Adverse drug reactions (ADRs) are a response to a drug that is noxious and unintended. They are a frequent cause of hospitalization and mortality in the UK, resulting in a significant financial burden for the NHS. Between one-third to a half of ADRs are avoidable. To minimize their occurrence, each patient's susceptibility should be assessed by evaluating risk factors such as age, co-morbidities and potential drug interactions before a medication is administered. Pharmacogenomics is an area of increasing interest that has been emphasized in the NHS 10-year health plan. A profile of a limited number genetic loci can provide vital information for safe prescribing of numerous common medications. This will enable clinicians to target drugs and dosages to the patients they are likely to benefit and reduce the risk of ADRs.
Anaesthetists and intensivists hold a crucial role in managing ADRs. Firstly, we are responsible for patient safety throughout the perioperative period, during which we often administer multiple medications which could potentially cause an ADR. Fortunately, we also meticulously observe physiological changes during this period, increasing the likelihood of detecting such events. Secondly, several ‘atypical’ drug reactions, such as anaphylaxis and toxic epidermal necrolysis, are so severe that they often necessitate management in an intensive care environment. Therefore, we have a professional responsibility to ensure we are familiar with recognizing, managing, and reporting ADRs.
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