Naranjo algorithm

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[edit intro]

The Naranjo algorithm is a questionnaire designed by Naranjo et al^[1] for determining the likelihood of whether an ADR (drug-related side effects and adverse reactions) 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[edit]

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[edit]

↑ Naranjo CA, Busto U, Sellers EM, et al (1981). "A method for estimating the probability of drug-related side effects and adverse reactionss". Clin. Pharmacol. Ther. 30 (2): 239-45. PMID 7249508. ^[e]
↑ Edwards IR, Aronson JK (2000). "Drug-related side effects and adverse reactionss: definitions, diagnosis, and management". Lancet 356 (9237): 1255–9. DOI:10.1016/S0140-6736(00)02799-9. PMID 11072960. Research Blogging.
↑ 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[edit]

Naranjo algorithm

[pmid7249508-1] Naranjo CA, Busto U, Sellers EM, et al (1981). "A method for estimating the probability of drug-related side effects and adverse reactionss". Clin. Pharmacol. Ther. 30 (2): 239-45. PMID 7249508. ^[e]

[pmid11072960-2] Edwards IR, Aronson JK (2000). "Drug-related side effects and adverse reactionss: definitions, diagnosis, and management". Lancet 356 (9237): 1255–9. DOI:10.1016/S0140-6736(00)02799-9. PMID 11072960. Research Blogging.

[pmid15148066-3] 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)

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