Adverse Drug Reactions

Type A - Augmented response
usually due to high plasma concentrations
can occur at normal plasma concentrations, reflecting inter-individual variability
Type B - unpredictable, dose independent and often serious.

Carbamazepine Core ADRs:

• Dizziness, drowsiness
• Rashes/SJS ( increased risk with carbamazepine if HLA - B1502 allele positive.
• Hyponatremia
• Leukopenia
• Hepatitis

Important causes for Stevens Johnson syndrome:

• Cotrimoxazole
• Lamotrigine
• Carbamazepine
• Phenytoin
• Barbiturate
• Sulfasalazine

Drugs probably not associated with Serious Cutaneous adverse reactions:

• ACEI
• Beta-blocker
• Calcium channel blocker
• Diuretics
• Sulfonylurea
• Insulin

Risk Factors for Rhabdomyolysis with Statins:

• Increased plasma concentrations
• CYP3A4 inhibitors
• Gemfibrozil
• Advanced age
• High statin dose

CYP2D6 - codeine and metoprolol
CYP2A6 - valporate and paracetamol
CYP2C9 - warfarin