Adverse drug reactions

Question 1

Type A reactions.

Answer 1

Common.
Dose related.
Predictable.

Question 2

Type B reactions.

Answer 2

Bizarre and unexpected.

Related to gene/host/environmental interactions.

Question 3

Adverse reactions:
Gentamicin.
Vancomycin.

Answer 3

Nephrotoxicity.

Ototoxicity.

Question 4

Adverse reactions:

Cephalosporins/ciproflaxcin.

Answer 4

C. Diff collitis.

Question 5

Adverse reactions:

ACEi.

Answer 5

Dry cough.
Hyperkalaemia.
AKI.

Question 6

Adverse reactions:

Beta blockers.

Answer 6

Hypotension.
Bradycardia.
Wheeze in asthmatics.
Worsened acute heart failure.

Question 7

Adverse reactions:

Calcium channel blockers.

Answer 7

Hypotension.
Peripheral oedema.
Flushing. 
Headache.
Arrhythmias and bradycardia.

Question 8

Adverse reactions:

Diuretics.

Answer 8

Hypotension.
AKI.
Electrolyte abnormalities.

Question 9

Adverse reactions:

Heparins.

Answer 9

Haemorrhage.

Heparin induced thrombocytopenia.

Question 10

Adverse reactions:

Warfarin.

Answer 10

Haemorrhage.

Question 11

Adverse reactions:

Aspirin.

Answer 11

Haemorrhage.
Peptic ulcers.
Tinnitus.

Question 12

Adverse reactions:

Digoxin.

Answer 12

Nausea, vomiting and diarrhoea.
Confusion.
Drowsiness.
Xanthopsia.

Question 13

Adverse reactions:

Amiodarone.

Answer 13

ILD.
Thyroid disease.
Skin greying.
Corneal deposits.

Question 14

Adverse reactions:

Lithium.

Answer 14

Early – tremor.

Late – arrhythmias, seizures, renal failure, coma, diabetes insipidus.

Question 15

Adverse reactions:

Haloperidol.

Answer 15

Dyskinesias.

Question 16

Adverse reactions:

Clozapine.

Answer 16

Agranulocytosis.

Constipation–> bowel perforation.

Question 17

Adverse reactions:

Fludrocortisone.

Answer 17

Hypertension/sodium.

Water retention.

Question 18

Adverse reactions:

Simvastatin.

Answer 18

Myalgia (--> rhabdomyalisis).
Abdominal pain.
Liver damage (increased ALT/AST).

Question 19

Cytochrome p450 inducers.

Answer 19

PC BRAS.
Phenytoin.
Carbamazepine.
Barbiturates.
Rifampicin.
Alcohol (chronic).
Sulphonylureas.

Question 20

Cytochrome p450 inhibitors.

Answer 20

AO DEVICES.
Allopurinol.
Omeprazole.
Disulfiram.
Erythromycin.
Valproate.
Isonazide.
Ciprofloxacin.
Ethanol (acute).
Suphonamides.

Question 21

Contraindications for the COCP.

Answer 21

Very overweight.
Previous history of clots/family history of clots at young age.
Smoking (or stopped <1 year) and >35yo.
Hypertension/heart abnormalities.
Migraine with aura.

Question 22

Rules for having missed on pill on COCP.

Answer 22

Take it immediately.
Continue taking others as normal.

No risk of pregnancy.

Question 23

Rules for having missed two or more pills on COCP.

Answer 23

Take the last missed pill immediately.
If you missed less than 7, when you get to the end of a pack (or the fake week of pills), then start a new pack immediately.
If you missed more than 7, have the break and start again as normal.

Question 24

What is regularly measured when taking the COCP?

Answer 24

Blood pressure – increased risk of hypertension.

Question 25

Reduced risks with COCP.

Answer 25

Endometrial and ovarian cancer.

Pregnancy.

Question 26

Reasons to stop taking the COCP immediately.

Answer 26

Sudden chest pain/breathlessness/swelling in calf.
Prolonged immobility.
Neurological symptoms.
High blood pressure

Question 27

Illness and the pill.

Answer 27

Vomiting within 2 hours of taking the pill – take another immediately.
If consistently vomiting – use a different form of contraception until you can take the pill for 7 days.
Very severe diarrhoea – use other forms of contraception.

Question 28

Going back on the COCP post pregnancy.

Answer 28

Not breastfeeding – start pill 21 days after delivery.
Breastfeeding – wait 6 weeks after birth.
Miscarriage/abortion – 5 days after. If over 5 days after, wait another week before starting.