Adverse Drug Reactions Flashcards
Drugs used with caution in asthma?
NSAIDs
Beta blockers
Adenosine (verapamil as an alternative)
What drugs exacerbate psoriasis?
Beta blockers
Lithium
Anti-malarials
NSAIDs
ACE-I
Infliximab
Withdrawal of steroids
Non-drug exacerbations can include alcohol, trauma and streptococcal infection for guttate psoriasis
What drugs exacerbate heart failure?
Pioglitazone
Verapamil
Flecainide
NSAIDs/corticosteroids
- Can cause fluid retention
- Low-dose aspirin is an exception
Which drugs should be avoided in epilepsy?
Alcohol, cocaine and amphetamines
Ciprofloxacin, levofloxacin
Aminophylline and theophylline
Bupoprion
Methylphenidate
Mefenamic acid
What diabetes medication is contraindicated in heart failure?
Pioglitazone
What drugs should be avoided in pregnancy?
ABX avoided are:
- Tetracyclines (tooth discolouratioN)
- Aminoglycosides (inc risk of birth defect and pre-term labour)
- Trimethoprim (folate antagonist so risk of neural tube defects)
- Sulphonamides
- Quinolones
ACE-I and ARBs
Statins
Warfarin
Retinoids
Cytotoxic agents
Sulphonylureas (gliclazide)
Anti-epileptics (however often kept on due to seizure risks)
What drugs cause hyperkalaemia?
ACE-I/ARBs
K+ sparing diuretics (spironolactone, epleronone, amiloride)
Potassium supplements (SandoK)
What drugs cause hypokalaemia?
Thiazide and loop diuretics
Acetazolamide
Salbutamol
Insulin
Epinephrine
Fludrocortisone
Theophylline
Verapamil
Laxatives
What drugs cause hyponatraemia?
SSRIs
Antipsychotics and anticonvulsants
Thiazide and loop diuretics
Omeprazole
Side effects of quinolone ABX?
Tendon rupture
(especially if on steroids too)
Prolonged QT interval (leading to reduced seizure threshold)
Examples - ciprofloxacin, levofloxacin
What should you remember when using methotrexate?
Given once weekly
When used with NSAIDs, can reduce platelet count
When used with trimethoprim, can cause bone marrow suppression
PPIs can increase the levels of methotrexate
What drugs can cause C. diff?
PPIs (omeprazole)
4Cs
- Co-amoxiclav
- Clindamycin
- Cephalosporins (ceftriaxone)
- Ciprofloxacin
Low Mg2+ and Na+
What are the 4Cs?
Co-amoxiclav
Clindamycin
Cephalosporins (ceftriaxone)
Ciprofloxacin
Other precipitants of C diff include PPIs, low Mg2+ and Na+
Side effects of macrolide ABX?
Mx of drug-induced Parkinsonism?
Procyclidine
Adverse effects of CCBs?
Oedema and ankle swelling
(classically amlodipine)
- don’t reduce the dose, just stop it and swap to another med
Which drugs can impair glucose tolerance?
Steroids
Antipsychotics
Tacrolimus/ciclosporin
Furosemide and thiazides
Nicotinic acid
Interferon-alpha
Beta blockers (use with caution in diabetics as they can impair responses to hypoglycaemia)
Why should beta blockers be used with caution in diabetics?
They can impair responses to hypoglycaemia
Adverse effects of sulphonylureas (gliclazide)?
Hypoglycaemia
Weight gain
Rarer:
- Hyponatraemia (due to SIADH)
- Bone marrow suppression
- Hepatotoxicity
- Peripheral neuropathy
Avoid in pregnancy and breastfeeding
What diabetes drug can cause euglycaemic ketoacidosis?
SGLT-2 inhibitors
(dapagliflozin, flozins)
Side effects of SGLT-2 inhibitors?
Euglycaemic ketoacidosis
UTIs
Drugs likely to cause peptic ulcer disease?
NSAIDs
Oral corticosteroids
Bisphosphonates
Mx = 8 weeks of PPI (omeprazole)
