Adverse effects Flashcards
What drugs prolong the QTc?
Long QTc = Bruce Lee
Come Mother Fucker
C.O.M.E M.F
Citalopram / venfexaline
Ondasetron
Macrolides
EPS / first gen antipsychotics
Macrolides/ Antibiotics
Fluranes
What drugs should be avoided in the elderly?
Benadryl and older antihistamines. …
Sleep medications. …
Muscle relaxers. …
Antispasmodics. …
Seroquel and other antipsychotic medications. …
Tricyclic antidepressants. …
Barbiturates. …
Indomethacin.
What is the normal QTc?
440ms in men and 460 ms in women
What is a risk of ondasetron in pregnancy?
Ondansetron during pregnancy is associated with a small increased risk of cleft palate/lip - the MHRA advise that these risks need to be discussed with the pregnant woman before use
What is the effect of the COCP?
Combined oral contraceptive pill
increased risk of breast and cervical cancer
protective against ovarian and endometrial cancer
What causes gingival hyperplasia?
Gingival hyperplasia: phenytoin, ciclosporin, calcium channel blockers and AML
ACE inhibitor side effects
C ough
A naphylaxis (or A ngioedema)
P alpitations
T aste disturbance
O rthostatic hypotension
P otassium elevated
R enal impairment
I mpotence
Sildenafil adverse effects
visual disturbances
blue discolouration
non-arteritic anterior ischaemic neuropathy
nasal congestion
flushing
gastrointestinal side-effects
headache
priapism
blue discolouration of vision
Gliclazide
Weight gain
Hypoglycaemia
What drug should be avoided in patients with an allergy to aspirin?
Patients who are allergic to aspirin may also react to sulfasalazine
Colchicine
Abdominal pain; diarrhoea; nausea; vomiting
Runs before walking
Monitor FBC
Allopurinol
Rash (discontinue therapy; if rash mild re-introduce cautiously but discontinue immediately if recurrence)
Amiodarone
Diarrhoea; gout aggravated; headache; hepatic disorders; nausea; oedema; skin reactions
Ciclosporin
Appetite decreased; diarrhoea; electrolyte imbalance; fatigue; fever; flushing; gastrointestinal discomfort; gingival hyperplasia; hair changes; headaches; hepatic disorders; hyperglycaemia; hyperlipidaemia; hypertension; hyperuricaemia; leucopenia; muscle complaints; nausea; paraesthesia; peptic ulcer; renal impairment (renal structural changes on long-term administration); seizure; skin reactions; tremor; vomiting
Name a drug that should never be prescribed in heart failure?
Verapamil as it is negatively ionotropic
What is given instead of adenosine for SVT in asthmatics?
Verapamil
Suggest which antibiotic should be avoided in epilepsy?
Levofloxacin is a fluoroquinolone antibiotic that has been associated with an increased risk of seizures in patients with epilepsy. This is thought to be due to its inhibitory effect on the gamma-aminobutyric acid (GABA) receptor, which plays a crucial role in the regulation of neuronal excitability. In patients with epilepsy, where there is already a tendency for hyperexcitability, this inhibition can potentially trigger seizures. Therefore, according to UK guidelines, it should be avoided in these patients.
Suggest how steroids should be reduced?
The BNF suggests gradual withdrawal of systemic corticosteroids if patients have:
received more than 40mg prednisolone daily for more than one week
received more than 3 weeks treatment
recently received repeated courses
What % of patients allergic to penicillin are allergic to cephalosporins?
The principal side-effect of the cephalosporins is hypersensitivity and about 0.5-6.5% of penicillin-sensitive patients will also be allergic to the cephalosporins.
Name two medicines taken at night?
Simvastatin
Amytriptalline
BPO and adapalene
What antibiotic is most likely to cause hearing loss?
Gentamicin is an aminoglycoside antibiotic and this class of medication can cause damage to the vestibular nerve if blood concentrations are high. As such, patients on these antibiotics should be monitored for signs of ototoxicity during treatment.
Suggest a co-prescription that increases risk of respiratory depression.
Co-prescription of benzodiazepines and opiates increases the risk of respiratory depression, coma, and death. Co-prescription should only be considered if there is no alternative and, if necessary, the lowest possible doses should be given for the shortest duration.
Oxybutynin side effects
Oxybutynin is an anti-muscarinic medication, which has a range of side effects that most commonly occur in elderly patients. A common anti-muscarinic side effect is dry mouth. Other common anti-muscarinic side effects include constipation, dizziness, drowsiness, dyspepsia, flushing, headache, nausea, palpitations, skin reactions, tachycardia, urinary disorders, vision disorders and vomiting. The BNF also lists diarrhoea as a general side effect of oxybutynin.
Co-amoxiclav side effects
Diarrhoea; hypersensitivity; nausea; skin reactions; thrombocytopenia; vomiting