1An undesirable event
experienced by a patient that involves or is suspected to
involve drug therapy and actually or potentially interferes
with a desired patient outcome
Medication-Related Problem (MRP)
2 5 classifications of Medication-Related Problem (MRP)
1. Adverse Drug Reaction
2. Side Effects
3. Dosing Problem
4. Drug Use Problem
5. Interaction
3is a response to a drug that is
noxious and unintended and occurs at doses normally used in
man for the prophylaxis, diagnosis or therapy of disease, or
for modification of physiological function.
Adverse Drug Reaction (ADR)
4An
unpleasant
effect
of
a drug, medical treatment, or vaccine
that happens in addition to the desired action
or intended effect
Side Effects
5reactions result from an exaggeration of a
drug’s normal pharmacological actions when given at the usual therapeutic
dose and are normally dose-dependent.
Type A Reactions [Augmented]
6example of Type A Reactions [Augmented]
respiratory depression with opioids or bleeding with
warfarin.
7also include those that are not directly related to the
desired pharmacological action of the drug, for example dry mouth that is
associated with tricyclic antidepressants.
Type A reactions
8accentuate the activity
of inhibitory neurons in the
brainstem and decrease the
respiratory
rate
and
tidal
volume.
opoids
9also decrease
the
ventilatory
response to
hypoxia and hypercapnia
opiodds
10is
an
oral
anticoagulant
commonly
used
to
treat
and
prevent
blood
clots.
warfarin
11has
multiple
FDA-approved and offlabel clinical uses.
warfarin
12are novel responses that are not
expected from the known pharmacological actions of the drug. These are
less common, and so may only be discovered for the first time after a drug
has already been made available for general use
Type B Reactions [Bizarre] reactions
13examples of Type B Reactions [Bizarre] reactions
anaphylaxis with penicillin or skin rashes with
antibiotics
14persist for a relatively long time
Type C Reactions [Continuing] reactions,
15examples of Type C Reactions [Continuing] reactions,
osteonecrosis of the jaw with bisphosphonates
16are a group of
drugs that work by slowing bone
loss.
Bisphosphonates
17become apparent some time after the use of
a medicine. The timing of these may make them more difficult to detect.
Type D Reactions [Delayed],
18example of Type D Reactions [Delayed],
leucopoenia, which can occur up to six weeks after a dose
of lomustine.
19An alkylating agent used as a part
of chemotherapeutic regimens for
the treatment of primary and
metastatic brain tumors
lomustine
20are associated with the
withdrawal of a medicine.
Type E Reactions [End-of-use] reactions
21examples of Type E Reactions [End-of-use] reactions
insomnia, anxiety and perceptual disturbances following
the withdrawal of benzodiazepines.