CNS Drugs - Tox Flashcards
1
Q
What are the Major and Secondary side effects of Levodopa (L-DOPA) (Dopar)
A
Major: Dyskinesias, on-off phenomenon (“off” = no symptoms relief, “on” = dyskinesia), NMS (muscle+autonomic+CNS probs) on withdrawal
Secondary: Peripheral DA-like side effects (anorexia, nausea, vomiting, fatigue, hypotension, dizziness, hallucinations, cardiac arrhythmias, pleural effusions, cough, SOB, pulmonary fibrosis, edema, psychosis with chronic use)
2
Q
What are the Major and Secondary side effects of Carbidopa (Lodosyn)
A
Major: Dyskinesias, on-off phenomenon, NMS on withdrawal
Secondary: Peripheral DA-like side effects
3
Q
What are the Major and Secondary side effects of Pergolide (Permax)
A
Major: Cardiac valve regurgitation
Secondary:
4
Q
What are the Major and Secondary side effects of Bromocriptine (Parlodel)
A
Major:
Secondary: Peripheral DA-like side effects
5
Q
What are the Major and Secondary side effects of Pramipexole (Mirapex)
A
Major: Somnolence/daytime sleep attacks, compulsive behavior (nucleus accumbens, D3)
Secondary: More acute side effects compared to bromocriptine (ex. nausea/GI distress, edema, psychosis)
6
Q
What are the Major and Secondary side effects of Ropinorole (Requip)
A
Major: Somnolence/daytime sleep attacks
Secondary: More acute side effects compared to bromocriptine (ex. nausea/GI distress, edema, psychosis)
7
Q
What are the Major and Secondary side effects of Rotigotine (Neupro)
A
Major: Somnolence/daytime sleep attacks
Secondary: More acute side effects compared to bromocriptine (ex. nausea/GI distress, edema, psychosis)
8
Q
What are the Major and Secondary side effects of Apomorphine (Apokyn)
A
Major: Emesis (treat with trimethobenzamide or domiperidone), hypotension/LOC if given with 5HT antagonists
Secondary: Peripheral DA-like side effects
9
Q
What are the Major and Secondary side effects of Entacapone (Comtan)
A
Major: Increase in dyskinesias, diarrhea (less than tolcapone), urine discoloration
Secondary: Peripheral DA-like side effects
10
Q
What are the Major and Secondary side effects of Tolcapone (Tasmar)
A
Major: Fatal hepatotoxicity, increase in dyskinesias, diarrhea (worse than entacapone), urine discoloration
Secondary:
11
Q
What are the Major and Secondary side effects of Benztropine (Cogentin)
A
Major: Confusion, impaired memory, hallucinations
Secondary: Typical anticholinergic (dry mouth, etc)
12
Q
What are the Major and Secondary side effects of Biperiden (Akineton)
A
Major: Confusion, impaired memory, hallucinations
Secondary: Typical anticholinergic (dry mouth, etc)
13
Q
What are the Major and Secondary side effects of Trihexyphenidyl (Artane)
A
Major: Confusion, impaired memory, hallucinations
Secondary: Typical anticholinergic (dry mouth, etc)
14
Q
What are the Major and Secondary side effects of Procyclidine (Kemadrin)
A
Major: Confusion, impaired memory, hallucinations
Secondary: Typical anticholinergic (dry mouth, etc)
15
Q
What are the Major and Secondary side effects of Ethopropazine (Parsidol)
A
Major: Confusion, impaired memory, hallucinations
Secondary: Typical anticholinergic (dry mouth, etc)
16
Q
What are the Major and Secondary side effects of Amantadine (Symmetrel)
A
Major: NMS upon withdrawal
Secondary: Peripheral DA-like side effects
17
Q
What are the Major and Secondary side effects of Deep brain stimulation
A
Major: Fatal intracerebral hemorrhage, cognitive impairment
Secondary: —
18
Q
What are the Major and Secondary side effects of Tetrabenazine (Xenazine)
A
Major: NMS, depression, suicidality
Secondary: —
19
Q
What are the Major and Secondary side effects of Riluzole (Rilutek)
A
Major: Rare hepatotoxicity (check serum transaminase levels)
Secondary: Nausea, diarrhea
20
Q
What are the Major and Secondary side effects of Chlorpromazine (Thorazine)
A
Major: NMS, EPS (parkinsonism, akathisia/involuntary movements, dystonia/muscular spasms), tardive dyskinesias, hyperprolactinemia, sexual dysfunction, seizure risk
Secondary: Sedation, postural hypotension, weight gain, anticholinergic effects
21
Q
What are the Major and Secondary side effects of Haloperidol (Haldol)
A
Major: NMS, EPS (more than chlorpromazine), tardive dyskinesias, hyperprolactinemia, sexual dysfunction
Secondary: Sedation, hypotension, anticholinergic effects (less than chlorpromazine)
22
Q
What are the Major and Secondary side effects of Fluphenazine (Prolixin)
A
Major: NMS, EPS (more than chlorpromazine), tardive dyskinesias, hyperprolactinemia, sexual dysfunction
Secondary: Sedation, hypotension, anticholinergic effects (less than chlorpromazine)
23
Q
What are the Major and Secondary side effects of Perphenazine (Trilafon)
A
Major: NMS, EPS (less than chlorpromazine), tardive dyskinesias, hyperprolactinemia, sexual dysfunction
Secondary: Sedation (less than chlorpromazine)
24
Q
What are the Major and Secondary side effects of Loxapine (Loxitane)
A
Major: NMS, EPS (less than chlorpromazine), tardive dyskinesias, hyperprolactinemia, sexual dysfunction
Secondary: Sedation (less than chlorpromazine)
25
What are the Major and Secondary side effects of Trifluoperazine (Stelazine)
Major: NMS, EPS (less than chlorpromazine), tardive dyskinesias, hyperprolactinemia, sexual dysfunction
Secondary: Sedation (less than chlorpromazine)
26
What are the Major and Secondary side effects of Thioridazine (Mellaril)
Major: NMS, EPS (less than chlorpromazine), tardive dyskinesias, hyperprolactinemia, sexual dysfunction
Secondary: Sedation (less than chlorpromazine)
27
What are the Major and Secondary side effects of Thiothixene (Navane)
Major: NMS, EPS (less than chlorpromazine), tardive dyskinesias, hyperprolactinemia, sexual dysfunction
Secondary: Sedation (less than chlorpromazine)
28
What are the Major and Secondary side effects of Clozapine (Clozaril)
Major: Agranulocytosis, granulocytopenia, seizure risk, myocarditis
Secondary: Metabolic complications (weight gain, diabetes, hyperlipidemia), constipation, akathesia (rare, at high doses)
29
What are the Major and Secondary side effects of Olanzapine (Zyprexa)
Major: EPS, increased serum hepatic transaminases
Secondary: Metabolic complications, somnolence, dizziness, postural hypotension, constipation, hyperprolactinemia, akathesia
30
What are the Major and Secondary side effects of Quetiapine (Seroquel)
Major: ---
Secondary: Metabolic complications, somnolence, dizziness, postural hypotension, constipation
31
What are the Major and Secondary side effects of Risperidone (Risperdal)
Major: EPS at greater doses (highest EPS risk of 2GAs)
Secondary: Fewer metabolic complications, insomnia, dizziness, postural hypotension, constipation, hyperprolactinemia
32
What are the Major and Secondary side effects of Paliperidone (Invega)
Major: EPS at greater doses, QT prolongation
Secondary: Fewer metabolic complications, insomnia, dizziness, postural hypotension, constipation, hyperprolactinemia
33
What are the Major and Secondary side effects of Ziprazidone (Geodon)
Major: EPS at greater doses, QT prolongation
Secondary: Fewer metabolic complications, somnolence, dizziness, postural hypotension, constipation, hyperprolactinemia
34
What are the Major and Secondary side effects of Asenapine
Major: Somnolence
Secondary: similar to other atypicals
35
What are the Major and Secondary side effects of Tranylcypromine (Parnate)
Major: Hypertensive crisis (with tyramine-rich foods); serotonin syndrome (MAOI + SSRI); agitation (rare), delerium --> seizures
Secondary: Anticholinergic, orthostatic hypotension, sexual dysfunction, weight gain, sedation
36
What are the Major and Secondary side effects of Phenelzine (Nardil)
Major: Hypertensive crisis (with tyramine-rich foods); serotonin syndrome (MAOI + SSRI); agitation (rare), delerium --> seizures
Secondary: Anticholinergic, orthostatic hypotension, sexual dysfunction, weight gain, sedation
37
What are the Major and Secondary side effects of Desipramine (Norpramin)
Major: Sympathomimetic (cardiac arrhythmias and conduction defects, especially at OD)
Secondary: Antimuscarinic, orthostatic hypotension, sedation (additive with alcohol), seizures
38
What are the Major and Secondary side effects of Imipramine (Tofranil)
Major: Sympathomimetic (cardiac arrhythmias and conduction defects, especially at OD)
Secondary: Antimuscarinic, orthostatic hypotension, sedation (additive with alcohol), seizures
39
What are the Major and Secondary side effects of Amitriptyline (Elavil)
Major: Sympathomimetic (cardiac arrhythmias and conduction defects, especially at OD)
Secondary: Antimuscarinic, orthostatic hypotension, sedation (additive with alcohol), seizures
40
What are the Major and Secondary side effects of Nortriptyline (Pamelor)
Major: Sympathomimetic (cardiac arrhythmias and conduction defects, especially at OD)
Secondary: Antimuscarinic, orthostatic hypotension, sedation (additive with alcohol), seizures
41
What are the Major and Secondary side effects of Fluoxetine (Prozac)
Major: Serotonin syndrome (with MAOIs)
Secondary: Fewer than tricyclics; mostly nausea, decreased sexual function
42
What are the Major and Secondary side effects of Paroxetine (Paxil)
Major: Serotonin syndrome (with MAOIs)
Secondary: Fewer than tricyclics; mostly nausea, decreased sexual function
43
What are the Major and Secondary side effects of Sertraline (Zoloft)
Major: Serotonin syndrome (with MAOIs)
Secondary: Fewer than tricyclics; mostly nausea, decreased sexual function
44
What are the Major and Secondary side effects of Escitalopram (Lexapro)
Major: Serotonin syndrome (with MAOIs)
Secondary: Fewer than tricyclics; mostly nausea, decreased sexual function
45
What are the Major and Secondary side effects of Citalopram (Celexa)
Major: Serotonin syndrome (with MAOIs)
Secondary: Fewer than tricyclics; mostly nausea, decreased sexual function
46
What are the Major and Secondary side effects of Bupropion (Wellbutrin)
Major: Lowers seizure threshold
Secondary: ---
47
What are the Major and Secondary side effects of Lithium
Major: If elevated levels: neurotoxicity, cardiac toxicity, renal dysfunction
Secondary: Drowsiness, weight gain, tremor, polydipsia, polyuria
48
What are the Major and Secondary side effects of alcohol / ethanol
Major: Liver toxicity, chronic gastritis, diuresis, decreased testosterone synthesis, decreased uterine motility and milk ejection, teratogenicity
Secondary: Cardioprotection; acute drinking slows P450 metabolism of other drugs, chronic drinking induces P450 for faster metabolism
49
What are the Major and Secondary side effects of methyl alochol
Major: acidosis, blindness
Secondary:
50
What are the Major and Secondary side effects of ethylene glycol
Major: acidosis, kidney damage, CNS excitement then depression
Secondary:
51
What are the Major and Secondary side effects of isopropyl alcohol
Major: acidosis, gastritis, CNS symptoms
Secondary:
52
What are the Major and Secondary side effects of Disulfiram (Antabuse)
Major:
Secondary: Pulsating headache, nausea, vomiting, chest pain, hyperthermia, weakness, dizziness
53
What are the Major and Secondary side effects of Cocaine
Major: Sympathetic effects; paranoia, aggression
Secondary: ---
54
What are the Major and Secondary side effects of Amphetamines (Benzadrine)
Major: Vasospasm leading to possible stroke or MI, arrhythmia, weight loss (anorexic effect)
Secondary: Tremor, anxiety, irritability, confusion, possibly paranoid state
55
What are the Major and Secondary side effects of Methyxanthines
Major:
Secondary: tremors, anxiety, irritability, restlessness, insomnia
56
What are the Major and Secondary side effects of LSD
Major: Bad trips (anxiety attack, panic attack), flashbacks, birth defects, chronic psychoses, chromosome damage, teratogenicity
Secondary: No recorded human overdose deaths
57
What are the Major and Secondary side effects of Marijuana (THC)
Major: Vasodilation --> tachycardia, dilation of conjunctival vessels, bronchodilation, decreased intraocular pressure, hunger
Secondary: May impair reproductive function in adolescents; heavy use may impair development of very young users; possible respiratory damage due to tar
58
What are the Major and Secondary side effects of Anandamide
Major: ---
Secondary: CB1 receptor antagonists reduce food intake
59
What are the Major and Secondary side effects of Phencyclidine (PCP)
Major: Violent behavior, coma, seizures, arrest; inexplicable psychoses
Secondary: Dissociation, confusion, ataxia, marked nystagmus
60
What are the Major and Secondary side effects of MDMA (Ecstasy)
Major: hyperthermia, dehydration, hallucinations, hypertensive crisis with intracerebral hemorrhage, paranoia, cardiac arrythmias, death
Secondary:
61
What are the Major and Secondary side effects of Morphine
Major: Miosis, constipation, respiratory depression
Secondary: Dry mouth, nausea/vomiting, sedation, sweating; dreams, dysphoria, delerium, myoclonus, seizures, pruritis, urticaria, urinary incontinence
62
What are the Major and Secondary side effects of Codeine
Major: Miosis, constipation, respiratory depression
Secondary: Dry mouth, nausea/vomiting, sedation, sweating; dreams, dysphoria, delerium, myoclonus, seizures, pruritis, urticaria, urinary incontinence
63
What are the Major and Secondary side effects of Tramadol (Ultram)
Major: Miosis, constipation, respiratory depression
Secondary: Dry mouth, nausea/vomiting, sedation, sweating; dreams, dysphoria, delerium, myoclonus, seizures, pruritis, urticaria, urinary incontinence
64
What are the Major and Secondary side effects of Fentanyl (Duragesic)
Major: Miosis, constipation, respiratory depression
Secondary: Dry mouth, nausea/vomiting, sedation, sweating; dreams, dysphoria, delerium, myoclonus, seizures, pruritis, urticaria, urinary incontinence
65
What are the Major and Secondary side effects of Methadone (Methadose)
Major: Miosis, constipation, respiratory depression
Secondary: Dry mouth, nausea/vomiting, sedation, sweating; dreams, dysphoria, delerium, myoclonus, seizures, pruritis, urticaria, urinary incontinence
66
What are the Major and Secondary side effects of Oxycodone
Major: Miosis, constipation, respiratory depression
Secondary: Dry mouth, nausea/vomiting, sedation, sweating; dreams, dysphoria, delerium, myoclonus, seizures, pruritis, urticaria, urinary incontinence
67
What are the Major and Secondary side effects of Meperidine (Demerol)
Major: Miosis, constipation, respiratory depression; mental status changes and seizures (normeperidine)
Secondary: Dry mouth, nausea/vomiting, sedation, sweating; dreams, dysphoria, delerium, myoclonus, seizures, pruritis, urticaria, urinary incontinence
68
What are the Major and Secondary side effects of Propoxyphene (Darvon)
Major: Miosis, constipation, respiratory depression; CNS toxicity (norpropoxyphene)
Secondary: Dry mouth, nausea/vomiting, sedation, sweating; dreams, dysphoria, delerium, myoclonus, seizures, pruritis, urticaria, urinary incontinence
69
What are the Major and Secondary side effects of Loperamide (Imodium)
Major: Miosis, constipation, respiratory depression
Secondary: Dry mouth, nausea/vomiting, sedation, sweating; dreams, dysphoria, delerium, myoclonus, seizures, pruritis, urticaria, urinary incontinence
70
What are the Major and Secondary side effects of Diphenoxylate (Lomotil)
Major: Miosis, constipation, respiratory depression
Secondary: Dry mouth, nausea/vomiting, sedation, sweating; dreams, dysphoria, delerium, myoclonus, seizures, pruritis, urticaria, urinary incontinence
71
What are the Major and Secondary side effects of Naloxone (Narcan)
Major: Can precipitate withdrawal (flu-like symptoms of nausea, vomiting, diarrhea; piloerection, yawning, irritability)
Secondary: ---
72
What are the Major and Secondary side effects of Naltrexone (Revia)
Major: May produce a prolonged withdrawal state (nausea, vomiting, piloerection, yawning)
Secondary: ---
73
What are the Major and Secondary side effects of Diazepam (Valium)
Major: ---
Secondary: Daytime sedation and drowsiness, anterograde amnesia, synergistic depression of CNS with other drugs, pyschologic and physiologic dependence (chronic use)
74
What are the Major and Secondary side effects of Chlordiazepoxide (Librium)
Major: ---
Secondary: Daytime sedation and drowsiness, anterograde amnesia, synergistic depression of CNS with other drugs, pyschologic and physiologic dependence (chronic use)
75
What are the Major and Secondary side effects of Lorazepam (Ativan)
Major: ---
Secondary: Daytime sedation and drowsiness, anterograde amnesia, synergistic depression of CNS with other drugs, pyschologic and physiologic dependence (chronic use)
76
What are the Major and Secondary side effects of Flurazepam (Dalmane)
Major: ---
Secondary: Daytime sedation and drowsiness, anterograde amnesia, synergistic depression of CNS with other drugs, pyschologic and physiologic dependence (chronic use)
77
What are the Major and Secondary side effects of Alprazolam (Xanax)
Major: ---
Secondary: Daytime sedation and drowsiness, anterograde amnesia, synergistic depression of CNS with other drugs, pyschologic and physiologic dependence (chronic use)
78
What are the Major and Secondary side effects of Triazolam (Halcion)
Major: ---
Secondary: Daytime sedation and drowsiness, anterograde amnesia, synergistic depression of CNS with other drugs, pyschologic and physiologic dependence (chronic use)
79
What are the Major and Secondary side effects of Midazolam (Versed)
Major: ---
Secondary: Daytime sedation and drowsiness, anterograde amnesia, synergistic depression of CNS with other drugs, pyschologic and physiologic dependence (chronic use)
80
What are the Major and Secondary side effects of Zolpidem (Ambien)
Major: Sleep-walking; next morning impairment
Secondary: ---
81
What are the Major and Secondary side effects of Flumazenil (Romazicon)
Major: Withdrawal (may be life-threatening); seizures in mixed overdoses
Secondary: ---
82
What are the Major and Secondary side effects of Thiopental (Pentothal)
Major: P450 induction; overdose can cause respiratory depression, coma, and death
Secondary: Daytime sedation and drowsiness, dose-dependent depression of CNS, pyschologic and physiologic dependence (chronic use)
83
What are the Major and Secondary side effects of Phenobarbitol
Major: P450 induction; overdose can cause respiratory depression, coma, and death
Secondary: Daytime sedation and drowsiness, dose-dependent depression of CNS, pyschologic and physiologic dependence (chronic use)
84
What are the Major and Secondary side effects of Nitrous Oxide
Major: PONV, inactivates vitamin B (leading to abnormal embryonic development, abortion); accumulates in closed, air-containing spaces (bowel, middle ear, pneumothoraces, air emboli) because N2O insoluble in blood
Secondary: ---
85
What are the Major and Secondary side effects of Isoflurane (Forane)
Major: Pungent
Secondary: Dose dependent CNS depression; decrease in BP and respiratory function; increase in cerebral blood flow, ICP, and HR; skeletal muscle relaxation; malignant hyperthermia
86
What are the Major and Secondary side effects of Desflurane (Suprane)
Major: Most pungent (airway irritation symptoms)
Secondary: Dose dependent CNS depression; decrease in BP and respiratory function; increase in cerebral blood flow, ICP, and HR; skeletal muscle relaxation; malignant hyperthermia
87
What are the Major and Secondary side effects of Sevoflurane (Ultane)
Major: Can form CO if not combined with CO2 correctly
Secondary: Dose dependent CNS depression; decrease in BP and respiratory function; increase in cerebral blood flow, ICP, and HR; skeletal muscle relaxation; malignant hyperthermia
88
What are the Major and Secondary side effects of Propofol (Diprivan)
Major: Propofol infusion syndrome: being given for several days leads to metabolic acidosis, rhabdomyolysis, renal failure, lowering of BP, bradycardia, and death (likely due to fatty acid oxidation)
Secondary: Painful injection site; supports bacterial growth
89
What are the Major and Secondary side effects of Etomidate (Amidate)
Major: Pain on administration (due to solvent, propylene glycol); involuntary myoclonic movements due to subcortical disinhibition (not a seizure); PONV; single dose inhibits cortisol synthesis
Secondary: ---
90
What are the Major and Secondary side effects of Ketamine (Ketalar)
Major: Stimulates sympathetic nervous system outflow; increases cerebral blood flow, ICP; emergence delerium; nystagmus, lacrimation, salivation, and dissociative anesthesia
Secondary: ---
91
What are the Major and Secondary side effects of Dexmedetomidine (Precedex)
Major: Limited respiratory depression (wide safety margin)
Secondary: ---
92
What are the Major and Secondary side effects of Succinylcholine (Anectine)
Major: Malignant hyperthermia; cardiac dysrhythmias, hyperkalemia, increased intraocular pressure, increased intracranial pressure
Secondary: Increased intragastric pressure, myalgias, masseter spasm
93
What are the Major and Secondary side effects of Pancuronium (Pavulon)
Major: Increase in HR
Secondary: ---
94
What are the Major and Secondary side effects of Vecuronium (Norcuron)
Major: No cardiovascular effects
Secondary: ---
95
What are the Major and Secondary side effects of Rocuronium (Zemuron)
Major: No cardiovascular effects
Secondary: ---
96
What are the Major and Secondary side effects of Atracurium (Tracrium)
Major: Histamine release (especially if given as rapid IV bolus), with resultant hypotension and tachycardia
Secondary: ---
97
What are the Major and Secondary side effects of Cis-atracurium (Nimbex)
Major: Unlike atracurium, no histamine release or downstream effects
Secondary: ---
98
What are the Major and Secondary side effects of Sugammadex (Bridion)
Major: Decrease in blood presure, nausea and vomiting, dry mouth
Secondary: ---
99
What are the Major and Secondary side effects of Glycopyrrolate (Robinul)
Major: DUMBELLS
Secondary: ---
100
What are the Major and Secondary side effects of Ester anesthetic
Major: Local: transient neurologic symptoms (basically, really bad pain), neuronal injury. Systemic (more common with long-acting local anesthetics): CNS (early excitation: decreased inhibition, sensory disturbances, restlessness, tremor, tinnitus; later depression: lethargy, hypotension, seizures), cardiovascular (reduced conductivity, excitability, and contractility; arrhythmias (QRS widening an early sign); indirect vasodilation and bradycardia.
Secondary: Methemoglobinemia (primarily with benzocaine and prilocaine)
101
What are the Major and Secondary side effects of Amide anesthetic
Major: Local: transient neurologic symptoms (basically, really bad pain); neuronal injury Systemic (more common with long-acting local anesthetics): CNS (early excitation: decreased inhibition, sensory disturbances, restlessness, tremor, tinnitus; later depression: lethargy, hypotension, seizures); cardiovascular (reduced conductivity, excitability, and contractility; arrhythmias (QRS widening an early sign); indirect vasodilation and bradycardia
Secondary: Methemoglobinemia (primarily with benzocaine and prilocaine)
102
What are the Major and Secondary side effects of Avonex
Major: Increased LFT (monitor every 6 mo.), hypothyroidism; least NAB formed
Secondary: Flu-like, injection site irritation, anemia (least side effects of the immunomodulants)
103
What are the Major and Secondary side effects of Rebif
Major: Leukopenia, menstrual irregularities, depression, increase LFT and hypothyroidism (monitor every 3 mo.), more NAB formed than avonex
Secondary: Flu-like, injection site reaction, anemia; neutropenia; thrombocytopenia
104
What are the Major and Secondary side effects of Betaseron / Betaferon
Major: Leukopenia, menstrual irregularities, depression, increase LFT and hypothyroidism (monitor every 3 mo.); more NAB formed than avonex and rebif
Secondary: Flu-like, inject site reaction, anemia
105
What are the Major and Secondary side effects of Extavia
Major: Leukopenia, menstrual irregularities, depression, increase LFT and hypothyroidism (monitor every 3 mo.)
Secondary: Flu-like, inject site reaction, anemia
106
What are the Major and Secondary side effects of Glatiramer acetate (Copaxone)
Major: Anxiety attack-like reaction
Secondary: injection site reaction
107
What are the Major and Secondary side effects of Natalizumab (Tysabri)
Major: PML (JC virus); acute urticaria, systemic hypersensitivity infusion reaction
Secondary: Headache, dizziness, fatigue, arthralgia, rigors
108
What are the Major and Secondary side effects of Fingolimod (Gilenya)
Major: Bradycardia and heartblock (EKG for first 6 hours); macular edema (need opthalmology exam before and after 3 months)
Secondary: Reduced FEV1, increased LFTs, lymphopenia, leukopenia, asthenia (weakness, lack of energy), back pain, blurred vision, headache, dizziness, infections
109
What are the Major and Secondary side effects of Teriflunomide (Aubagio)
Major: Hepatotoxicity; teratogenicity
Secondary:
110
What are the Major and Secondary side effects of Dimethyl fumarate / BG12 (Tecfidera)
Major: N & V; diarrhea; stomach pain; flushing
Secondary: Itching, redness, rash
111
What are the Major and Secondary side effects of Mitoxantrone (Novantrone)
Major: Dose-dependent cardiac toxicity (decreased LVEF, irreversible CHF); induction of acute leukemia
Secondary: Nausea and vomiting, alopecia, menstrual irregularities, increased susceptibility to infection
112
What are the Major and Secondary side effects of Azathioprine (Imuran)
Major: Systemic toxicity: monitor blood for changes
Secondary: ---
113
What are the Major and Secondary side effects of Methotrexate (Trexall)
Major: Systemic toxicity: monitor blood for changes
Secondary: ---
114
What are the Major and Secondary side effects of Cyclophosphamide (Cytoxan)
Major: Systemic toxicity: monitor blood for changes
Secondary: ---
115
What are the Major and Secondary side effects of Mycophenolate mofetil (CellCept)
Major: Systemic toxicity: monitor blood for changes
Secondary: ---
116
What are the Major and Secondary side effects of Methylprednisolone (MTP)
Major: ---
Secondary: Short-term: insomnia, mood changes, fluid retention, epigastric pain, hypertension; long-term: osteoporosis, cushingoid, secondary malignancies
117
What are the Major and Secondary side effects of Phenytoin (Dilantin)
Major: Rash, gingival hyperplasia, hirsutism, lupus-like reaction; can cause contraceptive failure
Secondary: Mild myelosuppression, increased LFT; long-term: cerebellar degeneration, peripheral neuropathy, osteoporosis
118
What are the Major and Secondary side effects of Carbamazepine (Tegretol)
Major: Rash (rarely, Stevens-Johnson), mild myelosuppression, mild increase in LFTs; can cause contraceptive failure
Secondary: ---
119
What are the Major and Secondary side effects of Oxcarbazepine (Trileptal)
Major: Rash (rarely, Stevens-Johnson), mild myelosuppression, mild increase in LFTs; can cause contraceptive failure
Secondary: ---
120
What are the Major and Secondary side effects of Lamotrigine (Lamictal)
Major: Rash, (rarely, Stevens-Johnson): slow initial titration important; may lead to contraceptive failure
Secondary: ---
121
What are the Major and Secondary side effects of Valproate (Depakote)
Major: Weight gain, hair turnover, hyperammonemia (which can be mitigated with oral carnitine), teratogenicity, blood dyscrasias
Secondary: Pancreatitus
122
What are the Major and Secondary side effects of Benzodiazapines
Major: Sedation
Secondary: ---
123
What are the Major and Secondary side effects of Gabapentin (Neurontin)
Major: Sedation only
Secondary: ---
124
What are the Major and Secondary side effects of Topiramate (Topamax)
Major: Mild metabolic acidosis, kidney stones (due to some carbonic anhydrase activity); modest weight loss; rare acute glaucoma; sedation
Secondary: Word-finding problems, cognitive problems
125
What are the Major and Secondary side effects of Felbamate (Felbatol)
Major: Uncommon but potentially fatal. Aplastic anemia, acute hepatic failure. Requires monitoring.
Secondary: ---
126
What are the Major and Secondary side effects of Levetiracetam (Keppra)
Major: Well tolerated; sedation, mostly; rarely, irritability, aphasia, thrombocytopenia
Secondary: ---
127
What are the Major and Secondary side effects of Ethosuximide (Zarontin)
Major: Nausea (transient), sedation, irritability
Secondary: ---
128
What are the Major and Secondary side effects of Barbiturates
Major: Drowsiness, dizziness
Secondary: ---
129
What are the Major and Secondary side effects of Ergotamines
Major: Nausea, dizziness, paresthesia, chest pain, abdominal cramps
Secondary: Contraindicated in women planning pregnancy, uncontrolled HTN, sepsis, renal or hepatic failure, vascular disease
130
What are the Major and Secondary side effects of DHE / dihydroergotamines (Migranal)
Major: Nausea (less than ergots); dizziness, paresthesia, chest pain, abdominal cramps
Secondary: Contraindicated in women planning pregnancy, uncontrolled HTN, sepsis, renal or hepatic failure, vascular disease; injectable
131
What are the Major and Secondary side effects of Triptans, esp. Sumatriptan (Imitrex)
Major: Flushing, tingling, dizziness, chest discomfort (noncardiac)
Secondary: Contraindicated in vascular disease (including Prinzmetal), uncontrolled HTN, complicated migraine
132
What are the Major and Secondary side effects of Onabotulinum toxin (Botox)
Major: ---
Secondary: Injection site pain, headache, neck weakness, ptosis
133
What are the Major and Secondary side effects of TCA
Major: Dry mouth, constipation, weight gain, cardiac toxicity, orthostatic hypotension
Secondary: ---
134
What are the Major and Secondary side effects of SSRIs
Major: Weight gain, sexual dysfunction, headache
Secondary: ---
135
What are the Major and Secondary side effects of Beta-blockers
Major: Drowsiness, depression, decreased libido, hypotension, memory disturbance
Secondary: ---
136
What are the Major and Secondary side effects of Calcium Channel Blockers
Major: Constipation, dizziness
Secondary: ---
137
What are the Major and Secondary side effects of Topiramate
Major: Mild metabolic acidosis, kidney stones (due to some carbonic anhydrase activity); modest weight loss; rare acute glaucoma; sedation
Secondary: Word-finding problems, cognitive problems, tingling (see above)
138
What are the Major and Secondary side effects of Valproate
Major: Weight gain, hair turnover, hyperammonemia (which can be mitigated with oral carnitine), teratogenicity, blood dyscrasias
Secondary: Pancreatitus
139
What are the Major and Secondary side effects of Gabapentin
Major: Sedation only
Secondary: ---
140
What are the Major and Secondary side effects of Lithium
Major: If elevated levels: neurotoxicity, cardiac toxicity, renal dysfunction
Secondary: Drowsiness, weight gain, tremor, polydipsia, polyuria
141
What are the Major and Secondary side effects of Donepezil (Aricept)
Major: Bradycardia, urinary incontinence, vivid dreams, syncope, fatigue, muscle cramps
Secondary: Nausea, vomiting, diarrhea, sleep disturbance
142
What are the Major and Secondary side effects of Galantamine (Razadyne)
Major: Bradycardia, depression, fatigue, somnolence
Secondary: Nausea, vomiting, diarrhea, dizziness, anorexia, weight loss, sleep disturbance
143
What are the Major and Secondary side effects of Rivastigmine (Exelon)
Major: Bradycardia, syncope
Secondary: Nausea, vomiting, diarrhea, sleep disturbance (less GI effects with patch)
144
What are the Major and Secondary side effects of Tacrine (Cognex)
Major: Hepatotoxicity
Secondary: Nausea, vomiting, diarrhea, abdominal cramping
145
What are the Major and Secondary side effects of Memantine (Namenda)
Major: Less GI, nausea, and vomiting problems
Secondary: Dizziness, confusion, headache, constipation
