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PSA > ADR's > Flashcards

ADR's Flashcards

1
Q

Which drugs are known to impair glucose tolerance?

A 
Thiazides
Furosemide
Steroids
Tacrolimus
Ciclosporin
Interferon-alpha
Nicotinic acid
Anti-psychotics

Beta Blockers

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2
Q

Why should beta blockers be used with caution in diabetics?

A

Slight impairment of glucose tolerance

Interfere with metabolic and autonomic response to hypoglycaemia

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3
Q

Which drugs are known to induce urinary retention?

A 
Tricyclic antidepressants
Anticholinergics
Opioids
NSAID's
Disopyramide
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4
Q

Give examples of tricyclic antidepressants

A

Amitriptyline
Nortriptyline
Trimipramine

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5
Q

Give examples of anticholinergics

A

Atropine
Ipratropium
Tolterodine

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6
Q

What is disopyramide used for?

A

Prevention and treatment of ventricular and supra ventricular tachycardia

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7
Q

What drugs are known to cause lung fibrosis?

A

Amiodarone
Cytotoxic agents - bleomycin and bulsuphan
Anti-Rheumatoid - Methotrexate and Sulfasalazine
Nitrofurantoin
Ergot-derived dopamine agonists - bromocriptine, cabergoline, pergolide

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8
Q

Which drugs are used to treat tuberculosis?

A 
6 Months:
- Rifampicin
- Isoniazid
2 Months:
- Pyrazinamide
- Ethambutol
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9
Q

What are the ADR’s associated with Rifampicin?

A
  • Liver enzyme inducer
  • Hepatitis
  • Orange secretions
  • Flu-like symptoms
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10
Q

What are the ADR’s associated with Isoniazid?

A
  • Peripheral neuropathy
  • Hepatitis
  • Agranulocytosis
  • Liver enzyme inhibitor
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11
Q

How are the peripheral neuropathy effects of Isoniazid prevented?

A

Pyridoxine (Vitamin B6)

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12
Q

What are the ADR’s associated with Pyrazinamide?

A
  • Hyperuricaemia - Gout
  • Arthralgia
  • Myalgia
  • Hepatitis
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13
Q

What are the ADR’s associated with Ethambutol?

A
  • Optic neuritis
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14
Q

What is important to know when prescribing ethambutol?

A

Check visual acuity pre and post treatment

Dose adjustment for renal impairment

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15
Q

What are the main side effects of glucocorticoids?

A

Endocrine - impaired glucose regulation, increased appetite, weight gain, hirsutism, hyperlipidaemia

Cushing’s syndrome

MSK - osteoporosis, proximal myopathy, avascular necrosis of femoral head

Immunosuppression

Psych - insomnia, depression, mania, psychosis

GI - peptic ulcer, acute pancreatitis

Ophthalm - glaucoma and cataracts

Intracranial hypertension

Suppression of growth in children

Neutrophilia

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16
Q

What are the main side effects of mineralocorticoids?

A

Fluid retention

Hypertension

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17
Q

What should you be aware of when prescribing long term steroids?

A

Double dose during illness

Gradual withdrawal if:

  • Pred >40mg daily >1wk
  • > 3wks of treatment or recently repeated courses
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18
Q

What common ADR’s are associated with Gentamicin and Vancomicin use?

A
  • Nephrotoxicitiy

- Ototoxicity

19
Q

What should you be aware of when prescribing antibiotics (specifically broad spectrum)?

A

C Diff colitis

Common in cephalosporins and ciprofloxacin

20
Q

What are the main ADR’s of ACE inhibitors?

A
  • Hypotension
  • Electrolyte abnormalities
  • AKI
  • Dry cough
21
Q

What are the main ADR’s of Beta Blockers?

A
  • Hypotension
  • Bradycardia
  • CI in asthmatics
  • Worsen heart failure but help chronic
  • Impair glucose tolerance
22
Q

What are the main ADR’s of Ca blockers

A
  • Hypotension
  • Bradycardia
  • Peripheral oedema
  • Flushing
23
Q

What are the main ADR’s of diuretics?

A
  • Hypotension
  • Electrolyte abnormalities (Key is K+ but also Ca2+ and Na+)
  • AKI
24
Q

What are the main ADR’s associated with Digoxin use?

A 
Nausea
D&V
Blurred vision
Confusion
Xanthosia - disturbed yellow/green visual perception

Toxicity managed with Digibind

25
Q

What are the main ADR’s associated with amiodarone use?

A

Interstitial lung disease
Thyroid disease
Skin greying
Corneal deposits

26
Q

What are the ADR’s of lithium?

A

Early - tremor

Intermediate - tiredness

Late - Seizures, arrhythmia’s, coma, renal failure, diabetes insipidus

27
Q

What are the ADR’s of antipsychotics?

A

Acute dystonia
Akathisia
Tardive dyskinesia
Drowsiness

Clozapine - agranulocytosis

28
Q

What are the key ADR’s of NSAID’s?

A 
Renal failure
Systolic dysfunction - heart failure
Asthma
Indigestion
Dyscrasia - clotting abnormality
29
Q

What are the main ADR’s of statins?

A

Myalgia
Abdo pain
Increased ALT/AST
Rhabdomyolysis

30
Q

What factors aggravate psoriasis?

A

Trauma
Alcohol
Drugs - beta blockers, lithium, antimalarials, NSAID’s, ACE inhibitors, infliximab
Withdrawal of systemic steroids

31
Q

What are the CYP450 Inhibitors?

A 
S - Sodium Valproate
I - Isoniazid
C - Cimetidine
K - Ketoconazole
F - Fluconazole
A - Allopurinol
C - Chloramphenicol
E - Erythromycin
S - SSRI's
C - Ciprofloxacin 
O - Omeprazole
M - Methotrexate
32
Q

What are the CYP450 Inducers?

A 
C - carbamazepine
R - rifampicin
A - Alcohol
P - Phenytoin
G - Goserulin
P - Phenobarbitone
S - Sulphonylureas/Smoking
33
Q

Which drugs interact with alcohol?

A 
NSAIDs
Warfarin
Metrinidazole and Disulfiram
Metformin
MAO inhibitors
Barbituates, opioids, benzodiazepines
34
Q

What may an NSAID alcohol interaction cause?

A

GI bleeding

35
Q

What may a Warfarin alcohol interaction cause?

A

Increased anticoagulation

36
Q

What may an alcohol metrinidazole/disulfiram interaction cause?

A

Sweating
Flushing
Nausea
Vomiting

37
Q

What may happen if alcohol and metformin interact?

A

Lactic Acidosis

38
Q

What may happen if alcohol interacts with MAO inhibitors?

A

Hypertensive crisis

39
Q

What may happen if alcohol interacts with barbituates, opioids or benzodiazepines?

A

Sedation

40
Q

Which drugs can cause peptic ulcer disease?

A

NSAID’s

Corticosteroids

41
Q

Which drugs can cause renal impairment?

A

ACE inhibitors

NSAID’s

42
Q

What can exacerbate psoriasis?

A 
Trauma
Alcohol
Beta blockers
Lithium
Antimalarials - chloroquine/hydroxychloroquine
NSAID's
ACEi
Infliximab
Steroid withdrawal
43
Q

Which drugs may exacerbate heart failure?

A

Thiazolinediones - pioglitazone - fluid retention

Verapamil - negative inotropic effect

NSAID/glucocorticoid caution - fluid retention (apart from 75mg aspirin)

Class I antiarrhythmics - negative inotropic and proarrhythmic effects

PSA (7 decks)

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