ADR

Question 1

Tamoxifen

Answer 1

Hot flushes
Menstrual irregularities
Vaginal bleeding

Risk of endometrial cancer
Risk of VTE
Nausea, vomiting

Neurotoxicity with high dose (hyperreflexia, tremors, unsteady gait, dizziness)

Question 2

Pembrolizumab

Answer 2

Infusion-related (rash, fever)
Joint pain
Diarrhea
Nausea
Fatigue
Life-threatening immune-mediated organ inflammation (endocrine glands, lungs, liver, kidneys, sepsis)

C/I in pregnant women, history of severe allergic reactions, current other severe diseases

Question 3

Leuprorelin

Answer 3

Local injection site pain
Flushes
Headache
GI disturbance
Altered mood
Hyperglycemia
Hyperlipidemia
Impotence

C/I: pre-existing CVDs, patient at-risk of osteoporosis

Question 4

Bicalutamide

Answer 4

Gynecomastia
Impotence
Fatigue
GI disturbance
Seizures (rare)

Question 5

Metformin

Answer 5

Nausea, vomiting, diarrhea
Anorexia
Metallic taste
Vit B12 deficiency
Lactic acidosis

DDI:
- Alcohol
- Iodine contrast media
- Cationic drugs (dofetilide, cimetidine, digoxin)

Question 6

Glipizide

Answer 6

Hypoglycemia
Weight gain
Blood dyscrasias (rare)

DDI:
- Beta blockers
- Alcohol
- CYP2C9 inhibitors (Amiodarone, 5FU, Fluoxetine)

Question 7

Thiazolidinediones

Answer 7

Risk of new onset HF
Hepatotoxicity
Edema
Weight gain
Fractures
Bladder cancer (Pio)
Increased LDL (Rosi)

DDI:
- P: 2C8 & 3A4
- R: 2C8

C/I: active liver disease, NYHA III-IV

Question 8

Acarbose

Answer 8

Nausea, vomiting, diarrhea
Flatulence
Elevated LFTs

C/I: breastfeeding women, active GI disease

Question 9

DPP4 inhibitors

Answer 9

(Sitagliptin)
GI disturbances
Skin reactions
Angioedema
Acute pancreatitis
Headache
Joint pain

(Linagliptin)
Flu-like syndrome

DDI:
S: reduce conc of digoxin
L: CYP3A4 inducers

Question 10

GLP-1 agonists

Answer 10

Nausea, vomiting, diarrhea
Acute pancreatitis
Dyspepsia (Exenatide)
Risk of medullary thyroid carcinoma

Question 11

SGLT2 inhibitors

Answer 11

Euglycemia ketoacidosis
Urinary tract infections
Genital mycotic infections
Hypotension, hypoglycaemia, renal impairment
Frequent urination
Fournier’s gangrene
Increased LDL
(Canagliflozin) Amputation, hyperkalemia, fractures

Question 12

Carbimazole

Answer 12

Rash (SJS risk)
Fever
Joint pain
Agranulocytosis (rare, usually within first 3 months)
Nausea
Jaundice (Hepatotoxicity)
Hypothyroidism

Question 13

Levothyroxine

Answer 13

Reduced appetite
Diarrhea
Anxiety
Difficulty sleeping
Hair loss

Cardiac abnormalities
Risk of fractures
Seizures

Question 14

Tamsulosin

Answer 14

Ejaculation dysfunction
Backpain
Muscle weakness
Fatigue
Headache
Intraoperative floppy iris syndrome (Tamsulosin)

Question 15

Finasteride

Answer 15

Ejaculatory disorders
Reduced libido
Sexual dysfunction
ED
Gynecomastia (rare)

Teratogenic upon skin contact

Question 16

PDE5 inhibitors

Answer 16

Dizziness
Headache
Flushing
Dyspepsia
Backpain
Priapism
Rare hearing loss (tinnitus)
(Vardenafil) QTc prolongation
(Tadalafil) Muscle pain
(Vardenafil & Sildenafil) Blue-green tinting of vision, photosensitivity, sudden vision loss

DDI:
- Alcohol
- Antihypertensives
- Nitrates
- CYP3A4 inhibitors

Question 17

Testosterone

Answer 17

Irritability
Aggressive behaviour
Undesirable hair growth
Increased BP
Dyslipidemia
Hepatotoxicity
Polycythemia
Prostatic hyperplasia

Question 18

Alprostadil

Answer 18

Pain
Burning sensation
Difficulty voiding
Bleeding
Spotting
Priapism
Fibrosis
Hematoma

Question 19

IUD

Answer 19

Uterine perforation
Risk of expulsion
Pelvic infections

Question 20

Ethinyl estradiol

Answer 20

Breast tenderness
Headache
Dizziness
Nausea, vomiting
Bloating
Weight gain

Increased risk of VTE, MI and stroke
Liver damage

Question 21

Northindrone / Norethisterone

Answer 21

Headache
Dizziness
Bloating
Weight gain
Breakthrough spotting or bleeding
Amenorrhea
Delayed return to fertility

Question 22

Drospirenone

Answer 22

Hyperkalemia
Thromboembolism
Bone loss

Question 23

Tibolone

Answer 23

Increased risk of stroke, breast cancer recurrence, endometrial cancer