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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
Q

What unique, newly approved HRT medication has the following ADRs…..

Sedation
Hypotension
Syncope

A

Flibanserin (Addyi)

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26
Q

What common ADRs are associated with Tamoxifen?

A 
Vasomotor Symptoms
Vaginal Atrophy
Hair Loss
N/V
Irregular menstruation
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27
Q

Does a patient taking tamoxifen have an increased risk of endometrial cancer?

A

Yes (2-3x)

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28
Q

Are patients taking Tamoxifen at increased risk for hypocalcemia pr hypercalcemia?

A

Hypercalcemia

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29
Q

Which SERM (tamoxifen or raloxifen) has a higher incidence of clotting?

A

Tamoxifen

30
Q

T/F: Cataracts are seen in Toremifene

A

True

31
Q

What cardiac concern is associated with Toremifene?

A

Prolonged QT

32
Q

Which has a lower incidence of clotting and uterine cancer….

SERMs or Aromatase Inhibitors

A

Aromatase Inhibitors

33
Q

What RISK FACTORS are associated with ED treatment?

A 
HTN
HLD
DM
Smoking
EtOH
34
Q

What ADRs are associated with PDE5 Inhibitors?

A

Headache
Flushing
Nasal Congestion

35
Q

Would patients taking PDE5 inhibitors be more likely to experience hypotension or hypertension?

A

Hypotension

36
Q

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?

A

PDE5 inhibitors

37
Q

Which PDE5 inhibitor is most likely to cause Priapism?

A

Tadalafil (Cialis)

38
Q

Which BPH treatment medications are more likely to see first dose syncope, hypotension, and dizziness?

A

Non-selective alpha-1 antagonists

Terazosin (Hytrin)
Doxazosin (Cardura)
Prazosin (Minipres)

39
Q

What are common ADRs of Tamsulosin (Flomax)?

A
  1. Tiredness
  2. Ejaculatory Dysfunction
  3. Nasal Congestion
40
Q

What ADRs are seen with 5-alpha reductase inhibitors?

A

Ejaculatory Dysfunction
ED
Nausea

41
Q

What ADRs are seen in patients undergoing testosterone replacement?

A
  1. Increase Hematocrit
  2. Acne / Oily Skin
  3. Mood Swings
  4. Sleep Apnea
  5. Gynecomastia
42
Q

Could patients undergoing testosterone replacement see a worsening of their BPH?

A

Yes

43
Q

What ADRs are seen in prostate cancer medications?

A

ED
Gynecomastia
Decreased Muscle Mass
Mood Swings

44
Q

What hematologic concern can be seen in patients on prostate cancer medications?

Bone abnormality?

A

Anemia

Osteoporosis

45
Q

What ADRs are commonly seen in patients taking anti-cholinergics for OAB?

A 
Dry Mouth
Dry Eyes
Constipation 
Somnolence
Tachycardia
46
Q

Which anti-cholinergics has some concern over a prolonged QT?

A

Tolterodine

Solifenacin

47
Q

What composes the anti-cholinergic toxidrome?

A 
Fever
Tachycardia
Lack of Diaphoresis
Flushed Skin
Delirium
Urinary Retention
Mydriasis
48
Q

What ADRs are seen with Mirabegron?

A

Constipation
Nausea
Headache
Tachycardia

49
Q

What are common (non-serious) ADRs seen in most AEDs?

A 
Drowsiness
Somnolence
Confusion
Headache 
Nausea
Rash
50
Q

Which AEDs are associated with hyponatremia?

A

Carbamazepine

Oxcarbazepine

51
Q

Which AEDs are associated with weight gain?

A

Valproic Acid
Gabapentin
Pregabalin
Vigabatrin

52
Q

Which AEDs are associated with weight loss?

A

Topiramate
Zonisamide
Felbamate

53
Q

Which AEDs are associated with Teratogenesis?

A 
Barbituates
Phenytoin
Carbamazepine
Valproic Acid
Topiramate
54
Q

Which AED is associated with ginigival hyperplasia

A

Phenytoin

55
Q

Which AEDs are most safe in pregnency?

A

Lamotrigine (Lamictal)

Levetiracetam (Keppra)

56
Q

What are common SERIOUS ADRs associated with AEDs?

A

SJS / TEN / DRESS
Depression / Suicidal Ideation
Hepatotoxicity

57
Q

T/F: Angioedema can bee seen with Oxcarbazepine and Pregabalin

A

True

58
Q

Which AED is aseptic meningitis seen with?

A

Lamotrigine (Lamictal)

59
Q

Hepatoxicity, teratogenicity, and pancreatitis are a major concern (especially in pediatrics) in patients taking which AED?

A

Valproic Acid (Depakote)

60
Q

T/F: Patients taking Topiramate are NOT at increased risk for kidney stones

A

False

61
Q

Are patients on Topiramate more at risk for a metabolic acidosis or alkalosis?

A

Metabolic Acidosis

62
Q

A patient with a history of absence seizures is taking Ethosuximide….

What color may the complain their urine is?

A

Pink-brown

63
Q

T/F: Osteomalacia is seen in patients taking Phenytoin

A

True

64
Q

Which second line AED is associated with a prolonger PR interval and Afib/flutter?

A

Lacosamide

65
Q

Is hypocalcemia or hypercalcemia seen in patients taking phenobarbital?

A

Hypocalcemia

66
Q

Can patients taking phenobarbital develop ED?

A

Yes

67
Q

Which AED medication showed an increase in pancreatic cancer in rats?

A

Gabapentin

68
Q

Which AED is associated with progressive and permanent vision loss?

A

Vigabatrin

69
Q

Urinary retention is a primary concern in patients taking which AED?

A

Ezogabine

70
Q

Felbamate is used last line due to an increased risk of what?

What additional serious ADR is seen in this medication?

A

Aplastic Anemia

Acute Hepatic Failure

71
Q

What is a unique, serious, ADR of Testosterone Undecanoate (Injection)?

A

Serious Pulmonary Oil Microembolism (POME)

Pharmacology II - EXAM 1 (5 decks)

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