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July 1976

Clinical Problems With Drugs

Author Affiliations

Department of Pharmacology and Toxicology and Medicine University of Rochester School of Medicine and Dentistry 601 Elmwood Ave Rochester, NY 14642

Am J Dis Child. 1976;130(7):786-787. doi:10.1001/archpedi.1976.02120080108029

The approach to a patient with a potential adverse drug reaction (ADR) should involve a series of logical steps. First, the physician must include an ADR in the differential diagnosis. Whether or not the patient ingested the medication and the temporal sequence between ingestion and appearance of the effect are basic facts to be established. Next, the clinical picture should be compared with the toxicity profile of the suspect drug or drugs. Signs, symptoms, and laboratory data may implicate a drug affecting a particular organ. The mechanism (allergic, pharmacologic, or idiosyncratic) by which the medication in question usually causes an adverse reaction may direct further observations (fever, nausea, eosinophilic leukocytosis, enzyme deficiency) and indicate when these may occur. All of this information will be needed to help differentiate disease-related problems from drug-induced effects. Stopping the drug and following the time course of resolution of the clinical picture also provides data

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