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PSA > Adverse Effects > Flashcards

Adverse Effects Flashcards

1
Q

Abx

A
  • Gentamicin/Vancomycin: ototoxicity and nephrotoxicity
  • Others: C.diff
  • Flucloxacillin and Co-amox: cholestatic hepatitis and jaundice
  • Idiosyncratic, not dose related
  • Onset may be delayed for up to 2 months following Tx
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2
Q

ACE-Is

A
  • Hypotension
  • Hyperkalaemia
  • AKI
  • Dry cough
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3
Q

Beta-blockers

A
  • Hypotension
  • Bradycardia
  • Wheeze in asthmatics
  • Worsens acute HF (but helps chronic HF)
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4
Q

CCBs

A
  • Hypotension
  • Bradycardia
  • Peripheral oedema
  • Flushing
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5
Q

Diuretics

A
  • Hypotension
  • Electrolyte disturbances
  • AKI
  • Spironolactone: gynaecomastia
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6
Q

Heparin

A
  • Haemorrhage (especially if renal failure/<50kg)
  • Heparin-induced thrombocytopenia
  • ?Hyperkalaemia
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7
Q

Warfarin

A
  • Haemorrhage

- Warfarin initially has procoag effect so take heparin alongside until INR exceeds 2

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8
Q

Aspirin

A
  • Haemorrhage
  • Peptic ulcers and gastritis
  • Tinnitus (large doses)
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9
Q

Digoxin

A
  • Nausea and vomiting
  • Diarrhoea
  • Blurred vision
  • Confusion
  • Dizziness
  • Xanthopsia (disturbed yellow/green visual perception including halo vision)
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10
Q

Digoxin and potassium

A
  • HypERkalaemia can limit digoxin effects

- HypOkalaemia ca increase digoxin effects (toxicity)

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11
Q

Amiodarone

A

SEs continue even after stopping!

  • Interstitial lung disease (pulmonary fibrosis)
  • Thyroid disease (both hypo- and hyper-)
  • Raised AST (steato hepatitis)
  • Phototoxicity
  • Skin greying
  • Corneal deposits
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12
Q

Lithium

A
  • EPSEs
  • Hyper/hypothyroidism
  • QT prolongation
  • Weight gain
  • Early: tremor
  • Intermediate: tiredness
  • Late: arrhythmias, seizures, coma, renal failure, diabetes insipidus, nephrotic syndrome
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13
Q

Haloperidol

A
  • Dyskinesias (acute dystonic reactions, drowsiness)
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14
Q

Clozapine

A
  • Agranuloyctosis - monitor FBCs
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15
Q

Dexamethasone and prednisolone

A

STEROIDS

  • Stomach ulcers
  • Thin skin
  • Edema
  • Right and left HF
  • Osteoporosis
  • Infection (candida)
  • Diabetes (hyperglycaemia)
  • Syndrome - Cushing’s
  • Mood changes
  • Hyperlipidaemia
  • Hypernatraemia
  • Hypokalaemia
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16
Q

Fludrocortisone

A
  • HTN

- Sodium and water retention

17
Q

Ibuprofen

A

NSAIDS

  • No urine (renal failure)
  • Systolic dysfunction (HF)
  • Asthma
  • Indigestion
  • Dyscrasia
18
Q

Simvastatin

A
  • Myalgia
  • Abdo pain
  • Interstitial lung disease
  • Increased ALT/AST
  • Rhabdomyolysis
19
Q

Tx of statin-induced myalgia

A
  • Exclude rhabdomyolysis (CK and urine dip - myoglobin)
  • Ensure needs statin
  • Reduce dose
  • Switch to another statin with lower risk
20
Q

Myalgia risk of statins (in order)

A
  1. Simvastatin
  2. Atorvastatin
  3. Pravastatin
  4. Fluvastatin
    or a fibrate
21
Q

Metformin

A
  • Lactic acidosis
22
Q

Alcohol use

A
  • Acute: increases warfarin effect

- Chronic: reduces warfarin effect

23
Q

MAOIs

A
  • Hypertensive crisis
24
Q

Sedation causes

A
  • Barbiturates
  • Opioids
  • Benzos
25
Q

Alcohol: Metronidazole and disulfiram

A
  • Sweating
  • Flushing
  • Nausea
  • Vomiting
26
Q

Tx of rhabdomyolysis

A
  • Stop drug
  • If renal failure - urgent dialysis
  • IV fluids
  • Consider sodium bicarbonate
  • Monitor serum potassium (hyper from cell breakdown)
27
Q

DOACs

A
  • Bleeding
  • Anaemia
  • Nausea
28
Q

Carbimazole

A
  • Rash
  • Pruiritis
  • Agranulocytosis (SORE THROAT)
  • Bone marrow suppression
  • Jaundice
  • Acute pancreatitis
29
Q

Methotrexate

A
  • Stomatitis
  • Stevens-Johnson
  • Toxic epidermal necrolysis
  • Blood disorders
  • Hepatotoxicity
  • Interstitial pneumonitis
30
Q

Phenytoin

A
  • Gingival hypertrophy
  • Hirsutism
  • Tremor
  • Leucopenia
  • Steven-Johnsons
  • Pneumonitis
31
Q

Theophylline

A
  • Hypokalaemia
  • N+V
  • Tremor
  • Palpitations
32
Q

Sodium Valproate

A
  • SIADH
  • Hyponatraemia
  • Pancreatitis
  • Bone marrow failure
  • Anaemia
33
Q

Drugs that increase GI bleed risk

A
  • Antiplatelets: aspirin, clopidogrel
  • Anticoagulants: warfarin
  • Corticosteroids
  • NSAIDs
  • SSRIs
  • Bisphosphonates
  • Doxycycline
34
Q

Drugs that cause weight gain

A
  • SSRIs
  • Anti-psychotics: clozapine, lithium, olanzapine, quetiapine, risperidone
  • Sulphonylureas
  • Corticosteroids
  • Amitryptilline
  • Sodium Valproate
  • Insulin
35
Q

HRT adverse effects

A
  • HTN, STOP if BP > 160/96 (sodium and fluid retention)
  • Can cause cholestatic jaundice, but no routine LFTs needed
  • Serum cholesterol can increase but unlikely if on statin. Regular statin measurements.
  • Can cause weight gain
  • Breast cancer
36
Q

HRT monitoring

A
  • BP
  • Breast status
  • Statins (not as important)
37
Q

Statins and ALT

A

Measure liver enzymes at baseline, 3 months and 12 months

  • Stop if > 3x baseline
  • Fine if < 3x baseline

PSA (8 decks)

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