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Pharmacology > Adverse Effects & Contraindications > Flashcards

Adverse Effects & Contraindications Flashcards

1
Q

Barbiturates

A

A/E: Somnolence, Hypoventilation, Nausea, Bradycardia, agitation, confusion, nightmares, lethargy, vomiting, diarrhea, hypotension.

Contraindicated in patients with hepatic impairment, nephritic patients, dyspnea or airway obstruction, porphyria. Not recommended to be given SUBQ or intra-arterially.

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2
Q

Antianxiety drugs (benzos/non-benzos)

A

A/E: Withdrawal syndrome after 4-6 weeks. Never discontinue abruptly. Decrease over 4-6 weeks.

Symptoms of withdrawal: Fatigue, metallic taste, HA, numbness in extremities, sweating, dry mouth.

Contraindications: Do not use in patients that are comatose or CNS depressed. Pregnancy Class D. Acute narrow-angle glaucoma.

Buspirone hydrochloride is pregnancy class B.

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3
Q

TCAs

A

A/E: Dry mouth, blurred vision, postural hypotension, urinary retention, constipation, orthostatic hypotension.

Contraindication: Do not prescribe with MAOIs or within 14 days of MOAI use. Recovery phase after a myocardial infarction.

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4
Q

MAOI

A

A/E: Food interactions, vertigo, nausea, constipation, dry mouth, headache, and over-activity.

Contraindications: CVA Disease, hypertension, CHF, and elderly.

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5
Q

SSRI

A

A/E: Nausea, vomiting, sexual dysfunction, insomnia, and weight gain.

Contraindications: Fluoxetine is less effective in patients who smoke.

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6
Q

Burpropion

A

Contraindicated in patients with a seizure disorder as it reduces the seizure threshold.

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7
Q

Antipsychotic

A

Anticholinergic: Dry mouth, hypotension, sedation, photophobia, photosensitivity, headache

Extrapyramidal: Parkinson like symptoms; facial grimacing

Tardive dyskinesia: Irreversible, involuntary dyskinetic movements, rhythmic, movements of face mouth or jaw. Tongue may protrude.

Neuroleptic malignment syndrome: Immediately stop.

Contraindications: Not recommended in use of severely depressed patient or hypotensive.

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8
Q

CNS Stimulants (Amphetamines/Anorexiants)

A

A/E: Headache, dizziness, apprehension. Can cause overstimulation of CNS. Insomnia, tachycardia, and blurred vision.

Contraindications: Hypertension, stroke, glaucoma.

Amphetamines has a risk of dependence.

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9
Q

Anticonvulsants

A

A/E: Nausea, vomiting, constipation, bradycardia, hypoventilations, agitation, bleeding, fever, sore throat, and nystagmus. Steven-Johnson syndrome.

Contraindications: In patients with CNS depression. Pregnancy D. Psychoses, acute narrow-angle glaucoma.

Avoid Alcohol.

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10
Q

Antiemetic

A

A/E: Drowsiness

Contraindications: Severe CNS Depression, Pregnancy X, Do not use with alcohol, makes sedation worse.

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11
Q

Ketamine

A

Ischemic heart disease. May increase HR and BP which may be detrimental due to imbalance between myocardial oxygen supply and demand.

12% experience side effects from prolonged emergence from anesthesia.

Hypertension (ketamine raises BP)

Schizophrenia

May increase the risk of laryngospasm

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12
Q

Salicylate

A

A/E: Gastric upset, heartburn, nausea, vomiting, anorexia, GI Bleeding

Reye syndrome in children with chickenpox or influenza

Pregnancy D

Not recommended for patients with bleeding disorders

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13
Q

Non-salicylate

A

A/E: Urticaria, hemolytic anemia, hepatotoxicity, hepatic impairment or severe liver disease

Warning: Acetaminophen can cause hepatotoxicity. Do not exceed the maximum dose (>4g daily). Chronic daily use may result in liver damage.

Pregnancy B, Mostly safe.

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14
Q

NSAIDs

A

A/E: GI nausea and vomiting, may increase risk of heart attack or stroke.

Celecoxib: may cause Dyspepsia, contains sulfa

Ibuprofen: May cause Peptic ulcer, GI Bleed, and Hypertension

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15
Q

Phenazopyridine

A

A/E: Causes patients urine to turn reddish-orange, headaches, dizziness, stomach cramps.

Contraindications: Renal insufficiency

Pregnancy B

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16
Q

Narcotic analgesics

A

A/E: Respiratory Depression, light-headedness, constipation, nausea/vomiting

Contraindication: Head injury or increased intra-cranial pressure (ICP), hypoxia, hepatic impairment.

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17
Q

Naloxone (Narcotic Antagonist)

A

A/E: Acute opioid withdrawal: Pain, tachycardia, hypertension, fever, sweating, abdominal cramps, diarrhea, nausea, vomiting, agitation, irritability.

Use with caution in patients with Coronary Artery Disease (CAD), pregnant women, and opioid dependent patients.

18
Q

Antihistamines (H1 & H2)

A

Anticholinergic effects: Drying effect may increase thickening of bronchial secretions, dizziness, fatigue, hypotension, headache.

Some antihistamines are Pregnancy C/D; Diphenhydramine is class B. May result in jaundice, hyperreflexia extrapyramidal symptoms in infants whose mothers received antihistamines (particularly promethazine)

19
Q

Decongestants

A

A/E: Sleeplessness, anxiety, dizziness, excitability, nervousness. Topical nasal or Opthalmic decongestants can develop tachyphylaxis; thus long term use is not recommended. Agents lose effectiveness after a few days.

Contraindications: Hypertension, Diabetes, increased intraocular pressure. Worsen prostatic hyperplasia/urinary obstruction. Elderly more sensitive.

Pregnancy C. Not recommended.

20
Q

Beta2 agonists

A

A/E: Paradoxical bronchospasm, nausea, vomiting, restlessness, tachycardia, increased respirations, nervousness, headache, palpitations, hyperglycemia.

Contraindications: Do not use with beta blockers, cardiac arrhythmias, narrow angle glaucoma.

Use albuterol with caution in diabetic patients (may increase serum blood glucose levels)

21
Q

Muscarinic Antagonists

A

Anticholinergic effects.

Contraindications: Peptic ulcer, seizure, arrhythmias, hyperthyroid.

Caution with >60 year old patients.

Pregnancy C. Use only if benefit outweighs the risk.

22
Q

Leukotriene Antagonists & Mast Cell Stabilizers

A

A/E: Headache, dizziness, unpleasant taste, fatigue.

Not FDA approved for the use in reversal of bronchospasm in acute asthma attacks.

Montelukast will not interrupt bronchoconstrictor response to aspirin or other NSAIDs.

23
Q

Inhale Corticosteroids

A

A/E: Throat irritation, cough

Contraindication: Acute bronchospasm, caution with compromised immune system.

24
Q

Antitussives

A

Codeine = respiratory depression, euphoria, and sedation.

Contraindication: Premature infants, caution with persistent or chronic cough

25
Q

Mucolytic/Expectorant

A

A/E: Nausea, vomiting and drowsiness

Warning: Caution with persistent cough

26
Q

Antiarrhythmics

A

A/E: Light-headedness, weakness, hypotension, bradycardia

27
Q

Nitrates (Nitroglycerin)

A

A/E: Headache, hypotension. Dizziness, vertigo, and weakness but disappears with continued use.

Contraindication: Postural hypotension (do not give if systolic BP is <100), closed-angle glaucoma, and right sided heart failure.

28
Q

ACE inhibitors

A

A/E: Hypotension, angioedema, hyperkalemia, dry hacking cough in 5-20% of patients (begins in 1-2 weeks, up to 6 months)

Contraindications: Renal/Hepatic disease.

May cause electrolyte imbalance.

29
Q

Dihydropyridines (CCB)

A

A/E: HA, Lightheadedness, flushing, & peripheral edema in 20% of patients

Contraindications: Hepatic impairment, severe coronary artery disease, severe aortic stenosis

30
Q

Non-dihydropyridines (CCB)

A

A/E: Constipation in 25% of patients, bradycardia, heart failure, heart block

Contraindications: Sick sinus syndrome, second- or third-degree heart block, acute myocardial infarction, and CHF

31
Q

Beta blockers

A

A/E: Hypotension, bradycardia, bronchospasm

Contraindications: Sinus bradycardia, heart block, hypotension, bronchial asthma

Do not stop abruptly.

32
Q

Diuretics

A

A/E: Fluid and electrolyte imbalance, hypertension, arrythmias

Contraindications: Cross sensitivity to sulfonamides, kidney disease, electrolyte imbalance, uncontrolled arrythmias

33
Q

Antihyperlipdemias

A

A/E: Constipation, abdominal pain/cramps, nausea, Rhabdomyolysis, liver dysfunction

34
Q

Antacids

A

A/E: Laxative effect, Constipation (aluminum/calcium containing), GI issues

Contraindication: Severe abdominal pain of unknown cause, Sodium containing antacids for CHF patients, Calcium containing antacids for renal impairment

35
Q

Histamine H2 antagonist

A

A/E: Dizziness, somnolence, headache, confusion, hallucinations, diarrhea, impotence

36
Q

Proton Pump Inhibitors

A

A/E: Headache, diarrhea, abdominal pain, nausea, flatulence, constipation, dry mouth

Warning: Risk of Osteoporosis in high doses/chronic use of PPI’s

37
Q

Antidiarrheals (Loperamide)

A

Contraindications: Diarrhea associated with organisms that can harm intestinal mucosa (E Coli, Salmonella, Shigella).

Pseudomembranous colitis, abdominal pain of unknown origin, obstructive jaundice.

38
Q

Laxatives

A

A/E: High doses can cause diarrhea and loss of water/electrolytes. Abdominal pain/GI issues. Long term use can cause a “Laxative habit”. Obstructions can occur with bulk forming laxatives.

Contraindications: Persistent abdominal pain, nausea, vomiting of unknown cause. Signs of appendicitis, fecal impaction, intestinal obstruction or acute hepatitis.

39
Q

Hemorrhoid agents

A

Adverse effects: May lead to atrophy of affected tissues. Avoid heavy use.

40
Q

Insulin

A

A/E: Hypoglycemia from too much insulin and not enough glucose in blood.

Contraindications: Allergy to pig or cow (USA insulin is from human or purified). Taking with hypoglycemia agents may result in hypoglycemia.

Pharmacology (8 decks)

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