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Pharmacology II - EXAM 1 > Adverse Drug Reactions > Flashcards

Adverse Drug Reactions Flashcards

1
Q

What are the reproductive effects of estrogen?

A

Female Sexual Maturation
Endometrial Growth
Breast Tissue Stimulation

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2
Q

What is the hematologic of estrogen?

A

Increased clotting tendency

Increased circulating vitamin K dependent clotting factors

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3
Q

What are the dermatological effects of estrogen?

A

Increased pigmentation

Increased skin thickness

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4
Q

What are the metabolic effects of estrogen?

A

Increased HDL and Triglycerides

Decreased LDL

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5
Q

How do progestrins effect cervical mucus?

A

Changes cervical secretions from watery to thick

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6
Q

T/F: Progestrins can be used to maintain pregnancy?

A

True

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7
Q

What effect do progestrins have on insulin?

A

Increase insulin secretion

Increase peripheral insulin resistance

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8
Q

What are the androgenic effects of progestrins?

A

Acne
Hirsutism
Increased LDL
Insulin Resistance

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9
Q

Which Progestrin has an increased risk of bone loss?

How is this corrected?

A

DMPA

Stop the medication, returns to baseline

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10
Q

Which generation of progestrins have an increased risk for DVT?

A

Third Generation

Norgestrel
Levonorgestrel
Desogestrel
Norgestimate
Dienogest
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11
Q

A patient taking a combination OCP complains of breast tenderness….

…. is this more likely due to the estrogen or progesterone?

A

Estrogen

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12
Q

A patient taking a combination OCP complains of increased acne….

…. is this more likely due to the estrogen or progesterone?

A

Progesterone

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13
Q

A patient taking a combination OCP presents to the ED and is diagnosed with a DVT….

…. is this more likely due to the estrogen or progesterone?

A

Estrogen

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14
Q

Nausea, breast tenderness, and cyclic weight gain are all symptoms of ________ (Estrogen/Progesterone) ______ (Excess/deficiency).

How is this fixed?

A

Estrogen Excess

Lower Dose

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15
Q

Vasomotor symptoms, nervousness, decrease libido, and amenorrhea are all symptoms of ________ (Estrogen/Progesterone) ______ (Excess/deficiency).

How is this fixed?

A

Estrogen Deficiency

Increase dose (check for pregnancy first)

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16
Q

Increased appetite, weight gain, fatigue, acne, and oily skin are all symptoms of ________ (Estrogen/Progesterone) ______ (Excess/deficiency).

How is this fixed?

A

Progesterone Excess

Decrease dose

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17
Q

Dysmenorrhea and late cycle breakthrough bleeding are all symptoms of ________ (Estrogen/Progesterone) ______ (Excess/deficiency).

How is this fixed?

A

Progesterone Deficiency

Increase dose

(Can use NSAIDs for dysmenorrhea)

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18
Q

What ADRs are associated with the NuvaRing

A

Vaginal Irritation. Infection, Secretions

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19
Q

What is the most common ADR associated with DMPA (Depo-Prpvera)?

A

Irregular Menstrual Bleeding

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20
Q

What are the TWO most common ADRs associated with the Yuzpe method?

A

Nausea

Vomiting

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21
Q

What is the most concerning ADR associated with Mifepristone?

A

Sepsis

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22
Q

T/F: Gallbladder disease is NOT seen in patients taking estrogen

A

False

It is

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23
Q

Women 50-79 y.o. taking estrogen alone showed an increased for what?

A

CVA

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24
Q

There is an increased risk of ________ cancer associated with women using estrogen replacement only who still have their uterus

A

Endometrial Cancer

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25
What unique, newly approved HRT medication has the following ADRs..... Sedation Hypotension Syncope
Flibanserin (Addyi)
26
What common ADRs are associated with Tamoxifen?
``` Vasomotor Symptoms Vaginal Atrophy Hair Loss N/V Irregular menstruation ```
27
Does a patient taking tamoxifen have an increased risk of endometrial cancer?
Yes (2-3x)
28
Are patients taking Tamoxifen at increased risk for hypocalcemia pr hypercalcemia?
Hypercalcemia
29
Which SERM (tamoxifen or raloxifen) has a higher incidence of clotting?
Tamoxifen
30
T/F: Cataracts are seen in Toremifene
True
31
What cardiac concern is associated with Toremifene?
Prolonged QT
32
Which has a lower incidence of clotting and uterine cancer.... SERMs or Aromatase Inhibitors
Aromatase Inhibitors
33
What RISK FACTORS are associated with ED treatment?
``` HTN HLD DM Smoking EtOH ```
34
What ADRs are associated with PDE5 Inhibitors?
Headache Flushing Nasal Congestion
35
Would patients taking PDE5 inhibitors be more likely to experience hypotension or hypertension?
Hypotension
36
A patient with ED complains of sensitivity to light and loss of the ability to see blue-green color? What class of medications is likely responsible?
PDE5 inhibitors
37
Which PDE5 inhibitor is most likely to cause Priapism?
Tadalafil (Cialis)
38
Which BPH treatment medications are more likely to see first dose syncope, hypotension, and dizziness?
Non-selective alpha-1 antagonists Terazosin (Hytrin) Doxazosin (Cardura) Prazosin (Minipres)
39
What are common ADRs of Tamsulosin (Flomax)?
1. Tiredness 2. Ejaculatory Dysfunction 3. Nasal Congestion
40
What ADRs are seen with 5-alpha reductase inhibitors?
Ejaculatory Dysfunction ED Nausea
41
What ADRs are seen in patients undergoing testosterone replacement?
1. Increase Hematocrit 2. Acne / Oily Skin 3. Mood Swings 4. Sleep Apnea 5. Gynecomastia
42
Could patients undergoing testosterone replacement see a worsening of their BPH?
Yes
43
What ADRs are seen in prostate cancer medications?
ED Gynecomastia Decreased Muscle Mass Mood Swings
44
What hematologic concern can be seen in patients on prostate cancer medications? Bone abnormality?
Anemia Osteoporosis
45
What ADRs are commonly seen in patients taking anti-cholinergics for OAB?
``` Dry Mouth Dry Eyes Constipation Somnolence Tachycardia ```
46
Which anti-cholinergics has some concern over a prolonged QT?
Tolterodine | Solifenacin
47
What composes the anti-cholinergic toxidrome?
``` Fever Tachycardia Lack of Diaphoresis Flushed Skin Delirium Urinary Retention Mydriasis ```
48
What ADRs are seen with Mirabegron?
Constipation Nausea Headache Tachycardia
49
What are common (non-serious) ADRs seen in most AEDs?
``` Drowsiness Somnolence Confusion Headache Nausea Rash ```
50
Which AEDs are associated with hyponatremia?
Carbamazepine | Oxcarbazepine
51
Which AEDs are associated with weight gain?
Valproic Acid Gabapentin Pregabalin Vigabatrin
52
Which AEDs are associated with weight loss?
Topiramate Zonisamide Felbamate
53
Which AEDs are associated with Teratogenesis?
``` Barbituates Phenytoin Carbamazepine Valproic Acid Topiramate ```
54
Which AED is associated with ginigival hyperplasia
Phenytoin
55
Which AEDs are most safe in pregnency?
Lamotrigine (Lamictal) | Levetiracetam (Keppra)
56
What are common SERIOUS ADRs associated with AEDs?
SJS / TEN / DRESS Depression / Suicidal Ideation Hepatotoxicity
57
T/F: Angioedema can bee seen with Oxcarbazepine and Pregabalin
True
58
Which AED is aseptic meningitis seen with?
Lamotrigine (Lamictal)
59
Hepatoxicity, teratogenicity, and pancreatitis are a major concern (especially in pediatrics) in patients taking which AED?
Valproic Acid (Depakote)
60
T/F: Patients taking Topiramate are NOT at increased risk for kidney stones
False
61
Are patients on Topiramate more at risk for a metabolic acidosis or alkalosis?
Metabolic Acidosis
62
A patient with a history of absence seizures is taking Ethosuximide.... What color may the complain their urine is?
Pink-brown
63
T/F: Osteomalacia is seen in patients taking Phenytoin
True
64
Which second line AED is associated with a prolonger PR interval and Afib/flutter?
Lacosamide
65
Is hypocalcemia or hypercalcemia seen in patients taking phenobarbital?
Hypocalcemia
66
Can patients taking phenobarbital develop ED?
Yes
67
Which AED medication showed an increase in pancreatic cancer in rats?
Gabapentin
68
Which AED is associated with progressive and permanent vision loss?
Vigabatrin
69
Urinary retention is a primary concern in patients taking which AED?
Ezogabine
70
Felbamate is used last line due to an increased risk of what? What additional serious ADR is seen in this medication?
Aplastic Anemia Acute Hepatic Failure
71
What is a unique, serious, ADR of Testosterone Undecanoate (Injection)?
Serious Pulmonary Oil Microembolism (POME)

Pharmacology II - EXAM 1 (5 decks)

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