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PSA > Drug Side Effects > Flashcards

Drug Side Effects Flashcards

1
Q

Red man syndrome

A

Rate related transfusion reaction with vancomycin
going red when you give the vanc or teic TOO FAST- it should be given as an infusion NOT bolus.

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2
Q

Warfarin is increased by waht drugs

A

Most antibiotics that kill gut microbiome

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3
Q

Methotrexate toxicity is induced by

A

Most antibiotics

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4
Q

Alcohol disulfiram reaction

A

metronidazole. avoid even for 48hr post last dose

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5
Q

Reduced efficacy of these antibiotics when drinking alcohol

A

doxycycline and erythromycin

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6
Q

ototoxicity and nephrotoxicity

A

gentimicin (hardly ever used so you probably wont see this except for intraabdominal sepsis AGM), vancomycin (more commonly used- C diff infections and MRSA)

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7
Q

Thrombocytopenia and neutropenia

A

Vancomycin

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8
Q

ondansetron side effect and the reason it is not used in palliative care?

A

Constipation!

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9
Q

tamoxifen side effects

A

endometrial carcinoma and dvt and hot flushes

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10
Q

Budesonide doesnt cause adrenal suppression as it only works topically in the gut. true or false?

A

true

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11
Q

adrenal suppression can be reduced by doubling the dose but then taking alternate day dosing

A

true

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12
Q

adrenal suppression is reduced most by taking it AM at normal time when adrenaline is produced

A

true

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13
Q

antiplatelets can cause gastric ulcers

A

yes so prescribe PPI

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14
Q

Which of the antiepileptics cause SIADH?

A

Carbamezapine

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15
Q

Which antidepressants cause SIADH?

A

amytriptylline and SSRI

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16
Q

strontium side effects

A

Strontium ranelate
‘dual action bone agent’ - increases deposition of new bone by osteoblasts (promotes differentiation of pre-osteoblast to osteoblast) and reduces the resorption of bone by inhibiting osteoclasts
concerns regarding the safety profile of strontium have been raised recently. It should only be prescribed by a specialist in secondary care
due to these concerns the European Medicines Agency in 2014 said it should only be used by people for whom there are no other treatments for osteoporosis
increased risk of cardiovascular events: any history of cardiovascular disease or significant risk of cardiovascular disease is a contraindication
increased risk of thromboembolic events: a Drug Safety Update in 2012 recommended it is not used in patients with a history of venous thromboembolism
may cause serious skin reactions such as Stevens Johnson syndrome

17
Q

raloxifene side effects?

A

firstly its a selective oestrogen receptor modulator (SERM)
has been shown to prevent bone loss and to reduce the risk of vertebral fractures but has NOT shown to reduce the risk of non-vertebral fractures
HAS been shown to increase bone density in the SPINE and proximal femur
THEN SIDE EFFECT WISE
1. may worsen menopausal symptoms
2. increased risk of thromboembolic events
3. may decrease the risk of breast cancer

18
Q

side effects of LMWH/UFH?

A

HYPERKALAEMIA
- Causes inhibition of aldosterone secretion

OSTEOPOROSIS

HIT - UFH (Days 5-10 or day 1 if exposed to it in the last month: 4Ts risk tool
30% reduction of platelet count or > 50% from the patient’s baseline platelet count, with thrombosis, or skin allergy.

19
Q

Clindamyicin biggest side effect ?

A

it has the highest risk of C diff so only prescribed in those with SEVERE penicillin allergy as an alternative

20
Q

quinolones biggest side effectS (6)?

A

MHRA warning-
1. ^ risk of aortic aneurysms,
2. aortic dissection,
3. aortic regurg,
4. suicide and
5. seizure
6. tendinopathy
HUGE WARNING USING THIS EVER

21
Q

SNRI- SSRI/SNRI side effects?

A

SNRI- SSRI/SNRI antidepressant medicines: small increased risk of postpartum haemorrhage when used in the month before delivery (January 2021).

22
Q

why is fidaxocin 2nd line for C diff?

A

Fidaxomicin is EXPENSIVE- £2000 per course. hence why it is 2nd line to vancomycin

23
Q

biggest side effect of beta blockers?

A

impotenence

24
Q

Side effect of ACE I?

A

Angioedema esp. in black patients

25
Q

Amlodipine contraindications

A

unstable angina (reflex tahcycarida)
Cardiogenic shock and
significant aortic stenosis

26
Q

why do NSAIDS increase risk of CVD, stroke and fluid retention?

A

nsaids
- why diclofenic is bad for heart failure and all NSAIDS in general is because of their action on COX2 - usually COX2 increases the GFR - increasing water and sodium loss. But when you inhibit this more renin is released and more water and sodium are reasborbed. But Diclofenic is the strongest for this, and also therefore has more vasoconstrictive effects hence why its association with stroke and thrombosis (as the lumen narrows are atheromas are more likely to break off)
- Naproxen is generally considered safer than diclofenac becauseit has a lower risk of cardiovascular events and gastrointestinal (GI) issues as it has less effect on COX2.

27
Q

Does vancomycin cause renal impairment ? what are its warnings/side effects ?

A

Vancomycin is associated with a higher incidence of nephrotoxicity than teicoplanin.

but not as much as gent- hence why you can give before levels come back

28
Q

donepezil side effects

A

bradycardia
potentially inappropriate in patients with a known history of persistent bradycardia (heart rate less than 60 beats per minute), heart block, recurrent unexplained syncope, or concurrent treatment with drugs that reduce heart rate (risk of cardiac conduction failure, syncope, and injury).

29
Q

beta blocker. if someones heart rate is 54 what do you do?

A
  1. anything under 60 u want to bring up (as this is marked bradycardia)
  2. so you need to reduce the dose.
  3. But caution - you do NOT do this quickly in any patient with heart disorders because sudden cessation of a beta-blocker can cause a rebound worsening of myocardial ischaemia and therefore gradual reduction of dose is preferable when beta-blockers are to be stopped.
30
Q

which drugs cause constipation out of the following:

Amlodipine
Bisoprolol
Amiodarone
Lithium

A

All except lithium

31
Q

Which of the following drugs cause sun sensitivity?

amiodarone
azathiopurine
lithium
doxycycline
hydroxychloroquine
ciprofloxacin
antifungals

A

Amiodarone
doxycycline
ciprofloxacin

32
Q

Medications that cause postural hypotension

A

Nitrates
Diuretics
Anticholinergic medications
Antidepressants
Beta-blockers
L-Dopa
Angiotensin-converting enzyme inhibitors - (ACE) inhibitors

33
Q

A lady in AMAU in Prince Phillip presents with N/V, blurred vision, tachycardia, palpitations and dehydration. She was taking digoxin, prednisolone for addisons and black seed oil. She had irritated eyes. What else do you want to know and what are your top 3 differentials?

A
  1. reaction to black seed oil, contact dermatitis allergic reaction around the eyes too.
  2. Addisonian crisis secondary to suboptimal prednisolone levels secondary to black seed oil interaction
  3. digoxin toxicity secondary to black seed oil interaction
  4. Addisonian crisis- low BP (dizziness, collapse, weakness, headache, blurry vision, feeling faint), electrolyte imbalance (low Na, high K- less urine output, and confusion, Irritability, fatigue), low glucose (similar symptoms to the above), characteristically there is a pain in the abdomen, lower back and legs! (large muscle groups feel the low BP and electrolyte abnormalities the most), hypercalcaemia (irritability, abdominal pains, psychosis, constipation- can go into ileus!)
  5. digoxin toxicity signs- 1. brady, 2. N/V, 3. Diarrhoea and late stage changes are 1. vision changes and 2. tachyarrhythmias. The adverse pharmacodynamic effects of digoxin are potentiated in the presence of hypokalaemia. A suspicion of digoxin toxicity can be confirmed by measuring the plasma digoxin concentration at least 6 hours after a dose, which should be between 0.8 and 2 micrograms/L.
    SO IF THEY ARE POTENTIATED BY HYPOKALAEMIA THEY ARE LESS LIKELY IN ADDISONIAN CRISIS TO CO-OCCUR.
34
Q

Peripheral neuropathy, lymphadenopathy, and bleeding gums

A

Phenytoin is an antiepileptic drug that can cause side effects such as peripheral neuropathy, characterized by numbness and reduced sensation in a glove-and-stocking distribution. Additionally, phenytoin can cause gingival hyperplasia, which may lead to bleeding gums. Lymphadenopathy is another potential side effect of phenytoin.

35
Q

blurred vision, bumping into things and dizziness

A

Carbamazepine can cause side effects such as dizziness, ataxia, and diplopia.

36
Q

other than being teratogenic, topiramate can also cause…

A

Topiramate can cause side effects like weight loss, cognitive impairment, and kidney stones.

37
Q

tremors, and hair loss and diarrhoea/constipation.

A

Sodium valproate can cause gastrointestinal disturbances, tremors, and hair loss.

38
Q

Stevens-Johnson syndrome, headache and dizziness.

A

Lamotrigine

39
Q

Warfarin why skin necrosis and why we start heparin initially?

A

it inhibits protein anticoagulant C faster than it inhibits clotting factors

PSA (12 decks)

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