首页> 外文期刊>Pharmacoepidemiology and drug safety >Classification of ADRs: a proposal for harmonization and differentiation based on the experience of the Comprehensive Hospital Drug Monitoring Bern/St. Gallen, 1974-1993.
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Classification of ADRs: a proposal for harmonization and differentiation based on the experience of the Comprehensive Hospital Drug Monitoring Bern/St. Gallen, 1974-1993.

机译:ADR的分类:根据伯尔尼/圣保罗医院综合药物监测的经验提出的统一和区别建议。加伦(1974-1993)。

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The present paper deals with the classification of adverse drug reactions (ADRs) according to today's largely accepted pathomechanisms. The classification system applied, relies primarily on the proposals of Rawlins and Thomson with type A ('augmented') and B ('bizarre') reactions. In the database of the Comprehensive Hospital Drug Monitoring (CHDM) Bern/St. Gallen on 48,005 consecutively hospitalized patients, ADRs had been attributed to 10 different pathomechanisms. These permit a versatile new system, easily adaptable to expanding knowledge. If we look at the 12,785 ADRs registered in the CHDM Bern/St. Gallen from 1974 to 1993, 76% were of type A, 13% of type B, and 11% of a pathomechanism not yet defined (type X). The main subgroups were A1 'not specified' in type A, Ba allergic/immunological and Bpa pseudoallergic/anaphylactoid in type B. Dose-related (A2) and drug-related reactions (A4, intolerance in a restricted sense), drug-to-drug interactions (A5), rebound/withdrawal effects (A6) and secondary reactions (A7) represented smaller subgroups. Patient-related reactions (A3, 'idiosyncrasy' in the strict sense) were not assessed. Today's algorithms for ADRs mainly rely on pharmacological, i.e. type A reactions. For most of the type B reactions adaptations including the experience of allergists, clinical immunologists and infectious disease specialists should be respected.
机译:本文根据当今广为接受的病理机制处理药物不良反应(ADR)的分类。所应用的分类系统主要依赖于Rawlins和Thomson提出的A型(“增强型”)和B型(“ bizarre”)反应的建议。在综合医院药物监控(CHDM)的数据库中,Bern / St。 Gallen在48005例连续住院的患者中,ADR归因于10种不同的发病机制。这些提供了通用的新系统,可以轻松适应不断扩展的知识。如果我们看一下CHDM Bern / St中注册的12,785个ADR。 Gallen在1974年至1993年间,有76%的人是A型,13%的人是B型,还有11%的病理机制尚未明确(X型)。主要亚组为A型“未指定” A1,B型过敏/免疫学和Bpa假过敏/类过敏。剂量相关(A2)和药物相关反应(A4,在某种程度上是不耐受性),药物相关-药物相互作用(A5),反弹/戒断效应(A6)和次要反应(A7)代表较小的亚组。未评估患者相关反应(严格意义上为A3,“特质”)。当今的ADR算法主要依靠药理学即A型反应。对于大多数B型反应适应症,包括过敏症医师,临床免疫学家和传染病专家的经验,都应予以尊重。

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