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Arizona Drug Profile (revised 3/27/2015) > Adverse Reactions > Flashcards

Adverse Reactions Flashcards

1
Q

ABIXIMAB

adverse reactions

A
  • Bleeding - spontaneous bleeding may occur with abciximab administration; most common sites include: venous and arterial access sites (including femoral artery, retroperitoneal, gastrointestinal, genitourinary)
  • Major bleeds have been demonstrated to occur more often in patients: >65 years old, <75kg, with a history of prior gastrointestinal disease, patients receiving thrombolytics or heparin
  • Hemorrhagic stroke and intracranial bleeding
  • Thrombocytopenia
  • Other adverse effects (incidence greater than 1 percent):
  • Cardiovascular - Hypotension, Bradycardia, atrial fibrillation/flutter pulmonary edema
  • Central nervous system - abnormal thinking, dizziness
  • Genitourinary - urinary tract infection
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2
Q

ACETYLSALICYLIC ACID, ASPIRIN, ASA

adverse reactions

A
  • Use with caution in the patient with history of asthma. Anaphylactic reactions in sensitive patients have occurred; skin eruptions
  • Other side effects rare with single dose
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3
Q

ACETYLSALICYLIC ACID, ASPIRIN, ASA (EMT Administration)

adverse reactions

A
  • Use with caution in the patient with history of asthma. Anaphylactic reactions in sensitive patients have occurred; skin eruptions
  • Other side effects rare with single dose
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4
Q

ADENOSINE

adverse reactions

A

CV: Transient dysrhythmias (systole, bardycardia, PVC’s) occur in 55% of patients (none reported as irreversible). Palpitations, chest pressure, chest pain, hypotension, transient hypertension; facial flushing, sweating.
Resp: Dyspnea, hyperventilation, tightness in throat, bronchospasm.
CNS: Lightheadedness, headache, dizziness, paresthesias, apprehension, blurred vision,
neck-back pain.
GI: Nausea, metallic taste.

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5
Q

ALBUMIN, normal serum 5% / 25%

adverse reactions

A

CV: Fluid overload, hypotension, erractic pulse, tachycardia
Resp: Altered respirations, pulmonary edema
CNS: Fever, chills, flushing, headache
Integ: Rash, urticaria
GI: Nausea, vomiting, increased salivation

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6
Q

ALUTEROL SULFATE

adverse reactions

A

Dysrhythmias, tachycardia (with excessive use), peripheral vasodilation Bronchospasm (rare paradoxical with excessive use)
Tremors, nervousness
Nausea, vomiting
Hyperglycemia

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7
Q

AMIODARONE

adverse reactions

A

Cardiovascular: bradycardia, hypotension, asystole/cardiac arrest, atrio-ventricular block
Torsades de Pointes (prolongs QTc interval), congestive heart failure
GI & Hepatic: nausea, vomiting, abnormal liver function tests
Skin: slate-blue pigmentation
Other: fever, headache, dizziness, flushing, abnormal salivation, photophobia

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8
Q

ATROPINE SULFATE

adverse reactions

A

Major: Tachydysrhythmias; flushing; ventricular irritability; exacerbation/initiation of angina; acute narrow angle glaucoma; blurred vision; mydriasis; agitation to delirium; bloating; constipation; decreased gastric emptying
Minor: Dry mouth/mucous membranes; loss of taste; nausea; vomiting; urinary retention; neuromuscular weakness; decreased sweating/increased body temperature.

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9
Q

BUMETANIDE

adverse reactions

A
  • Dizziness (most common), headache, muscle cramps
  • Hypotension
  • EKG changes associated with hypokalemia, hyponatremia, hypocalcemia,
    hypomagnesemia
  • Nausea, vomiting, diarrhea, dry mouth, ringing in ears
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10
Q

CALCIUM CHLORIDE

adverse reactions

A
  • Brady-asystolic arrest
  • Severe tissue necrosis if solution extravasates
  • Use cautiously in patients on digitalis; may cause serious arrhythmias
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11
Q

CALCIUM GLUCONATE GEL, 2.5%

adverse reactions

A

None reported.

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12
Q

CHARCOAL, ACTIVATED (without sorbitol)

adverse reactions

A

May provoke vomiting
May worsen poison induced Ileus

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13
Q

CIMETIDINE

adverse reactions

A

GI: Mild and transient diarrhea
Cardiac: Heart block in elderly patients

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14
Q

DEXAMETHASONE SODIUM PHOSPHATE

adverse reactions

A

Sodium retention, fluid retention, potassium loss, hypokalemic alkalosis, hypertension, convulsions, hyperglycemia, myocardial rupture following recent myocardial infarction

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15
Q

DEXTROSE 50%

adverse reactions

A
  • Cerebral edema in children when given IV undiluted.
  • Worsening elevated ICP or cerebral edema from trauma or cerebral vascular accident.
  • Extravasation leads to severe tissue necrosis.
  • Sclerosing effect on peripheral veins.
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16
Q

DIAZEPAM

adverse reactions

A

CV: Bradycardia, hypotension, cardiovascular collapse; venous thrombosis; phlebitis; vascular spasm
Resp: Respiratory arrest; may be prolonged in neonate
CNS: Somnolence, confusion, coma, diminished reflexes; s/s may be prolonged in
neonate
Other: Burning proximal to IV injection site; local irritation; swelling; extravasation will
cause tissue necrosis

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17
Q

DILTIAZEM

adverse reactions

A

CV: hypotension, bradycardia, heart block, chest pain, and asystole
GI: nausea and vomiting
CNS: headache, fatigue, drowsiness

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18
Q

DIPHENHYDRAMINE HCL

adverse reactions

A

CV: Hypotension; palpitations; arrhythmias; hemolytic anemia.
Resp: Anaphylaxis; thickening of bronchial secretions, tightness in chest;
wheezing; nasal stuffiness.
CNS: Sedation; visual disturbances; seizures.
GU/GI: Urinary frequency or retention; vomiting.
Children: In children, may cause paradoxical CNS excitation, seizures, palpitations,
thickening of bronchial secretions.

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19
Q

DOPAMINE

adverse reactions

A

CV: Cardiac arrhythmias may occur due to increased myocardial oxygen demand (usually tachydysrhythmias), hypertension, hypotension at low doses.
GI: Nausea and vomiting
GU: Renal shutdown (at higher doses)
Other: Extravasation may cause tissue necrosis

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20
Q

EPINEPHRINE AUTO-INJECTOR

adverse reactions

A
  • Ventricular arrhythmia
  • Precipitation of angina or myocardial infarction
  • Tachycardia
  • Anxiety and nervousness
  • Hypertension
  • Headache
  • Pallor
  • Sweating
  • Dizziness
  • Weakness
  • Tremor
  • Nausea and vomiting
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21
Q

EPINEPHRINE HCL

adverse reactions

A

CV: Hypertension, ventricular dysrhythmias; tachycardia; angina
CNS: Anxiety, agitation
GI: Nausea/vomiting

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22
Q

EPTIFIBATIDE

adverse reactions

A
  • Bleeding - spontaneous bleeding may occur with eptifibatide administration; most common sites include: venous and arterial access sites (including femoral artery, retroperitoneal, gastrointestinal, genitourinary)
  • Major bleeds have been demonstrated to occur more often in patients: >65 years old, <75kg, with a history of prior gastrointestinal disease, patients receiving thrombolytics or heparin
  • Hemorrhagic stroke and intracranial bleeding
  • Thrombocytopenia
  • Other adverse effects (incidence greater than 1 percent):
  • Cardiovascular - Bradycardia, Dissection of coronary artery, edema, swelling, vasovagal
    reaction
  • Central nervous system - dizziness, sweating, pain (leg and pelvic)
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23
Q

ETOMIDATE

adverse reactions

A
  • Transient muscle movements
  • Apnea
  • Causes minimal but not clinically significant suppression of cortisol levels
  • May cause myoclonus and tremors that can resemble seizure activity
24
Q

FAMOTIDINE

adverse reactions

A

CV: Palpitations, flushing
EENT: Tinnitus, orbital edema
GI: Diarrhea, constipation, anorexia, taste perversion, dry mouth
Other: Transient irritant at IV site
Children less than 1 year of age may have vomiting and agitation

25
Q

FENTANYL CITRATE

adverse reactions

A

MS: Muscle rigidity, particularly involving muscles of respiration.
CV: Bradydysrhythmias (common) or tachydysrhythmias, hypotension, orthostatic
hypotension.
Resp: Respiratory depression (common) or arrest.
CNS: Excess sedation, seizures leading to coma and arrest, pupillary constriction,
dizziness, blurred vision.
GI: Nausea and vomiting.
Derm: Histamine release may cause local or generalized urticaria. Diaphoresis.

26
Q

FUROSEMIDE

adverse reactions

A
  • May exacerbate hypovolemia
  • Hyperglycemia (due to hemoconcentration)
  • Hypokalemia
  • May decrease the response to pressors
27
Q

GLUCAGON

adverse reactions

A
  • Rare side effects
  • Nausea and vomiting
  • Generalized allergic reactions including urticaria, respiratory distress and hypotension
    (made from beef/pork pancreas)
  • Palpitations, hypertension, tachycardia
28
Q

HEMOSTATIC AGENTS

adverse reactions

A

None

29
Q

HYDROXOCOBALAMIN

adverse reactions

A

Emergency Patient Management: In addition to hydroxocobalamin, treatment of cyanide poisoning must include immediate attention to airway patency, adequacy of oxygenation and hydration, cardiovascular support, and management of any seizure activity. Consideration should be given to decontamination measures based on the route of exposure.
Allergic: Anaphylaxis, chest tightness, edema, urticarial, pruritis, dyspnea, and rash.
Cardiovascular: Elevations in blood pressure, usually transient and return to baseline levels within 4 hours.
Interference with Clinical Laboratory Evaluations: Red-colored urine, interference with clinical chemistry, hematology, coagulation, and urine parameters.

30
Q

INSULIN

adverse reactions

A

Metabolic: hypokalemia, sodium retention, hypoglycemia, rebound hyperglycemia (Somogyi effect).
Skin: urticaria, rash, pruritus
Other: edema; lipodystrophy; lipohypertrophy; erythema, stinging, or warmth at injection site; allergic reactions including anaphylaxis.

31
Q

IPRATROPIUM BROMIDE

adverse reactions

A

Resp: Coughing. Sputum increased
CNS: Dizziness. Insomnia. Tremor. Nervousness
GI: Nausea

32
Q

KETAMINE HYDROCHLORIC INJECTION

adverse reactions

A

An emergence reaction (in approximately 12% of patients) may occur near end of medication half-life, when patient is awakening, that may require Versed 1-5 mg IV/IM/IO to calm patient.

33
Q

LIDOCAINE HCL

adverse reactions

A

CV: May also cause SA nodal depression or conduction problems and hypotension in large doses, or if given too rapidly. Excessive doses in pediatric patient may produce myocardial and circulatory depression.
CNS: In large doses drowsiness, disorientation, paresthesias, decreased hearing acuity, muscle twitching, agitation, focal or generalized seizures.

34
Q

LORAZEPAM

adverse reactions

A
  • Most frequent adverse reaction is sedation
  • Transient amnesia or memory impairment
  • Confusion
  • Hypotension
  • Respiratory depression
  • Dizziness
  • Headache
35
Q

MAGNESIUM SULFATE

adverse reactions

A

CV: Hypotension (may be transient), flushing, circulatory collapse, depressed cardiac function, heart block, asystole, smooth muscle relaxant (antihypertensive effects).
Resp: Respiratory depression and/or paralysis. This adverse reaction may occur in both mother and/or infant during or up to 24 hours after the administration of Magnesium Sulfate.
CNS: Sweating, drowsiness, hypothermia, depressed reflexes progressing to flaccidity and paralysis. This adverse reaction may occur in both mother and/or infant during the administration of or up to 24 hours after the administration of Magnesium Sulfate.
GI: Nausea
GU: Mild diuretic
Meta: Hypocalcemia, hypermagnesemia

36
Q

METHYLPREDNISOLONE SODIUM SUCCINATE

adverse reactions

A

None from single dose

37
Q

MIDAZOLAM HYDROCHLORIDE

adverse reactions

A

CV: Hypotension (especially in patients premedicated with narcotic); cardiac arrest; irregular or fast heartbeat
Resp: Apnea; respiratory depression, respiratory arrest; paradoxical hyperventilation; wheezing or difficulty in breathing; hiccups; coughing
CNS: Emergence delirium; muscle tremor; uncontrolled or jerky movements of body; unusual excitement, irritability, or restlessness; dizziness, light-headedness, or feeling faint; prolonged drowsiness; headache
GI: Nausea and/or vomiting

38
Q

MORPHINE SULFATE

adverse reactions

A

CV: Brady or tachydysrhythmias, orthostatic hypotension
Resp: Respiratory depression or arrest
CNS: Excess sedation, seizures to coma and arrest, pupillary constriction GI: Nausea and vomiting, GI spasm
Derm: Histamine release may cause local urticaria

39
Q

NALMEFENE HCL

adverse reactions

A

Withdrawal symptoms: nausea, vomiting, diaphoresis, increased heart rate, pulmonary edema, cardiovascular instability, ventricular fibrillation, hypotension or hypertension, tremors.
*Be prepared for combative patient after administration.

40
Q

NALOXONE HCL

adverse reactions

A
  • Withdrawal symptoms, especially in neonates (nausea, vomiting, diaphoresis, increased heart rate, hypotension or hypertension, tremors).
  • Be prepared for combative patient after administration.
41
Q

NITROGLYCERIN

adverse reactions

A

CV: Hypotension, reflex tachycardia, bradycardia, decreased coronary perfusion at high doses (secondary to hypotension), headache secondary to dilation of meningeal vessels.

42
Q

NOREPINEPHRINE

adverse reactions

A
  • CNS: headache, anxiety
  • CV: bradycardia, severe hypertension, arrhythmias
  • Respiratory: respiratory difficulty
  • Skin: irritation with extravasation, necrosis
  • Other: ischemic injury
  • Overdosage with norepinephrine may result in headache, severe hypertension, reflex bradycardia, marked increase in peripheral resistance, and decreased cardiac output. In case of accidental overdosage, as evidenced by excessive blood pressure elevation, discontinue norepinephrine until the condition of the patient stabilizes.
43
Q

ONDANSETRON

adverse reactions

A

CNS: Headache, malaise, fatigue, dizziness, fever, sedation, extrapyramidal syndrome
CV: Chest pain, arrhythmias
Resp: Hypoxia
GI/Hepatic: Diarrhea, constipation, abdominal pain, xerostomia, decreased appetite
Skin: Rash

44
Q

OXYTOCIN

adverse reactions

A

CV: Shock, tachycardia, dysrhythmias
Resp: Anaphylaxis
GI: Nausea and vomiting
GU: If used prior to delivery, can cause uterine rupture, uterine spasm, lacerations,
and fetal damage.
Other: Clotting disorders, electrolyte disturbances

45
Q

PHENYLEPHRINE NASAL SPRAY 0.5%

adverse reactions

A

CV: Hypertension, palpitations
CNS: Tremors

46
Q

PROPARACAINE HYDROCHLORIDE OPTHALMIC

adverse reactions

A

OCULAR: Pupillary dilation, local irritation, softening and erosion of cornea (rare). Severe hyperallergic corneal reaction with corneal sloughing (extremely rare).
Derm: Allergic dermatitis conjunctiva and eyelids (rare).

47
Q

PROPOFOL

adverse reactions

A

Bradycardia, arrhythmia, hypotension, HTN, tachycardia nodal, decreased cardiac output, CNS movement, injection-site burning/stinging/pain, hyperlipemia, apnea, rash, pruritus, respiratory acidosis during weaning.

48
Q

RACEMIC EPINEPHRINE

adverse reactions

A
  • Tachycardia
  • Dysrhythmias
  • Headache
  • Nausea
  • Palpitations
  • Angina
49
Q

RANITIDINE

adverse reactions

A 
CNS: Headache, vertigo, malaise
EENT: Blurred vision
Hepatic: Jaundice
CV: Bradycardia, heart block 
Other: Anaphylaxis, angioedema
50
Q

SODIUM BICARBONATE 8.4%

adverse reactions

A

CV: Congestive heart failure, edema secondary to sodium overload.
Metabolic: Hyperosmolarity, metabolic alkalosis, hypernatremia, in cardiac arrest may cause extracellular alkalosis and intracellular acidosis.

51
Q

SUCCINYLCHOLINE

adverse reactions

A
  • Vagal stimulation leading to bradycardia or asystole
  • Hyperkalemia
  • Rhabdomyolysis
  • Hypersalivation
  • Elevated intraocular pressure
  • Release of histamine
  • Malignant hyperthermia
  • Dysrhythmias
  • Hypotension
52
Q 
THIAMINE HCL (VITAMIN B1)
adverse reactions
A

Hypotension (rare) Nausea/vomiting

53
Q

TIROFIBAN

adverse reactions

A
  • Bleeding - spontaneous bleeding may occur with tirofiban administration; most common sites include: venous and arterial access sites (including femoral artery, retroperitoneal, gastrointestinal, genitourinary)
  • Major bleeds have been demonstrated to occur more often in patients: >65 years old, <75kg, with a history of prior gastrointestinal disease, patients receiving thrombolytics or heparin
  • Hemorrhagic stroke and intracranial bleeding
  • Thrombocytopenia
  • Other adverse effects (incidence greater than 1 percent):
  • Cardiovascular - Bradycardia, Dissection of coronary artery, edema, swelling, vasovagal
    reaction
  • Central nervous system - dizziness, sweating, pain (leg and pelvic)
54
Q

TOTAL PARENTERAL NUTRITION

adverse reactions

A
  • Adverse reactions are related to TPN’s components:
  • Water–fluid overload
  • Insulin and dextrose–hypoglycemia or hyperglycemia
  • Heparin–hemorrhage
  • Electrolytes–abnormal levels of sodium, chloride, potassium, magnesium
  • Vitamins–deficiency in vitamin D, excess of vitamin A
  • Dextrose–respiratory distress, liver dysfunction

A partial list of symptoms caused by the above: body swelling, respiratory distress, high or low blood glucose, bleeding, changes in level of consciousness, cardiac arrhythmias, diaphoresis, confusion, lethargy, headache, hunger, tremors, fever, sepsis. Should a problem develop during transport, contact medical control for direction.

55
Q

VASOPRESSIN

adverse reactions

A
  • Can increase peripheral vascular resistance and provoke cardiac ischemia and angina pectoris
  • Abdominal distress
  • Nausea and vomiting
  • Tremors
  • Tissue necrosis if extravasation occurs
56
Q

VERAPAMIL HCL

adverse reactions

A
  • Extreme bradycardia
  • Asystole
  • AV block
  • Hypotension
  • Congestive heart failure

Arizona Drug Profile (revised 3/27/2015) (8 decks)

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