ADRs to peri-operative drugs continue to result in high morbidity and mortality.