ADVERSE REACTION
SURVEILLANCE
Almost all drugs have adverse
effects associated with their use; these range in severity from mild
inconven-iences to severe morbidity and death. Some adverse ef- fects are
extensions of the drug’s pharmacological effect and are predictable, for
example, orthostatic hypoten-sion with some antihypertensive agents,
arrhythmias with certain cardioactive drugs, and electrolyte imbal-ance with diuretics.
Other adverse effects are not pre-dictable and may occur rarely or be delayed
for months or years before the association is recognized. Examples of such
reactions are aplastic anemia associated with chloramphenicol and clear cell
carcinoma of the uterus in offspring of women treated with diethylstilbestrol
during pregnancy. Postmarketing surveillance programs and adverse reaction
reporting systems may detect such events. The best defense against devastating
adverse ac-tions is still the vigilance and suspicion of the physician.
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