Drug reaction | Examples |
Type A: Reactions occurring in most normal patients, given sufficient dose and duration of therapy: Common and predictable | |
Overdose | Hepatic failure (acetaminophen) Metabolic acidosis (aspirin) |
Side effects | Nausea, headache (with methylxanthines) Oral thrush or vaginal candidiasis (with glucocorticoids) Nephrotoxicity (with aminoglycosides) |
Secondary or indirect effects | Diarrhea due to alteration in GI bacteria after antibiotics Phototoxicity (with doxycycline or thiazide diuretics) |
Drug interactions | Macrolide antibiotics increasing theophylline, digoxin, or statin blood levels |
Type B: Drug hypersensitivity reactions restricted to a small subset of the general population: Rare and mostly unpredictable | |
Intolerance* | Tinnitus after a single aspirin tablet |
Idiosyncrasy¶ (pharmacogenetics) | G6PD deficiency: Hemolytic anemia after antioxidant drugs (eg, dapsone)Δ TPMT deficiency: Toxicity during azathioprine therapyΔ Pseudoallergic reaction (with NSAIDs) |
Immunologic drug reactions (allergy) | Anaphylaxis from beta-lactam antibiotics Photoallergy with quinidine Immune-mediated thrombocytopenia (with heparin) Serum sickness (with antivenom preparations) Vasculitis (with phenytoin) Stevens-Johnson syndrome (with trimethoprim-sulfamethoxazole) Drug-induced hypersensitivity syndrome (with allopurinol in HLA-B*58:01 individuals)Δ |
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