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Since I still hear about people dying from adverse effects of anesthesia, prescription drugs, and clinical trials, we obviously don't have a perfect ex vivo test for adverse reactions to arbitrary drugs. But what DO we have, how effective are they, and are there any up-and-coming techniques in research?

  • What have you discovered so far in your research on this question? – Carey Gregory Jun 20 '18 at 1:51
  • I think a better version of this question would be through which stages a medication has to go through until it can be officially used, which wouldn’t be too broad and answerable. – Narusan Jun 22 '18 at 7:07
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The only way to know if a drug is going to kill you, or have a serious side affect is to take it and see what happens. However, there are usually many ways to predict risk of such reactions. Researchers do their best to figure this out in the drug development and testing stage, so each drug that get's approved will come with a list of contraindications (conditions that have been determined to put you at greater risk of the side effects).

There's no such thing as a general drug safety test - nor could there ever be, since each potentially deadly reaction happens in it's own way. Researchers do attempt to identify the mechanism behind serious drug reactions. Once that mechanism is identified, then they are sometimes able to develop tests for susceptibility to that particular mechanism, but this is typically on a case by case basis. In some cases, a particular mechanism might apply to a whole class of drugs so one test can help predict a potential negative affect to any drug in the class.

Anesthesia

There are various risks associated with anesthesia - all of which are very rare. They include interactions with other drugs and conditions, as well as human error (overdose, etc.). One significant cause of death directly due to a reaction to anesthesia itself is due to something called malignant hyperthermia. The first manifestation of this is typically in the operating room, so it's difficult to predict. It seems the only approved test involves a muscle biopsy (they have to take a cell sample from a muscle), so this is only done if you have a family history of the condition. Research on less invasive tests is ongoing and promising, including a genetic test and an injection test

Drug allergies

Many drug reactions (including some deadly ones) fall under the category of what you know as an 'allergy'. Often times these reactions can be tested with a skin or blood test.

Other types of reactions

This list can go on and on, so I'll just refer the interested reader to a paper that does a much better job than I could: Adverse Drug Reactions: Types and Treatment Options

  • "The main deadly reaction caused by general anesthesia is due to something called malignant hyperthermia" - this does not sound correct to me at all, can you provide a citation? You might be correct if you limit to interactions with a known genetic contribution, but I think the statement as-is is far too general a claim. – Bryan Krause Jun 21 '18 at 20:48
  • Ok, I added a source and clarified what I'm saying. Anesthesia is dangerous for various reasons. However - as far as I can find - the only common cause of death due to a reaction to the anesthesia itself, is malignant hyperthermia. Since the question was about reactions, I didn't really say anything about overdoses, preexisting conditions, etc. – argentum2f Jun 21 '18 at 21:03
  • I think you are using the term "reaction" more narrowly than I am familiar with it being used. "Reaction" in my view is broad enough to encompass things that you might more often hear referred to as "side effects." Respiratory/cardiac depression, aspiration, etc. Certainly preexisting conditions can influence susceptibility to those sorts of side effects, as well as other unknown contributors to the person-to-person variance of drug effects. – Bryan Krause Jun 21 '18 at 21:16
  • I don't think things like overdoses were what the author was referring to. Most of the other causes of death seemed to be related more to human error, or other unrelated medical complications - in other words, they aren't really caused by the drug itself - so I don't think they are what the OP was asking about. I changed the language in any case to not give the impression that MH is the only risk associated with anesthesia. – argentum2f Jun 21 '18 at 21:23
  • Okay, thanks for the edits. I'm probably just being a bit pedantic because it's an area I am active in research, and all those 'other causes' are actually quite important to anesthesiologists; there is a constant desire to help identify those patients who are at risk of anesthesia-related complications, with knowledge that some simply cannot be avoided (e.g., when you are trying to save lives with surgery, no matter the skill and knowledge of everyone involved there will be a border where people cannot be saved). – Bryan Krause Jun 21 '18 at 21:34

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