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id="toc-Mechanisms" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Mechanisms"> <div class="vector-toc-text"> <span class="vector-toc-numb">3</span> <span>Mechanisms</span> </div> </a> <button aria-controls="toc-Mechanisms-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> <span class="vector-icon mw-ui-icon-wikimedia-expand"></span> <span>Toggle Mechanisms subsection</span> </button> <ul id="toc-Mechanisms-sublist" class="vector-toc-list"> <li id="toc-Abnormal_pharmacokinetics" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Abnormal_pharmacokinetics"> <div class="vector-toc-text"> <span class="vector-toc-numb">3.1</span> <span>Abnormal pharmacokinetics</span> </div> </a> <ul id="toc-Abnormal_pharmacokinetics-sublist" class="vector-toc-list"> <li id="toc-Comorbid_disease_states" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Comorbid_disease_states"> <div class="vector-toc-text"> <span class="vector-toc-numb">3.1.1</span> <span>Comorbid disease states</span> </div> </a> <ul id="toc-Comorbid_disease_states-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Genetic_factors" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Genetic_factors"> <div class="vector-toc-text"> <span class="vector-toc-numb">3.1.2</span> <span>Genetic factors</span> </div> </a> <ul id="toc-Genetic_factors-sublist" class="vector-toc-list"> <li id="toc-Phase_I_reactions" class="vector-toc-list-item vector-toc-level-4"> <a class="vector-toc-link" href="#Phase_I_reactions"> <div class="vector-toc-text"> <span class="vector-toc-numb">3.1.2.1</span> <span>Phase I reactions</span> </div> </a> <ul id="toc-Phase_I_reactions-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Phase_II_reactions" class="vector-toc-list-item vector-toc-level-4"> <a class="vector-toc-link" href="#Phase_II_reactions"> <div class="vector-toc-text"> <span class="vector-toc-numb">3.1.2.2</span> <span>Phase II reactions</span> </div> </a> <ul id="toc-Phase_II_reactions-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Protein_binding" class="vector-toc-list-item vector-toc-level-4"> <a class="vector-toc-link" href="#Protein_binding"> <div class="vector-toc-text"> <span class="vector-toc-numb">3.1.2.3</span> <span>Protein binding</span> </div> </a> <ul id="toc-Protein_binding-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> </ul> </li> <li id="toc-Drug_interactions" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Drug_interactions"> <div class="vector-toc-text"> <span class="vector-toc-numb">3.2</span> <span>Drug interactions</span> </div> </a> <ul id="toc-Drug_interactions-sublist" class="vector-toc-list"> <li id="toc-Additive_drug_effects" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Additive_drug_effects"> <div class="vector-toc-text"> <span class="vector-toc-numb">3.2.1</span> <span>Additive drug effects</span> </div> </a> <ul id="toc-Additive_drug_effects-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Altered_metabolism" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Altered_metabolism"> <div class="vector-toc-text"> <span class="vector-toc-numb">3.2.2</span> <span>Altered metabolism</span> </div> </a> <ul id="toc-Altered_metabolism-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> </ul> </li> <li id="toc-Assessing_causality" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Assessing_causality"> <div class="vector-toc-text"> <span class="vector-toc-numb">4</span> <span>Assessing causality</span> </div> </a> <ul id="toc-Assessing_causality-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Monitoring_bodies" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Monitoring_bodies"> <div class="vector-toc-text"> <span class="vector-toc-numb">5</span> <span>Monitoring bodies</span> </div> </a> <ul id="toc-Monitoring_bodies-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Epidemiology" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Epidemiology"> <div class="vector-toc-text"> <span class="vector-toc-numb">6</span> <span>Epidemiology</span> </div> </a> <ul id="toc-Epidemiology-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-See_also" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#See_also"> <div class="vector-toc-text"> <span class="vector-toc-numb">7</span> <span>See also</span> </div> </a> <ul id="toc-See_also-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-References" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#References"> <div class="vector-toc-text"> <span class="vector-toc-numb">8</span> <span>References</span> </div> </a> <ul id="toc-References-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Further_reading" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Further_reading"> <div class="vector-toc-text"> <span class="vector-toc-numb">9</span> <span>Further reading</span> </div> </a> <ul id="toc-Further_reading-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-External_links" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#External_links"> <div class="vector-toc-text"> <span class="vector-toc-numb">10</span> <span>External links</span> </div> </a> <ul id="toc-External_links-sublist" class="vector-toc-list"> </ul> </li> </ul> </div> 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<div class="vector-dropdown-content"> <div id="vector-page-titlebar-toc-unpinned-container" class="vector-unpinned-container"> </div> </div> </div> </nav> <h1 id="firstHeading" class="firstHeading mw-first-heading"><span class="mw-page-title-main">Adverse drug reaction</span></h1> <div id="p-lang-btn" class="vector-dropdown mw-portlet mw-portlet-lang" > <input type="checkbox" id="p-lang-btn-checkbox" role="button" aria-haspopup="true" data-event-name="ui.dropdown-p-lang-btn" class="vector-dropdown-checkbox mw-interlanguage-selector" aria-label="Go to an article in another language. Available in 29 languages" > <label id="p-lang-btn-label" for="p-lang-btn-checkbox" class="vector-dropdown-label cdx-button cdx-button--fake-button cdx-button--fake-button--enabled cdx-button--weight-quiet cdx-button--action-progressive mw-portlet-lang-heading-29" aria-hidden="true" ><span class="vector-icon mw-ui-icon-language-progressive mw-ui-icon-wikimedia-language-progressive"></span> <span class="vector-dropdown-label-text">29 languages</span> </label> <div class="vector-dropdown-content"> <div class="vector-menu-content"> <ul class="vector-menu-content-list"> <li class="interlanguage-link interwiki-ar mw-list-item"><a href="https://ar.wikipedia.org/wiki/%D8%AA%D9%81%D8%A7%D8%B9%D9%84%D8%A7%D8%AA_%D8%AF%D9%88%D8%A7%D8%A6%D9%8A%D8%A9_%D8%B6%D8%A7%D8%A6%D8%B1%D8%A9" title="تفاعلات دوائية ضائرة – Arabic" lang="ar" hreflang="ar" data-title="تفاعلات دوائية ضائرة" data-language-autonym="العربية" data-language-local-name="Arabic" class="interlanguage-link-target"><span>العربية</span></a></li><li class="interlanguage-link interwiki-bs mw-list-item"><a href="https://bs.wikipedia.org/wiki/Nuspojava" title="Nuspojava – Bosnian" lang="bs" hreflang="bs" data-title="Nuspojava" data-language-autonym="Bosanski" data-language-local-name="Bosnian" class="interlanguage-link-target"><span>Bosanski</span></a></li><li class="interlanguage-link interwiki-ca mw-list-item"><a href="https://ca.wikipedia.org/wiki/Reacci%C3%B3_adversa" title="Reacció adversa – Catalan" lang="ca" hreflang="ca" data-title="Reacció adversa" data-language-autonym="Català" data-language-local-name="Catalan" class="interlanguage-link-target"><span>Català</span></a></li><li class="interlanguage-link interwiki-da mw-list-item"><a href="https://da.wikipedia.org/wiki/Bivirkning_(medicin)" title="Bivirkning (medicin) – Danish" lang="da" hreflang="da" data-title="Bivirkning (medicin)" data-language-autonym="Dansk" data-language-local-name="Danish" class="interlanguage-link-target"><span>Dansk</span></a></li><li class="interlanguage-link interwiki-de mw-list-item"><a href="https://de.wikipedia.org/wiki/Nebenwirkung" title="Nebenwirkung – German" lang="de" hreflang="de" data-title="Nebenwirkung" data-language-autonym="Deutsch" data-language-local-name="German" class="interlanguage-link-target"><span>Deutsch</span></a></li><li class="interlanguage-link interwiki-es mw-list-item"><a href="https://es.wikipedia.org/wiki/Reacci%C3%B3n_adversa_a_medicamento" title="Reacción adversa a medicamento – Spanish" lang="es" hreflang="es" data-title="Reacción adversa a medicamento" data-language-autonym="Español" data-language-local-name="Spanish" class="interlanguage-link-target"><span>Español</span></a></li><li class="interlanguage-link interwiki-eu mw-list-item"><a href="https://eu.wikipedia.org/wiki/Bigarren_mailako_ondorio" title="Bigarren mailako ondorio – Basque" lang="eu" hreflang="eu" data-title="Bigarren mailako ondorio" data-language-autonym="Euskara" data-language-local-name="Basque" class="interlanguage-link-target"><span>Euskara</span></a></li><li class="interlanguage-link interwiki-fa mw-list-item"><a href="https://fa.wikipedia.org/wiki/%D8%B9%D9%88%D8%A7%D8%B1%D8%B6_%D9%86%D8%A7%D8%AE%D9%88%D8%A7%D8%B3%D8%AA%D9%87_%D8%AF%D8%A7%D8%B1%D9%88%DB%8C%DB%8C" title="عوارض ناخواسته دارویی – Persian" lang="fa" hreflang="fa" data-title="عوارض ناخواسته دارویی" data-language-autonym="فارسی" data-language-local-name="Persian" class="interlanguage-link-target"><span>فارسی</span></a></li><li class="interlanguage-link interwiki-fr mw-list-item"><a href="https://fr.wikipedia.org/wiki/%C3%89v%C3%A9nement_ind%C3%A9sirable_m%C3%A9dicamenteux" title="Événement indésirable médicamenteux – French" lang="fr" hreflang="fr" data-title="Événement indésirable médicamenteux" data-language-autonym="Français" data-language-local-name="French" class="interlanguage-link-target"><span>Français</span></a></li><li class="interlanguage-link interwiki-gl mw-list-item"><a href="https://gl.wikipedia.org/wiki/Efecto_adverso_(medicina)" title="Efecto adverso (medicina) – Galician" lang="gl" hreflang="gl" data-title="Efecto adverso (medicina)" data-language-autonym="Galego" data-language-local-name="Galician" class="interlanguage-link-target"><span>Galego</span></a></li><li class="interlanguage-link interwiki-hy mw-list-item"><a href="https://hy.wikipedia.org/wiki/%D4%B4%D5%A5%D5%B2%D5%B8%D6%80%D5%A1%D5%B5%D6%84%D5%AB_%D5%A1%D5%B6%D5%A2%D5%A1%D6%80%D5%A5%D5%B6%D5%BA%D5%A1%D5%BD%D5%BF_%D5%BC%D5%A5%D5%A1%D5%AF%D6%81%D5%AB%D5%A1" title="Դեղորայքի անբարենպաստ ռեակցիա – Armenian" lang="hy" hreflang="hy" data-title="Դեղորայքի անբարենպաստ ռեակցիա" data-language-autonym="Հայերեն" data-language-local-name="Armenian" class="interlanguage-link-target"><span>Հայերեն</span></a></li><li class="interlanguage-link interwiki-hr mw-list-item"><a href="https://hr.wikipedia.org/wiki/Nuspojava" title="Nuspojava – Croatian" lang="hr" hreflang="hr" data-title="Nuspojava" data-language-autonym="Hrvatski" data-language-local-name="Croatian" class="interlanguage-link-target"><span>Hrvatski</span></a></li><li class="interlanguage-link interwiki-it mw-list-item"><a href="https://it.wikipedia.org/wiki/Reazione_avversa_a_farmaco" title="Reazione avversa a farmaco – Italian" lang="it" hreflang="it" data-title="Reazione avversa a farmaco" data-language-autonym="Italiano" data-language-local-name="Italian" class="interlanguage-link-target"><span>Italiano</span></a></li><li class="interlanguage-link interwiki-he mw-list-item"><a href="https://he.wikipedia.org/wiki/%D7%AA%D7%95%D7%A4%D7%A2%D7%AA_%D7%9C%D7%95%D7%95%D7%90%D7%99_(%D7%AA%D7%A8%D7%95%D7%A4%D7%94)" title="תופעת לוואי (תרופה) – Hebrew" lang="he" hreflang="he" data-title="תופעת לוואי (תרופה)" data-language-autonym="עברית" data-language-local-name="Hebrew" class="interlanguage-link-target"><span>עברית</span></a></li><li class="interlanguage-link interwiki-ku mw-list-item"><a href="https://ku.wikipedia.org/wiki/Tes%C3%AEra_advers" title="Tesîra advers – Kurdish" lang="ku" hreflang="ku" data-title="Tesîra advers" data-language-autonym="Kurdî" data-language-local-name="Kurdish" class="interlanguage-link-target"><span>Kurdî</span></a></li><li class="interlanguage-link interwiki-la mw-list-item"><a href="https://la.wikipedia.org/wiki/Adversa_drogae_reactio" title="Adversa drogae reactio – Latin" lang="la" hreflang="la" data-title="Adversa drogae reactio" data-language-autonym="Latina" data-language-local-name="Latin" class="interlanguage-link-target"><span>Latina</span></a></li><li class="interlanguage-link interwiki-mk mw-list-item"><a href="https://mk.wikipedia.org/wiki/%D0%9D%D0%B5%D1%81%D0%B0%D0%BA%D0%B0%D0%BD%D0%B0_%D1%80%D0%B5%D0%B0%D0%BA%D1%86%D0%B8%D1%98%D0%B0" title="Несакана реакција – Macedonian" lang="mk" hreflang="mk" data-title="Несакана реакција" data-language-autonym="Македонски" data-language-local-name="Macedonian" class="interlanguage-link-target"><span>Македонски</span></a></li><li class="interlanguage-link interwiki-no mw-list-item"><a href="https://no.wikipedia.org/wiki/Bivirkning" title="Bivirkning – Norwegian Bokmål" lang="nb" hreflang="nb" data-title="Bivirkning" data-language-autonym="Norsk bokmål" data-language-local-name="Norwegian Bokmål" class="interlanguage-link-target"><span>Norsk bokmål</span></a></li><li class="interlanguage-link interwiki-nds mw-list-item"><a href="https://nds.wikipedia.org/wiki/Nevenwirken" title="Nevenwirken – Low German" lang="nds" hreflang="nds" data-title="Nevenwirken" data-language-autonym="Plattdüütsch" data-language-local-name="Low German" class="interlanguage-link-target"><span>Plattdüütsch</span></a></li><li class="interlanguage-link interwiki-pl mw-list-item"><a href="https://pl.wikipedia.org/wiki/Niepo%C5%BC%C4%85dane_dzia%C5%82anie_leku" title="Niepożądane działanie leku – Polish" lang="pl" hreflang="pl" data-title="Niepożądane działanie leku" data-language-autonym="Polski" data-language-local-name="Polish" class="interlanguage-link-target"><span>Polski</span></a></li><li class="interlanguage-link interwiki-ro mw-list-item"><a href="https://ro.wikipedia.org/wiki/Reac%C8%9Bie_advers%C4%83_la_medicamente" title="Reacție adversă la medicamente – Romanian" lang="ro" hreflang="ro" data-title="Reacție adversă la medicamente" data-language-autonym="Română" data-language-local-name="Romanian" class="interlanguage-link-target"><span>Română</span></a></li><li class="interlanguage-link interwiki-ru mw-list-item"><a href="https://ru.wikipedia.org/wiki/%D0%9D%D0%B5%D0%B6%D0%B5%D0%BB%D0%B0%D1%82%D0%B5%D0%BB%D1%8C%D0%BD%D0%B0%D1%8F_%D0%BB%D0%B5%D0%BA%D0%B0%D1%80%D1%81%D1%82%D0%B2%D0%B5%D0%BD%D0%BD%D0%B0%D1%8F_%D1%80%D0%B5%D0%B0%D0%BA%D1%86%D0%B8%D1%8F" title="Нежелательная лекарственная реакция – Russian" lang="ru" hreflang="ru" data-title="Нежелательная лекарственная реакция" data-language-autonym="Русский" data-language-local-name="Russian" class="interlanguage-link-target"><span>Русский</span></a></li><li class="interlanguage-link interwiki-sl mw-list-item"><a href="https://sl.wikipedia.org/wiki/Stranski_u%C4%8Dinek" title="Stranski učinek – Slovenian" lang="sl" hreflang="sl" data-title="Stranski učinek" data-language-autonym="Slovenščina" data-language-local-name="Slovenian" class="interlanguage-link-target"><span>Slovenščina</span></a></li><li class="interlanguage-link interwiki-sv mw-list-item"><a href="https://sv.wikipedia.org/wiki/Biverkning" title="Biverkning – Swedish" lang="sv" hreflang="sv" data-title="Biverkning" data-language-autonym="Svenska" data-language-local-name="Swedish" class="interlanguage-link-target"><span>Svenska</span></a></li><li class="interlanguage-link interwiki-th mw-list-item"><a href="https://th.wikipedia.org/wiki/%E0%B8%AD%E0%B8%B2%E0%B8%81%E0%B8%B2%E0%B8%A3%E0%B9%84%E0%B8%A1%E0%B9%88%E0%B8%9E%E0%B8%B6%E0%B8%87%E0%B8%9B%E0%B8%A3%E0%B8%B0%E0%B8%AA%E0%B8%87%E0%B8%84%E0%B9%8C%E0%B8%88%E0%B8%B2%E0%B8%81%E0%B8%A2%E0%B8%B2" title="อาการไม่พึงประสงค์จากยา – Thai" lang="th" hreflang="th" data-title="อาการไม่พึงประสงค์จากยา" data-language-autonym="ไทย" data-language-local-name="Thai" class="interlanguage-link-target"><span>ไทย</span></a></li><li class="interlanguage-link interwiki-tr mw-list-item"><a href="https://tr.wikipedia.org/wiki/%C4%B0la%C3%A7_yan_etkisi" title="İlaç yan etkisi – Turkish" lang="tr" hreflang="tr" data-title="İlaç yan etkisi" data-language-autonym="Türkçe" data-language-local-name="Turkish" class="interlanguage-link-target"><span>Türkçe</span></a></li><li class="interlanguage-link interwiki-uk mw-list-item"><a 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div.hatnote{padding-left:1.6em;margin-bottom:0.5em}.mw-parser-output .hatnote i{font-style:normal}.mw-parser-output .hatnote+link+.hatnote{margin-top:-0.5em}@media print{body.ns-0 .mw-parser-output .hatnote{display:none!important}}</style><div role="note" class="hatnote navigation-not-searchable">Not to be confused with <a href="/wiki/Vaccine_adverse_event" title="Vaccine adverse event">Vaccine adverse event</a>.</div> <p class="mw-empty-elt"> </p> <div class="shortdescription nomobile noexcerpt noprint searchaux" style="display:none">Medical condition</div><style data-mw-deduplicate="TemplateStyles:r1257001546">.mw-parser-output .infobox-subbox{padding:0;border:none;margin:-3px;width:auto;min-width:100%;font-size:100%;clear:none;float:none;background-color:transparent}.mw-parser-output .infobox-3cols-child{margin:auto}.mw-parser-output .infobox .navbar{font-size:100%}@media screen{html.skin-theme-clientpref-night .mw-parser-output .infobox-full-data:not(.notheme)>div:not(.notheme)[style]{background:#1f1f23!important;color:#f8f9fa}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .infobox-full-data:not(.notheme) div:not(.notheme){background:#1f1f23!important;color:#f8f9fa}}@media(min-width:640px){body.skin--responsive .mw-parser-output .infobox-table{display:table!important}body.skin--responsive .mw-parser-output .infobox-table>caption{display:table-caption!important}body.skin--responsive .mw-parser-output .infobox-table>tbody{display:table-row-group}body.skin--responsive .mw-parser-output .infobox-table tr{display:table-row!important}body.skin--responsive .mw-parser-output .infobox-table th,body.skin--responsive .mw-parser-output .infobox-table td{padding-left:inherit;padding-right:inherit}}</style><table class="infobox infobox-has-images-with-white-backgrounds"><tbody><tr><th colspan="2" class="infobox-above" style="background:#ccc">Adverse drug reaction</th></tr><tr><td colspan="2" class="infobox-full-data"><span class="mw-default-size" typeof="mw:File/Frameless"><a href="/wiki/File:Drugreaction.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/0/06/Drugreaction.jpg/250px-Drugreaction.jpg" decoding="async" width="220" height="268" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/0/06/Drugreaction.jpg/330px-Drugreaction.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/0/06/Drugreaction.jpg/500px-Drugreaction.jpg 2x" data-file-width="3095" data-file-height="3769" /></a></span></td></tr><tr><td colspan="2" class="infobox-full-data">A rash due to a drug reaction</td></tr></tbody></table><style data-mw-deduplicate="TemplateStyles:r1236303919">@media screen{html.skin-theme-clientpref-night .mw-parser-output .infobox-has-images-with-white-backgrounds img{background:white}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .infobox-has-images-with-white-backgrounds img{background:white}}</style> <p>An <b>adverse drug reaction</b> (<b>ADR</b>) is a harmful, unintended result caused by taking <a href="/wiki/Medication" title="Medication">medication</a>.<sup id="cite_ref-MEDIA482_1-0" class="reference"><a href="#cite_note-MEDIA482-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup><sup class="reference nowrap"><span title="Location: 1.1 Adverse Drug Reaction (ADR)">: 1.1 Adverse Drug Reaction (ADR) </span></sup><sup id="cite_ref-2" class="reference"><a href="#cite_note-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> ADRs may occur following a single dose or prolonged administration of a <a href="/wiki/Drug" title="Drug">drug</a> or may result from the combination of two or more drugs. The meaning of this term differs from the term "<a href="/wiki/Side_effect" title="Side effect">side effect</a>" because side effects can be beneficial as well as detrimental.<sup id="cite_ref-pmid15148066_3-0" class="reference"><a href="#cite_note-pmid15148066-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> The study of ADRs is the concern of the field known as <i><a href="/wiki/Pharmacovigilance" title="Pharmacovigilance">pharmacovigilance</a></i>.<sup id="cite_ref-pmid15148066_3-1" class="reference"><a href="#cite_note-pmid15148066-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> An <a href="/wiki/Adverse_event" title="Adverse event">adverse event</a> (AE) refers to any unexpected and inappropriate occurrence at the time a drug is used, whether or not the event is associated with the administration of the drug.<sup id="cite_ref-MEDIA482_1-1" class="reference"><a href="#cite_note-MEDIA482-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup><sup class="reference nowrap"><span title="Location: 1.2 Adverse Event (AE)">: 1.2 Adverse Event (AE) </span></sup> An ADR is a special type of AE in which a causative relationship can be shown.<sup id="cite_ref-pmid15148066_3-2" class="reference"><a href="#cite_note-pmid15148066-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> ADRs are only one type of medication-related harm. Another type of medication-related harm type includes not taking prescribed medications, known as <a href="/wiki/Adherence_(medicine)" title="Adherence (medicine)">non-adherence</a>.<sup id="cite_ref-U.S._Food_&_Drug_Administration_2016_4-0" class="reference"><a href="#cite_note-U.S._Food_&_Drug_Administration_2016-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> Non-adherence to medications can lead to death and other negative outcomes.<sup id="cite_ref-U.S._Food_&_Drug_Administration_2016_4-1" class="reference"><a href="#cite_note-U.S._Food_&_Drug_Administration_2016-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> Adverse drug reactions require the use of a <a href="/wiki/Medication" title="Medication">medication</a>.<sup id="cite_ref-pmid15148066_3-3" class="reference"><a href="#cite_note-pmid15148066-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> </p> <style data-mw-deduplicate="TemplateStyles:r886046785">.mw-parser-output .toclimit-2 .toclevel-1 ul,.mw-parser-output .toclimit-3 .toclevel-2 ul,.mw-parser-output .toclimit-4 .toclevel-3 ul,.mw-parser-output .toclimit-5 .toclevel-4 ul,.mw-parser-output .toclimit-6 .toclevel-5 ul,.mw-parser-output .toclimit-7 .toclevel-6 ul{display:none}</style><div class="toclimit-3"><meta property="mw:PageProp/toc" /></div> <div class="mw-heading mw-heading2"><h2 id="Classification">Classification</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Adverse_drug_reaction&action=edit&section=1" title="Edit section: Classification"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <div class="mw-heading mw-heading3"><h3 id="Traditional">Traditional</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Adverse_drug_reaction&action=edit&section=2" title="Edit section: Traditional"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <ul><li>Type A: augmented pharmacological effects, which are dose-dependent and predictable<sup id="cite_ref-Coleman_2016_5-0" class="reference"><a href="#cite_note-Coleman_2016-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup></li></ul> <dl><dd>Type A reactions, which constitute approximately 80% of adverse drug reactions, are usually a consequence of the drug's primary pharmacological effect (e.g., bleeding when using the anticoagulant <a href="/wiki/Warfarin" title="Warfarin">warfarin</a>) or a low <a href="/wiki/Therapeutic_index" title="Therapeutic index">therapeutic index</a> of the drug (e.g., nausea from <a href="/wiki/Digoxin" title="Digoxin">digoxin</a>), and they are therefore predictable. They are dose-related and usually mild, although they may be serious or even fatal (e.g. <a href="/wiki/Intracranial_bleeding" class="mw-redirect" title="Intracranial bleeding">intracranial bleeding</a> from warfarin). Such reactions are usually due to inappropriate dosage, especially when drug elimination is impaired. The term <i><a href="/wiki/Side_effect" title="Side effect">side effects</a></i> may be applied to minor type A reactions.<sup id="cite_ref-6" class="reference"><a href="#cite_note-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup></dd></dl> <ul><li><a href="/wiki/Idiosyncratic_drug_reaction" title="Idiosyncratic drug reaction">Type B</a>: Type B reactions are not dose-dependent and are not predictable, and so may be called <i>idiosyncratic</i>.<sup id="cite_ref-Coleman_2016_5-1" class="reference"><a href="#cite_note-Coleman_2016-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> These reactions can be due to particular elements within the person or the environment.<sup id="cite_ref-7" class="reference"><a href="#cite_note-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup></li></ul> <p>Types A and B were proposed in the 1970s,<sup id="cite_ref-8" class="reference"><a href="#cite_note-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup> and the other types were proposed subsequently when the first two proved insufficient to classify ADRs.<sup id="cite_ref-9" class="reference"><a href="#cite_note-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup> </p><p>Other types of adverse drug reactions are Type C, Type D, Type E, and Type F.<sup id="cite_ref-Aronson_2003_10-0" class="reference"><a href="#cite_note-Aronson_2003-10"><span class="cite-bracket">[</span>10<span class="cite-bracket">]</span></a></sup> Type C was categorized for chronic adverse drug reactions, Type D for delayed adverse drug reactions, Type E for withdrawal adverse drug reactions, and Type F for failure of therapy as an adverse drug reaction. Adverse drug reactions can also be categorized using time-relatedness, dose-relatedness, and susceptibility, which collectively are called the DoTS classification.<sup id="cite_ref-Aronson_2003_10-1" class="reference"><a href="#cite_note-Aronson_2003-10"><span class="cite-bracket">[</span>10<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Seriousness">Seriousness</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Adverse_drug_reaction&action=edit&section=3" title="Edit section: Seriousness"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>The U.S <a href="/wiki/Food_and_Drug_Administration" title="Food and Drug Administration">Food and Drug Administration</a> defines a serious <a href="/wiki/Adverse_event" title="Adverse event">adverse event</a> as one when the patient outcome is one of the following:<sup id="cite_ref-11" class="reference"><a href="#cite_note-11"><span class="cite-bracket">[</span>11<span class="cite-bracket">]</span></a></sup> </p> <ul><li>Death</li> <li>Life-threatening</li> <li>Hospitalization (initial or prolonged)</li> <li>Disability — significant, persistent, or permanent change, impairment, damage or disruption in the patient's body function/structure, physical activities or quality of life.</li> <li>Congenital abnormality</li> <li>Requires intervention to prevent permanent impairment or damage</li></ul> <p>Severity is a measure of the intensity of the adverse event in question.<sup id="cite_ref-EMA_1995_12-0" class="reference"><a href="#cite_note-EMA_1995-12"><span class="cite-bracket">[</span>12<span class="cite-bracket">]</span></a></sup> The terms "severe" and "serious", when applied to adverse events, are technically very different.<sup id="cite_ref-EMA_1995_12-1" class="reference"><a href="#cite_note-EMA_1995-12"><span class="cite-bracket">[</span>12<span class="cite-bracket">]</span></a></sup> They are easily confused but can not be used interchangeably, requiring care in usage.<sup id="cite_ref-EMA_1995_12-2" class="reference"><a href="#cite_note-EMA_1995-12"><span class="cite-bracket">[</span>12<span class="cite-bracket">]</span></a></sup> Seriousness usually indicates patient outcome (such as negative outcomes including disability, long-term effects, and death).<sup id="cite_ref-EMA_1995_12-3" class="reference"><a href="#cite_note-EMA_1995-12"><span class="cite-bracket">[</span>12<span class="cite-bracket">]</span></a></sup> </p><p>In adverse drug reactions, the seriousness of the reaction is important for reporting.<sup id="cite_ref-EMA_1995_12-4" class="reference"><a href="#cite_note-EMA_1995-12"><span class="cite-bracket">[</span>12<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Location">Location</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Adverse_drug_reaction&action=edit&section=4" title="Edit section: Location"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Some <a href="/wiki/Ocular_antihypertensive" class="mw-redirect" title="Ocular antihypertensive">ocular antihypertensives</a> cause systemic effects,<sup id="cite_ref-Rang146_13-0" class="reference"><a href="#cite_note-Rang146-13"><span class="cite-bracket">[</span>13<span class="cite-bracket">]</span></a></sup> although they are administered locally as <a href="/wiki/Eye_drop" title="Eye drop">eye drops</a>, since a fraction escapes to the systemic circulation. </p> <div class="mw-heading mw-heading2"><h2 id="Mechanisms">Mechanisms</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Adverse_drug_reaction&action=edit&section=5" title="Edit section: Mechanisms"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Drug-induced_hepatitis_low_mag.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/8/88/Drug-induced_hepatitis_low_mag.jpg/250px-Drug-induced_hepatitis_low_mag.jpg" decoding="async" width="220" height="332" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/8/88/Drug-induced_hepatitis_low_mag.jpg/330px-Drug-induced_hepatitis_low_mag.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/8/88/Drug-induced_hepatitis_low_mag.jpg/500px-Drug-induced_hepatitis_low_mag.jpg 2x" data-file-width="2173" data-file-height="3284" /></a><figcaption>Adverse drug reaction leading to <a href="/wiki/Hepatitis" title="Hepatitis">hepatitis</a> (drug-induced hepatitis) with <a href="/wiki/Granulomata" class="mw-redirect" title="Granulomata">granulomata</a>. Other causes were excluded with extensive investigations. <a href="/wiki/Liver" title="Liver">Liver</a> <a href="/wiki/Biopsy" title="Biopsy">biopsy</a>. <a href="/wiki/H%26E_stain" title="H&E stain">H&E stain</a>.</figcaption></figure> <div class="mw-heading mw-heading3"><h3 id="Abnormal_pharmacokinetics">Abnormal pharmacokinetics</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Adverse_drug_reaction&action=edit&section=6" title="Edit section: Abnormal pharmacokinetics"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <div class="mw-heading mw-heading4"><h4 id="Comorbid_disease_states">Comorbid disease states</h4><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Adverse_drug_reaction&action=edit&section=7" title="Edit section: Comorbid disease states"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Various diseases, especially those that cause <a href="/wiki/Renal_failure" class="mw-redirect" title="Renal failure">renal</a> or <a href="/wiki/Liver_failure" title="Liver failure">hepatic</a> insufficiency, may alter drug metabolism. Resources are available that report changes in a drug's metabolism due to disease states.<sup id="cite_ref-14" class="reference"><a href="#cite_note-14"><span class="cite-bracket">[</span>14<span class="cite-bracket">]</span></a></sup> </p><p>The Medication Appropriateness Tool for Comorbid Health Conditions in Dementia<sup id="cite_ref-15" class="reference"><a href="#cite_note-15"><span class="cite-bracket">[</span>15<span class="cite-bracket">]</span></a></sup> (<a href="/wiki/MATCH-D" class="mw-redirect" title="MATCH-D">MATCH-D</a>) criteria warns that people with <a href="/wiki/Dementia" title="Dementia">dementia</a> are more likely to experience adverse effects, and that they are less likely to be able to reliably report symptoms.<sup id="cite_ref-16" class="reference"><a href="#cite_note-16"><span class="cite-bracket">[</span>16<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading4"><h4 id="Genetic_factors">Genetic factors</h4><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Adverse_drug_reaction&action=edit&section=8" title="Edit section: Genetic factors"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p><a href="/wiki/Pharmacogenomics" title="Pharmacogenomics">Pharmacogenomics</a> includes how genes can predict potential adverse drug reactions.<sup id="cite_ref-Roden_2023_17-0" class="reference"><a href="#cite_note-Roden_2023-17"><span class="cite-bracket">[</span>17<span class="cite-bracket">]</span></a></sup> However, pharmacogenomics is not limited to adverse events (of any type), but also looks at how genes may impact other responses to medications, such as low/no effect or expected/normal responses (especially based on drug metabolism).<sup id="cite_ref-Roden_2023_17-1" class="reference"><a href="#cite_note-Roden_2023-17"><span class="cite-bracket">[</span>17<span class="cite-bracket">]</span></a></sup> </p><p>Abnormal drug metabolism may be due to inherited factors of either Phase I oxidation or Phase II conjugation.<sup id="cite_ref-pmid11710893_18-0" class="reference"><a href="#cite_note-pmid11710893-18"><span class="cite-bracket">[</span>18<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-pmid12571264_19-0" class="reference"><a href="#cite_note-pmid12571264-19"><span class="cite-bracket">[</span>19<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading5"><h5 id="Phase_I_reactions">Phase I reactions</h5><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Adverse_drug_reaction&action=edit&section=9" title="Edit section: Phase I reactions"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Phase I reactions include metabolism by cytochrome P450.<sup id="cite_ref-20" class="reference"><a href="#cite_note-20"><span class="cite-bracket">[</span>20<span class="cite-bracket">]</span></a></sup> Patients have abnormal metabolism by <a href="/wiki/Cytochrome_P450" title="Cytochrome P450">cytochrome P450</a> due to either inheriting abnormal <a href="/wiki/Allele" title="Allele">alleles</a> or due to drug interactions. Tables are available to check for drug interactions due to P450 interactions.<sup id="cite_ref-Drug-Interactions.com_21-0" class="reference"><a href="#cite_note-Drug-Interactions.com-21"><span class="cite-bracket">[</span>21<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-pmid12571261_22-0" class="reference"><a href="#cite_note-pmid12571261-22"><span class="cite-bracket">[</span>22<span class="cite-bracket">]</span></a></sup> </p><p>Inheriting abnormal <a href="/wiki/Cholinesterase_enzyme" class="mw-redirect" title="Cholinesterase enzyme">butyrylcholinesterase</a> (<a href="/wiki/Cholinesterase_enzyme" class="mw-redirect" title="Cholinesterase enzyme">pseudocholinesterase</a>) may affect metabolism of drugs such as <a href="/wiki/Succinylcholine" class="mw-redirect" title="Succinylcholine">succinylcholine</a>.<sup id="cite_ref-pmid12571262_23-0" class="reference"><a href="#cite_note-pmid12571262-23"><span class="cite-bracket">[</span>23<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading5"><h5 id="Phase_II_reactions">Phase II reactions</h5><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Adverse_drug_reaction&action=edit&section=10" title="Edit section: Phase II reactions"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Inheriting abnormal <a href="/wiki/Acetyltransferase" title="Acetyltransferase"><i>N</i>-acetyltransferase</a> which conjugated some drugs to facilitate excretion may affect the metabolism of drugs such as <a href="/wiki/Isoniazid" title="Isoniazid">isoniazid</a>, <a href="/wiki/Hydralazine" title="Hydralazine">hydralazine</a>, and <a href="/wiki/Procainamide" title="Procainamide">procainamide</a>.<sup id="cite_ref-pmid12571261_22-1" class="reference"><a href="#cite_note-pmid12571261-22"><span class="cite-bracket">[</span>22<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-pmid12571262_23-1" class="reference"><a href="#cite_note-pmid12571262-23"><span class="cite-bracket">[</span>23<span class="cite-bracket">]</span></a></sup> </p><p>Inheriting abnormal <a href="/wiki/Thiopurine_methyltransferase" title="Thiopurine methyltransferase">thiopurine <i>S</i>-methyltransferase</a> may affect the metabolism of the <a href="/wiki/Thiopurine" title="Thiopurine">thiopurine</a> drugs <a href="/wiki/Mercaptopurine" title="Mercaptopurine">mercaptopurine</a> and <a href="/wiki/Azathioprine" title="Azathioprine">azathioprine</a>.<sup id="cite_ref-pmid12571261_22-2" class="reference"><a href="#cite_note-pmid12571261-22"><span class="cite-bracket">[</span>22<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading5"><h5 id="Protein_binding">Protein binding</h5><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Adverse_drug_reaction&action=edit&section=11" title="Edit section: Protein binding"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Protein binding interactions are usually transient and mild until a new steady state is achieved.<sup id="cite_ref-pmid12473961_24-0" class="reference"><a href="#cite_note-pmid12473961-24"><span class="cite-bracket">[</span>24<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-pmid11907485_25-0" class="reference"><a href="#cite_note-pmid11907485-25"><span class="cite-bracket">[</span>25<span class="cite-bracket">]</span></a></sup> These are mainly for drugs without much first-pass liver metabolism. The principal plasma proteins for drug binding are:<sup id="cite_ref-pmid12369572_26-0" class="reference"><a href="#cite_note-pmid12369572-26"><span class="cite-bracket">[</span>26<span class="cite-bracket">]</span></a></sup> </p> <ol><li><a href="/wiki/Albumin" title="Albumin">albumin</a></li> <li>α1-acid glycoprotein</li> <li><a href="/wiki/Lipoprotein" title="Lipoprotein">lipoproteins</a></li></ol> <p>Some drug interactions with <a href="/wiki/Warfarin" title="Warfarin">warfarin</a> are due to changes in protein binding.<sup id="cite_ref-pmid12369572_26-1" class="reference"><a href="#cite_note-pmid12369572-26"><span class="cite-bracket">[</span>26<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Drug_interactions">Drug interactions</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Adverse_drug_reaction&action=edit&section=12" title="Edit section: Drug interactions"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>The risk of <a href="/wiki/Drug_interaction" title="Drug interaction">drug interactions</a> is increased with <a href="/wiki/Polypharmacy" title="Polypharmacy">polypharmacy</a>, especially in older adults.<sup id="cite_ref-27" class="reference"><a href="#cite_note-27"><span class="cite-bracket">[</span>27<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading4"><h4 id="Additive_drug_effects">Additive drug effects</h4><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Adverse_drug_reaction&action=edit&section=13" title="Edit section: Additive drug effects"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Two or more drugs that contribute to the same mechanism in the body can have additive <a href="/wiki/Toxicity" title="Toxicity">toxic</a> or adverse effects. One example of this is multiple medications administered concurrently that prolong the <a href="/wiki/QT_interval" title="QT interval">QT interval</a>, such as <a href="/wiki/Antiarrhythmics" class="mw-redirect" title="Antiarrhythmics">antiarrhythmics</a> like <a href="/wiki/Sotalol" title="Sotalol">sotalol</a> and some <a href="/wiki/Macrolide_antibiotics" class="mw-redirect" title="Macrolide antibiotics">macrolide antibiotics</a>, such as systemic <a href="/wiki/Azithromycin" title="Azithromycin">azithromycin</a>.<sup id="cite_ref-28" class="reference"><a href="#cite_note-28"><span class="cite-bracket">[</span>28<span class="cite-bracket">]</span></a></sup> Another example of additive effects for adverse drug reactions is in <a href="/wiki/Serotonin_toxicity" class="mw-redirect" title="Serotonin toxicity">serotonin toxicity</a> (<a href="/wiki/Serotonin_syndrome" title="Serotonin syndrome">serotonin syndrome</a>).<sup id="cite_ref-Curry_2019_29-0" class="reference"><a href="#cite_note-Curry_2019-29"><span class="cite-bracket">[</span>29<span class="cite-bracket">]</span></a></sup> If medications that cause increased <a href="/wiki/Serotonin" title="Serotonin">serotonin</a> levels are combined, they can cause <a href="/wiki/Serotonin_syndrome" title="Serotonin syndrome">serotonin toxicity</a> (though therapeutic doses of one agent that increases <a href="/wiki/Serotonin" title="Serotonin">serotonin</a> levels can cause <a href="/wiki/Serotonin_syndrome" title="Serotonin syndrome">serotonin toxicity</a> in certain cases and individuals).<sup id="cite_ref-Curry_2019_29-1" class="reference"><a href="#cite_note-Curry_2019-29"><span class="cite-bracket">[</span>29<span class="cite-bracket">]</span></a></sup> Some of the medications that can contribute to <a href="/wiki/Serotonin_syndrome" title="Serotonin syndrome">serotonin toxicity</a> include <a href="/wiki/MAO_inhibitors" class="mw-redirect" title="MAO inhibitors">MAO inhibitors</a>, <a href="/wiki/Selective_serotonin_reuptake_inhibitor" title="Selective serotonin reuptake inhibitor">SSRIs</a>, and <a href="/wiki/Tricyclic_antidepressant" title="Tricyclic antidepressant">tricyclic antidepressants</a>.<sup id="cite_ref-Curry_2019_29-2" class="reference"><a href="#cite_note-Curry_2019-29"><span class="cite-bracket">[</span>29<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading4"><h4 id="Altered_metabolism">Altered metabolism</h4><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Adverse_drug_reaction&action=edit&section=14" title="Edit section: Altered metabolism"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Some medications can either <a href="/wiki/Enzyme_inhibitor" title="Enzyme inhibitor">inhibit</a> or <a href="/wiki/Enzyme_inducer" title="Enzyme inducer">induce</a> key <a href="/wiki/Drug_metabolism" title="Drug metabolism">drug metabolizing</a> <a href="/wiki/Enzyme" title="Enzyme">enzymes</a> or <a href="/wiki/Drug_transporter" class="mw-redirect" title="Drug transporter">drug transporters</a>, which when combined with other medications that utilize the same proteins can lead to either toxic or sub-therapeutic adverse effects. One example of this is a patient taking a <a href="/wiki/CYP3A4" title="CYP3A4">cytochrome P450 3A4</a> (CYP3A4) inhibitor such as the <a href="/wiki/Antibiotic" title="Antibiotic">antibiotic</a> <a href="/wiki/Clarithromycin" title="Clarithromycin">clarithromycin</a>, as well as another medication metabolized by CYP3A4 such as the <a href="/wiki/Anticoagulant" title="Anticoagulant">anticoagulant</a> <a href="/wiki/Apixaban" title="Apixaban">apixaban</a>, which results in elevated blood concentrations of apixaban and greater risk of serious bleeds.<sup id="cite_ref-Mar_2022_30-0" class="reference"><a href="#cite_note-Mar_2022-30"><span class="cite-bracket">[</span>30<span class="cite-bracket">]</span></a></sup> Additionally, Clarithromycin is a <a href="/wiki/P-glycoprotein" title="P-glycoprotein">permeability glycoprotein</a> (P-gp) efflux pump inhibitor, which when given with apixaban (a substrate for P-gp) will lead to increased absorption of apixaban, resulting in the same adverse effects as with CYP3A4 inhibition.<sup id="cite_ref-Mar_2022_30-1" class="reference"><a href="#cite_note-Mar_2022-30"><span class="cite-bracket">[</span>30<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Assessing_causality">Assessing causality</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Adverse_drug_reaction&action=edit&section=15" title="Edit section: Assessing causality"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p><a href="/wiki/Causality" title="Causality">Causality</a> assessment is used to determine the likelihood that a drug caused a suspected ADR.<sup id="cite_ref-pmid15148066_3-4" class="reference"><a href="#cite_note-pmid15148066-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> There are a number of different methods used to judge causation, including the <a href="/wiki/Naranjo_algorithm" title="Naranjo algorithm">Naranjo algorithm</a>, the Venulet algorithm and the WHO causality term assessment criteria. Each have pros and cons associated with their use and most require some level of expert judgement to apply.<sup id="cite_ref-31" class="reference"><a href="#cite_note-31"><span class="cite-bracket">[</span>31<span class="cite-bracket">]</span></a></sup> An ADR should not be labeled as 'certain' unless the ADR abates with a <a href="/wiki/Challenge-dechallenge-rechallenge" class="mw-redirect" title="Challenge-dechallenge-rechallenge">challenge-dechallenge-rechallenge</a> protocol (stopping and starting the agent in question).<sup id="cite_ref-pmid15148066_3-5" class="reference"><a href="#cite_note-pmid15148066-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> The <a href="/wiki/Chronology" title="Chronology">chronology</a> of the onset of the suspected ADR is important, as another substance or factor may be implicated as a cause; co-prescribed medications and underlying <a href="/wiki/Psychiatric_conditions" class="mw-redirect" title="Psychiatric conditions">psychiatric conditions</a> may be factors in the ADR.<sup id="cite_ref-pmid15148066_3-6" class="reference"><a href="#cite_note-pmid15148066-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> </p><p>Assigning <a href="/wiki/Causality" title="Causality">causality</a> to a specific agent often proves difficult, unless the event is found during a clinical study or large databases are used. Both methods have difficulties and can be fraught with error. Even in clinical studies, some ADRs may be missed as large numbers of test individuals are required to find a specific adverse drug reaction, especially for rare ADRs. Psychiatric ADRs are often missed as they are grouped together in the questionnaires used to assess the population.<sup id="cite_ref-pmid20852483_32-0" class="reference"><a href="#cite_note-pmid20852483-32"><span class="cite-bracket">[</span>32<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-pmid14626141_33-0" class="reference"><a href="#cite_note-pmid14626141-33"><span class="cite-bracket">[</span>33<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Monitoring_bodies">Monitoring bodies</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Adverse_drug_reaction&action=edit&section=16" title="Edit section: Monitoring bodies"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Many countries have official bodies that monitor drug safety and reactions. On an international level, the <a href="/wiki/WHO" class="mw-redirect" title="WHO">WHO</a> runs the <a href="/wiki/Uppsala_Monitoring_Centre" title="Uppsala Monitoring Centre">Uppsala Monitoring Centre</a>.<sup id="cite_ref-34" class="reference"><a href="#cite_note-34"><span class="cite-bracket">[</span>34<span class="cite-bracket">]</span></a></sup> The <a href="/wiki/European_Union" title="European Union">European Union</a> runs the <a href="/wiki/European_Medicines_Agency" title="European Medicines Agency">European Medicines Agency</a> (EMA).<sup id="cite_ref-35" class="reference"><a href="#cite_note-35"><span class="cite-bracket">[</span>35<span class="cite-bracket">]</span></a></sup> In the <a href="/wiki/United_States" title="United States">United States</a>, the <a href="/wiki/Food_and_Drug_Administration" title="Food and Drug Administration">Food and Drug Administration</a> (FDA) is responsible for monitoring post-marketing studies.<sup id="cite_ref-U.S._Food_&_Drug_Administration_2018_36-0" class="reference"><a href="#cite_note-U.S._Food_&_Drug_Administration_2018-36"><span class="cite-bracket">[</span>36<span class="cite-bracket">]</span></a></sup> The FDA has a reporting system called the <a href="/wiki/FDA_Adverse_Event_Reporting_System" title="FDA Adverse Event Reporting System">FDA Adverse Event Reporting System</a>, where individuals can report adverse drug events.<sup id="cite_ref-U.S._Food_&_Drug_Administration_2018_36-1" class="reference"><a href="#cite_note-U.S._Food_&_Drug_Administration_2018-36"><span class="cite-bracket">[</span>36<span class="cite-bracket">]</span></a></sup> Healthcare professionals, consumers, and the pharmaceutical industry can all submit information to this system.<sup id="cite_ref-U.S._Food_&_Drug_Administration_2018_36-2" class="reference"><a href="#cite_note-U.S._Food_&_Drug_Administration_2018-36"><span class="cite-bracket">[</span>36<span class="cite-bracket">]</span></a></sup> For health products marketed in <a href="/wiki/Canada" title="Canada">Canada</a>, a branch of <a href="/wiki/Health_Canada" title="Health Canada">Health Canada</a> called The Canada Vigilance Program is responsible for surveillance.<sup id="cite_ref-Government_of_Canada_2008_37-0" class="reference"><a href="#cite_note-Government_of_Canada_2008-37"><span class="cite-bracket">[</span>37<span class="cite-bracket">]</span></a></sup> Both healthcare professionals and consumers can report to this program.<sup id="cite_ref-Government_of_Canada_2008_37-1" class="reference"><a href="#cite_note-Government_of_Canada_2008-37"><span class="cite-bracket">[</span>37<span class="cite-bracket">]</span></a></sup> In <a href="/wiki/Australia" title="Australia">Australia</a>, the <a href="/wiki/Therapeutic_Goods_Administration" title="Therapeutic Goods Administration">Therapeutic Goods Administration</a> (TGA) conducts postmarket monitoring of therapeutic products.<sup id="cite_ref-38" class="reference"><a href="#cite_note-38"><span class="cite-bracket">[</span>38<span class="cite-bracket">]</span></a></sup> In the UK, a monitoring system called the <a href="/wiki/Yellow_Card_Scheme" title="Yellow Card Scheme">Yellow Card Scheme</a> was established in 1964.<sup id="cite_ref-39" class="reference"><a href="#cite_note-39"><span class="cite-bracket">[</span>39<span class="cite-bracket">]</span></a></sup> The <a href="/wiki/Yellow_Card_Scheme" title="Yellow Card Scheme">Yellow Card Scheme</a> was set up to surveil medications and other health products.<sup id="cite_ref-40" class="reference"><a href="#cite_note-40"><span class="cite-bracket">[</span>40<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Epidemiology">Epidemiology</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Adverse_drug_reaction&action=edit&section=17" title="Edit section: Epidemiology"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>A study by the <a href="/wiki/Agency_for_Healthcare_Research_and_Quality" title="Agency for Healthcare Research and Quality">Agency for Healthcare Research and Quality</a> (AHRQ) found that in 2011, <a href="/wiki/Sedative" title="Sedative">sedatives</a> and <a href="/wiki/Hypnotic" title="Hypnotic">hypnotics</a> were a leading source for adverse drug events seen in the <a href="/wiki/Hospital" title="Hospital">hospital</a> setting. Approximately 2.8% of all ADEs present on admission and 4.4% of ADEs that originated during a hospital stay were caused by a sedative or hypnotic drug.<sup id="cite_ref-41" class="reference"><a href="#cite_note-41"><span class="cite-bracket">[</span>41<span class="cite-bracket">]</span></a></sup> A second study by AHRQ found that in 2011, the most common specifically identified causes of adverse drug events that originated during hospital stays in the U.S. were <a href="/wiki/Steroid" title="Steroid">steroids</a>, <a href="/wiki/Antibiotic" title="Antibiotic">antibiotics</a>, opiates/narcotics, and <a href="/wiki/Anticoagulant" title="Anticoagulant">anticoagulants</a>. Patients treated in urban teaching hospitals had higher rates of ADEs involving <a href="/wiki/Antibiotic" title="Antibiotic">antibiotics</a> and opiates/narcotics compared to those treated in urban nonteaching hospitals. Those treated in private, nonprofit hospitals had higher rates of most ADE causes compared to patients treated in public or private, for-profit hospitals.<sup id="cite_ref-hcup-us.ahrq.gov_42-0" class="reference"><a href="#cite_note-hcup-us.ahrq.gov-42"><span class="cite-bracket">[</span>42<span class="cite-bracket">]</span></a></sup> </p><p>Medication related harm (MRH) is common after hospital discharge in older adults, but methodological inconsistencies between studies and a paucity of data on risk factors limits clear understanding of the epidemiology. There was a wide range in incidence, from 0.4% to 51.2% of participants, and 35% to 59% of harm was preventable. Medication related harm incidence within 30 days after discharge ranged from 167 to 500 events per 1,000 individuals discharged (17–51% of individuals).<sup id="cite_ref-43" class="reference"><a href="#cite_note-43"><span class="cite-bracket">[</span>43<span class="cite-bracket">]</span></a></sup> </p><p>In the U.S., females had a higher rate of ADEs involving <a href="/wiki/Opiate" title="Opiate">opiates</a> and <a href="/wiki/Narcotic" title="Narcotic">narcotics</a> than males in 2011, while male patients had a higher rate of <a href="/wiki/Anticoagulant" title="Anticoagulant">anticoagulant</a> ADEs. Nearly 8 in 1,000 adults aged 65 years or older experienced one of the four most common ADEs (steroids, antibiotics, opiates/narcotics, and anticoagulants) during hospitalization.<sup id="cite_ref-hcup-us.ahrq.gov_42-1" class="reference"><a href="#cite_note-hcup-us.ahrq.gov-42"><span class="cite-bracket">[</span>42<span class="cite-bracket">]</span></a></sup> A study showed that 48% of patients had an adverse drug reaction to at least one drug, and pharmacist involvement helps to pick up adverse drug reactions.<sup id="cite_ref-Yeung_E_44-0" class="reference"><a href="#cite_note-Yeung_E-44"><span class="cite-bracket">[</span>44<span class="cite-bracket">]</span></a></sup> </p><p>In 2012, <a href="/wiki/McKinsey_%26_Company" title="McKinsey & Company">McKinsey & Company</a> concluded that the cost of the 50-100 million preventable error-related adverse drug events would be between US$18–115 billion.<sup id="cite_ref-Ebel_2012_45-0" class="reference"><a href="#cite_note-Ebel_2012-45"><span class="cite-bracket">[</span>45<span class="cite-bracket">]</span></a></sup> </p><p>An article published in <a href="/wiki/JAMA" title="JAMA">The Journal of the American Medical Association</a> (JAMA) in 2016 reported adverse drug event statistics from <a href="/wiki/Emergency_department" title="Emergency department">emergency departments</a> around the <a href="/wiki/United_States" title="United States">United States</a> in 2013-2014.<sup id="cite_ref-Shehab_2016_46-0" class="reference"><a href="#cite_note-Shehab_2016-46"><span class="cite-bracket">[</span>46<span class="cite-bracket">]</span></a></sup> From this article, an estimated prevalence of adverse drug events that were presented to the emergency department (ED) was 4 events out of every 1000 people.<sup id="cite_ref-Shehab_2016_46-1" class="reference"><a href="#cite_note-Shehab_2016-46"><span class="cite-bracket">[</span>46<span class="cite-bracket">]</span></a></sup> This article reported that 57.1% of these adverse drug events presented to the ED were in females.<sup id="cite_ref-Shehab_2016_46-2" class="reference"><a href="#cite_note-Shehab_2016-46"><span class="cite-bracket">[</span>46<span class="cite-bracket">]</span></a></sup> As well, out of all of the adverse drug events presented to the emergency department documented in this article, 17.6% were from <a href="/wiki/Anticoagulant" title="Anticoagulant">anticoagulants</a>, 16.1% were from <a href="/wiki/Antibiotic" title="Antibiotic">antibiotics</a>, and 13.3% from <a href="/wiki/Diabetes" title="Diabetes">diabetic</a> agents.<sup id="cite_ref-Shehab_2016_46-3" class="reference"><a href="#cite_note-Shehab_2016-46"><span class="cite-bracket">[</span>46<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="See_also">See also</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Adverse_drug_reaction&action=edit&section=18" title="Edit section: See also"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <style data-mw-deduplicate="TemplateStyles:r1184024115">.mw-parser-output .div-col{margin-top:0.3em;column-width:30em}.mw-parser-output .div-col-small{font-size:90%}.mw-parser-output .div-col-rules{column-rule:1px solid #aaa}.mw-parser-output .div-col dl,.mw-parser-output .div-col ol,.mw-parser-output .div-col ul{margin-top:0}.mw-parser-output .div-col li,.mw-parser-output .div-col dd{page-break-inside:avoid;break-inside:avoid-column}</style><div class="div-col" style="column-width: 30em;"> <ul><li><a href="/wiki/Criticism_of_the_Food_and_Drug_Administration#Alleged_problems_in_the_drug_approval_process" title="Criticism of the Food and Drug Administration">Alleged problems in the drug approval process</a></li> <li><a href="/wiki/Classification_of_Pharmaco-Therapeutic_Referrals" title="Classification of Pharmaco-Therapeutic Referrals">Classification of Pharmaco-Therapeutic Referrals</a></li> <li><a href="/wiki/Drug_therapy_problems" title="Drug therapy problems">Drug therapy problems</a></li> <li><a href="/wiki/EudraVigilance" title="EudraVigilance">EudraVigilance</a> (<a href="/wiki/European_Union" title="European Union">European Union</a>)</li> <li><a href="/wiki/History_of_pharmacy" title="History of pharmacy">History of pharmacy</a></li> <li><a href="/wiki/Iatrogenesis" title="Iatrogenesis">Iatrogenesis</a></li> <li><a href="/wiki/Lethal_dose" title="Lethal dose">Lethal dose</a></li> <li><a href="/wiki/List_of_withdrawn_drugs" title="List of withdrawn drugs">List of withdrawn drugs</a></li> <li><a href="/wiki/Paradoxical_reaction" title="Paradoxical reaction">Paradoxical reaction</a></li> <li><a href="/wiki/Polypharmacy" title="Polypharmacy">Polypharmacy</a></li> <li><a href="/wiki/Toxicity" title="Toxicity">Toxicity</a></li> <li><a href="/wiki/Toxicology" title="Toxicology">Toxicology</a></li> <li><a href="/wiki/The_Medical_Letter_on_Drugs_and_Therapeutics" title="The Medical Letter on Drugs and Therapeutics">The Medical Letter on Drugs and Therapeutics</a></li> <li><a href="/wiki/Yellow_Card_Scheme" title="Yellow Card Scheme">Yellow Card Scheme</a> (UK)</li></ul> </div> <div class="mw-heading mw-heading2"><h2 id="References">References</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Adverse_drug_reaction&action=edit&section=19" title="Edit section: References"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <style data-mw-deduplicate="TemplateStyles:r1239543626">.mw-parser-output .reflist{margin-bottom:0.5em;list-style-type:decimal}@media screen{.mw-parser-output .reflist{font-size:90%}}.mw-parser-output .reflist .references{font-size:100%;margin-bottom:0;list-style-type:inherit}.mw-parser-output .reflist-columns-2{column-width:30em}.mw-parser-output .reflist-columns-3{column-width:25em}.mw-parser-output .reflist-columns{margin-top:0.3em}.mw-parser-output .reflist-columns ol{margin-top:0}.mw-parser-output .reflist-columns li{page-break-inside:avoid;break-inside:avoid-column}.mw-parser-output .reflist-upper-alpha{list-style-type:upper-alpha}.mw-parser-output .reflist-upper-roman{list-style-type:upper-roman}.mw-parser-output .reflist-lower-alpha{list-style-type:lower-alpha}.mw-parser-output .reflist-lower-greek{list-style-type:lower-greek}.mw-parser-output .reflist-lower-roman{list-style-type:lower-roman}</style><div class="reflist"> <div class="mw-references-wrap mw-references-columns"><ol class="references"> <li id="cite_note-MEDIA482-1"><span class="mw-cite-backlink">^ <a href="#cite_ref-MEDIA482_1-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-MEDIA482_1-1"><sup><i><b>b</b></i></sup></a></span> <span class="reference-text"><style data-mw-deduplicate="TemplateStyles:r1238218222">.mw-parser-output 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a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-limited a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-registration a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-subscription a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .cs1-ws-icon a{background-size:contain;padding:0 1em 0 0}.mw-parser-output .cs1-code{color:inherit;background:inherit;border:none;padding:inherit}.mw-parser-output .cs1-hidden-error{display:none;color:var(--color-error,#d33)}.mw-parser-output .cs1-visible-error{color:var(--color-error,#d33)}.mw-parser-output .cs1-maint{display:none;color:#085;margin-left:0.3em}.mw-parser-output .cs1-kern-left{padding-left:0.2em}.mw-parser-output .cs1-kern-right{padding-right:0.2em}.mw-parser-output .citation .mw-selflink{font-weight:inherit}@media screen{.mw-parser-output .cs1-format{font-size:95%}html.skin-theme-clientpref-night .mw-parser-output .cs1-maint{color:#18911f}}@media screen and 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class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/27893129">27893129</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=JAMA&rft.atitle=US+Emergency+Department+Visits+for+Outpatient+Adverse+Drug+Events%2C+2013-2014&rft.volume=316&rft.issue=20&rft.pages=%3Cspan+class%3D%22nowrap%22%3E2115-%3C%2Fspan%3E2125&rft.date=2016-11&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC6490178%23id-name%3DPMC&rft_id=info%3Apmid%2F27893129&rft_id=info%3Adoi%2F10.1001%2Fjama.2016.16201&rft.aulast=Shehab&rft.aufirst=N&rft.au=Lovegrove%2C+MC&rft.au=Geller%2C+AI&rft.au=Rose%2C+KO&rft.au=Weidle%2C+NJ&rft.au=Budnitz%2C+DS&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC6490178&rfr_id=info%3Asid%2Fen.wikipedia.org%3AAdverse+drug+reaction" class="Z3988"></span></span> </li> </ol></div></div> <div class="mw-heading mw-heading2"><h2 id="Further_reading">Further reading</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Adverse_drug_reaction&action=edit&section=20" title="Edit section: Further reading"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <ul><li><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3312730/">Incidence of adverse drug reactions in human immune deficiency virus-positive patients using highly active antiretroviral therapy</a> <a href="/wiki/PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3312730/">3312730</a></li></ul> <div class="mw-heading mw-heading2"><h2 id="External_links">External links</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a 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style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="row" class="navbox-group" style="width:1%;background: #EAECF0;color:black;">Classification</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"><div style="position:relative; float:right; font-size:0.8em;"><a href="https://www.wikidata.org/wiki/Q45959" class="extiw" title="d:Q45959">D</a></div><div class="hlist" style="text-align:left;"><ul><li><b><a href="/wiki/International_Statistical_Classification_of_Diseases_and_Related_Health_Problems" class="mw-redirect" title="International Statistical Classification of Diseases and Related Health Problems">ICD</a>-<a href="/wiki/ICD-10" title="ICD-10">10</a></b>: <a rel="nofollow" class="external text" href="https://icd.who.int/browse10/2019/en#/T88.7">T88.7</a>, <a rel="nofollow" class="external text" href="https://icd.who.int/browse10/2019/en#/Y40-Y59">Y40-Y59</a>, <a rel="nofollow" class="external text" href="https://icd.who.int/browse10/2019/en#/U12.9">U12.9</a></li><li><b><a href="/wiki/International_Statistical_Classification_of_Diseases_and_Related_Health_Problems" class="mw-redirect" title="International Statistical Classification of Diseases and Related Health Problems">ICD</a>-<a href="/wiki/List_of_ICD-9_codes" title="List of ICD-9 codes">9-CM</a></b>: <a rel="nofollow" class="external text" href="http://www.icd9data.com/getICD9Code.ashx?icd9=995.2">995.2</a>, <a rel="nofollow" class="external text" href="http://www.icd9data.com/getICD9Code.ashx?icd9=E850">E850</a>-<a rel="nofollow" class="external text" href="http://www.icd9data.com/getICD9Code.ashx?icd9=E858">E858</a></li><li><b><a href="/wiki/Medical_Subject_Headings" title="Medical Subject Headings">MeSH</a></b>: <a rel="nofollow" class="external text" href="https://meshb.nlm.nih.gov/record/ui?ui=D004362">D004362</a></li><li><b><a href="/wiki/Diseases_Database" title="Diseases Database">DiseasesDB</a></b>: <a rel="nofollow" class="external text" href="http://www.diseasesdatabase.com/ddb295.htm">295</a></li></ul></div></div></td></tr></tbody></table></div> <div style="clear:both;" class=""></div> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374" /><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236075235" /></div><div role="navigation" class="navbox" aria-labelledby="Medical_harm82" style="padding:3px"><table class="nowraplinks mw-collapsible autocollapse navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="col" class="navbox-title" colspan="2" style="text-align:center;"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374" /><style data-mw-deduplicate="TemplateStyles:r1239400231">.mw-parser-output .navbar{display:inline;font-size:88%;font-weight:normal}.mw-parser-output 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drug reaction</a></li></ul></li> <li><a href="/wiki/Iatrogenesis" title="Iatrogenesis">Iatrogenesis</a></li> <li><a href="/wiki/Informed_consent" title="Informed consent">Informed consent</a></li> <li><a href="/wiki/Involuntary_treatment" title="Involuntary treatment">Involuntary treatment</a></li> <li><a href="/wiki/Medical_law" title="Medical law">Medical law</a></li> <li><a href="/wiki/Medical_malpractice" title="Medical malpractice">Medical malpractice</a></li> <li><a href="/wiki/Medical_error" title="Medical error">Medical error</a></li> <li><a href="/wiki/Medical_ethics" title="Medical ethics">Medical ethics</a></li> <li><a href="/wiki/Never_event" title="Never event">Never event</a></li> <li><a href="/wiki/Patient_abuse" title="Patient abuse">Patient abuse</a></li> <li><a href="/wiki/Patient_safety" title="Patient safety">Patient safety</a></li> <li><a href="/wiki/Primum_non_nocere" title="Primum non nocere">Primum non nocere</a></li> <li><a href="/wiki/Unnecessary_health_care" title="Unnecessary health care">Unnecessary health care</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="text-align:center;;width:1%">Economic and financial concerns</th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Medical_debt" title="Medical debt">Medical debt</a></li> <li><a href="/wiki/Balance_billing" title="Balance billing">Balance billing</a></li> <li><a href="/wiki/Financial_toxicity" title="Financial toxicity">Financial toxicity</a></li> <li><a href="/wiki/Medication_costs" title="Medication costs">Medication costs</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="text-align:center;;width:1%">Political abuse</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Drapetomania" title="Drapetomania">Drapetomania</a></li> <li><a href="/wiki/Sluggish_schizophrenia" title="Sluggish schizophrenia">Sluggish schizophrenia</a></li> <li><a href="/wiki/Compulsory_sterilization" title="Compulsory sterilization">Compulsory sterilization</a></li> <li><a href="/wiki/Medical_torture" title="Medical torture">Medical torture</a></li> <li><a href="/wiki/Pharmacological_torture" title="Pharmacological torture">Pharmacological torture</a></li> <li><a href="/wiki/Physician_gag_law" title="Physician gag law">Physician gag law</a></li> <li><i><a href="/wiki/The_Protest_Psychosis" title="The Protest Psychosis">The Protest Psychosis</a></i></li> <li><a href="/wiki/Political_abuse_of_psychiatry" title="Political abuse of psychiatry">Political abuse of psychiatry</a> <ul><li><a href="/wiki/Political_abuse_of_psychiatry_in_Russia" title="Political abuse of psychiatry in Russia">in Russia</a></li> <li><a href="/wiki/Political_abuse_of_psychiatry_in_the_Soviet_Union" title="Political abuse of psychiatry in the Soviet Union">in the Soviet Union</a></li> <li><a href="/wiki/Political_abuse_of_psychiatry_in_the_United_States" class="mw-redirect" title="Political abuse of psychiatry in the United States">in the United States</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="text-align:center;;width:1%">Related concerns</th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Hospital-acquired_pneumonia" title="Hospital-acquired pneumonia">Hospital-acquired pneumonia</a></li> <li><a href="/wiki/Hospital-acquired_infection" title="Hospital-acquired infection">Hospital-acquired infection</a></li> <li><a href="/wiki/Iatrogenic_anemia" title="Iatrogenic anemia">Iatrogenic anemia</a></li> <li><a href="/wiki/Medical_resident_work_hours" title="Medical resident work hours">Medical resident work hours</a></li> <li><a href="/wiki/Physician_supply" title="Physician supply">Physician supply</a></li> <li><a href="/wiki/Drug_pollution" title="Drug pollution">Drug pollution</a> <ul><li><a href="/wiki/List_of_medicine_contamination_incidents" title="List of medicine contamination incidents">List</a></li></ul></li></ul> </div></td></tr></tbody></table></div> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374" /><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236075235" /></div><div role="navigation" class="navbox" aria-labelledby="Consequences_of_external_causes765" style="padding:3px"><table class="nowraplinks hlist mw-collapsible autocollapse navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374" /><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1239400231" /><div class="navbar plainlinks hlist navbar-mini"><ul><li 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navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%">Elevated</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Burn" title="Burn">Burn</a></li> <li><a href="/wiki/Hyperthermia" title="Hyperthermia">Hyperthermia</a></li> <li><a href="/wiki/Heat_syncope" title="Heat syncope">Heat syncope</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Reduced</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Hypothermia" title="Hypothermia">Hypothermia</a></li> <li><a href="/wiki/Immersion_foot_syndromes" title="Immersion foot syndromes">Immersion foot syndromes</a> <ul><li><a href="/wiki/Trench_foot" title="Trench foot">Trench foot</a></li> <li><a href="/wiki/Tropical_immersion_foot" class="mw-redirect" title="Tropical immersion foot">Tropical immersion foot</a></li> <li><a href="/wiki/Warm_water_immersion_foot" class="mw-redirect" title="Warm water immersion foot">Warm water immersion foot</a></li></ul></li> <li><a href="/wiki/Non-freezing_cold_injury" title="Non-freezing cold injury">Non-freezing cold injury</a></li> <li><a href="/wiki/Chilblains" title="Chilblains">Chilblains</a></li> <li><a href="/wiki/Frostbite" title="Frostbite">Frostbite</a></li> <li><a href="/wiki/Aerosol_burn" title="Aerosol burn">Aerosol burn</a></li> <li><a href="/wiki/Cold_intolerance" class="mw-redirect" title="Cold intolerance">Cold intolerance</a></li> <li><a href="/wiki/Acrocyanosis" title="Acrocyanosis">Acrocyanosis</a></li> <li><a href="/wiki/Erythrocyanosis_crurum" title="Erythrocyanosis crurum">Erythrocyanosis crurum</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Radiation</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Chronic_radiation_keratosis" class="mw-redirect" title="Chronic radiation keratosis">Chronic radiation keratosis</a></li> <li><a href="/wiki/Eosinophilic,_polymorphic,_and_pruritic_eruption_associated_with_radiotherapy" class="mw-redirect" title="Eosinophilic, polymorphic, and pruritic eruption associated with radiotherapy">Eosinophilic, polymorphic, and pruritic eruption associated with radiotherapy</a></li> <li><a href="/wiki/Radiation_acne" class="mw-redirect" title="Radiation acne">Radiation acne</a></li> <li><a href="/wiki/Radiation_burn" title="Radiation burn">Radiation burn</a></li> <li><a href="/wiki/Radiation-induced_cancer" title="Radiation-induced cancer">Radiation-induced cancer</a></li> <li><a href="/wiki/Radiation-induced_erythema_multiforme" class="mw-redirect" title="Radiation-induced erythema multiforme">Radiation-induced erythema multiforme</a></li> <li><a href="/wiki/Radiation-induced_hypertrophic_scar" class="mw-redirect" title="Radiation-induced hypertrophic scar">Radiation-induced hypertrophic scar</a></li> <li><a href="/wiki/Radiation-induced_keloid" class="mw-redirect" title="Radiation-induced keloid">Radiation-induced keloid</a></li> <li><a href="/wiki/Radiation-induced_morphea" class="mw-redirect" title="Radiation-induced morphea">Radiation-induced morphea</a></li> <li><a href="/wiki/Radiation_poisoning" class="mw-redirect" title="Radiation poisoning">Radiation poisoning</a></li> <li><a href="/wiki/Radiation_recall_reaction" class="mw-redirect" title="Radiation recall reaction">Radiation recall reaction</a></li> <li><a href="/wiki/Sunburn" title="Sunburn">Sunburn</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Oxygen</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Hypoxia_(medical)" class="mw-redirect" title="Hypoxia (medical)">Hypoxia</a>/<a href="/wiki/Asphyxia" title="Asphyxia">Asphyxia</a></li> <li><a href="/wiki/Oxygen_toxicity" title="Oxygen toxicity">Oxygen toxicity</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Pressure</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Barotrauma" title="Barotrauma">Barotrauma</a> <ul><li><a href="/wiki/Arterial_gas_embolism" class="mw-redirect" title="Arterial gas embolism">Arterial gas embolism</a></li> <li><a href="/wiki/Aerosinusitis" title="Aerosinusitis">Aerosinusitis</a></li> <li><a href="/wiki/Middle_ear_barotrauma" title="Middle ear barotrauma">Middle ear barotrauma</a></li> <li><a href="/wiki/Pneumothorax" title="Pneumothorax">Pneumothorax</a></li></ul></li> <li><a href="/wiki/Decompression_sickness" title="Decompression sickness">Decompression sickness</a> <ul><li><a href="/wiki/Inner_ear_decompression_sickness" title="Inner ear decompression sickness">Inner ear decompression sickness</a></li></ul></li> <li><a href="/wiki/Effects_of_high_altitude_on_humans" title="Effects of high altitude on humans">High altitude</a> <ul><li><a href="/wiki/Altitude_sickness" title="Altitude sickness">Altitude sickness</a></li> <li><a href="/wiki/Chronic_mountain_sickness" title="Chronic mountain sickness">Chronic mountain sickness</a></li> <li><a href="/wiki/Death_zone" title="Death zone">Death zone</a></li> <li><a href="/wiki/High-altitude_pulmonary_edema" title="High-altitude pulmonary edema">High-altitude pulmonary edema</a> (HAPE)</li> <li><a href="/wiki/High-altitude_cerebral_edema" title="High-altitude cerebral edema">High-altitude cerebral edema</a> (HACE)</li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Food</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Starvation" title="Starvation">Starvation</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Maltreatment</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Physical_abuse" title="Physical abuse">Physical abuse</a></li> <li><a href="/wiki/Sexual_abuse" title="Sexual abuse">Sexual abuse</a></li> <li><a href="/wiki/Psychological_abuse" title="Psychological abuse">Psychological abuse</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Travel</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Motion_sickness" title="Motion sickness">Motion sickness</a></li> <li><a href="/wiki/Seasickness" class="mw-redirect" title="Seasickness">Seasickness</a></li> <li><a href="/wiki/Airsickness" title="Airsickness">Airsickness</a></li> <li><a href="/wiki/Space_adaptation_syndrome" title="Space adaptation syndrome">Space adaptation syndrome</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Adverse effect</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Hypersensitivity" title="Hypersensitivity">Hypersensitivity</a> <ul><li><a href="/wiki/Anaphylaxis" title="Anaphylaxis">Anaphylaxis</a></li> <li><a href="/wiki/Angioedema" title="Angioedema">Angioedema</a></li> <li><a href="/wiki/Allergy" title="Allergy">Allergy</a></li> <li><a href="/wiki/Arthus_reaction" title="Arthus reaction">Arthus reaction</a></li></ul></li></ul> <ul><li><a class="mw-selflink selflink">Adverse drug reaction</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Other</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Electrical_injury" title="Electrical injury">Electrical injury</a> <ul><li><a href="/wiki/Lightning_injuries" class="mw-redirect" title="Lightning injuries">Lightning injuries</a></li></ul></li> <li><a href="/wiki/Drowning" title="Drowning">Drowning</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Ungrouped <br /> skin conditions <br /> resulting from <br /> physical factors</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Dermatosis_neglecta" title="Dermatosis neglecta">Dermatosis neglecta</a></li> <li><a href="/wiki/Pinch_mark" title="Pinch mark">Pinch mark</a></li> <li><a href="/wiki/Pseudoverrucous_papules_and_nodules" title="Pseudoverrucous papules and nodules">Pseudoverrucous papules and nodules</a></li> <li><a href="/wiki/Sclerosing_lymphangitis" title="Sclerosing lymphangitis">Sclerosing lymphangitis</a></li> <li><a href="/wiki/Tropical_anhidrotic_asthenia" class="mw-redirect" title="Tropical anhidrotic asthenia">Tropical anhidrotic asthenia</a></li> <li><a href="/wiki/UV-sensitive_syndrome" title="UV-sensitive syndrome">UV-sensitive syndrome</a></li> <li><i>environmental skin conditions</i> <ul><li><a href="/wiki/Electrical_burn" title="Electrical burn">Electrical burn</a></li></ul></li> <li><i>frictional/traumatic/sports</i> <ul><li><a href="/wiki/Black_heel_and_palm" title="Black heel and palm">Black heel and palm</a></li> <li><a href="/wiki/Equestrian_perniosis" title="Equestrian perniosis">Equestrian perniosis</a></li> <li><a href="/wiki/Fissure_of_the_nipple" title="Fissure of the nipple">Fissure of the nipple</a></li> <li><a href="/wiki/Pulling_boat_hands" title="Pulling boat hands">Pulling boat hands</a></li> <li><a href="/wiki/Runner%27s_rump" title="Runner's rump">Runner's rump</a></li> <li><a href="/wiki/Surfer%27s_knots" title="Surfer's knots">Surfer's knots</a></li> <li><a href="/wiki/Tennis_toe" class="mw-redirect" title="Tennis toe">Tennis toe</a></li> <li><a href="/wiki/Vibration_white_finger" class="mw-redirect" title="Vibration white finger">Vibration white finger</a></li> <li><a href="/wiki/Weathering_nodule_of_ear" title="Weathering nodule of ear">Weathering nodule of ear</a></li> <li><a href="/wiki/Wrestler%27s_ear" class="mw-redirect" title="Wrestler's ear">Wrestler's ear</a></li> <li><a href="/wiki/Coral_cut" title="Coral cut">Coral cut</a></li> <li><a href="/wiki/Painful_fat_herniation" class="mw-redirect" title="Painful fat herniation">Painful fat herniation</a></li></ul></li> <li><a href="/wiki/Uranium_dermatosis" title="Uranium dermatosis">Uranium dermatosis</a></li> <li><i>iv use</i> <ul><li><a href="/wiki/Skin_pop_scar" title="Skin pop scar">Skin pop scar</a></li> <li><a href="/wiki/Skin_track" title="Skin track">Skin track</a></li> <li><a href="/wiki/Slap_mark" class="mw-redirect" title="Slap mark">Slap mark</a></li> <li><a href="/wiki/Pseudoacanthosis_nigricans" class="mw-redirect" title="Pseudoacanthosis nigricans">Pseudoacanthosis nigricans</a></li> <li><a href="/wiki/Narcotic_dermopathy" title="Narcotic dermopathy">Narcotic dermopathy</a></li></ul></li></ul> </div></td></tr><tr><td class="navbox-abovebelow" colspan="2" style="font-weight: bold;"><div> <ul><li><span class="noviewer" typeof="mw:File"><span title="Category"><img alt="" src="//upload.wikimedia.org/wikipedia/en/thumb/9/96/Symbol_category_class.svg/16px-Symbol_category_class.svg.png" decoding="async" width="16" height="16" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/9/96/Symbol_category_class.svg/23px-Symbol_category_class.svg.png 1.5x, //upload.wikimedia.org/wikipedia/en/thumb/9/96/Symbol_category_class.svg/31px-Symbol_category_class.svg.png 2x" data-file-width="180" data-file-height="185" /></span></span> <b><a href="/wiki/Category:Medicine" title="Category:Medicine">Category</a></b></li> <li><span class="noviewer" typeof="mw:File"><span title="Commons page"><img alt="" src="//upload.wikimedia.org/wikipedia/en/thumb/4/4a/Commons-logo.svg/20px-Commons-logo.svg.png" decoding="async" width="12" height="16" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/4/4a/Commons-logo.svg/40px-Commons-logo.svg.png 2x" data-file-width="1024" data-file-height="1376" /></span></span> <b><a href="https://commons.wikimedia.org/wiki/Category:Medicine" class="extiw" title="commons:Category:Medicine">Commons</a></b></li> <li><span class="noviewer" typeof="mw:File"><span title="List-Class article"><img alt="" src="//upload.wikimedia.org/wikipedia/en/thumb/d/db/Symbol_list_class.svg/16px-Symbol_list_class.svg.png" decoding="async" width="16" height="16" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/d/db/Symbol_list_class.svg/23px-Symbol_list_class.svg.png 1.5x, //upload.wikimedia.org/wikipedia/en/thumb/d/db/Symbol_list_class.svg/31px-Symbol_list_class.svg.png 2x" data-file-width="180" data-file-height="185" /></span></span> <b><a href="/wiki/Glossary_of_medicine" title="Glossary of medicine">Glossary</a></b></li> <li><span class="noviewer" typeof="mw:File"><span title="Outline"><img alt="" src="//upload.wikimedia.org/wikipedia/commons/thumb/4/41/Global_thinking.svg/20px-Global_thinking.svg.png" decoding="async" width="10" height="16" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/4/41/Global_thinking.svg/40px-Global_thinking.svg.png 2x" data-file-width="130" data-file-height="200" /></span></span> <b><a href="/wiki/Outline_of_medicine" title="Outline of medicine">Outline</a></b></li> <li><span class="noviewer" typeof="mw:File"><a href="/wiki/File:Symbol_portal_class.svg" class="mw-file-description" title="Portal"><img alt="" src="//upload.wikimedia.org/wikipedia/en/thumb/e/e2/Symbol_portal_class.svg/20px-Symbol_portal_class.svg.png" decoding="async" width="16" height="16" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/e/e2/Symbol_portal_class.svg/40px-Symbol_portal_class.svg.png 1.5x" data-file-width="180" data-file-height="185" /></a></span> <b><a href="/wiki/Portal:Medicine" title="Portal:Medicine">Portal</a></b></li></ul> </div></td></tr></tbody></table></div> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374" /><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236075235" /></div><div role="navigation" class="navbox" aria-labelledby="Adverse_drug_reactions133" style="padding:3px"><table class="nowraplinks mw-collapsible autocollapse navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374" /><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1239400231" /><div class="navbar plainlinks hlist navbar-mini"><ul><li class="nv-view"><a href="/wiki/Template:Drug_reactions" title="Template:Drug reactions"><abbr title="View this template">v</abbr></a></li><li class="nv-talk"><a href="/wiki/Template_talk:Drug_reactions" title="Template talk:Drug reactions"><abbr title="Discuss this template">t</abbr></a></li><li class="nv-edit"><a href="/wiki/Special:EditPage/Template:Drug_reactions" title="Special:EditPage/Template:Drug reactions"><abbr title="Edit this template">e</abbr></a></li></ul></div><div id="Adverse_drug_reactions133" style="font-size:114%;margin:0 4em"><a class="mw-selflink selflink">Adverse drug reactions</a></div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Antibiotics" class="mw-redirect" title="Antibiotics">Antibiotics</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Penicillin_drug_reaction" class="mw-redirect" title="Penicillin drug reaction">Penicillin drug reaction</a></li> <li><a href="/wiki/Sulfonamide_hypersensitivity_syndrome" title="Sulfonamide hypersensitivity syndrome">Sulfonamide hypersensitivity syndrome</a></li> <li><a href="/wiki/Urticarial_erythema_multiforme" title="Urticarial erythema multiforme">Urticarial erythema multiforme</a></li> <li><a href="/wiki/Adverse_effects_of_fluoroquinolones" class="mw-redirect" title="Adverse effects of fluoroquinolones">Adverse effects of fluoroquinolones</a></li> <li><a href="/wiki/Red_man_syndrome_(Drug_eruption)" class="mw-redirect" title="Red man syndrome (Drug eruption)">Red man syndrome</a></li> <li><a href="/wiki/Jarisch%E2%80%93Herxheimer_reaction" title="Jarisch–Herxheimer reaction">Jarisch–Herxheimer reaction</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Hormone_therapy" title="Hormone therapy">Hormones</a></th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Steroid_acne" title="Steroid acne">Steroid acne</a></li> <li><a href="/wiki/Steroid_folliculitis" title="Steroid folliculitis">Steroid folliculitis</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Chemotherapy" title="Chemotherapy">Chemotherapy</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Chemotherapy-induced_acral_erythema" title="Chemotherapy-induced acral erythema">Chemotherapy-induced acral erythema</a></li> <li><a href="/wiki/Chemotherapy-induced_hyperpigmentation" title="Chemotherapy-induced hyperpigmentation">Chemotherapy-induced hyperpigmentation</a></li> <li><a href="/wiki/Scleroderma-like_reaction_to_taxanes" title="Scleroderma-like reaction to taxanes">Scleroderma-like reaction to taxanes</a></li> <li><a href="/wiki/Hydroxyurea_dermopathy" title="Hydroxyurea dermopathy">Hydroxyurea dermopathy</a></li> <li><a href="/wiki/Exudative_hyponychial_dermatitis" title="Exudative hyponychial dermatitis">Exudative hyponychial dermatitis</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Anticoagulants" class="mw-redirect" title="Anticoagulants">Anticoagulants</a></th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Anticoagulant-induced_skin_necrosis" class="mw-redirect" title="Anticoagulant-induced skin necrosis">Anticoagulant-induced skin necrosis</a></li> <li><a href="/wiki/Warfarin_necrosis" title="Warfarin necrosis">Warfarin necrosis</a></li> <li><a href="/wiki/Vitamin_K_reaction" title="Vitamin K reaction">Vitamin K reaction</a></li> <li><a href="/wiki/Texier%27s_disease" title="Texier's disease">Texier's disease</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Immunologics</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Adverse_reaction_to_biologic_agents" class="mw-redirect" title="Adverse reaction to biologic agents">Adverse reaction to biologic agents</a></li> <li><a href="/wiki/Leukotriene_receptor_antagonist-associated_Churg%E2%80%93Strauss_syndrome" title="Leukotriene receptor antagonist-associated Churg–Strauss syndrome">Leukotriene receptor antagonist-associated Churg–Strauss syndrome</a></li> <li><a href="/wiki/Methotrexate-induced_papular_eruption" title="Methotrexate-induced papular eruption">Methotrexate-induced papular eruption</a></li> <li><a href="/wiki/Adverse_reaction_to_cytokines" class="mw-redirect" title="Adverse reaction to cytokines">Adverse reaction to cytokines</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Other drugs</th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Anticonvulsant_hypersensitivity_syndrome" title="Anticonvulsant hypersensitivity syndrome">Anticonvulsant hypersensitivity syndrome</a></li> <li><a href="/wiki/Allopurinol_hypersensitivity_syndrome" title="Allopurinol hypersensitivity syndrome">Allopurinol hypersensitivity syndrome</a></li> <li><a href="/wiki/Vaccine_adverse_event" title="Vaccine adverse event">Vaccine adverse event</a> <ul><li><a href="/wiki/Eczema_vaccinatum" title="Eczema vaccinatum">Eczema vaccinatum</a></li></ul></li> <li><a href="/wiki/Bromoderma" title="Bromoderma">Bromoderma</a></li> <li><a href="/wiki/Halogenoderma" title="Halogenoderma">Halogenoderma</a></li> <li><a href="/wiki/Iododerma" title="Iododerma">Iododerma</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">General</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%">Skin and body membranes</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Acute_generalized_exanthematous_pustulosis" title="Acute generalized exanthematous pustulosis">Acute generalized exanthematous pustulosis</a></li> <li><a href="/wiki/Generalized_bullous_fixed_drug_eruption" title="Generalized bullous fixed drug eruption">Generalized bullous fixed drug eruption</a></li> <li><a href="/wiki/Acne_medicamentosa" title="Acne medicamentosa">Drug-induced acne</a></li> <li><a href="/wiki/Drug-induced_angioedema" title="Drug-induced angioedema">Drug-induced angioedema</a></li> <li><a href="/wiki/Drug-related_gingival_hyperplasia" title="Drug-related gingival hyperplasia">Drug-related gingival hyperplasia</a></li> <li><a href="/wiki/Drug-induced_lichenoid_reaction" class="mw-redirect" title="Drug-induced lichenoid reaction">Drug-induced lichenoid reaction</a></li> <li><a href="/wiki/Drug-induced_lupus_erythematosus" title="Drug-induced lupus erythematosus">Drug-induced lupus erythematosus</a></li> <li><a href="/wiki/Drug-induced_nail_changes" class="mw-redirect" title="Drug-induced nail changes">Drug-induced nail changes</a></li> <li><a href="/wiki/Drug-induced_pigmentation" title="Drug-induced pigmentation">Drug-induced pigmentation</a></li> <li><a href="/wiki/Drug-induced_urticaria" title="Drug-induced urticaria">Drug-induced urticaria</a></li> <li><a href="/wiki/Stevens%E2%80%93Johnson_syndrome" title="Stevens–Johnson syndrome">Stevens–Johnson syndrome</a></li> <li><a href="/wiki/Injection_site_reaction" title="Injection site reaction">Injection site reaction</a></li> <li><a href="/wiki/Linear_IgA_bullous_dermatosis" title="Linear IgA bullous dermatosis">Linear IgA bullous dermatosis</a></li> <li><a href="/wiki/Toxic_epidermal_necrolysis" title="Toxic epidermal necrolysis">Toxic epidermal necrolysis</a></li> <li><a href="/wiki/HIV_disease-related_drug_reaction" class="mw-redirect" title="HIV disease-related drug reaction">HIV disease-related drug reaction</a></li> <li><a href="/wiki/Photosensitive_drug_reaction" title="Photosensitive drug reaction">Photosensitive drug reaction</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Other</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Fixed_drug_reaction" title="Fixed drug reaction">Fixed drug reaction</a></li> <li><a href="/wiki/Serum_sickness-like_reaction" title="Serum sickness-like reaction">Serum sickness-like reaction</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr></tbody></table></div> <p class="mw-empty-elt"> </p>    </div><noscript><img src="https://auth.wikimedia.org/loginwiki/wiki/Special:CentralAutoLogin/start?useformat=desktop&type=1x1&usesul3=1" alt="" width="1" height="1" style="border: none; position: absolute;"></noscript> <div class="printfooter" data-nosnippet="">Retrieved from "<a dir="ltr" href="https://en.wikipedia.org/w/index.php?title=Adverse_drug_reaction&oldid=1277508820">https://en.wikipedia.org/w/index.php?title=Adverse_drug_reaction&oldid=1277508820</a>"</div></div> <div id="catlinks" class="catlinks" data-mw="interface"><div id="mw-normal-catlinks" class="mw-normal-catlinks"><a href="/wiki/Help:Category" title="Help:Category">Categories</a>: <ul><li><a href="/wiki/Category:Pharmacy" 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