Adverse Effect Flashcards
muscle cramps
Tyrosine kinase inhibitor - Imatinib
(1) Formation of inhibitors, anti-factor VIII/IX antibodies (IgG)(2) Viral infection(3) Thrombophlebitis at the infusion site(4) Bacterial contamination of the concentrate(5) Primary prophylaxis(a) Cost (very expensive)(b) Catheter-related infections (often a central venous line isnecessary)”
Factor VIII/IX replacement Plasma-derived products and Recombinant factor VIII/IX
Acute infusion reactions, associated particularly with the first infusion, including fever, chills, urticaria, headache, bronchospasm, angioedema and hypotension
Rituximab
a) Pulmonary emboli b) DVTc) MI
Prothrombin complex concentrate (PCC) and activated PCC(aPCC)
Inhibition of protein synthesis in normal tissues which can lead to hyperglycemia due to insulin deficiency, clotting abnormalities due to deficient clotting factors, and hypoalbuminemia
Asparaginase
stomatitis, conjunctivitis, dermatitis,
Cytarabine
Myelosuppression
flucytosine
Peripheral neuropathy
Fludarabine; Lamivudine (nucleoside analog of cytosine), Emtricitabine (fluorinated analog of lamivudine), Tenofovir (nucleotide analog of adenosine)
N/V; diarrhea, dizziness; rare: neutropenia, anemia, hemolysis, allergic reactions
Artemisinin
“Dose-related QT and PR intervals prolongation; Embryo-toxic, thus contraindicated in pregnancy”
Halofantrine
Rash which could progress to Stevens-Johnson syndrome
Nonnucleoside: Efavirenz and TMP/SMX and Pyrimethamine/sulfadiazine
Can cause anaphylaxis
iron dextran
a. Formation of inhibitors b. Viral infection associated with use of plasma-derived product sc. Thrombophlebitis at the infusion site
Plasma-derived vWF-containing products
neurotoxic, urotoxic, myelosuppression
cyclophosphamide
cardiotoxic
Doxorubicin, daunorubicin - anthracyclines
Mucositis
Doxorubicin, daunorubicin - anthracyclines; methotrexate
Cough, pyrexia, upper respiratory tract infection, rash, musculoskeletal symptoms, abdominal pain and postural dizziness, Hepatotoxicity
Penetration blocker: Maraviroc
ECG abnormalities
Mefloquine; Chloroquine; Quinine
Dry skin, cheilitis, reversible hepatic enzyme abnormalities
Tretinoin
– Hyperlipidemia– Leukopenia– Thrombocytopenia
sirolimus
Pruritus; Nausea, abdominal pain, blurring of vision; Hemolysis in persons deficient in G6PD; Hypotension; ECG changes: QRS widening; T wave abnormalities
Chloroquine
lipoatrophy
Lamivudine (nucleoside analog of cytosine), Emtricitabine (fluorinated analog of lamivudine), Tenofovir (nucleotide analog of adenosine)
Mitochondrial toxicity due to inhibition of mitochondrial DNA polymerase-γ
Lamivudine (nucleoside analog of cytosine), Emtricitabine (fluorinated analog of lamivudine), Tenofovir (nucleotide analog of adenosine)
pancreatitis
Lamivudine (nucleoside analog of cytosine), Emtricitabine (fluorinated analog of lamivudine), Tenofovir (nucleotide analog of adenosine)
Antigenicity as a foreign protein-Hypersensitivity reactions can occur and may be fatal
Asparaginase
seizures, dementia, and coma (cerebral toxicity)
Cytarabine
Peripheral neuropathy, pancreatitis, lipoatrophy, myopathy, anemia, increased transaminases Mitochondrial toxicity due to inhibition of mitochondrial DNA polymerase-γ
Lamivudine (nucleoside analog of cytosine), Emtricitabine (fluorinated analog of lamivudine), Tenofovir (nucleotide analog of adenosine)
can cause allergic reactions (pruritus, wheals,rash, anaphylaxis)
Deferoxamine
↑Risk of reactivating latent tuberculosis – screenpatients for TB; ↑Risk of demyelinating disease
TNF-α Inhibitors: Etanercept, Infliximab, Adalimumab
myelosuppression, N/V, anorexia
Mercaptopurine, Fludarabine
Lower risk of anaphylactic reactions
Sodium Ferric gluconate and iron sucrose
Hepatotoxicity
Penetration blocker: Maraviroc; cyclosporine; Amodiaquine; Protease inhibitors: Atazanavir, Darunavir, Ritonavir
Well-tolerated: diarrhea, nausea, dizziness, and headache
Integrase inhibitor: raltegravir
Hemolytic abnormalities; Hypoglycemia; ECG abnormalities; Flushing; Hypersensitivity reactions
Quinine and Quinidine
Diarrhea
leflunomide
Nephrotoxicity and pulmonary toxicity can occur after long-term use
methotrexate
reversible hepatic enzyme elevations, noncardiogenic pulmonary edema; GI disturbances; myelosuppression
Cytarabine
Metabolic changes including increased lipids, insulin insensitivity, and central fat accumulation
Protease inhibitors: Atazanavir, Darunavir, Ritonavir
Neutropenia, aplastic anemia and hepatotoxicity are common adverse effects
Amodiaquine
edema (ankles and periorbital tissues)
Tyrosine kinase inhibitor - Imatinib
Skin necrosis, fetal toxicity, and bleeding
warfarin
Cinchonism: Tinnitus; Headache; Visual disturbances; Nausea; Dizziness
Quinine and Quinidine
Almost all patients develop local injection site reactions,with mild or moderate pain, erythema, induration, nodules and cysts
enfuvirtide
hepato-, nephro-,& neuro—toxicity; hypertension, hyperlipidemia
cyclosporine
Prolonged high dose - Irreversible ototoxicity; retinopathy; myopathy; peripheral neuropathy
Chloroquine
bleeding and risk of hemorrhage; HIT
Heparin and LWMH
Tissue necrosis upon extravasation
Doxorubicin, daunorubicin - anthracyclines; dacarbazine
Facial flushing
DDAVP (desmopressin)
GI symptoms; photosensitivity
Doxycycline
↑Risk of cancer, especially bladder cancer
cyclophosphamide
ataxia and slurred speech (Cerebellar toxicity)
Cytarabine
Antidiuretic effects: water retention and dilutional hyponatremia
DDAVP (desmopressin)
(a) heartburn (b) constipation or diarrhea (c) nausea (more prevalent at higher doses) (d) upper abdominal pain (more prevalent at higher doses)
oral iron
N/V, Rash, Hepatitis, Endocrinologic abnormalities: women, menstrual irregularities; men, gynecomastia; due to inhibition of steroid biosynthesis
azoles, particularly ketoconazole
Abdominal pain, nausea, vomiting, diarrhea, rash
“Atovaquone-proguanilaka Malarone”
Hyperpigmentation, hyperkeratosis, erythema, and ulcerations over the elbows, knuckles, and other pressure areas
Bleomycin
Begins with cough and rales progressing to fibrosis;may be reversible but patients die of this complication.
Bleomycin
numbness and tingling of the extremities and loss of deep tendon reflexes, and motor weakness (Neurotoxicity)
vincristine
Stevens Johnson syndrome; kernicterus in infants; Acute hemolytic anemia in G6PD deficiency; Crystalluria
TMP/SMX and Pyrimethamine/sulfadiazine
Nephrotoxicity, normochromic and normocytic anemia
Polyenes: Amphotericin B
