AE Flashcards
amiodarone
pulmonary fibrosis,hepatotoxicity, hypothyroidism/
hyperthyroidism (amiodarone is 40% iodine byweight), acts as hapten (corneal deposits, blue/gray skin deposits resulting in photodermatitis),neurologic effects, constipation, cardiovasculareffects (bradycardia, heart block, HF).
aminoglycosides
Nephrotoxicity, Neuromuscular blockade,
Ototoxicity (especially when used with loop
diuretics). Teratogen.
NNOT
Μαννιτόλη (διουρητικο
Proximal renal tubular acidosis, paresthesias,
NH3 toxicity, sulfa allergy.
Διουρητικά Αγκύλης Furosemide, bumetanide, torsemide
Ototoxicity, Hypokalemia, Dehydration,
Allergy (sulfa)/metabolic Alkalosis, Nephritis
(interstitial), Gout.
ΟΗ DANG
Diourtiko αιθακρινικό οξύ
Similar to furosemide, but more ototoxic.
Thiazide diuretics Hydrochlorothiazide, chlorthalidone,
metolazone
Hypokalemic metabolic alkalosis,
hyponatremia, hyperGlycemia,
hyperLipidemia, hyperUricemia,
hyperCalcemia. Sulfa allergy.
Potassium-sparing
diuretics Spironolactone and eplerenone; Triamterene,
and Amilorid
Hyperkalemia (can lead to arrhythmias),
endocrine effects with spironolactone (eg,
gynecomastia, antiandrogen effects).
b blockers
Impotence, exacerbation of COPD and asthma, cardiovascular effects (bradycardia, AV block, HF),
CNS effects (sedation, sleep alterations). May mask the signs of hypoglycemia.
Metoprolol can cause dyslipidemia. Propranolol can exacerbate vasospasm in Prinzmetal angina.
β-blockers (except the nonselective α- and β-antagonists carvedilol and labetalol) cause unopposed
α1-agonism if given alone for pheochromocytoma or cocaine toxicity. Treat β-blocker overdose with
saline, atropine, glucagon
corticosteroids
Beclomethasone, dexamethasone, hydrocortisone, methylprednisolone, prednisone, triamcinolone.
Iatrogenic Cushing syndrome (hypertension, weight gain, moon facies, truncal obesity,
buffalo hump, thinning of skin, striae, acne, osteoporosis, hyperglycemia, amenorrhea,
immunosuppression), adrenocortical atrophy, peptic ulcers, steroid diabetes, steroid psychosis,
cataracts.
Adrenal insufficiency when drug stopped abruptly after chronic use.
bisphosphonates
Alendronate, ibandronate, risedronate, zoledronate.
Esophagitis (if taken orally, patients are advised to take with water and remain upright for 30
minutes), osteonecrosis of jaw, atypical stress fractures.
Aspirin
Gastric ulceration, tinnitus (CN VIII). Chronic use can lead to acute renal failure, interstitial
nephritis, GI bleeding. Risk of Reye syndrome in children treated with aspirin for viral infection.
Causes respiratory alkalosis early, but transitions to mixed metabolic acidosis-respiratory alkalosis.
NSAIDs
Interstitial nephritis, gastric ulcer (prostaglandins protect gastric mucosa), renal ischemia
(prostaglandins vasodilate afferent arteriole).
Acetaminophen
Overdose produces hepatic necrosis; acetaminophen metabolite (NAPQI) depletes glutathione and
forms toxic tissue byproducts in liver. N-acetylcysteine is antidote—regenerates glutathione.
Doxorubicin
Cardiotoxicity (dilated cardiomyopathy), myelosuppression, alopecia. Dexrazoxane (iron chelating agent), used to prevent cardiotoxicity.
Angiotensinconverting
enzyme
inhibitors
Captopril, enalapril, lisinopril, ramipril.
Cough, Angioedema (due to bradykinin; contraindicated in C1 esterase inhibitor deficiency), Teratogen (fetal renal malformations), Creatinine ( GFR), Hyperkalemia, and Hypotension. Used with caution in bilateral renal artery stenosis, because ACE inhibitors will further GFR renal failure. Captopril’s CATCHH.
aminophylline
Stomach pain/cramping, nausea, vomiting, diarrhea, loss of appetite, headache, trouble sleeping, irritability, restlessness, nervousness, shaking (tremors), flushing, and increased urination may occu
heparin
Bleeding, thrombocytopenia (HIT), osteoporosis, drug-drug interactions. For rapid reversal
(antidote) , use protamine sulfate (positively charged molecule that binds negatively charged
heparin) .
warfarin
Bleeding, teratogenic, skin/tissue necrosis A ,
drug-drug interactions. Proteins C and S have
shorter half-lives than clotting factors II,
VII, IX, and X, resulting in early transient
hypercoagulability with warfarin use. Skin/
tissue necrosis within first few days of large
doses believed to be due to small vessel
microthromboses
methotrexate
Myelosuppression, which is reversible with leucovorin “rescue.” Hepatotoxicity. Mucositis (eg, mouth ulcers). Pulmonary fibrosi
cyclophosphamide
Myelosuppression; hemorrhagic cystitis, prevented with mesna (thiol group of mesna binds toxic metabolites) or N-acetylcysteine.
ΑΥΑ Ανταγωνιστές Υποδοχέα Αγγειοτασίνης ΙΙ
Hyperkalemia, μειωνουν GFR, hypotension; teratogen.
β-λακτάμες
Penicillin G, V
Hypersensitivity reactions, direct Coombs ⊕ hemolytic anemia.
Penicillinase-sensitive penicillins
Hypersensitivity reactions; rash; pseudomembranous colitis.
Penicillinase-resistant penicillins Dicloxacillin, nafcillin, oxacillin.
Hypersensitivity reactions, interstitial nephritis.
Antipseudomonal penicillins Piperacillin, ticarcillin.
hypersensivity
Infliximab
serious infections
reactivation of hepatitis B
reactivation of tuberculosis[18]
lethal hepatosplenic T-cell lymphoma (generally only when combined with 6-mercaptopurine)
drug-induced lupus
demyelinating central nervous system disorders
psoriasis and psoriasiform skin lesions
new-onset vitiligo
Cases of leukopenia, neutropenia, thrombocytopenia, and pancytopenia (some fatal) have been reported with inflixima
statines
Hepatotoxicity ( LFTs),
myopathy (esp. when used
with fibrates or niacin)
Tetracyclines
GI distress, discoloration of teeth and inhibition of bone growth in children, photosensitivity.
Contraindicated in pregnancy.
πεντασθενούς αντιμμωνίου
Sodium stibogluconate is exceedingly phlebotoxic. One of the practical problems is that after a few doses it can become exceedingly difficult to find a vein in which to inject the drug. The insertion of a PICC does not prevent the problem and can instead exacerbate it: the entire vein along the course of the PICC line can become inflamed and thrombose. Large doses of sodium stibogluconate are often administered as dilute solutions.
Pancreatitis is a common problem and the serum amylase or lipase should be monitored twice weekly; there is no need to stop treatment if the amylase remains less than four times the upper limit of normal; if the amylase rises above the cut-off then treatment should be interrupted until the amylase falls to less than twice the upper limit of normal, whereupon treatment can be resumed. Cardiac conduction disturbances are less common, but ECG monitoring while the medicine is injected is advisable and changes quickly reverse after the drug is stopped or the infusion rate is decreased.
The drug can be given intramuscularly but is exceedingly painful when given by this route. It can also be given intralesionally when treating cutaneous leishmaniasis (i.e., injected directly into the area of infected skin) and again, this is exceedingly painful and does not give results superior to intravenous administration.
Sodium stibogluconate can also cause a reduced appetite, metallic taste in mouth, nausea, vomiting, diarrhoea, headache, tiredness, joint pains, muscle aches, dizziness, and anaphylaxis.
Αναστολείς διαύλων ασβεστίων verapamili dialtazemi
Constipation, flushing, edema, cardiovascular effects (HF, AV block, sinus node depression
ζολενδρονικό οξύ
difosfoniko
δακτυλίτιδα
digoxin
Cholinergic—nausea, vomiting, diarrhea, blurry yellow vision (think van Gogh), arrhythmias, AV
block.
Can lead to hyperkalemia, which indicates poor prognosis.
Factors predisposing to toxicity: renal failure ( excretion), hypokalemia (permissive for digoxin
binding at K+-binding site on Na+/K+ ATPase), drugs that displace digoxin from tissue-binding
sites, and clearance (eg, verapamil, amiodarone, quinidine).
κλαριθρομυκίνη
makrolidi
ριτουξιμάμπη
increases risk of progressive multifocal leukoencephalopathy
κολχικίνη
?
tmp/smx
TMP - Megaloblastic anemia, leukopenia,
granulocytopenia. (May alleviate with
supplemental folinic acid). TMP Treats
Marrow Poorly.
SMX-Hypersensitivity reactions, hemolysis if G6PD
deficient, nephrotoxicity (tubulointerstitial
nephritis), photosensitivity, kernicterus in
infants, displace other drugs from albumin
(eg, warfarin).
vancomycin
Well tolerated in general—but NOT trouble free. Nephrotoxicity, Ototoxicity, Thrombophlebitis,
diffuse flushing—red man syndrome A (can largely prevent by pretreatment with antihistamines
and slow infusion rate).
macrolides -Azithromycin, clarithromycin, erythromycin.
MACRO: Gastrointestinal Motility issues, Arrhythmia caused by prolonged QT interval, acute
Cholestatic hepatitis, Rash, eOsinophilia. Increases serum concentration of theophylline, oral
anticoagulants. Clarithromycin and erythromycin inhibit cytochrome P-450.
