The importance of ADRs is often underestimated. They are common, can be life threatening and unnecessarily expensive.
CONCLUSION
The
importance of ADRs is often underestimated. They are common, can be life
threatening and unnecessarily expensive. Because of the wide range of drugs
avail-able, the manifestations of toxicity can be variable and affect any organ
system. In fact, ADRs have taken over from syphilis and tuberculosis as the
great mimics of other diseases. It is also likely that the pattern of toxicity
is going to change with the introduction of new biotechnology products. It is
therefore important for the prescribing clinician to be aware of the toxic
profile of drugs they prescribe and to be ever vigilant for the occurrence of
unexpected adverse reactions.
Both
type A and type B adverse reactions are complex, and their prevention for
future populations will depend on an understanding of their pathogen-esis and
exactly how a foreign chemical, i.e. drug, interacts with macromolecules within
the body. Phar-macogenomic strategies have been proposed for the prevention of
these reactions in the future by the predic-tion of susceptible individuals
(Roses, 2000). However, despite the hype surrounding the area, this is likely
to be a long-term goal and will crucially depend on (a) the availability of
accurately phenotyped patients, which for the rare reactions will necessitate
multi-centre international collaborations; (b) the demonstration that
genotyping is clinically and cost-effective; (c) an under-standing of the
mechanisms of the adverse reactions so that more targeted SNP profiling can be
undertaken and (d) most crucially, education of the end users, i.e. clinicians,
so that they understand the rationale for performing the tests and how to
interpret the results.
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