Factors predisposing to ADRs may relate either to the properties
of the drug or to the characteristics of the individual. Different factors
predisposing to ADRs are discussed below:
1. Multiple drug
therapy: The incidence of ADRs has been known to increase sharply with the
number of drugs taken. E.g. occurrence of synergistic effects and additive
effects.
2. Age: The very
old and the very young are more susceptible to ADRs. In the elderly, physiologic
changes due to ageing and chronic disease states often contribute to impaired
drug metabolism, which can lead to increased incidence of ADRs. Neonates and
children also differ from adults in the way they handle and respond to drugs,
making them more susceptible to ADRs. E.g. neonates are more prone to adverse
effects of chloramphenicol, Ryes syndrome due to aspirin in children and
increased ADRs due to hypnotics, diuretics, etc in elderly.
3. Gender: women
are generally more susceptible to ADRs then men. E.g. women are more
susceptible to blood dyscrasias due to phenylbutazone and chloramphenicol than
men.
4. Intercurrent
diseases: Patients with impaired renal or hepatic function are at
substantially increased risk of developing ADRs to drugs metabolized and
eliminated by these organs. Other specific
disease states like human immunodeficiency virus (HIV)
positive patients are also known to suffer an increased incidence of ADRs. E.g.
increased occurrence of ADRs due to antitubercular drugs in human
immunodeficiency virus (HIV) positive patients.
5. Race and genetic
polymorphism: Inherited factors
that affect the pharmacokinetics of drugs can also predispose to an
individual’s risk of ADRs. E.g. increased incidence of ADRs due to isoniazid
and other cytochrome P450 metabolized drugs in poor metabolizers.
i am doing research on ADRs.
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