J Korean Med Assoc.  2019 Sep;62(9):472-479. 10.5124/jkma.2019.62.9.472.

Adverse drug reactions

Affiliations
  • 1Drug Safety Center, Seoul National University Hospital, Korea. helenmed@snu.ac.kr
  • 2Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Korea.
  • 3Division of Allergy and Clinical Immunology, Seoul National University Hospital, Seoul, Korea.

Abstract

There are no drugs without the risk of potential adverse reactions. All pharmacologically active substances can cause adverse drug reactions (ADRs). This paper aims at introducing recent trends in pharmacosurveillance systems for ADRs, which can be broadly classified into type A and B reactions. Since type A reactions are associated with drug pharmacology, they are usually dose-dependent and predictable. Whereas, type B reactions occur in some susceptible individuals, regardless of the pharmacological action of drug. Drug hypersensitivity reactions are typical examples of type B reactions and are subclassified according to the underlying pathomechanism. Recent advancements in pharmacogenomics have enlightened the understanding of individual differences in drug efficacy and susceptibility to ADRs. Therefore, expectations for safe personalized medicines are higher than ever before. However, premarketing clinical trials are too small and too short to uncover rare but serious ADRs and detect long-standing ADRs. In the past, post-marketing surveillance systems mainly focused on passive ADR monitoring systems, based on spontaneous reports. Recently, the importance of active pharmacovigilance systems, which use big data, is growing with recent advancements in medical informatics. Thus, regarding ADRs, suspecting and detecting the causative drug using causality assessment based on data science may contribute to decrease suffering induced by ADRs.

Keyword

Drug-related side effects and adverse reactions; Pharmacovigilance; Adverse drug reaction reporting systems; Pharmacogenetics; Big data

MeSH Terms

Adverse Drug Reaction Reporting Systems
Drug Hypersensitivity
Drug-Related Side Effects and Adverse Reactions*
Humans
Individuality
Medical Informatics
Pharmacogenetics
Pharmacology
Pharmacovigilance
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