Adverse Reactions Flashcards
ABIXIMAB
adverse reactions
- 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
ACETYLSALICYLIC ACID, ASPIRIN, ASA
adverse reactions
- 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
ACETYLSALICYLIC ACID, ASPIRIN, ASA (EMT Administration)
adverse reactions
- 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
ADENOSINE
adverse reactions
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.
ALBUMIN, normal serum 5% / 25%
adverse reactions
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
ALUTEROL SULFATE
adverse reactions
Dysrhythmias, tachycardia (with excessive use), peripheral vasodilation Bronchospasm (rare paradoxical with excessive use)
Tremors, nervousness
Nausea, vomiting
Hyperglycemia
AMIODARONE
adverse reactions
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
ATROPINE SULFATE
adverse reactions
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.
BUMETANIDE
adverse reactions
- Dizziness (most common), headache, muscle cramps
- Hypotension
- EKG changes associated with hypokalemia, hyponatremia, hypocalcemia,
hypomagnesemia - Nausea, vomiting, diarrhea, dry mouth, ringing in ears
CALCIUM CHLORIDE
adverse reactions
- Brady-asystolic arrest
- Severe tissue necrosis if solution extravasates
- Use cautiously in patients on digitalis; may cause serious arrhythmias
CALCIUM GLUCONATE GEL, 2.5%
adverse reactions
None reported.
CHARCOAL, ACTIVATED (without sorbitol)
adverse reactions
May provoke vomiting
May worsen poison induced Ileus
CIMETIDINE
adverse reactions
GI: Mild and transient diarrhea
Cardiac: Heart block in elderly patients
DEXAMETHASONE SODIUM PHOSPHATE
adverse reactions
Sodium retention, fluid retention, potassium loss, hypokalemic alkalosis, hypertension, convulsions, hyperglycemia, myocardial rupture following recent myocardial infarction
DEXTROSE 50%
adverse reactions
- 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.
DIAZEPAM
adverse reactions
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
DILTIAZEM
adverse reactions
CV: hypotension, bradycardia, heart block, chest pain, and asystole
GI: nausea and vomiting
CNS: headache, fatigue, drowsiness
DIPHENHYDRAMINE HCL
adverse reactions
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.
DOPAMINE
adverse reactions
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
EPINEPHRINE AUTO-INJECTOR
adverse reactions
- Ventricular arrhythmia
- Precipitation of angina or myocardial infarction
- Tachycardia
- Anxiety and nervousness
- Hypertension
- Headache
- Pallor
- Sweating
- Dizziness
- Weakness
- Tremor
- Nausea and vomiting
EPINEPHRINE HCL
adverse reactions
CV: Hypertension, ventricular dysrhythmias; tachycardia; angina
CNS: Anxiety, agitation
GI: Nausea/vomiting
EPTIFIBATIDE
adverse reactions
- 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)
ETOMIDATE
adverse reactions
- Transient muscle movements
- Apnea
- Causes minimal but not clinically significant suppression of cortisol levels
- May cause myoclonus and tremors that can resemble seizure activity
FAMOTIDINE
adverse reactions
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
FENTANYL CITRATE
adverse reactions
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.
FUROSEMIDE
adverse reactions
- May exacerbate hypovolemia
- Hyperglycemia (due to hemoconcentration)
- Hypokalemia
- May decrease the response to pressors
GLUCAGON
adverse reactions
- Rare side effects
- Nausea and vomiting
- Generalized allergic reactions including urticaria, respiratory distress and hypotension
(made from beef/pork pancreas) - Palpitations, hypertension, tachycardia
HEMOSTATIC AGENTS
adverse reactions
None
HYDROXOCOBALAMIN
adverse reactions
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.
INSULIN
adverse reactions
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.
IPRATROPIUM BROMIDE
adverse reactions
Resp: Coughing. Sputum increased
CNS: Dizziness. Insomnia. Tremor. Nervousness
GI: Nausea
KETAMINE HYDROCHLORIC INJECTION
adverse reactions
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.
LIDOCAINE HCL
adverse reactions
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.
LORAZEPAM
adverse reactions
- Most frequent adverse reaction is sedation
- Transient amnesia or memory impairment
- Confusion
- Hypotension
- Respiratory depression
- Dizziness
- Headache
MAGNESIUM SULFATE
adverse reactions
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
METHYLPREDNISOLONE SODIUM SUCCINATE
adverse reactions
None from single dose
MIDAZOLAM HYDROCHLORIDE
adverse reactions
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
MORPHINE SULFATE
adverse reactions
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
NALMEFENE HCL
adverse reactions
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.
NALOXONE HCL
adverse reactions
- Withdrawal symptoms, especially in neonates (nausea, vomiting, diaphoresis, increased heart rate, hypotension or hypertension, tremors).
- Be prepared for combative patient after administration.
NITROGLYCERIN
adverse reactions
CV: Hypotension, reflex tachycardia, bradycardia, decreased coronary perfusion at high doses (secondary to hypotension), headache secondary to dilation of meningeal vessels.
NOREPINEPHRINE
adverse reactions
- 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.
ONDANSETRON
adverse reactions
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
OXYTOCIN
adverse reactions
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
PHENYLEPHRINE NASAL SPRAY 0.5%
adverse reactions
CV: Hypertension, palpitations
CNS: Tremors
PROPARACAINE HYDROCHLORIDE OPTHALMIC
adverse reactions
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).
PROPOFOL
adverse reactions
Bradycardia, arrhythmia, hypotension, HTN, tachycardia nodal, decreased cardiac output, CNS movement, injection-site burning/stinging/pain, hyperlipemia, apnea, rash, pruritus, respiratory acidosis during weaning.
RACEMIC EPINEPHRINE
adverse reactions
- Tachycardia
- Dysrhythmias
- Headache
- Nausea
- Palpitations
- Angina
RANITIDINE
adverse reactions
CNS: Headache, vertigo, malaise EENT: Blurred vision Hepatic: Jaundice CV: Bradycardia, heart block Other: Anaphylaxis, angioedema
SODIUM BICARBONATE 8.4%
adverse reactions
CV: Congestive heart failure, edema secondary to sodium overload.
Metabolic: Hyperosmolarity, metabolic alkalosis, hypernatremia, in cardiac arrest may cause extracellular alkalosis and intracellular acidosis.
SUCCINYLCHOLINE
adverse reactions
- Vagal stimulation leading to bradycardia or asystole
- Hyperkalemia
- Rhabdomyolysis
- Hypersalivation
- Elevated intraocular pressure
- Release of histamine
- Malignant hyperthermia
- Dysrhythmias
- Hypotension
THIAMINE HCL (VITAMIN B1) adverse reactions
Hypotension (rare) Nausea/vomiting
TIROFIBAN
adverse reactions
- 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)
TOTAL PARENTERAL NUTRITION
adverse reactions
- 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.
VASOPRESSIN
adverse reactions
- Can increase peripheral vascular resistance and provoke cardiac ischemia and angina pectoris
- Abdominal distress
- Nausea and vomiting
- Tremors
- Tissue necrosis if extravasation occurs
VERAPAMIL HCL
adverse reactions
- Extreme bradycardia
- Asystole
- AV block
- Hypotension
- Congestive heart failure
