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Renal Pharm > Adverse effects > Flashcards

Adverse effects Flashcards

1
Q

Reflex tachycardia; headache, flushing & ↑Intraocular pressure

A

Fenoldopam

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2
Q

Nitrofurantoin

A

(1) Nausea, vomiting and diarrhea (take with meals to decrease adverse effects) (2) Hemolytic anemia associated with G6PD deficiency (3) Colors the urine brown

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3
Q

Hypokalemia Impaired glucose tolerance/hyperglycemia Hyperuricemia Hyperlipidemia*

A

Hydrochlorothiazide and indapamide

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4
Q

– Hyperkalemia – Renal impairment – Potential teratogen

A

Aliskiren

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5
Q

Sodium nitroprusside

A

excessive lowering of BP; accumulation of cyanide byproduct of its metabolism

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6
Q

Clonidine

A

Dry mouth; sedation; rebound hypertension (on withdrawal)

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7
Q

bradycardia & cardiac conduction problems; impotence, peripheral vascular insufficiency, hyperglycemia, diabetes, asthma Withdrawal s/s nervousness, tachycardia, increase BP

A

Propranolol

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8
Q

Calcium acetate & calcium carbonate

A

GI side effects including constipation, diarrhea, nausea, vomiting, and abdominal pain Hypercalcemia

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9
Q

(1) Nausea, vomiting and diarrhea (take with meals to decrease adverse effects) (2) Hemolytic anemia associated with G6PD deficiency (3) Colors the urine brown

A

Nitrofurantoin

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10
Q

Irreversible ototoxicity: high-pitched tinnitus; high frequency loss followed by loss of low frequency (cochlear); N/V, vertigo (vestibular) Reversible nephrotoxicity Neuromuscular blockade (inhibit ACh release; Administration of a calcium salt can overcome this effect)

A

Aminoglycosides

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11
Q

Nilutamide

A

Hot flashes, gynecomastia, GI disturbances (nausea, diarrhea or constipation), liver function test abnormalities (including hepatitis) can cause interstitial pneumonitis

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12
Q

Captopril, Lisinopril, Enalapril, Ramipril

A

– Dry cough – Angioedema – Teratogenic Hyperkalemia

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13
Q

Fosfomycin

A

Diarrhea, nausea

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14
Q

i. Hypertension ii. Thrombotic/vascular events iii. Deep vein thrombosis

A

Erythropoietic growth factors (epoetin alfa)

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15
Q

Angioedema; teratogenic

A

Losartan, Candesartan, Valsartan, Eprosartan

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16
Q

Ferrous sulfate and ferric gluconate

A

Oral admin: (a) heartburn (b) constipation or diarrhea (c) nausea (d) upper abdominal pain IV admin anaphylaxis hypotension dizziness iron overload

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17
Q

Impotence and gynecomastia Hyperkalemia Metabolic acidosis

A

Spironolactone

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18
Q

Spironolactone

A

Impotence and gynecomastia Hyperkalemia Metabolic acidosis

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19
Q

(1) Nausea, vomiting (2) Rash (3) Hepatitis (rare but fatal),  liver enzymes (4) Endocrinologic abnormalities, e.g., women, menstrual irregularities; men, gynecomastia; due to inhibition of steroid biosynthesis

A

Azoles more important for ketoconazole

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20
Q

Sedation; postural hypotension (in volume depleted patients)

A

Methyldopa (Aldomet)

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21
Q

Hypersensitivity reactions GI distress and diarrhea Neurotoxicity (myoclonus or seizures, agitation, confusion and hallucinations, or lethargy and stupor progressing to coma) Ampicillin rash

A

Penicillins - Piperacillin-tazobactam

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22
Q

Aminoglycosides

A

Irreversible ototoxicity: high-pitched tinnitus; high frequency loss followed by loss of low frequency (cochlear); N/V, vertigo (vestibular) Reversible nephrotoxicity Neuromuscular blockade (inhibit ACh release; Administration of a calcium salt can overcome this effect)

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23
Q

Hypotension Peripheral edema Headache/dizziness Cardiodepression

A

Verapamil; Diltiazem

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24
Q

Verapamil; Diltiazem

A

Hypotension Peripheral edema Headache/dizziness Cardiodepression

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25
Dorzolamide; Acetazolamide
Metabolic acidosis
26
Metabolic acidosis
Dorzolamide; Acetazolamide
27
Bicalutamide & flutamide Antiandrogens
Hot flashes, gynecomastia, GI disturbances (nausea, diarrhea or constipation), liver function test abnormalities (including hepatitis)
28
a. GI: nausea, vomiting, abdominal discomfort b. CNS: headache, dizziness c. Have been shown to cause arthropathy in immature animals of a variety of species
Fluoroquinolones ciprofloxacin, levofloxacin
29
i. Hypernatremia and dehydration due to water loss in excess of sodium excretion ii. Increases plasma osmolality leading to hyponatremia manifested as headache, nausea and vomiting due to the movement of fluid into the extracellular compartments
Mannitol
30
Propranolol
bradycardia & cardiac conduction problems; impotence, peripheral vascular insufficiency, hyperglycemia, diabetes, asthma Withdrawal s/s nervousness, tachycardia, increase BP
31
Calcitriol, paricalcitol
i. Hypercalcemia ii. Hyperphosphatemia iii. soft-tissue and vascular calcification
32
Mannitol
i. Hypernatremia and dehydration due to water loss in excess of sodium excretion ii. Increases plasma osmolality leading to hyponatremia manifested as headache, nausea and vomiting due to the movement of fluid into the extracellular compartments
33
Ethacrynic acid
i. Hypocalcemia ii. Hypomagnesemia iii. Hypokalemia; predisposes patient to cardiac arrythmias iv. Metabolic alkalosis Decreased glucose tolerance Irreversible ototoxicity
34
Sevelamer
GI side effects including constipation, diarrhea, nausea, vomiting, and abdominal pain
35
Fluoroquinolones ciprofloxacin, levofloxacin
a. GI: nausea, vomiting, abdominal discomfort b. CNS: headache, dizziness c. Have been shown to cause arthropathy in immature animals of a variety of species
36
Leuprolide; Goserelin
i. Disease flare-up manifested clinically as increased bone pain or increased urinary symptoms ii. Endocrine-related including hot flashes, impotence, and decreased libido
37
3rd Generation Cephalosporin - Ceftriaxone
Hypersensitivty Local reactions at injection site Nephropathy (Risk of tubular necrosis in patients with underlying renal disease or who are taking potentially nephrotoxic drugs)
38
Acute hemolytic anemia (G6P deficiency) Steven Johnson Syndrome Crystalluria Kernicterus in newborns
Trimethoprim-Sulfamethoxazole
39
i. Hypocalcemia ii. Hypomagnesemia iii. Hypokalemia; predisposes patient to cardiac arrythmias iv. Metabolic alkalosis Decreased glucose tolerance Reversible ototoxicity
Furosemide
40
Aliskiren
– Hyperkalemia – Renal impairment – Potential teratogen
41
Hypotension Peripheral edema Headache/dizziness
Nifedipine; Amlodipine
42
Nifedipine; Amlodipine
Hypotension Peripheral edema Headache/dizziness
43
Testosterone replacement
Sodium retention Gynecomastia Decreased HDL cholesterol levels Polycythemia Hepatotoxicity (oral) contact dermatitis (topical)
44
Hot flashes, gynecomastia, GI disturbances (nausea, diarrhea or constipation), liver function test abnormalities (including hepatitis) can cause interstitial pneumonitis
Nilutamide
45
Oral admin: (a) heartburn (b) constipation or diarrhea (c) nausea (d) upper abdominal pain IV admin anaphylaxis hypotension dizziness iron overload
Ferrous sulfate and ferric gluconate
46
Alfuzosin, doxazosin, tamsulosin, and terazosin
Cardiovascular: Orthostatic hypotension CNS: Dizziness, somnolence Genitourinary: Impotence Increased hypotensive effect when given with antihypertensive drugs such as β-blockers, diuretics, ACEIs, calcium channel blockers
47
Reflex tachycardia; Postural hypotension
Prazosin; Doxazosin
48
Losartan, Candesartan, Valsartan, Eprosartan
Angioedema; teratogenic
49
Sildenafil, tadalafil, vardenafil
Hypotension i. Increased sensitivity to light ii. Blurred vision iii. Loss of blue-green color discrimination Back and muscle pain Priapism Sudden hearing loss usually on one side involving partial or complete loss of usual hearing; reversible Headache, facial flushing, rhinitis (due to vasodilation)
50
Finasteride; Dutasteride
i. Genitourinary: ejaculation disorders (dry sex or delayed ejaculation) and erectile dysfunction (may be due to drug-induced inhibition of NO synthesis) ii. Endocrine: gynecomastia iii. Pregnancy category X - suppresses levels of DHT in male fetus inhibiting development of external genital organs and leading to feminization of a male fetus
51
Hypotension i. Increased sensitivity to light ii. Blurred vision iii. Loss of blue-green color discrimination Back and muscle pain Priapism Sudden hearing loss usually on one side involving partial or complete loss of usual hearing; reversible Headache, facial flushing, rhinitis (due to vasodilation)
Sildenafil, tadalafil, vardenafil
52
i. Hypercalcemia ii. Hyperphosphatemia iii. soft-tissue and vascular calcification
Calcitriol, paricalcitol
53
Diarrhea, nausea
Fosfomycin
54
Dry mouth; sedation; rebound hypertension (on withdrawal)
Clonidine
55
Minoxidil; Pinacidil
(i) Reflex tachycardia; (ii) Fluid retention; (iii) Excessive hair growth; (iv) Headaches/Flushing excess cerebral/cutaneous dilation
56
Sodium retention Gynecomastia Decreased HDL cholesterol levels Polycythemia Hepatotoxicity (oral) contact dermatitis (topical)
Testosterone replacement
57
Prazosin; Doxazosin
Reflex tachycardia; Postural hypotension
58
GI side effects including constipation, diarrhea, nausea, vomiting, and abdominal pain
Sevelamer
59
Alprostadil
Intracavernosal Cavernosal plaques or areas of fibrosis at injection sites Burning discomfort or dull pain near the injection site or during the erection Priapism Intraurethral Urethra injury leading to urethral stricture and difficulty voiding Urethral pain Female sexual partners may experience vaginal burning, itching, or pain Priapism
60
i. Nausea and vomiting ii. Hypocalcemia manifested as paresthesias, myalgias, cramping, tetany, and convulsions
Cinacalcet
61
Hyperkalemia Metabolic acidosis
Triamterene; Amiloride
62
Reflex sympathetic activation → Tachycardia; ↓Insulin release (due to Kchannel opening); Edema (salt and water retention)
Diazoxide
63
i. Genitourinary: ejaculation disorders (dry sex or delayed ejaculation) and erectile dysfunction (may be due to drug-induced inhibition of NO synthesis) ii. Endocrine: gynecomastia iii. Pregnancy category X - suppresses levels of DHT in male fetus inhibiting development of external genital organs and leading to feminization of a male fetus
Finasteride; Dutasteride
64
Triamterene; Amiloride
Hyperkalemia Metabolic acidosis
65
Cardiovascular: Orthostatic hypotension CNS: Dizziness, somnolence Genitourinary: Impotence Increased hypotensive effect when given with antihypertensive drugs such as β-blockers, diuretics, ACEIs, calcium channel blockers
Alfuzosin, doxazosin, tamsulosin, and terazosin
66
i. Disease flare-up manifested clinically as increased bone pain or increased urinary symptoms ii. Endocrine-related including hot flashes, impotence, and decreased libido
Leuprolide; Goserelin
67
(i) Reflex tachycardia; (ii) Fluid retention; (iii) Excessive hair growth; (iv) Headaches/Flushing excess cerebral/cutaneous dilation
Minoxidil; Pinacidil
68
GI side effects including constipation, diarrhea, nausea, vomiting, and abdominal pain Hypercalcemia
Calcium acetate & calcium carbonate
69
Hot flashes, gynecomastia, GI disturbances (nausea, diarrhea or constipation), liver function test abnormalities (including hepatitis)
Bicalutamide & flutamide Antiandrogens
70
Hypersensitivty Local reactions at injection site Nephropathy (Risk of tubular necrosis in patients with underlying renal disease or who are taking potentially nephrotoxic drugs)
3rd Generation Cephalosporin - Ceftriaxone
71
Penicillins - Piperacillin-tazobactam
Hypersensitivity reactions GI distress and diarrhea Neurotoxicity (myoclonus or seizures, agitation, confusion and hallucinations, or lethargy and stupor progressing to coma) Ampicillin rash
72
Furosemide
i. Hypocalcemia ii. Hypomagnesemia iii. Hypokalemia; predisposes patient to cardiac arrythmias iv. Metabolic alkalosis Decreased glucose tolerance Reversible ototoxicity
73
GI disturbances (diarrhea or constipation, nausea)
Saw palmetto
74
Erythropoietic growth factors (epoetin alfa)
i. Hypertension ii. Thrombotic/vascular events iii. Deep vein thrombosis
75
Azoles more important for ketoconazole
(1) Nausea, vomiting (2) Rash (3) Hepatitis (rare but fatal),  liver enzymes (4) Endocrinologic abnormalities, e.g., women, menstrual irregularities; men, gynecomastia; due to inhibition of steroid biosynthesis
76
excessive lowering of BP; accumulation of cyanide byproduct of its metabolism
Sodium nitroprusside
77
Cinacalcet
i. Nausea and vomiting ii. Hypocalcemia manifested as paresthesias, myalgias, cramping, tetany, and convulsions
78
Diazoxide
Reflex sympathetic activation → Tachycardia; ↓Insulin release (due to Kchannel opening); Edema (salt and water retention)
79
Hydrochlorothiazide and indapamide
Hypokalemia Impaired glucose tolerance/hyperglycemia Hyperuricemia Hyperlipidemia\*
80
Trimethoprim-Sulfamethoxazole
Acute hemolytic anemia (G6P deficiency) Steven Johnson Syndrome Crystalluria Kernicterus in newborns
81
Saw palmetto
GI disturbances (diarrhea or constipation, nausea)
82
Methyldopa (Aldomet)
Sedation; postural hypotension (in volume depleted patients)
83
Intracavernosal Cavernosal plaques or areas of fibrosis at injection sites Burning discomfort or dull pain near the injection site or during the erection Priapism Intraurethral Urethra injury leading to urethral stricture and difficulty voiding Urethral pain Female sexual partners may experience vaginal burning, itching, or pain Priapism
Alprostadil
84
i. Hypocalcemia ii. Hypomagnesemia iii. Hypokalemia; predisposes patient to cardiac arrythmias iv. Metabolic alkalosis Decreased glucose tolerance Irreversible ototoxicity
Ethacrynic acid
85
Fenoldopam
Reflex tachycardia; headache, flushing & ↑Intraocular pressure
86
– Dry cough – Angioedema – Teratogenic Hyperkalemia
Captopril, Lisinopril, Enalapril, Ramipril

Renal Pharm (14 decks)

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