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Clinical pharmacology and therapeutics > Adverse drug reactions > Flashcards

Adverse drug reactions Flashcards

1
Q

Main concept in prescribing

A

Benefits must be better than drawbacks

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2
Q

Main adverse drug reaction

A

NSAIDs

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3
Q

Adverse effects of NSAIDs

A

GI bleeding
Renal impairment
Wheezing

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4
Q

adverse effects of diuretics and how to monitor

A

Hypotension

Electrolyte imbalance = monitor K+ as can cause hypokalaemia

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5
Q

What are type A drug reactions

How to manage

A

Augmented response

  • Dose related
  • Managed by dose adjustment
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6
Q

What NSAID also carries a risk of GI bleeding

A

Aspirin

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7
Q

What anti platelet drug may also cause GI bleeding

A

Clopidogrel

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8
Q

How to minimise GI damage

A

paracetamol use instead

Identify patients at risk e.g. >65yo, history of ulcers, infection with H. pylori

Prophylaxis with PPI

Give in combination with misoprostol (acts on prostanoid receptors to inhibit gastric H+ secretion)

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9
Q

Side effect of antibiotics

A

Diarrhoea

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10
Q

Side effects of PPIs on the older patient

A

Increase risk of food poisoning

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11
Q

Side effects of opioids and antimuscarinics and how to overcome

A

Constipation

-laxatives

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12
Q

What drugs are contraindicated in asthma and why

A

beta-blockers

-They block bronchial B2 adrenoceptors and may cause bronchospasm

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13
Q

can beta blockers be used in COPD

A

Yes, but caution

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14
Q

Can drugs which are selective B1 antagonists be used in asthma

A

No- as they have poor selectivity

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15
Q

What can fibrosis be induced by

A

Amiodarone

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16
Q

Why are some people allergic to penicillin

A

Penicillins couple to proteins, forming immunogens. Causes a hypersensitivity reaction

17
Q

What should also be avoided in those with a penicillin allergy

A

cephalosporins

18
Q

What can drugs which cause QT prolongation do

A

Cause arrythmias

19
Q

Which drugs are cardio toxic

A

Some anti cancer drugs

20
Q

Which drugs can worsen chronic heart failure

A

Fluid retaining drugs: NSAIDs, corticosteroids

Rate limiting CCIs: verapamil and dilkazem (reduce force of contraction)

High dose beta blockers: atenolol

GLitazones: worsen oedema

21
Q

Which drugs increase CV disease

A

Some NSAIDs: Diclofenac, Rofecoxib

22
Q

What can cause postural hypotensive

A

Diuretics

23
Q

What drugs can cause hypertension

A

Some anti depressant

NSAIDs because of fluid retaining factor

24
Q

Symptoms of neutropenia

A

Increased infections

25
Q

Symptoms of thrombocytopenia and why

A

Increased bleeding and bruising because of decreased platelet count

26
Q

Cause of myelosuppression

A

Anticancer chemotherapy

27
Q

Issue with anticoagulants

A

Bleeding

28
Q

Symptoms of agranulocytosis

A

Absence of neutrophils

-Mouth ulcers, severe sore throat; infections

29
Q

What can worsen renal function

A

NSAIDs
Aminoglycosides
ACEis/ATRAs

30
Q

What can increase fluid retention

A

NSAIDs

Steroids

31
Q

What drugs can cause

  • Hypokalaemia
  • Hyperkalaemia
A

Hypo: thiazide and loop diuretics

Hyper: ACEi

32
Q

What is erythematous eruptions

A

ADR where there is reddening, and may resemble measles ommaculopapular

33
Q

What is toxic epidermal necrolysis

A

rare bye often fatal blistering and skin peels off

34
Q

What is Stevens Johnson syndrome

A

Fever, rash, blisters

35
Q

What drugs to be cautious about that cause Stevens Johnson syndrome and how to stop this occurring

A

Carbamazepine and phenytoin

-Screen patients of Han Chinese, Hong Kong Chinese and Thai origin before use for allele

36
Q

What ADR can statins have and how can this ADR be increased

A

Can cause myopathy which may progress to rhabdomyolysis (breakdown of muscles) which may result in renal damage.

Chance increases through drug reactions

37
Q

What can the antipsychotic drug clozapine cause

A

Neutropenia

38
Q

What can anti epileptic drug carbamazepine cause

A

NEutropenia

Stevens Johnson syndrome

39
Q

What can the aminoglycoside gentamicin cause

A

renal toxicity

Clinical pharmacology and therapeutics (16 decks)

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