Adverse Reactions & Side Effects Flashcards
acetaminophen
Integumentary: Itching, rash
Gastrointestinal: upper
abdominal pain, loss of
appetite
Other: Overdose may cause
hepatotoxicity
activated charcoal
Gastrointestinal:
Emesis, constipation, black stools, diarrhea, bowel obstruction
adenosine
Note: Because adenosine has an extremely short half-life, adverse reactions and side
effects are usually transient and of short duration.
–Cardiovascular: Dysrhythmias (including asystole), hypotension, chest pain, tachycardia
–Neurological: Feeling of impending doom, nervousness, dizziness, paresthesia Use with
caution in patients with hx of seizures.
–Integumentary: Flushing, sweating
–Respiratory: Severe bronchospasm in patients with hx of asthma and COPD - use with caution in these patients
albuterol
–Cardiovascular: Dysrhythmias, chest pain, palpitations
–Neurological: Tremors, headache, nervousness, dizziness
amiodorone
Cardiovascular: Hypotension, heart failure, worsening of dysrhythmias, prolonged QT
interval, bradycardia, AV block
Respiratory: Cough, progressive dyspnea
Neurological: Dizziness, fatigue
Other: Burning at IV site, Stevens-Johnson syndrome
aspirin
Respiratory: Bronchospasm/wheezing in allergic patients
Gastrointestinal: GI bleeding, epigastric distress, heartburn
Other: Anaphylaxis, Reye syndrome
atropine
Note: Expected effects of anticholinergics include pupillary dilation, dry
mouth/nose/skin, urinary retention, and constipation.
Cardiovascular: Palpitations, dysrhythmias
Neurological: drowsiness, confusion, headache, blurred vision
calcium chloride
Cardiovascular: bradycardia, asystole, hypotension, coronary artery spasm, syncope
Neurological: cerebral artery spasm
Other: metallic taste with rapid injection, tissue necrosis at injection site
calcium gluconate
Cardiovascular: bradycardia, asystole, hypotension, coronary artery spasm, syncope
Neurological: cerebral artery spasm
Other: metallic taste with rapid injection, tissue necrosis at injection site
dexamethasone
Note: all listed side effects are from cumulative doses or prolonged use.
Neurological: headache, restlessness, nervousness, increased appetite, insomnia
Other: retention of sodium and water
dextrose
Neurological: Cerebral hemorrhage, cerebral ischemia
Other: Warmth, pain, burning or phlebitis from IV infusion
diazepam
Cardiovascular: Hypotension, reflex tachycardia, thrombosis
Neurological: Dizziness, drowsiness, confusion, headache, ataxia, muscle weakness
diltiazem
Cardiovascular: Cardiac arrest, dysrhythmias, heart failure, hypotension, syncope, chest
pain, peripheral edema
Neurological: Dizziness, weakness, headache
Respiratory: dyspnea
diphenhydramine hydrochloride
Note: Hallucinations, confusion, and paradoxical CNS excitation can occur in children.
Cardiovascular: Dysrhythmias, palpitations, hypotension
Neurological: Seizures, dizziness, headache, blurred vision
Respiratory: wheezing, thickening of bronchial secretions
dopamine hydrochloride
Cardiovascular: Dysrhythmias, hypotension, hypertension, palpitations, chest pain
Respiratory: Dyspnea
Neurological: Headache, anxiety
epinephrine
Cardiovascular: dysrhythmias, chest pain, increased myocardial oxygen demand,
palpitations, hypertension
Neurological: Nervousness, restlessness, headache, tremor
etomidate
Cardiovascular: Dysrhythmias, hypotension, hypertension
Respiratory: Apnea of short duration, respiratory depression, hypoventilation,
hyperventilation
Neurological: Nystagmus, transient involuntary skeletal muscle movement
fentanyl citrate
Cardiovascular: Dysrhythmias, hypotension, syncope
Respiratory: Respiratory depression, chest wall rigidity
Neurological: Confusion, paradoxical excitation, delirium, drowsiness, fatigue
Other: abdominal pain, dehydration
flumazenil
Cardiovascular: dysrhythmias, chest pain, hypertension
Neurological: seizures, dizziness, agitation, confusion, headache, visual disturbances,
uncontrollable shivering, rigors
Other: hiccups, pain at the injection site
furosemide
Cardiovascular: Dysrhythmias, orthostatic hypotension, hypotension
Neurological: weakness, headache, dizziness
Other: Hyperglycemia, hypokalemia, dry mouth, diarrhea
glucagon
Cardiovascular: Hypotension, tachycardia
Neurological: Dizziness, headache
Other: Rebound hyperglycemia
glucose, oral
None
haloperidol
Cardiovascular: Hypotension, orthostatic hypotension, tachycardia. Excessive dosing and
off-label use may result in Torsades, QT prolongation and sudden death
Neurological: Seizures, confusion, restlessness, extrapyramidal/dystonic reactions,
blurred vision
Gastrointestinal: constipation, dry mouth, drooling
hydromorphone
Cardiovascular: Hypotension, syncope
Respiratory: Apnea
Neurological: Dizziness, headache, drowsiness, weakness
hydroxycobalamin
Cardiovascular: Hypertension, GI bleed
Respiratory: dyspnea
Neurological: dizziness, headache
ibuprofen
Neurologic: headache, dizziness, drowsiness, fatigue, restless sleep, thirst, sweating,
paresthesia, tinnitus, blurred vision, eye irritation
Renal: Fluid retention, frequent urination
ipratropium bromide
Cardiovascular: Hypertension, tachycardia, palpitations, myocardial infarction
Respiratory: Dyspnea, worsening COPD symptoms
Neurological: headache, dizziness, nervousness, tremors
Gastrointestinal: dry mouth, GI distress
ketamine
Cardiovascular: Hypertension, tachycardia
Respiratory: respiratory depression, increased secretions, hypersalivation, laryngospasm
Neurological: Hallucinations, nystagmus
ketorolac tromethamine
Cardiovascular: Vasodilation, hypotension, hypertension, GI bleeding, edema
Respiratory: bronchospasm, dyspnea
Neurological: Drowsiness, dizziness, headache, sedation
labetolol
Cardiovascular: bradycardia, heart failure, pulmonary edema, orthostatic hypotension,
hypotension, ventricular dysrhythmias
Neurological: Fatigue, weakness, depression, headache, dizziness
Respiratory: Bronchospasm, dyspnea
lidocaine hydrochloride
Cardiovascular: Hypotension, dysrhythmias, cardiac arrest
Neurological: Drowsiness, confusion, seizures, slurred speech
lorazepam
Cardiovascular: Hypotension, bradycardia
Neurological: Drowsiness, dizziness
Respiratory: Apnea
magnesium sulfate
Cardiovascular: Hypotension and bradycardia with rapid administration, vasodilation
Respiratory: Respiratory depression, respiratory paralysis
Neurological: Drowsiness, CNS depression, decreased deep tendon reflexes
mannitol
Cardiovascular: Tachycardia, chest pain, hypotension, hypertension, heart failure
Neurological: Headache, confusion, blurred vision, rebound increase in ICP
Metabolic: hypo/hyperkalemia, hypo/hypernatremia, dehydration
methylprednisolone sodium succinate
Cardiovascular: Heart failure, hypertension
Neurological: depression, euphoria, headache, restlessness, seizure, increased ICP
Other: fluid retention, peptic ulcer, hypernatremia, hyperkalemia, tuberculosis
midazolam hydrochloride
None
morphine sulfate
Cardiovascular: Hypotension, orthostatic hypotension, syncope, bradycardia, tachycardia
Neurological: Confusion, headache
Respiratory: Respiratory depression, apnea, dyspnea, bronchospasm
naloxone hydrochloride
Cardiovascular: Hypertension/hypotension with rapid administration, dysrhythmias
Neurological: Restlessness, seizures, withdrawal symptoms in opioid-dependent patients
Respiratory: dyspnea, pulmonary edema
Other: Diaphoresis
nitroglycerin
Cardiovascular: Reflex tachycardia, syncope, hypotension
Neurological: Headache, dizziness, weakness, muscle twitching
Other: Diaphoresis, dry mouth
norepinephrine bitartrate
Cardiovascular: hypertension, dysrhythmias, chest pain, peripheral cyanosis, cardiac
arrest, decreased blood flow to GI tract/kidneys/skin/skeletal muscles
Neurological: Headache, anxiety, dizziness, restlessness
Respiratory: Dyspnea
Renal: Urinary retention, renal failure
ondansetron hydrochloride
Cardiovascular: Syncope, palpitations, dysrhythmias
Neurological: Headache, serotonin syndrome
Respiratory: Wheezing/bronchospasm
Gastrointestinal/other: Malaise, constipation, diarrhea, hives, rash
oxygen
None
oxytocin
Cardiovascular:Hypotension, dysrhythmias
Neurological: Coma, seizures, anxiety, maternal intracranial hemorrhage
Other: Anaphylaxis, painful uterine contractions, electrolyte disturbances
phenylephrine
Cardiovascular: palpitations, hypertension
Neurological: Tremors
pralidoxime
Cardiovascular: tachycardia, cardiac arrest
Respiratory: Laryngospasm, apnea, hyperventilation
Neurological: Dizziness, drowsiness, headache, seizures, neuromuscular blockade,
muscle rigidity, muscle weakness
procainamide hydrochloride
Cardiovascular: dysrhythmias, severe hypotension, widening of QRS complex, PRI and
QT intervals
Neurological: Confusion, seizures
promethazine hydrochloride
Cardiovascular: Chest tightness, palpitations, bradycardia, reflex tachycardia, QT
prolongation, orthostatic hypotension
Neurological: Headache, dizziness, drowsiness, confusion, restlessness
Respiratory: wheezing, thickening of bronchial secretions
rocuronium bromide
Cardiovascular: transient hypo/hypertension, dose-related tachycardia
Respiratory: hiccups, wheezing
Other: Injection site edema, itching, residual muscle weakness
sodium bicarbonate
Cardiovascular: Heart failure
Respiratory: Pulmonary edema
Neurological: Tremors, twitching, seizures
Other: electrolyte imbalances
VI. Dosage
Adult: 1 mEq/kg slow IV/IO push
Pediatric: 1mEq/kg slow IV/IO push.
VII. Special Considerations
● Extravasation may cause tissue sloughing, cellulitis and necrosis.
● 4.2% concentration recommended for infants younger than 1 month.
VIII. Drug Interactions
● Will precipitate with amiodarone. Use a different IV if possible.
● Likelihood of precipitating with other medications is high - flush IV very well.
● Decreases the effects of benzodiazepines and TCAs.
succinylcholine chloride
Cardiovascular: cardiac arrest, dysrhythmias
Respiratory: increased salivation
Metabolic/Other: Prolonged muscle rigidity, rhabdomyolysis, malignant hyperthermia,
hyperkalemia, increased intracranial/intraocular/intragastric pressure
terbutaline sulfate
Cardiovascular: dysrhythmias, chest pain
Neurological: CNS stimulation, headache, seizures, restlessness
Respiratory: bronchospasm/wheezing, coughing
thiamine hydrochloride
Cardiovascular: Vasodilation, hypotension
Neurological: weakness
Integumentary: Sweating, itching, hives
tranexemic acid
Cardiovascular: rapid infusion may cause hypotension, may increase risk of
thromboembolic disorders, anemia
Neurological: Fatigue, headache, dizziness
Other: Abdominal pain, back pain, joint pain, musculoskeletal pain
vecuronium bromide
Respiratory: excessive salivation
Neurological: prolonged neuromuscular blockade
Other: Itching, hypersensitivity reactions associated with histamine release
verapamil hydrochloride
Cardiovascular: dysrhythmias (including AV blocks and asystole), decreased myocardial
contractility, vasodilation
Neurological: Dizziness, headache
