Adverse effects

Question 0

Adrenaline - Adverse effects - Alpha effects

Answer 0

• Acute hypertension (risk of cerebral haemorrhage or acute pulmonary oedema)
• Nausea and vomiting
• Cold skin
• Acute renal failure
• Urinary retention
• Diploplia
• Hyperglycaemia
• Vasocontriction
  
  • Gangrene of fingers , toes, nose or ear if administered locally
  • Tissue necrosis from extravasation

Question 1

Adenosine - Adverse effects

Answer 1

• Transient
• CVS
  
  • Vasodilation
    
    • Flushing
    • Light-headedness
    • Headache
    • Hypotension
  • Arrhythmias
    
    • Chest pain, palpitations
    • Transient or prolonged sinus bradycardia/sinus arrest/heart blocks/asystole
    • Ventricular ectopics, non-sustained V Tach, sustained torsades de pointes, V Fib
    • Supraventricular tachyarrhythmias
• Other:
  
  • Paresthaesia
  • Diaphoresis
  • Dyspnoea
  • Bronchoconstriction
  • Nausea
  • Metallic taste in mouth
  • Chest tightness

Question 2

Andrenaline - Adverse effects - Beta1 effects

Answer 2

• Tachycardia/palpitations
• Arrhythmias/cardiac arrest
• Angina, Myocardial ischemia

Question 3

Adrenaline - Adverse effects - Beta2 effects

Answer 3

• Tremors, cramps

- Restlessness, anxiety, confusion, headache

Question 4

Amiodarone Hydrochloride - Adverse effects

Answer 4

• Vasodilation/hypotension
• Negative inotropic effects
• Negative chronotropic effects
• Prolongation of QT interval

Question 5

Atropine Sulphate - Adverse effects

Answer 5

• Confusion, restlesness
• Mydriasis (72hrs), diploplia, photophobia, blurred vision
• Dry mucous membranes:mouth, eyes, respiratory and digestive tract
• Tachycardia, palpitations, arrhythmias, paradoxical bradycardia
• Dry, hot, flushed skin
• Acute urinary retention
• Constipation, nausea, vomitting

Question 6

Beta2 Adrenergic Stimulants - Adverse effects

Answer 6

• Tremors, restlesness, anxiety, confusion, headache
• Hypotension
• Tachycardia, palpitations
• Cramps
• Nausea, vomiting
• Urinary retention
• Tocolysis
• Hyperglycaemia
• Hypokalaemia

Question 7

Calcium Chloride 10% - Adverse effects

Answer 7

• Tissue necrosis (if extravasation occurs)
• Thrombophlebitis
• Vasospasm (coronary and cerebral vessels)

Question 8

Clopidogrel - Adverse effects

Answer 8

• Haemorrhagic disorders and bleeding tendencies
• Thrombotic trhombocytopenic purpura (TTP)
• Gastro-intestinal disturbances - abdominal pain, dyspepsia, gastritis, constipation
• Skin rash and pruritis
• Hypersensitivity reactions

Question 9

Corticosteroids - Adverse effects

Answer 9

Side effects occur following prolonged use and are of little consequence in an emergency setting

Question 10

Dextrose 50% - Adverse effects

Answer 10

• Local irritation of vein
• Thrombophlebitis
• Local tissue necrosis
• Hyperosmolarity
• Diuresis
• Hyperglycemia

Question 11

Diazepam - Adverse effects

Answer 11

• CNS Depression
• Resp: Depression (rapid administration)
• CVS: Hypotension (large dosages and rapid administration)
• Nausea, vomitting
• Diplopia
• Thrombophlebitis
• Paradoxical excitation
• Physical and psychological dependence

Question 12

Flumazenil - Adverse effects

Answer 12

CVS:
	-Flushed skin
	-Thrombophlebitis
	-Arrhythmias
	-Hypertension
	-Chest pain
CNS:
	-Excitation
	-Convulsions
General:
	-Acute benzodiazepine withdrawal in dependant patients
	-Tremors and involuntary movements

Question 13

Furosemide - Adverse effects

Answer 13

• Hyponatraemia
• Hypokalaemia
• Hypotension
• Hypovolemia
• Hyperuricaemia/gout
• Tinnitus and deafness (following rapid IVI administration)

Question 14

Glucagon - Adverse effects

Answer 14

• Nausea & vomiting may occur - dose related (may be caused by the hypoglycaemia)
• Uncommonly, dizziness, light-headedness, skin rash, dyspnoea
• Hypokalaemia
• Myocardial ischaemia may be aggravated in patients with pre-existing cardiac disease