Adverse Drugs Effect Flashcards
Mode of action of ACE inhibitors?
Inhibits angiotensin I -> angiotensin II
Breaks down bradykinin
Side effects of ACE inhibitors?
Dry cough
Hyperkalaemia
Renal impairment
Foetal Injury
Mode of action of Thiazide diuretics?
Decrease Sodium + Chloride absorption in DCT
Side effects of Thiazide diuretics?
Gout -> hyperuricaemia
Hypokalaemia
Hyponatremia
Metabolic alkalosis
Hypercalcaemia
Hyperglycaemia
Mode of action of CCBs?
Stop calcium entering cells of hearts and arteries so decreases vascular tone
Side effects of CCBs?
Ankle oedema
Headache
Palpitations
Constipation
Mode of action of Beta Blockers?
Inhibits Beta-1 Receptors so that Adrenaline and Noradrenaline cannot have their effects.
Causes heart to beat more slowly and with less force
Side effects of Beta Blockers?
Bronchospasm
Hypotension
Bradycardia
Mode of action of Metformin?
Activation of AMPK -> inhibiting hepatic gluconeogenesis and opposing the action of glucagon.
Side effects of Metformin?
Lactic Acidosis
GI symptoms
Mode of action of Sulfonylureas?
Inhibits the VGKCs of pancreatic beta cells -> ultimately resulting in insulin release
Side effects of Sulfonylureas?
Hypoglycaemia
Weight gain
Mode of action of SGLT-2 inhibitors?
Prevents reabsorption of glucose in PCT
Side effects of SGLT-2 inhibitors?
UTIs
Thrush
Can worsen DKA
Mode of action of Lamotrigine?
FIRST LINE FOR FOCAL SEIZURES
Sodium Channel Blocker
Side Effects of Lamotrigine?
Steven Johnson Syndrome
Suicidal thoughts
Mode of action of Sodium Valproate?
FIRST LINE FOR GENERALISED SEIZURES
Sodium channel blocker and increased GABA
Side effects of Sodium Valproate?
Teratogenic
Neural tube defects
Hepatotoxicity
Pancreatitis
Name the drugs used in the treatment of Tuberculosis.
RIPE
Rifampicin
Isoniazid
Pyrazinamide
Ethambutol
Side effects of Rifampicin?
Orange secretions
Haemolysis
Side effects of Isoniazid?
Peripheral Neuropathy
Drug induced Lupus
Side effects of Pyrazinamide?
Gout -> hyperuricaemia
Arthralgia
Liver Toxicity
Side effects of Ethambutol?
Optic neuritis
Colour blindness
Avoid in CKD
Mode of action of Glucocorticoids?
Anti-inflammatory
Inhibition of cytokines
Give some examples of Glucocorticoids
Prednisolone
Dexamethasone
Fluticasone
Mometasone
Budesonide
(last 3 used in asthma)
Side effects of Glucocorticoids?
CUSHINOID
Ulcers
Immunosuppression
Hypertension
Adrenal suppression
Hyperglycaemia
Infection
Necrosis
Glycosuria
Osteoporosis
Dyspepsia
Depression
Glaucoma
Raised WCC
Cataracts
Intracranial HTN
Mode of action of NSAIDs?
Anti-inflammatory
Inhibition of COX
Side effects of NSAIDs
STOMACH ULCERS
Possible Nephritis
Chronic renal failure
What is Amiodarone used for?
Treatment of arrhythmias
Side effects of Amiodarone?
Hypothyroidism
Thyrotoxicosis
Corneal deposits
Stevens-Johnson
Liver failure
Pneumonitis
Pulmonary fibrosis
What is Lithium used to treat?
Bipolar Disorder
(works as an anti-psychotic)
Side effects of Lithium?
Nephrogenic Diabetes Insipidus
Confusion + blackouts
Difficulty speaking
Muscle weakness/twitches/jerks/spasms
Mode of action of Diazepam?
Increases Chloride ion influx in response to GABA
Side effects of Diazepam?
Haemolytic anaemia
Jaundice
Respiratory depression
Mode of action of Sitagliptin?
DPP-4 inhibitor
Increases incretins which then stimulate production of insulin when it’s needed
Side effects of Sitagliptin?
Upper Respiratory Infection
Allergic reaction
Avoid in pancreatitis
Side effects of SSRIs?
GI effects (nausea, diarrhoea)
Sexual dysfunction
Anxiety + agitation
Insomnia
QT interval prolongation (Citalopram)
Hyponatremia
Gastric Ulcer
Side effects of ARBs?
Hyperkalaemia
Foetal injury
Mode of action of Salbutamol?
Agonist at Beta-2 receptor
Reduces Ca2+ entry and prevents smooth muscle contraction
Side effects of Salbutamol?
Palpitation
Tachycardia
Arrhythmias
Hypokalaemia
Mode of action of Montelukast?
Antagonism of CysLT1 leukotriene receptor.
Decreases eosinophil migration, broncho-constriction + inflammation induced oedema
Side effects of Montelukast?
Mood changes
Anaphylaxis
Mode of action of Statins?
Selective competitive inhibitor of HMG-CoA
Side effects of Statins?
Muscle toxicity
Mode of action of Gentamicin?
Binds to bacterial ribosomal unit and disrupts translation.
Leading to formation of dysfunctional proteins
Side effects of Gentamicin?
Ototoxicity
Nephrotoxicity
Mode of action of Spironolactone?
Aldosterone antagonist
Side effects of Spironolactone?
Hyperkalaemia
Renal impairment
Gynaecomastia
Changes in libido
Mode of action of Furosemide?
Loop diuretic
Side effects of Furosemide?
Hypotension
Hyponatremia/kalaemia
Mode of action of Hydralazine/Nitrate?
Relax vascular smooth muscle promoting vasodilation
Side effects of Hydralazine/Nitrate?
Headache
Palpitation
Flushing
Mode of action of Digoxin?
Increase in intracellular sodium that will drive an influx of calcium in the heart and cause an increase in contractility
Side effects of Digoxin?
Dizziness
Blurred vision
GI disturbances
Side effects of SNRIs?
Nausea
Insomnia
Increased HR
Agitation
Side effects of NASSA e.g. Mirtazapine?
Sedation
Increased appetite
Weight gain
Constipation/diarrhoea
Side effects of Tricyclic anti-depressants?
Urinary retention
Drowsiness
Blurred vision
Constipation
Dry mouth
Side effects of Monoamine Oxidase inhibitors?
Hypertensive reactions with Tyramine-containing foods e.g. pickled herring, Bovril, OXO, marmite, cheese + salami
Side effects of bisphosphonates e.g. alendronic acid?
Oesophagitis
Oesophageal ulcers
Erosions + strictures
Hypocalcaemia
Osteonecrosis of jaw/auditory canal
How do you reduce the side effects of Bisphosphonates?
Tablets given whole with LOTS OF WATER.
Taken on an empty stomach at least 30min before breakfast.
Patients should remain seated/upright for 30 minutes
Mode of action of Methotrexate?
Folic acid inhibitor
Side effects of Methotrexate?
GI disturbance
Folate deficiency
Immunosuppression
Pulmonary fibrosis
Liver toxicity
Interstitial pneumonitis
Rash
Teratogenicity
Side effects of Sulfalazine?
Myelosuppression
Nausea
Rash
Oral ulcers
Decreased sperm count
Side effects of Hydroxychloroquine?
Retinopathy
Rash
Side effects of Biologic Therapy?
Immunosuppression
Reactivation of TB
Allergic reaction
Side effects of Gold?
Myelosuppression
Renal toxicity (nephrotic syndrome)
Mouth ulcers
Photosensitivity
Chrysiasis (skin discolouration)
Consequences of Anti-platelet therapy?
Bleeding
Bruising
GI side effects (particularly NSAIDs)
Haemorrhagic stroke
Surgical complications
Name some Anticoagulants
Warfarin
Heparin
DOAC e.g. Apixaban/Rivaroxaban
Low Molecular Weight Heparin e.g. Enoxaparin
When are Anti-Coagulants and Anti-Platelets contraindicated?
Active bleeding
High risk of bleeding (recent major surgery, trauma or intracranial malignancy, peptic ulcer, GI bleed history)
Severe renal impairment or liver disease
Uncontrolled HTN
Pregnancy
Thrombocytopenia
Side effects of Heparin?
Haemorrhage
Thrombocytopenia
Skin reactions
Hyperkalaemia
How to reverse Heparin in clinical setting?
Usually sufficient to withdraw But if rapid reversal required = protamine sulfate is a specific antidote (only partially reverses the effects of low molecular weight heparins).
How to reverse effects of Warfarin?
Can wean off.
Minor bleeding = Vitamin K
Major bleeding = Vitamin K + Prothrombin Complex Concentrate
How to reverse effects of Dabigatran?
IV Idarucizumab
How to reverse effects of Factor Xa inhibitors e.g. Apixaban, Rivaroxaban, Edoxaban
Andexanet alfa
Side effects of Aspirin?
Bronchospasm
Dyspepsia
Haemorrhage
Side effects of Clopidogrel?
Diarrhoea
GI discomfort
Haemorrhage
How to reverse Anti-Platelets?
Platelet transfusion
Tranexamic Acid (works indirectly to improve clot formation)
Desmopressin (efficacy unclear)
What are the side effects of Levodopa?
Postural hypotension
Hallucinations + Psychosis
Confusion
Dyskinesia
How are the peripheral side effects of Levodopa reduced?
By co-prescription of Carbidopa a decarboxylase inhibitor
What are the side effects of Colchicine?
Abdominal pain
Diarrhoea
What are the ophthalmic side effects of steroids?
Cataracts
Glaucoma
