Adverse reactions

Question 1

Terazosin

Answer 1

orthostatic hypotension (first dose), sinus tach (angina, palpitations), syncope, vertigo

Question 2

Prazosin

Answer 2

First dose orthostatic hypotension, sinus tach (angina, palp.), syncope, vertigo

Question 3

Phentolamine

Answer 3

Postural hypotension, reflex tachycardia (can lead to arrhythmias)

Question 4

Phenoxybenzamine

Answer 4

Sinus tach, nasal congestion, drowsiness, fatigue, weakness, malaise, confusion, headache, xerostomia, ejaculation dysfunction

Question 5

Beta blockers

Answer 5

CHF, bradycardia, bradyarrhythmias, cold extremities, tachyarrythmia with abrupt stopping of drug, bronchospasm for non-selective ones esp., CNS depression if lipophilic (mental disorders, fatigue, vivid dreams), increased TG, decreased HDL, delayed recovery from hypoglycemia in T1 diabetics, decreased exercise tolerance, fatigue

Question 6

Ganglionic blockers

Answer 6

Postural hypotension, tachycardia, arrhythmias, blurred vision, double vision, asthma (2º to histamine release), dry mouth, constipation, paralytic ileus, N/V, urinary retention, impotence, drowsiness, seizures, hallucinations, tremor, confusion, neuromuscular blockade

Question 7

Clonidine

Answer 7

Somnolence, dry mouth, abdom. pain, constipation, hypotension, sinus bradycardia, decreased libido, impotence, pregnancy cat. C

Question 8

Methyldopa

Answer 8

Messes with catecholamine quantitation, sedation, sleep disturbances, erectile dysfunction, NA/water retention, lactation, positive Coombs

Question 9

Reserpine

Answer 9

Sedation, inability to concentrate/perform complex tasks, suicidal tendencies, teratogenic

Question 10

Procaineamide

Answer 10

Drug induced lupus, torsade de pointes

Question 11

Lidocaine

Answer 11

CNS: agitation, confusion, seizures

Question 12

Amiodarone

Answer 12

Pulmonary fibrosis, gray-blue skin (photosensitivity dermatitis), corneal halos, optic neuritis, hypo/hyperthyroidism, proximal muscle weakness, hepatitis

Question 13

Sotolol

Answer 13

Torsade de pointes

Question 14

Ibutilide

Answer 14

Torsade, transient asystole

Question 15

Verapamil

Answer 15

SA/AV block, impaired contractility, hypotension, sinus bradycardia or AV block in people with CHF or LV dysfunction

Question 16

Digoxin

Answer 16

Any kind of arrhythmia (ventricular bigeminy is specific), DADs, visual changes (yellow-green halo), headache, fatigue, drowsiness, confusion, seizures

Question 17

Adenosine

Answer 17

Chest tightness, transient asystole, flushing

Question 18

Epinephrine

Answer 18

Cerebral hemorrhage (esp with non-specific BBs), ventricular arrhythmias, angina

Question 19

Norepinephrine

Answer 19

Cerebral hemorrhage (esp with non-specific BBs), ventricular arrythmias, angina, bigger increase in BP than epi

Question 20

Dopamine

Answer 20

at high doses, increased peripheral vasc. resist. and renal vasoconstriction

Question 21

Ephedrine

Answer 21

angina, ventricular dysfunction, palpitations, V tach, fatal arrhythmias (including Vfib)

Question 22

Statins

Answer 22

Mild transient GI distress, increased liver enzymes, sleep disturbance, reduced daytime vigilance, memory loss, teratogen, myalgia, myositis, rhabdomyolysis

Question 23

Bile acid sequestrants

Answer 23

GI: bloating, nausea, flatulence, constipation, fecal impaction, hypertriglyceridemia

Question 24

Ezetimibe

Answer 24

Fatigue, abdominal pain, diarrhea, arthralgias, back pain, liver enzyme elev. (discontinue drug if >3X normal value)

Question 25

Fibrates

Answer 25

gastroesophageal reflux, diarrhea, increased liver enzymes, gallstones, teratogen

Question 26

Fenofibrate

Answer 26

Increased creatinine (reversible)

Question 27

Niacin

Answer 27

Cutaneous flushing, elevated liver enzymes, hepatic failure, hepatitis, GI irritation (nausea), hyperuricemia, gout, conjuctivitis, cystoid macular edema, retinal detachment, myositis (rare), dry skin, pruritis, icthyosis, acanthosis nigricans, insuline resistance (glucose intolerance, hyperglycemia)

Question 28

ACE inhibitors

Answer 28

Hypotension, azotemia, cough, angioedema, metallic taste in mouth, hyperkalemia, teratogen

Question 29

Diuretics

Answer 29

Electrolyte imbalances, hyperchloremic metabolic alkalosis, azotemia, dehydration, hypotension, tinnitus, hearing loss (loops)

Question 30

Nitroglycerine

Answer 30

Hypotension (high dose effect), dizziness, orthostatic hypotension, syncope, headache, drug rash

Question 31

Dihydropyridine CCBs

Answer 31

Excessive vasodilation: dizziness, hypotension, headache, GI: nausea, Edema, coronary steal (worse angina), reflex tachycardia, constipation

Question 32

Non-hydrypyridines

Answer 32

Bradycardia, asystole, AV block

Question 33

Ranolazine

Answer 33

Dizziness, headache, constipation, nausea, small reversible elev. in serum creatinine and BUN, syncope, asthenia

Question 34

ARBs

Answer 34

Hypotension, hyperkalemia, hepatic dysfunction (losartan), teratogen

Question 35

Minoxidil

Answer 35

hersutism, elevated renin

Question 36

Nitroprusside

Answer 36

excessive hypotension, tachycardia, palpitations, cyanide poisoning

Question 37

Atropine

Answer 37

Atropine blush