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ADVERSE REACTIONS TO DRUGS When a new drug is introduced, it has usually been studied only in relatively few patients - typi­cally 1,500. If  patients have been studied, and no serious effects are observed, there is still a chance of a serious adverse effect's occurring in the general population as frequently as 3/n (1:500).

Adverse effects can be divided into types. First, those which are closely related to the concentration of the drug and accord with what is known of its pharmacology. These so-called type-A t(augmented pharmacological) effects are distinguished from type-B (bizarre) effects which are unpredictable, usually rare, and often severe, anaphylaxis is the most obvious of these, though bone-marrow sup­pression with co-trimoxazole, hepatic failure (see hepatitis) with sodium valproate, or pul­monary fibrosis with amiodarone would all be other examples. A more comprehensive classification includes reactions type С (chronic effects), D (delayed effects - such as teratogen-esis or carcinogenesis) and E (end-of-dose effects - withdrawal effects). Examples of ad­verse reactions include nausea, skin eruptions, jaundice, sleepiness and headaches.

Patients should remind their doctors of any drug allergy, or adverse effect they have suf­fered in the past. Medical warning bracelets are easily obtained. Doctors should report adverse effects to the authorities, in the case of Britain o the Committee on Safety of Medicines (CSM), using the yellow-card reporting machinery

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