adverse effects (review lecture) Flashcards by Jeri Sheldon (AZ PA Mast 20)

drugs that have interactions with thyroid hormones

estrogen

tamoxifen

warfarin

steroids

not mentioned but bolded:

salicylates, iodides, antacides, phenytoin, rifampin, carbemazepine, anti-DM drugs

How well did you know this?

Not at all

Perfectly

Bisphosphonates cause (4)

osteonecrosis of the jaw

abdominal pain

renal toxicity (IV)

upper GI irritation (oral)

How well did you know this?

Not at all

Perfectly

Corticosteroids cause a million side effects….

iatrogenic adrenal insufficiency

infection susceptibility

peptic ulcers

hyperglycemia

eye effects (cataracts, increased IOP, glaucoma)

CNS (restlessness, insomnia)

osteoporosis

muscle wasting and weakness

How well did you know this?

Not at all

Perfectly

the only DM drugs that are not oral and are SC instead

GLP-1 agonists (glutides, exenatide)

pramlintide (amylin analog, given with insulin)

How well did you know this?

Not at all

Perfectly

testosterone/methyltestosterone in either sex (3)

oily skin

decreased HDL

psych changes

How well did you know this?

Not at all

Perfectly

finasteride/dutasteride (2, male specific)

(5 alpha reductase inhibitors)

gynecomastia

How well did you know this?

Not at all

Perfectly

clomiphene can cause

(anti-estrogen)

multiple pregnancies

How well did you know this?

Not at all

Perfectly

combo oral contraceptives drug interactions (5)

antibiotics

warfarin

anticonvulsants

tricyclic antidepressants

oral hypoglycemic agents

How well did you know this?

Not at all

Perfectly

“glutides” (GLP-1 agonists)

exenatide

(liraglutide, dulaglutide, abiglutide, lixisenatide)

Could cause…..

acute pancreatitis

How well did you know this?

Not at all

Perfectly

testosterone/methyltestosterone in men

decrease testosterone

How well did you know this?

Not at all

Perfectly

fertility treatment can cause 2 things in women and 1 thing in men

*** ovarian hyperstimulation syndrome ***

multiple births

gynecomastia

How well did you know this?

Not at all

Perfectly

Only anti-DM med approved for type 1

Pramlintide

How well did you know this?

Not at all

Perfectly

Nifedipine can cause

hypotension

don’t combo with mag sulfate

How well did you know this?

Not at all

Perfectly

acarbose, miglitol

(alpha glucosidase inhibitors)

flatulence

How well did you know this?

Not at all

Perfectly

corticosteroids adverse effects (4)

ulcers

hyperglycemia

osteoporosis

chronic tx (more than 1-2 weeks) depresses HPA axis so you CANNOT DC abruptly, taper off

How well did you know this?

Not at all

Perfectly

Hormone Replacement Therapy adverse effects

Cancers: endometrial/ uterine/ breast

hyperplasia

gallbladder dz

thromboembolism

How well did you know this?

Not at all

Perfectly

*Metformin has 3 major adverse effects that you should really know*

lactic acidosis

B12 deficiency

diarrhea

How well did you know this?

Not at all

Perfectly

anti DM drugs with the biggest hypoglycemia risk

sulfonylureas

Insulin has the most tho

How well did you know this?

Not at all

Perfectly

exemestane/anastrozole/ letrozole

(aromatase inhibitors)

Mostly cause….

menopausal sxs

(hot flashes)

repaglinide/nateglinide vs hypoglycemia

(same as sulfonylureas but no sulfa allergy)

low hypoglycemia effects

insulin (3)

hypoglycemia

weight gain

cough/ bronchospasm (inhaled)

testosterone/methyltestosterone in a fetus

pseudohermatphroditism

fulvestrant (3)

hot flashes

GI sxs

danazol adverse effects

(antiprogestin)

“very unpleasant”

weight gain, edema, acne, oily skin, HA

Cause fetal hypoxia DO NOT GIVE TO INDUCE LABOR

ergonovine maleate methylergonovine maleate (ergots)

**"gliptins" (DDP-4 agonists)** (sitagliptin, saxagliptin, linagliptin, alogliptin)

acute pancreatitis

sulfonylureas with the worst hypoglycemia

glyburide then first gens

"glitazones" can cause (4) | (pioglitazone, rosiglitazone)

**edema --\> increased risk of HF** hypoglycemia weight gain bone fractures

carbost tromethamine and dinoprostone mostly cause... (prostaglandins)

vomiting diarrhea

Tamoxifen has an | (anti-estrogen)

increased risk of uterine cancer

sulfonylurea with the least hypoglycemic effects

glipizide

propylthiouracil can cause: | (this is also it's contraindication)

Black Box Warning: liver injury acute liver failure

**"gliflozins"** can cause (4) (canagliflozin, dapagliflozin, empagliflozin)

vag infections (fungal, UTI) polyuria acute kidney injury increased LDL

indomethacin (fetal, not maternal, effect)

closure of fetal ductus arteriosus

oxytocin (3 maternal, 1 fetal)

**water intoxication at high concentration** uterine rupture in large dose anaphylaxis sinus bradycardia of the fetus

raloxifene (2) | (anti-estrogen)

hot flashes DVT

ketoconazole (2)

Decreased androgens: gynecomastia/libido decrease/impotence reversibly hepatotoxicity *Even so, typically a first line for Cushing's*

testosterone/methyltestosterone in women

masculinization

norethindrone/ norgestrel/ levonorgestrel estradiol/ mestranol Can cause lots of adverse effects:

**thromboembolic and blood clotting disorders** weight gain nausea edema depression HTN migraine MI

adverse effect of ART: Ovarian hyperstimulation syndrome is......

sudden ovarian enlargement increased vascular permeability rapid accumulation of fluids (peritoneal, pleural, pericardial) hypovolemia fever shock

**tolbutamide, chlorpropamide, tolazamide** ## Footnote (1st gen sulfonylureas) **glyburide, glipizide, glimepiride** (2nd gen sulfonylureas) 2 adverse effects

**hypoglycemia-** highest risk of any noninsulin tx weight gain (these effects are the same as insulin, because they cause the release of insulin)

levothyroxine sodium/liothyronine sodium can cause

**hyperthyroidism** (tx by decreasing dose or take a day off)

mag sulfate

hypotension don't combo with nifedipine

estradiol estrone estriol

dose dependent: **thromoboembolism** **increased blood clotting** **gall bladder dz** migraines HTN

GnRH agonists (leuprolide, goserelin) GnRH antagonists (cetrorelix, ganirelix) Can cause (2)

menopausal sxs testicular atrophy