Adverse effects RR Flashcards by LL Cool G

Severe local vesicant action and tissue necrosis upon extravasation

Doxo/daunorubicin Dacarbazine Vincristine

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Facial flushing + antidiuretic effects

Desmopressin (DDAVP)

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In Anti-retroviral therapy (ART), hyperlipidemia is a complication; statins are used to lower lipids, but statin metabolism is inhibited by Protease inhibitors; Inc. levels of statins can then cause:

rhabdomyolysis

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Acute infusion reactions including fever, chills, urticaria, headache, bronchospasm, angioedema and hypotension

Rituximab

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Vomiting brown or bloody stomach contents with pills

iron poisoning s/s

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Crystalluria-can be avoided with adequate fluid intake or increasing pH of urine

Trimethoprim/sulfamethoxazole and Pyrimethamine/sulfadiazine

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irreversible ototoxicity, retinopathy, myopathy, and peripheral neuropathy

Chloroquine

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nausea and vomiting, chills and fever, malaise, anorexia, and weakness

Fludarabine

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what causes cardiac toxicity in doxo?

Free radicals

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Leukopenia, cardiotoxicity, & ↑Risk of cancer,

Cyclophosphamide

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Toxoplasma gondii treatment

Prophylaxis for first episode –>TMP/SMX

Therapy for Encephalitis  Pyrimethamine/sulfadiazine

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Mucositis.

Doxo/daunorubicin Methotrexate

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upper respiratory tract infection, rash

Penetration blocker: Maraviroc

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noncardiogenic pulmonary edema

Cytarabine

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hyperglycemia due to insulin deficiency, clotting abnormalities due to deficient clotting factors, and hypoalbuminemia.

Asparaginase

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hemorrhagic cystitis prevented by:

mesna (2-mercaptoethanesulfonate)

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ankle and periorbital edema

Imatinib (Tyrosine Kinase Inhibitor

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postural dizziness

Penetration blocker: Maraviroc

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loss of deep tendon reflexes, and motor weakness

Vincristine and Vinblastine (Vinca Alkaloids)

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Pneumocystis jiroveci treatment

Trimethoprim/sulfamethoxazole

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• Nausea & vomiting + Diarrhea & dizziness

Artemisinin

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Used only in combination with amphotericin B

flucytosine

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blurring of vision

chloroquine;

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catheter-related infections

Factor VIII replacement if used prophylactically;

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pruritus, wheals, rash, anaphylaxis

Deferoxamine

dec. dose with allopurinol

Mercaptuopurine

Dacarbazine A/E

Nausea and vomiting. Myelosuppression Extravasation of the drug upon IV can cause severe pain and tissue damage

Facial flushing

Desmopressin (DDAVP); Quinine; quinidine (cinchonism)

Pulmonary fiborosis/toxicity

Bleomycin Methotrexate (after long-term use)

Hepatotoxicity

Penetration blocker: Maraviroc Amodiaquine

myelosuppression

Doxo/daunorubicin Cyclophosphamide Dacarbazine Cytarabine Fludarabine Methotrexate

Cutaneous toxicity: Hyperpigmentation, hyperkeratosis, erythema, and ulcerations over the elbows, knuckles, and other pressure areas

Bleomycin

Long-term complications of ART include:

hyperlipidemia

Allergic skin reactions

TMP/SMX; Pyrimethamine/sulfadiazine

hypoalbuminemia.

Asparaginase

Neutropenia • ↑Susceptibility to infection

Anakinra

Cryptococcus neoformans treatment

Therapy for meningitis: Amphotericin B + flucytosine followed by fluconazole Secondary prophylaxis: fluconazole

Stevens-Johnson syndrome.

Efavirenz TMP/SMX

Gastrointestinal distress

Protease inhibitors ("navir) Cytarabine

can cause water retention and dilutional hyponatermia

Desmopressin (DDAVP) --\> antidiuretic effects

Ferrous Sulfate a/e

Confined to the GIT: Heartburn Constipation Nausea

osteoporosis

Glucocorticoids

stomatitis--\> inflammation of mouth and lips

Cytarabine

Mitochondrial toxicity

Reverse transcriptase inhibitors: Emtricitabine Lamivudine\* Tenofovir

ECG abnormalities

Quinolone derivatives (Chloro;Quinine,quinidine) Doxo;Daunorubicin; Halofantrine

Acute reaction (characterized by fever, or even anaphylaxis)

Anti-thymocyte globulin (ATG)

methotrexate myelosuppression reveresed by:

folinic acid (leucovorin

hypotension

Chloroquine; Rituximab

flucytosine a/e

myelosuppression

local injection site reactions with mild or moderate pain, erythema, induration, nodules and cysts

Enfuvirtide

explain side affects in Vincristine

microtubules are important in nerve conduction and neurotransmission

Anaphylaxis—although rare—can be fatal

Iron Dextran

Neutropenia and thrombocytopenia

Imatinib (Tyrosine Kinase Inhibitor

tinnitus, dizziness and flushing, vision issues

Cinchonism-\> Quinine and Quinidine

ulcerations over the elbows, knuckles,

Bleomycin

Peripheral neuropathy--\>numbness and tingling of the extremities

Vincristine Fludarabine

photosensitivity.

Doxycyclin and Tetracyclin

Kernicterus in newborns

TMP/SMX; Pyrimethamine/sulfadiazine

Cerebellar toxicity, manifest as ataxia and slurred speech

Cytarabine

Hypersensitivity rxns

Quinine and Quinidine

Thrombophlebitis at the infusion site

Factor VIII replacement; Plasma-derived vWF

active against Hep B

Reverse transcriptase inhibitors: Emtricitabine Lamivudine\* Tenofovir

hemorrhagic cystitis

Cyclophosphamide

• Abdominal pain • Diarrhea • Vomiting brown or bloody stomach contents with pills. • Lassitude & drowsiness • Pallor or cyanosis. • Hyperventilation (due to acidosis). • Cardiovascular collapse.

iron poisoning s/s

pruritus

Chloroquine; Deferoxamine

– Leukopenia – Thrombocytopenia

Sirolimus

Cinchonism --\> tinnitus, headache, visual disturbances, nausea, dizziness and flushing.

Quinine and Quinidine

cardiac toxicity due to doxo prevented by?

dexrazoxane

Normochromic, normocytic anemia caused by inc. erythropoietin; reversible

Polyenes: Amphotericin B

Pulmonary emboli, DVT, MI

Prothrombin complex concentrate (PCC) and activated PCC (aPCC)

Long-term use → diabetes mellitus

Glucocorticoids

↑Appetite → Weight gain

Glucocorticoids

Stevens-Johnson Syndrome which is characterized by blistering of the mucous membranes (mouth, eyes, vagina

TMP/SMX; Pyrimethamine/sulfadiazine

Neurotoxicity: altered mental status, coma, seizures.

Cyclophosphamide

Anaphylactic rxns—but lower risk than iron dextran

Sodium Ferric Gluconate + Iron Sucrose

irreversible ototoxicity

Chloroquine

urticaria,, bronchospasm, angioedema and hypotension

Rituximab (infusion rxn)

Cerebellar toxicity and cerebral toxicity

Cytarabine

myopathy

Chloroquine; Nucleoside RTIs (Lamivudine, Emtri, Tenofo)

Nephrotoxicity; reversible

Polyenes: Amphotericin B

increased transaminases

Reverse transcriptase inhibitors: Emtricitabine Lamivudine\* Tenofovir

hyperlipidemia

Cyclosporine Sirolimus

1) displace bilirubin from plasma albumin. The free bilirubin deposits in basal ganglia

1) sulfonamides

dermatitis.

Cytarabine

Endocrinologic abnormalities, e.g., women, menstrual irregularities; men, gynecomastia

Azoles

pancreatitis

Reverse transcriptase inhibitors: Emtricitabine Lamivudine\* Tenofovir

hypertension, hyperlipidemia

Cyclosporine

retinopathy,

Chloroquine

conjunctivitis

Cytarabine

Adverse effects: – Diarrhea

Leflunomide

hyperglycemia

Protease inhibitors ("navir) Glucocorticoids Aspiriginase

Cough, pyrexia,

Penetration blocker: Maraviroc

Avoid abrupt stoppage; taper dosage slowly

Glucocorticoids

lipoatrophy myopathy,

Reverse transcriptase inhibitors: Emtricitabine Lamivudine\* Tenofovir

integrase strand transfer inhibitor (INSTI)

raltegravir

Protease inhibitors ("navir) inhibit metabolism of

statins

Nephrotoxicity and pulmonary toxicity

methotrexate

central fat accumulation

Protease inhibitors ("navir)

↑Risk of demyelinating disease

TNF-α Inhibitors: Etanercept, Infliximab, Adalimumab

Hemolysis in G6PD deficient pts.

Quinolone derivatives (Chloro;Quinine,quinidine) TMP/SMX

neural tube defects

folate deficiency; Efavirenz

Dry skin

Tretinoin

cerebral toxicity, including seizures, dementia, and coma,

Cytarabine

cheilitis--\> infl of lip

Tretinoin

↑Risk of reactivating latent tuberculosis

TNF-α Inhibitors: Etanercept, Infliximab, Adalimumab

what is mesna

conjugates acrolein; prevents hemorrhagic cystitis due to cyclophos

Hypoglycemia

Quinine and Quinidine;

Acute hemolytic anemia in patients with reduced glucose-6-phosphate dehydrogenase activity

TMP/SMX; Pyrimethamine/sulfadiazine

Peripheral neuropathy

Vincristine Fludarabine Nucleo. RTIs (Emtri, Lamiv\* Tenof); Chloroquine

why does dexrazoxane work?

When iron is given with Doxo, more FREE RADICALS are formed; dexrazoxane is an iron chelating agent;

Cardiac toxicity manifested as ECG changes

Doxo/daunorubicin

hepato-, nephro-, and neuro—toxicity

Cyclosporine

leucopenia, thrombocytopenia, neutropenia (agranulocytosis)

Quinine and Quinidine

amodiaquine a/e

aplastic anemia; hepatotoxicity