Naranjo algorithm

From Citizendium, the Citizens' Compendium
Jump to: navigation, search
This article is developing and not approved.
Main Article
Talk
Related Articles  [?]
Bibliography  [?]
External Links  [?]
Citable Version  [?]
 
This editable Main Article is under development and not meant to be cited; by editing it you can help to improve it towards a future approved, citable version. These unapproved articles are subject to a disclaimer.

The Naranjo algorithm is a questionnaire designed by Naranjo et al[1] for determining the likelihood of whether an ADR (adverse drug reaction) is actually due to the medication rather than the result of other factors. Probability is assigned via a score termed definite, probable, possible or doubtful.

An alternative, simpler scale has been proposed by the World Health Organization (WHO).[2][3]

Questionnaire

1. Are there previous conclusive reports on this reaction?

Yes (+1) No (0) Do not know or not done (0)

2. Did the adverse event appear after the suspected drug was given?

Yes (+2) No (-1) Do not know or not done (0)

3. Did the adverse reaction improve when the drug was discontinued or a specific antagonist was given?

Yes (+1) No (0) Do not know or not done (0)

4. Did the adverse reaction appear when the drug was readministered?

Yes (+2) No (-1) Do not know or not done (0)

5. Are there alternative causes that could have caused the reaction?

Yes (-1) No (+2) Do not know or not done (0)

6. Did the reaction reappear when a placebo was given?

Yes (-1) No (+1) Do not know or not done (0)

7. Was the drug detected in any body fluid in toxic concentrations?

Yes (+1) No (0) Do not know or not done (0)

8. Was the reaction more severe when the dose was increased, or less severe when the dose was decreased?

Yes (+1) No (0) Do not know or not done (0)

9. Did the patient have a similar reaction to the same or similar drugs in any previous exposure?

Yes (+1) No (0) Do not know or not done (0)

Scoring

  • > 9 = definite ADR
  • 5-8 = probable ADR
  • 1-4 = possible ADR
  • 0 = doubtful ADR

References

  1. Naranjo CA, Busto U, Sellers EM, et al (1981). "A method for estimating the probability of adverse drug reactions". Clin. Pharmacol. Ther. 30 (2): 239-45. PMID 7249508[e]
  2. Edwards IR, Aronson JK (2000). "Adverse drug reactions: definitions, diagnosis, and management". Lancet 356 (9237): 1255–9. DOI:10.1016/S0140-6736(00)02799-9. PMID 11072960. Research Blogging.
  3. Nebeker JR, Barach P, Samore MH (2004). "Clarifying adverse drug events: a clinician's guide to terminology, documentation, and reporting". Ann. Intern. Med. 140 (10): 795–801. PMID 15148066[e] (See table 2)

External links