An adverse drug reaction (abbreviated ADR) is an expression that describes the unwanted, negative consequences associated with the use of given medications. An ADR is a particular type of adverse effect. The meaning of this expression differs from the meaning of "side effect", as this last expression might also imply that the effects can be beneficial. The study of ADRs is the concern of the field known as pharmacovigilance.
These interactions are usually transient and mild until a new steady state is achieved. These are mainly for drugs without much first-pass liver metabolism. The prinicple plasma proteins for drug binding are:
Some drug interactions with warfarin are due to changes in protein binding.
Patients have abnormal metabolism by cytochromeP450 due to either inheriting abnormal alleles or due to drug interactions. Tables are available to check for drug interactions due to P450 interactions..
An example of synergism is two drugs that both prolong the QT interval.
A simple scale is available at http://annals.org/cgi/content/full/140/10/795.
Note that an ADR should not be labeled as 'certain' unless the ADR abates with dechallenge and recurs with rechallenge are true.
A more complicated scale is the Naranjo algorithm.
^ ab Nebeker JR, Barach P, Samore MH (2004). "Clarifying adverse drug events: a clinician's guide to terminology, documentation, and reporting". Ann. Intern. Med.140 (10): 795-801. PMID 15148066.
^ Rawlins MD, Thompson JW. Pathogenesis of adverse drug reactions. In: Davies DM, ed. Textbook of adverse drug reactions. Oxford: Oxford University Press, 1977:10.
^ Aronson JK. Drug therapy. In: Haslett C, Chilvers ER, Boon NA, Colledge NR, Hunter JAA, eds. Davidson's principles and practice of medicine 19th ed. Edinburgh: Elsevier Science, 2002:147-63. ISBN 0-44307-035-0.
^ MedWatch - What Is A Serious Adverse Event?. Retrieved on 2007-09-18.
^ "'Traffic-light' medicine risk website to launch", The Guardian, 2007-10-02.
^ Rang, H. P. (2003). Pharmacology. Edinburgh: Churchill Livingstone. ISBN 0-443-07145-4. Page 146
^ abc Weinshilboum R (2003). "Inheritance and drug response". N. Engl. J. Med.348 (6): 529–37. doi:10.1056/NEJMra020021. PMID 12571261.
^ ab Evans WE, McLeod HL (2003). "Pharmacogenomics--drug disposition, drug targets, and side effects". N. Engl. J. Med.348 (6): 538–49. doi:10.1056/NEJMra020526. PMID 12571262.
^ DeVane CL (2002). "Clinical significance of drug binding, protein binding, and binding displacement drug interactions". Psychopharmacology bulletin.36 (3): 5–21. PMID 12473961.
^ Benet LZ, Hoener BA (2002). "Changes in plasma protein binding have little clinical relevance". Clin. Pharmacol. Ther.71 (3): 115–21. doi:10.1067/mcp.2002.121829. PMID 11907485.OVID full text summary table at OVID
^ ab Sands CD, Chan ES, Welty TE (2002). "Revisiting the significance of warfarin protein-binding displacement interactions". The Annals of pharmacotherapy36 (10): 1642–4. PMID 12369572.