Adverse Drug Reactions Flashcards by Reece Weaver

Gentamicin, Vancomycin

Nephrotoxicity

Ototoxicity

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Anti antibiotic, but usually broad spec

C. Diff infection

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ACEi

Hypotension
Electrolyte abnormalities
AKI
Dry cough

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Beta Blockers

Hypotension
Bradycardia
Wheeze in asthmatics
worsens acute HF (but helps w/ chronic)

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CCBs

Hypotension
bradycardia
peripheral oedema
flushing

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Diuretics

Hypotension
electrolyte abnormality
AKI

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Heparin

Haemorrhage (esp if renal failure or <50kg)

Heparin induced thrombocytopenia

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Warfarin

Haemorrhage

Note, warfarin is pro-coagulant in first few days (so prescribe with heparin until INR >2)

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Aspirin

haemorrhage
Peptic ulcers
gastritis
tinnitus in large doses

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DIgoxin

Nausea, vomiting, diarrhoea
Blurred vision
Confusion and drowsiness
Xanthopsia - disturbed yellow green visual perception inc halo vision
Note, hypokalaemia increases digoxin affect (digoxin competes w/ K at Na/K pump, which is required for Ca2+ release –> Ca2+ release causes contractions –> therefore digoxin slows heart rate) –> less K = less competition = more effect

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Amiodarone

Lung fibrosis
Thyroid disease - both hyper and hypo (contains iodine0
skin greying
corneal deposits

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Lithium

Early - tremor
intermediate - tiredness
Late - arrythmia, seizures, coma, renal failure, diabetes insidious

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Haloperidol

Dyskinesias e.g acute dystonic reactions

drowsiness

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Clozapine

Agranulocytosis - needs FBC monitoring

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Dexamethasone/prednisolone (STEROIDS)

Stomach Ulcers
Thin Skin
Edema 
Right and Left heart faulure
Osteoperosis 
Infection
Diabetes 
Cushing's syndrome

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Fludrocortisone

HTN

Sodium and water retention

NSAIDs

No urine - renal failure 
Systolic dysfunction - heart failure
Asthma
Indigestion
Dyscrasia - clotting abnormalities

Statins

Myalgia
Abdominal pain
Increased AST/ALT
Rhabdomyolsys - can just be mildly raised CK

β blocker and verapamil together

Profound hypotension and asystole

combo strictly contradicted if IV verapamil

Drugs w/ a narrow therapeutic window

warfarin
digoxin
phenytoin

Drugs require careful titrating

Anithypertensives

Antidiabetics

Metformin - what to bare in mind (re contrast)

Iodinated contrast media can cause renal impairment
this increases risk of metformin induced lactic acidosis
If the scenario has things like low GCS, kussmaul breathing etc, look for metformin

What can contrast media do w/ ACEi

contrast media causes renal impairment, which increase risk of ACEi induced AKI

most common enzyme inhibitors

Ketoconazole
Ciprofloxacin
Erythromycin (clarithromycin too apparently)

Also - valproate, isoniazid, sulphonamides, allopurinol, disulfram, grape fruit juice

What drug class, w/ alcohol, causes GI bleeding

NSAIDs

What drug, w/ alcohol, causes lactic acidosis

Metformin

What drug, w/ alcohol, causes increased anticoagulastion

warfarin (w/ acute intoxication as it's an enzyme inhibitor --> chronic alcohol will reduce warfarin's effects as its an inducer)

What drug, w/ alcohol, causes sweating, flushing, nausea and vomiting

Metronidazole | also, disulfram (but that's the point innit)

What drug, w/ alcohol, causes a hypertensive crisis

Monoamine oxidase inhibitors

What drugs, w/ alcohol, causes sedations

barbituates opioids benzos

Drugs causing urinary retention

``` opiates Anticholinergics (eg, antipsychotic drugs, antidepressant agents, anticholinergic respiratory agents, detrusor relaxants), General anaesthetics, Alpha-adrenoceptor agonists, Benzodiazepines (e.g. diazepam), Non-steroidal anti-inflammatory drugs (e.g. ibuprofen), Calcium-channel blockers, Antihistamines, Alcohol. ```

drugs causing confusion

opiates Metoclopramide Other drugs that might cause confusion include: Anticholinergics (eg, antipsychotic drugs, antidepressant agents, anticholinergic respiratory agents, detrusor relaxants), Antipsychotics, Antidepressants, Anticonvulsants. Less common causes (histamine H2 receptor antagonists, digoxin, beta-blockers, corticosteroids, non-steroidal anti-inflammatory agents and antibiotics.