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Top 100 Drugs > Adverse Effects > Flashcards

Adverse Effects Flashcards

1
Q

Adrenaline

A

After Cardiac arrest —> adrenaline induced hypertension

Use in conscious pts —> anxiety, tremor, headaches, palpitations

In those with existing heart disease —> angina, MI, arrhythmias

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2
Q

Corticosteroids (systemic)

A

1️⃣ Immunosuppression
2️⃣Metabolic - osteoporosis, diabetes mellitus, proximal muscle weakness, bruising, gastritis
3️⃣Mood changes - suicidal, insomnia, confusion
4️⃣Mineralocorticoid - hypertension, hypokalaemia, oedema
5️⃣Adrenal atrophy over time -> Addisonian crisis if rapidly withdrawn
6️⃣Chronic glucocorticoid deficiency (fatigue, weight loss, arthralgia)

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3
Q

Thiazide like Diuretics

A

⚠️ Hyponatraemia
⚠️ Hypokalaemia (Na swapped for K in DCT) —> arrhythmias
⚠️ Increase plasma glucose, TGs, LDL-cholesterol
⚠️ Impotence in men

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4
Q

Statins

A

⚠️Headaches and GI Distrubances
‼️ Muscle problems ranging from aches to myopathy to rhabdomyolysis
⚠️ Increase in ALT
‼️ Drug induced hepatitis (rare but serious)

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5
Q

Clopidogrel

A

⚠️Bleeding
⚠️GI upset
⚠️Thrombocytopenia

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6
Q

Antihistamines

A 
First generation (e.g. chlorphenamine) cause sedation as act in the 🧠 
Second gen are fine
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7
Q

5a-reductase inhibitors

A 
Impotence
Reduced libido
Gynaecomastia
Hair growth
Breast cancer
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8
Q

Alpha blockers

Doxazosin, tamsulosin, alfuzosin

A

Postural hypotension
Dizziness
Syncope

Particularly after first dose

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9
Q

Acetylcholinesterase inhibitors

Donepezil, Rivastigmine

A

Increased cholinergic activity in peripheral nervous system ->
Nausea
Vomiting
Diarrhoea

Exacerbation of asthma/COPD
Peptic Ulcers and bleeding
Bradycardia and heart block

Central cholinergic effects ->
Hallucinations
Altered/aggressive behaviour

Extrapyramidal symptoms
Neuroleptic malignant syndrome

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10
Q

B-blockers

Propanolol, bisoprolol, atenolol, metoprolol, carvedilol

A 
Fatigue
Cold extremities
Headache
GI disturbance
Sleep disturbance
Impotence
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11
Q

Acetylcysteine

A

Can cause anaphylactoid reaction - give antihistamine & bronchodilator, then restart acetylcysteine.

When inhaled can cause bronchospasm so give bronchodilator first

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12
Q

Activated charcoal

A

Aspiration ➡️ pneumonitis, bronchospasm, airway obstruction

Intestinal obstruction

Black stools

Vomiting

💊 will reduce dose available for absorption of therapeutic drugs as well as poisons

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13
Q

Adenosine

A

By interfering with SAN and AVN it can induce bradycardia and asystole accompanied with SOB and ‘sense of impending doom’ - this is all short lived

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14
Q

Aldosterone antagonists

spironolactone, eplenerone

A

Hyperkalaemia –> muscle weakness, arrhythmias, cardiac arrest
Gynaecomastia (spironolactone)
Endocrine side effects (eplenerone)
Liver impairment and jaundice
Steven-Johnson syndrome (T-cell-mediated hypersensitivity reaction that causes bullous skin eruption)

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15
Q

Alginates and antacids

Gaviscon, Peptac

A

Diarrhoea (Mg salts)

Constipation (Al salts)

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16
Q

Allopurinol

A 
Starting can trigger or worsen acute attack of gout therefore co-px with NSAID or colchicine in the initiation phase.
Skin rash (Stevens-Johnson syndrome, toxic epidermal necrolysis)
Allopurinol hypersensitivity syndrome = severe, fever, eosinophilia, lymphadenopathy and other organ involvement
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17
Q

Aminoglycosides

gentamicin, amikacin, nneomycin

A

Ototoxicity (hearing loss, tinnitus, vertigo)
Nephrotoxicity (reduced eurine output, rising serum creatinine and urea)
(due to accumulation in cells –> apoptosis)

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18
Q

Aminosalicylates

mesalazine, sulfasalazine

A 
GI upset
Headache
Blood abnormalities (leucopenia, thrombocytopenia)
Renal impairment
Oligospermia (sulfasalazine)
Serious hypersensitivity reaction
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19
Q

Amiodarone

A 
Acute = sometimes hypotension
Chronic use:
pneumonitis
bradycardia / AV block
hepatitis
photosensitivity / grey discolouration
thyroid abnormalities (as contains iodine)
V LONG t1/2
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20
Q

ACE-i

ramipril, lisinopril, perindopril

A

First dose hypotension
Cough (due to increased bradykinin)
Hyperkalaemia (due to lower aldosterone level)
Renal failure (esp. in renal artery stenosis)
Angioedema and anaphylactoid reactions

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21
Q

ARBs

loasartan, candesartan, irbesartan

A

First dose hypotension
Hyperkalaemia
Renal Failure

22
Q

Antidepressants - SSRI’s

citalopram, sertraline, fluoxetine, escitalopram

A

GI upset
Changes in appetite and weight
Hypersensitivity rxn
Hyponatraemia
Suicidal thoughts and behaviour
Lower seizure threshold
Some can prolong the QT interval -> arrhythmias
Increase risk of bleeding
Serotonin syndrome (autonomic hyperactivity, altered mental state and neuromuscular excitation)
Sudden withdrawal can cause GI upset, neuro sx, flu like sx and sleep disturbance

23
Q

Antidepressants - tricyclics

Amitriptyline, lofepramine

A

Blocking antimuscarinic receptors causes -> dry mouth, constipation, urinary retention and blurred vision
Blockade of H1- and α1- receptors -> sedation and hypotension
Cardiac adverse effects
Brain adverse effects (convulsions, hallucinations and mania)
Blockade of dopamine receptors -> breast changes, sexual dysfxn and extrapyramidal effects (tremor and dyskinesia)
Dangerous in overdose
Sudden withdrawal can cause GI upset, neuro sx, flu like sx and sleep disturbance

24
Q

Antidepressants - venlafaxine and mirtazapine

A 
GI upset
Neurological effects
Hyponatraemia
Serotonin syndrome
Suicidal thoughts
Prolong QT interval (venlafaxine)
Sudden withdrawal can cause GI upset, neuro sx, flu like sx and sleep disturbance
25
Q

Antiemetics - D2 receptor antagonists

domperidone, metoclopramide

A 
Diarrhoea
Extrapyramidal sx (metoclopramide) - mostly acute dystonic reaction 
QT interval prolonged + arrhythmias (domperidone)
26
Q

Antiemetics - H1 receptor antagonists

cyclizine, cinnarizine, promethazine

A

Drowsiness
Dry throat and mouth (anti-cholinergic effects)
Transient tachycardia (after IV infusion)

27
Q

Antiemetics - 5-HT3 receptor antagonists

ondansetron, granisetron

A

Rare

28
Q

Antifungal drugs

fluconazole, clotrimazole, nystatin

A

Topical - local irritation

Fluconazole (oral):
GI upset
headache
hepatitis
hypersensitivity
Rare but life threatening = severe hepatic toxicity, prolonged QT interval, arrhythmias, cutaneous reactions, anaphylaxis
29
Q

Antihistamines - H1 receptor antagonists

cetirizine, loratidine, fexofenadine, chlorphenamine

A

1st gen = sedation

2nd gen = few adverse effects (do not cross blood brain barrier)

30
Q

Antimotility drugs

loperamide, codeine phosphate

A 
GI effects (e.g. constipation, flatulence, abdo cramps)
Opioid toxicity/dependence
31
Q

Antimuscarinics, bronchodilators

ipratropium, tiatropium, glycopyrronium, aclidinium

A

After inhalation antimuscarinic bronchodilators are absorbed from lungs into circulation where inactivated by hydrolysis - happens at different rates.
Can cause irritation of respiratory tract
GI disturbance
Urinary retention
Blurred vision
Headaches

32
Q

Antimuscarinics, cardiovascular and GI uses

atropine, hyoscine butylbromide, glycopyrronium

A 
Tachycardia
Dry mouth
Constipation
Urinary retention
Blurred vision
Drowsiness
Confusion
33
Q

Antimuscarinics, GU uses

oxybutynin, tolterodine, solifenacin

A 
Tachycardia
Dry mouth
Constipation
Blurred vision
Urinary retention may occur if there is bladder outflow obstruction
34
Q

Antipsychotics - first generation

haloperidol, chlorpromazine, prochlorperazine

A

Extrapyramidal side effects - acute dystonia/akathisia/neuroleptic malignant syndrome (rigidity, confusion, autonomic dysregulation, pyrexia)/tardive dyskinesia
drowsiness
hypotension
QT interval prolongation -> arrhythmias
erectile dysfunction
hyperprolactinaemia -> galactorrhoea, menstrual disturbances, breast pain

35
Q

Antipsychotics - second generation

olanzapine, risperidone, clozapine

A

sedation
EPSE (less common that 1st gen)
Metabolic disturbance (weight gain, DM, lipid changes)
prolong QT interval -> arrhythmias
Sexual dysfunction and breast symptoms
Clozapine -> agranulocytosis and myocarditis

36
Q

Antiviral drugs

aciclovir

A 
headache
dizziness
GI disturbances
Skin rash
phlebitis ast injection site
acute renal failure (minimise risk with good hydration and slow infusion)
37
Q

Antiplatelet drugs - ADP receptor antagonists

clopidogrel, ticagrelor, prasugrel

A

Bleeding
GI upset
thrombocytopenia

38
Q

Antiplatelet drugs - aspirin

A 
GI irritation
Peptic ulceration and haemorrhage
Hypersensitivity (bronchospasm)
Tinnitus in regular high-dose
Fatal in overdose (hyperventilation, hearing changes, metabolic acidosis, confusion, convulsions, cardiovasular collapse and respiratory arrest)
39
Q

Azathioprine

A

Bone marrow suppression -> leukopenia and increased risk of infection
Nausea
Hypersensitivity (diarrhoea, rash, vomiting, fever, myalgia, hypotension and pancreatitis)
Veno-occlusive disease
hepatotoxicity
lymphoma risk

40
Q

β-blockers

propanolol, bisoprolol, metoprolol, atenolol, carvediol

A 
Fatigue
cold-extremities
headache
GI disturbance
Sleep disturbance
Impotence in men
41
Q

β2-agonists

salbutamol, terbutaline, salmeterol, formoterol, indacaterol

A

fight or flight effects, e.g. tachycardia, palpitations, anxiety and tremor

Increased serum glucose, lactate and muscle cramps

42
Q

Benzodiazepines

diazepam, temazepam, lorazepam, chlordiazepoxide, midazolam

A

drowsiness, sedation and coma
overdose -> loss of airway reflexes -> death
dependence
withdrawal reaction

43
Q

Bisphosphonates

alendronic acid, zolendronic acid, disodium pamidronate

A

oesophagitis
hypophosphataemia
jaw osteonecrosis
atypical femoral fracture

44
Q

Calcium and Vitamin D

calcium carbonate, calcium gluconate, colecalciferol, alfacalcidol

A

dyspepsia
constipation
cardiovascular collapse (if administered too quickly)
local tissue damage (if accidentally given subcut)

45
Q

Calcium channel blockers

amlodipine, nifedipine, verapamil, diltiazem

A 
A&N:
swelling
flushing
headache
palpitations
V:
constipation
bradycardia
heart block
cardiac failure
D:
all the above
46
Q

Carbamazepine

A

GI upset and neurological effects
hypersensitivity (skin rash)
Antiepileptic hypersensitivity syndrome (10% mortality)
Oedema and hyponatraemia due to an ADH effect

47
Q

Cephalosporins and carbapenems

cefalexin, cefotaxime, meropenem, ertapenem

A

GI upset
Antibiotic-associated colitis
Hypersensitivity
Neurological toxicity inc seizures

48
Q

Chloramphenicol

A

Topical: burning, itching, stinging
Systemic: bone marrow suppression or aplastic anaemia
Grey baby syndrome
Optic and peripheral neuritis

49
Q

Corticosteroids (inhaled)

beclometasone, budesonide, fluticasone

A

oral thrush
hoarse voice
In COPD may cause pneumonia

50
Q

Corticosteroids (topical)

hydrocortisone, betamethasone

A

Potent steroids can cause local adverse effects - skin thinning, striae, telangiectasia
use on face - dermatitis or exacerbate acne
withdrawal can cause rebound worsening
adrenal suppression

51
Q

Digoxin

A 
Bradycardia
GI disturbance
Rash
Dizziness
Visual disturbance
Arrhythmias with toxic level (narrow therapeutic range)

Top 100 Drugs (4 decks)

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