Drug SIde-Effects Flashcards
What are some side-effects of aminoglycoside antibiotics?
Ototoxicity
Nephrotoxicity
Neuromuscular blockade (skeletal muscle paralysis)
What are some common side-effects of macrolide antibiotics?
Nausea
Vomiting
Abdominal pain
Diarrhoea
What are some common side-effects of cephalosporin and penicillin antibiotics?
Nausea
Vomiting
Diarrhoea
Thrush
Rash
Abdominal pain
What are some potential side-effects of tetracycline antibiotics?
Teeth staining in children
Sun sensitivity
Stomach issues
Headache
What is a potentially severe side-effect of statins?
Rhabdomyolysis- breakdown of muscle tissue that can cause liver and kidney damage and death.
Statins cause muscle pain in 1/10 patients.
What is a potentially severe side-effect of ACE inhibitors?
Angioedema- the sudden swelling of the mouth, tongue and throat.
What is a potentially severe side-effect of biguanides (metformin)?
Lactic acidosis- build up of lactic acid in the blood that can lead to severe hypotension and hypothermia.
What are some potentially severe side-effects of fluoroquinolone antibiotics?
Severe irreversible tendon injuries, peripheral neuropathy (numbness and tingling) and ruptures or tears of the aorta.
What are some side-effects associated with diphenhydramine (Benadryl)?
Drowsiness and dry mouth
What are some examples of medications that can discolour your urine?
Senna
Sulfasalazine
Nitrofurantoin
Rifampicine
Entacapone
Levodopa-containing preparations
What are some potential side-effects of ACE inhibitors?
Hyperkalaemia
Persistent dry cough
Angioedema
Hypoglycaemia
Renal impairment
What are some potential side-effects of ARBs?
Hyperkalaemia
Angioedema
Hyponatraemia
Myalgia
Arthralgia
What are some potential side-effects of beta-blockers?
Bronchospasm
Coldness of extremities
Sleep disturbances
Exacerbation of psoriasis
Why should the abrupt withdrawal of CCBs be avoided?
Can cause exacerbation of myocardial ischaemia
What are some potential side-effects of cytotoxic drugs?
-Pregnancy and reproductive function
-Extravasation of IV drugs
-Nausea and vomiting
-Alopecia
-Tumour lysis syndrome
-Hyperuricaemia
-Bone marrow suppression
-Oral mucositis
Thromboembolism
What are corticosteroids?
Hormones inbolved in a wide array of physiological responses such as inflammation, stress, the immune response and carbohydrate/protein metabolism.
What are some side-effects of corticosteroids?
Cushing’s syndrome
Osteoporosis
Retardation of growth
Thin skin, easily bruised
Immunosuppression
Cataracts ang glaucoma
Oedema
Suppression of HPA axis
Teratogenic
Emotional disturbances
Rise in blood pressure
Obesity
Increased hair growth (hirsutism)
Diabetes mellitus
Striae
Which drugs can cause hypokalaemia?
Beta2 agonists
Laxative abuse
Insulin
Theophylline
Aminophylline
Diuretics
Fludrocortisone
Hydrocortisone
What are some potential side-effects of ACE inhibitors?
Renal Impairment
Hyperkalaemia
Dry cough
Angioedema
What are some potential side-effects of CCBs?
Gingival hyperplasia
Dizziness
Oedema
Flushing
What are some potential side-effects of thiazide-like diuretics?
Hyperuricaemia
Hyperglycaemia
Erectile dysfunction
Electrolyte changes
What are some potential side-effects of spironolactone?
Hyperkalaemia
Gynaecomastia
Changes in libido
Hepatotoxicity
What are some potential side-effects of alpha blockers? (e.g. doxazosin)
Floppy iris syndrome
Postural hypotension
Urinary disorders
What are some potential side-effects of aspirin?
Asthma
Skin reactions
Peptic ulceration
Increased bleeding time
Reye’s syndrome
Intestinal bleeding
Na retention
What are some common medicines known to cause GI bleeding and ulceration?
Antiplatelets
SSRIs
Anticoagulants
Corticosteroids
NSAIDs
Nicorandil (potassium-channel activator)
What are some rare but severe potential side-effects of macrolide antibiotics?
Cardiac arrhythmias
Abnormal liver function
What are some rare, but serious, side-effects of erythromycin?
-Arrhythmias
-Severe stomach pain, which can be a pancreas issue
-Jaundice, or pale stools with dark peak- liver or gallbladder issues
-Hallucinations
-Temporary hearing loss/ringing in ears/unsteady on feet
-Fever
Which drugs have a potential side-effect of causing hyponatraemia?
SSRIs
Carbamazepine
Thiazide-like diuretics
Loop diuretics
What is Stephen-Johnson Syndrome?
A rare but serious skin reaction that can be caused by taking certain medications
Which three medication types most commonly cause Stephen-Johnson syndrome?
Epilepsy medications (carbamazepine, lamotrigine, phenobarbital, phenytoin)
Antibiotics (sulfamethoxazole and other sulfa antibiotics)
Anti-inflammatory medications (oxicam anti-inflammatories such as meloxicam and piroxicam).
Also sulfasalazine and allopurinol
What are the symptoms of Stephens-Johnson Syndrome?
- Flu-like symptoms initially, such as a fever, sore throat, cough and joint pain.
-A rash, which is made up of circular patches that are darker in the middle and lighter around the outside. Usually starts on the upper body before spreading to the face, arms and legs. Not usually itchy.
-Blisters and sores (lips, mouth, urethra and eyes)
Which anti-epileptic is most likely to cause gingival hyperplasia (gingival overgrowth)?
Phenytoin- reported in up to 50% of patients that take the drug
How may a clopidogrel allergy manifest?
As a rash
Which drug is Idarucizumab used to reverse the effects of in overdose/toxicity?
Dabigatran
Carbamazepine can cause severe allergic reactions, affecting multiple organ systems. What are some symptoms?
Fever
Dark urine
Rash
Stomach pain
Tiredness
Yellow eyes/skin
Which drug type is linked to the side-effect of angioedema?
ACE inhibitors
Common ADR Topics in the Exam
-ACE inhibitors- first dose hypotension and dry cough
-NSAIDs causing ulceration
-Metformin causing a metallic taste in the mouth
-Taste disturbances: amiodarone, captopril, carbimazole, metronidazole and zopiclone
-Rifampicin can cause urine to go red, and discolour contact lenses
-Levodopa can make urine dark red
-Dry mouth/antimuscarinic side-effects- TCAs and antimuscarinics can cause this
-Atenolol does NOT pass through the BBB, unlike propranolol- avoids CNS side-effects such as bad dreams
Medications and Some Side-effects Worth Knowing
-Deafness and kidney failure: Gentamicin
-Depression or hepatic injury: Interferon
-Diabetes: Atypical antipsychotics
-Diarrhoea: Orlistat
-Erectile dysfunction: Many drugs, such as antidepressants
-Glaucoma: corticosteroid-based eye drops
-Lactic acidosis: Metformin
-Peripheral neuropathy: fluoroquinolone antibiotics
-Stroke/MI: sildenafil when used with nitroglycerine
-Tardive dyskinesia: long-term use of metoclopramide and many antipsychotics
-SPontaneous tendon rupture: fluoroquinolone antibiotics, even up to 6 months after treatment cessation.
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Yellow Card Scheme
-Report ALL black triangle drugs (intensely monitored)
-For established drugs and herbal remedies, report all SERIOUS ADRs in adults
-Report all serious AND minor ADRs reported in children (under 18s)
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Steroids can raise blood glucose levels.
True or False?
True
Diuretics can cause hypokalaemia.
True or False?
True
Skin necrosis is a rare but serious side-effect of which drug?
Warfarin
REMEMBER: Heparin can induce _, where you get a significant reduction in platelet count and a rash can also develop.
Thrombocytopenia
Why should metoclopramide not be used for N&V in Parkinson’s patients?
Can cause muscle spasms/worsen Parkinson symptoms
Diuretic Side-Effects
Thiazides: can cause hyponatreamia, hypokalaemia and HYPERcalcaemia
Loops: can cause hyponatraemia, hypokalaemia and hypocalcaemia
Which beta-blocker is most likely to cause cold extremeties?
Propranolol
What electrolyte can be depleted in the body by prolonged use of PPIs?
Magnesium
Which steroid is most likely to cause hypertension as a side-effect?
Hydrocortisone