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Top 100 Drugs > Adverse Effects > Flashcards

Adverse Effects Flashcards

1
Q

5α reductase inhibitors

finasteride

A

Antiandrogen action:

Impotence

Reduced libido

Hair growth

Breast cancer (men)

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2
Q

α-blockers

doxazosin, tamsulosin, alfuzosin

A

Postural hypotension

Dizziness

Syncope

(Particularly present after first dose)

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3
Q

Acetylcholinesterase inhibitors

donepezil, rivastigmine

A

Nausea, diarrhoea and vomiting

Exacerbation of asthma/COPD

Peptic ulcers, bleeding, bradycardia, heart block

Hallucinations

Altered/aggressive behaviour

Extrapyramidal symptoms & neuroleptic malignant syndrome

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4
Q

Acetylcysteine (N-acetylcysteine)

A

IV administration:
Anaphylactoid reaction

Nebulised administration:
Bronchospasm

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5
Q

Activated charcoal

A

Black stools, vomiting

Aspiration → pneumonitis, bronchospasm, airway obstruction

Intestinal obstruction

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6
Q

Adenosine

A

Bradycardia

Asystole

Sinking feeling, breathlessness

Sense of impending doom

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7
Q

Adrenaline

epinephrine

A

After Cardiac arrest:
Adrenaline induced hypertension

Use in conscious patients:
Anxiety, tremor, headaches, palpitations

In those with existing heart disease:
Angina, MI, arrhythmias

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8
Q

Aldosterone antagonists

spironolactone, eplerenone

A

Hyperkalaemia

Gynaecomastia

Liver impairment + jaundice

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9
Q

Alginates and antacids

gaviscon, peptac

A

Magnesium salts → diarrhoea

Aluminium salts→ constipation

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10
Q

Allopurinol

A

Can trigger/worsen acute attack of gout

Skin rash (Stevens-Johnson syndrome, toxic epidermal necrolysis)

Allopurinol hypersensitivity syndrome (fever, eosinophilia, lymphadenopathy)

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11
Q

Aminoglycosides

gentamicin, amikacin, neomycin

A

Nephrotoxicity (reduce urine output, rising serum creatinine + urea)

Ototoxicity (hearing loss, tinnitus, vertigo)

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12
Q

Aminosalicylates

mesalazine, sulfasalazine

A

GI upset

Headache

Leucopenia, thrombocytopenia

Renal impairment

Sulfasalazine:
Oligospermia (reversible)
Serious hypersensitivity reaction

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13
Q

Amiodarone

A

Hypotension

Lungs (pneumonitis)

Heart (bradycardia, AV block)

Liver (hepatitis)

Skin (photosensitivity, grey discolouration)

Thyroid abnormalities

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14
Q

ACE inhibitors

ramipril, lisinopril, perindopril

A

Hypotension (particularly after first dose)

Persistent, dry cough (increased bradykinin)

Hyperkalaemia (low aldosterone promotes K retention)

Can cause or worsen renal failure

Angioedema

Anaphylactoid reactions

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15
Q

Angiotensin receptor blockers

losartan, candesartan, irbesartan

A

Hypotension (particularly after first dose)

Persistent, dry cough (increased bradykinin)

Hyperkalaemia (low aldosterone promotes K retention)

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16
Q

Antidepressants

tricyclics; amitriptyline, lofepramine

A

GI upset

Changes in appetite/weight loss

Hypersensitivity reactions (inc. rash)

Hyponatraemia

Suicidal thoughts and behaviour

Lower seizure threshold

Prolonged QT interval

Bleeding

Serotonin syndrome

Sudden withdrawal can cause GI upset, neurological and influenza-like symptoms and sleep disturbance

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17
Q

Antidepressants

venlafaxine, mirtazapine

A

Dry mouth

Sedation

Hypotension

Arrhythmias + ECG changes

Convulsions, hallucinations ad mania

Breast changes

Sexual dysfunction

Extrapyramidal symptoms (rarely)

Dangerous in overdose

Sudden withdrawal can cause GI upset, neurological and influenza-like symptoms and sleep disturbance

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18
Q

Antiemetics - dopamine D2-receptor antagonists

metoclopramide, domperidone

A

Diarrhoea

Metoclopramide:
Extrapyramidal symptoms (movement abnormalities)
Acute dystonic reaction

Domperidone:
QT-prolongations
Arrhythmias

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19
Q

Antiemetics - histamine H1-receptor antagonists

cyclizine, cinanrizine, promethazine

A

Drowsiness

Dry throat + mouth

Tachycardia, palpitations

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20
Q

Antiemetics - serotonin 5-HT3-receptor antagonists

ondansetron, granisetron

A

Rare

Constipation, diarrhoea and headaches can occur

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21
Q

Antifungal drugs

nystatin, clotrimazole, fluconazole

A

Topical nystatin and clotrimazole:
Local irritation

Oral fluconazole:
GI upset
Headache
Hepatitis
Hypersensitivity
Rare:
Severe hepatic toxicity
Prolonged QT interval, arrhythmias 
Cutaneous reactions 
Anaphylaxis
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22
Q

Antihistamines - H1-receptor antagonists)

cetirizine, loratadine, fexofenadine, chlorphenamine

A

Chorphenamine can cause sedation

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23
Q

Antimotility drugs

loperamide, codeine phosphate

A

GI effects

Indirectly, risk of opioid toxicity and dependence with codeine

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24
Q

Antimuscarinics - bronchodilators

ipratropium, tiotropoium, glycopyrronium, aclidinium

A

Irritation to respiratory tract (nasopharyngitis, sinusitis, cough)

GI disturbance (dry mouth, constipation, urinary retention, blurred vision, headaches)

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25
Q

Antimuscarinics - cardiovascular and GI uses

atropine, hyoscine butylbromide, glycopyrronium

A

Tachycardia

Dry mouth

Constipation

Urinary retention in patients with BPH

Blurred vision

Drowsiness + confusion

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26
Q

Antimuscarinics - GU uses

oxybutynin, tolterodine, solifenacin

A

Dry mouth

Tachycardia

Constipation

Blurred vision

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27
Q

Antipsychotics - 1st generation (typical)

haloperidol, chlorpromazine, prochlorperazine

A

Extrapyramidal effects:

  • Acute dystonic reactions
  • Akathisia
  • Neuroleptic malignant syndrome
  • Tardive dyskinesia
Drowsiness
Hypotension
QT prolongation
Arrythmias
Hyperprolactinaemia
Erectile dysfunction
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28
Q

Antipsychotics - 2nd generation (atypical)

quetiapine, olanzapine, risperidone, clozapine

A

Sedation

Extrapyramidal effects

Metabolic disturbance

QT prolongation

Arrythmias

Breast symptoms

Sexual dysfunction

Agranulocytosis

Myocarditis

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29
Q

Antiviral drugs

aciclovir

A

Headache

Dizziness

GI disturbances

Rash

Phlebitis at injection site

Acute renal failure

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30
Q

Antiplatelet drugs - ADP-receptor antagonists

clopidogrel, ticagrelor, prasugrel

A

Bleeding

GI upset

Thrombocytopenia

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31
Q

Antiplatelet drugs

aspirin

A

GI irritation

Peptic ulceration

Haemorrhage

Bronchospasm

Tinnitus

Life-threatening in overdose

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32
Q

Azathioprine

A

Bone marrow suppression

Nausea

Hypersensitivity reactions:

  • Diarrhoea + vomiting
  • Rash
  • Fever
  • Myalgia
  • Hypotension
  • Pancreatitis

Veno-occlusive disease

Hepatotoxicity

Lymphoma

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33
Q

β-blockers

bisoprolol, atenolol, propanolol, metoprolol, carvedilol

A

Fatigue

Cold extremities

Headache

Nausea

Impotence

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34
Q

β2-agonists

salbutamol, terbutaline, salmeterol, formoterol, indacaterol

A

Tachycardia

Palpitations

Anxiety

Tremor

Muscle cramps

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35
Q

Benzodiazepines

diazepam, temazepam, lorazepam, chlordiazepoxide, midazolam

A

Drowsiness

Sedation

Coma

Dependence

Withdrawal reaction

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36
Q

Bisphosphonates

alendronic acid, disodium pamidronate, zoledronic acid

A

Oesophagitis

Hypophosphataemia

Osteonecrosis of the jaw

Atypical femoral fracture

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37
Q

Calcium and vitamin D

calcium carbonate, calcium gluconate, colecalciferol, alfacalcidol

A

Dyspepsia

Constipation

Cardiovascular collapse

Local tissue damage

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38
Q

Calcium channel blockers

amlodipine, nifedipine, dilitiazem, verapamil

A

Amlodipine + nifedipine:
Ankle swelling

Flushing

Headache

Palpitations

Verapamil:
Constipation

Bradycardia

Heart block

Cardiac failure

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39
Q

Carbamazepine

A

GI upset

Neurological effects

Hypersensitivity

Anti-epileptic hypersensitivity syndrome

Oedema

Hyponatraemia

40
Q

Cephalosporins and carbapenems

cefalexin, cefotazime, meropenem, ertapenem

A

GI upset

Antibiotic-associated colitis

Hypersensitivity

Neurological toxicity

Seizures

41
Q

Chloramphenicol

A

Stinging, burning + itching

Dose-related bone marrow suppression

Aplastic anaemia

Grey baby syndrome

Optic and peripheral neuritis

42
Q

Corticosteroids (glucocorticoids) - inhaled

beclometasone, budesonide, fluticasone

A

Oral candidiasis

Hoarse voice

Pneumonia (COPD)

43
Q

Corticosteroids (glucocorticoids) - systemic

prednisolone, hydrocortisone, dexamethasone

A

Immunosuppression

Metabolic effects

Mood + behavioural changes

Adrenal atrophy

Addisonian crisis

Chronic glucocorticoid deficiency

44
Q

Corticosteroids (glucocorticoids) - topical

hydrocortisone, betamethasone

A

Local adverse effects e.g. skin thinning, striae, telangiectasia and contact dermatitis

Rebound worsening of skin condition

Adrenal suppression

Systemic adverse effects

45
Q

Digoxin

A

Bradycardia

GI disturbance

Rash

Dizziness

Visual disturbance

Digoxin toxicity

46
Q

Dipeptidylpeptidase-4 inhibitors

sitagliptin, linagliptin, saxagliptin

A

Hypoglycaemia

Acute pancreatitis

47
Q

Direct oral anticoagulants (DOACs)

apixaban, dabigatran, edoxaban, rivaroxaban

A

Bleeding

GI bleeding

Anaemia

GI upset

Dizziness

Elevated liver enzymes

48
Q

Loop diuretics

furosemide, bumetanide

A

Dehydration

Hypotension

Low electrolyte state

Hearing loss + tinnitus

49
Q

Thiazide and thiazide-like diuretics

bendroflumethiazide, indapamide, chlortalidone

A

Hyponatraemia

Hypokalaemia

Cardiac arrhythmias

Impotence

50
Q

Dopaminergic drugs for Parkinson’s disease

levodopa as co-careldopa/co-beneldopa, ropinirole, premipexol

A

Nausea

Drowsiness

Confusion

Hallucinations

Hypotension

Dyskinesias

51
Q

Emollients

aqueous cream, liquid paraffin

A

Greasy skin

Exacerbation of acne

Folliculitis

52
Q

Fibrinolytic drugs

alteplase, streptokinase

A

Nausea + vomiting

Bruising

Hypotension

Serious bleeding

Allergic reaction

Cardiogenic shock

Cardiac arrest

Cerebral oedema

Arrythmias

53
Q

Gabapentin and pregablin

A

Drowsiness

Dizziness

Ataxia

54
Q

Heparins and fondaparinux

enoxaparin, dalteparin, fondaparinux, unfractioned heparin

A

Haemorrhage

Hyperkalaemia

Heparin-induced thrombocytopenia

55
Q

Insulin

insulin aspart, insulin glargine, biphasic insulin, soluble insulin

A

Hypoglycaemia

56
Q

Iron

ferrous fumarate, ferrous sulfate

A

Intestinal disease

Atopic predisposition

57
Q

Lamotrigine

A

Headache

Drowsiness

Irritability

Blurred vision

Dizziness

GI symptoms

Skin rash

Severe hypersensitivity reaction

58
Q

Laxatives - osmotic

lactulose, macrogol, phosphate enema

A

Flatulence

Abdominal cramps

Nausea

Diarrhoea

Local irritation

Electrolyte disturbances

59
Q

Leukotriene receptor antagonists

montelukast

A

Headache

Abdominal pain

Hyperactivity + reduced concentration

Churg-Strauss syndrome

60
Q

Lidocaine

A

Stinging on administration

Drowsiness

Restlessness

Tremor

Fits

Hypotension

Arrhythmias

61
Q

Macrolides

clarithromycin, erythromycin, azithromycin

A

Irritant

Allergy

Antibiotic-associated colitis

Cholestatic jaundice

QT prolongation

Arrythmias

Ototoxicity

62
Q

Metformin

A

GI upset

Lactic acidosis

63
Q

Methotrexate

A

Mucosal damage

Bone marrow suppression

Hypersensitivity reactions

Hepatic cirrhosis

Pulmonary fibrosis

Risk of accidental overdose

64
Q

Metronidazole

A

GI upset

Hypersensitivity

Peripheral and optic neuropathy

Seizures

Encephalopathy

65
Q

Naloxone

A

Effect of opioid reversal may be significant in an opioid-dependent individual

66
Q

Nitrates

isosorbide mononitrate, glyceryl trinitrate

A

Flushing

Headaches

Light-headedness

Hypotension

Tolerance

67
Q

Nitrofurantoin

A

GI upset

Hypersensitivity

Chronic pulmonary reactions

Hepatitis

Peripheral neuropathy

Haemolytic anaemia

68
Q

NSAIDs

naproxen, ibuprofen, etoricoxib

A

GI toxicity

Renal impairment

Cardiovascular events

Hypersensitivity reactions

Fluid retention

69
Q

Ocular lubricants - artificial tears

hypromellose, carbomers, liquid and white soft paraffin

A

Stinging on application

Blurring of vision

70
Q

Oestrogens and progestogens

combined ethinylestradiol products, desogestrel

A

Irregular bleeding

Mood changes

Cardiovascular disease

Stroke

Breast/cervical cancer risk

71
Q

Opioids - strong

morphine, oxycodone

A

Respiratory depression

Neurological depression

Nausea + vomiting

Pupillary constriction

Constipation

Itching

Tolerence + dependence

Withdrawal reaction

72
Q

Opioids - weak/moderate

tramadol, codeine, dihydrocodeine

A

Nausea

Constipation

Dizziness

Drowsiness

Neurological + respiratory depression

Codeine + dihydrocodeine must never be given IV - causes reaction similar to anaphylaxis

73
Q

Oxygen

A

Discomfort from mask e.g. dry throat

74
Q

Paracetamol

A

Few side effects

Causes liver failure in overdose

75
Q

Penicillins

benzylpenicilin, phenoxymethylpenicillin

A

Allergy occurs in 1-10% if people

Skin rash

Anaphylactic reaction

Neurological toxicity

76
Q

Penicillins - antipseudomonal

piperacilllin with tazobactam - tazocin

A

GI upset

Antibiotic-associated colitis

Hypersensitivity

77
Q

Penicillins - broad-spectrum

amoxicillin, co-amoxiclav

A

GI upset

Antibiotic-associated colitis

Allergy

Acute liver injury e.g. jaundice, hepatitis

78
Q

Penicillins - penicillinase-resistant

flucloxacillin

A

GI upset

Allergy

Skin rash

Anaphylactic reaction

Liver toxicity

79
Q

Phosphodiesterase (type 5) inhibitors

sildenafil

A

Flushing

Headache

Dizziness

Nasal congestion

Hypotension

Tachycardia

Palpitations

80
Q

Prostaglandin analogue of eye drops

latanoprost, bimatoprost

A

Blurred vision

Conjunctival reddening (hyperaemia)

Occular irritation + pain

Permanent change in eye colour

81
Q

Protein pump inhibitors

lansoprazole, omeprazole, pantoprazole

A

GI disturbances

Headache

Hypomagnesaemia

82
Q

Quinine

quinine sulfate

A

Tinnitus

Deafness

Blindness

GI upset

Hypersensitivity reactions

QT prolongation

Hypoglycaemia

83
Q

Quinolones

ciprofloxacin, moxifloxacin, levofloxacin

A

GI upset

Hypersensitivity reactions

Neurological effects

Rupture of muscle tendons

QT prolongation

Arrhythmias

84
Q

Serotonin 5HT1-receptor agonists

sumatriptan

A

Pain/discomfort in chest + throat

MI

85
Q

Sex hormone antagonists for breast cancer

tamoxifen, anastrozole, letrozole

A

Vaginal dryness

Hot flushes

Loss of bone density

VTE

Endometrial cancer

Agranulocytosis

Liver failure

86
Q

Statins

simvastatin, atorvastatin, pravastatin, rosuvastatin

A

Headache

GI disturbances

Aches

Myopathy

Rhabdomyolysis

Rise in liver enzymes

87
Q

Sulphonylureas

glicazide

A

GI upset

Hypoglycaemia

Rare hypersensitivity reactions

88
Q

Tetracyclines

doxycycline, lymecycline

A

Nausea, vomiting + diarrhoea

Hypersensitivity reactions

Oesophageal irritation

Photosensitivity

Discolouration and/or hypoplasia of tooth enamel

Hepatotoxicity

Intracranial hypertension

89
Q

Thyroid hormones

levothyroxine, liothyronine

A

Similar to symptoms of hyperthyroidism

GI - diarrhoea, vomiting, weight loss

Cardiac - palpitations, arrhythmias, angina

Neurological - tremors, restlessness, insomnia

90
Q

Trimethoprim

trimethoprim, co-trimoxazole

A

GI upset

Skin rash

Hypersensitivity reactions

Haematological disorders

Hyperkalaemia

91
Q

Valproate (valproic acid)

sodium valproate, valproic acid

A

GI upset

Neurological and psychiatric effects

Thromobcytopenia

Increased liver enzymes

Hair loss

92
Q

Vancomycin

A

Thrombophlebitis

Red man syndromem

Immediate/delayed hypersensitivity reaction

Nephrotoxicity

Ototoxicity

Neutropenia

Thrombocytopenia

93
Q

Vitamins

folic acid, thiamine, hydroxocobalamin, phytomenadione

A

Anaphylaxis (rarely)

94
Q

Warfarin

A

Bleeding

95
Q

Z-drugs

zopiclone, zolpidem

A

Daytime sleepiness

Rebound insomnia when stopped

Neurological effects

Dependence

Withdrawal symptoms

Drowsiness, coma and respiratory depression in overdose

Zopiclone:
Taste disturbance

Zolpidiem:
GI upset

Top 100 Drugs (4 decks)

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