Drug side effects

Question 1

Neuro/epilepsy drugs which cause myelosuppression/agranulocytosis

Answer 1

phenytoin
carbamazepine
antipsychotics

Question 2

Immunosuppressant drugs which cause myelosuppression/agranulocytosis

Answer 2

azathioprine
methotrexate
interferon-alpha

Question 3

Other drugs (not neuro/rheum) which cause myelosuppression/agranulocytosis

Answer 3

carbimazole
thiazides
ganciclovir
chloramphenicol

Question 4

drugs which cause tardive dyskinesia?

Answer 4

levodopa
antipsychotics
phenytoin

Question 5

fusidic acid

Answer 5

cholestatic (can cause jaundice)

Question 6

Ca channel blockers

Answer 6

flushing, bradycardia (verapamil and diltiazem), ankle swelling (dihydropiridines)

Question 7

PPAR gamma receptor antagonists (thiazolidinediones) eg. pioglitazone

Answer 7

• weight gain
• liver impairment: monitor LFTs
• fluid retention - therefore contraindicated in heart failure.
• increased risk of: fractures, bladder cancer

Question 8

phenytoin

Answer 8

everything....
gum hypertrophy
Acute
 - headaches
 - confusion, heading to seizures
Chronic (dose dependent)
 - facial coarsening
 - gum hyperplasia
 - PDGF induction
 - alters folate (megaloblastic anaemia) and vit D metabolism (osteomalacia)
 - dyskinesia
 - lymphadenopathy
Idiopathic
 - Dupuytren's contracture
 - hepatitis
Teratogenic
 - cleft palate
 - congenital heart defect

Question 9

Drugs which cause jaundice:

Answer 9

Pre-hepatic:
Causes of haemolysis - chemo or malaria drugs)
Impaired uptake of bilirubin - inhibited by rifampicin and radio-contrast agents

Hepatic

• paracetamol (hepatitis)
• TB drugs except for ethambutol (ison, rifamp, pyramidazine)
• halothane
• statins
• MAOIs
• valproate

Post-hepatic:

• chlorpromazine & prochlorperazine
• lots of antibiotics: fluclox, co-amoxiclav, fusidic acid
• sulphonylureas
• steroids

Question 10

Quinolone (eg. moxi/levo/o - flaxacin/fluroquinolone)

Answer 10

Decreased seizure threshold

Tendon damage - mainly in animal studies, limited evidence

Question 11

Sulphonylureas

Answer 11

Can cause hypos (whereas metformin doesn’t)

Question 12

B-blockers and diabetes?

Answer 12

reduced awareness of hypos

Question 13

SEs of ergot-derived dopamine agonists (bromocriptine and cabergoline)?

Answer 13

cardiopulmonary retroperitoneal fibrosis

Question 14

New dopamine agonists?

Answer 14

ropinerol

Question 15

Osteonecrosis of the jaw is most characteristically caused by 
aceI
amiodarone
phenytoin
bisphosphonates
warfarin
sildenafil

Answer 15

bisphosphonates

adverse effects of bisphosphonates:

• oesophagitis (upto 25%)
• oesteonecrosis of the jaw
• increased risk of atypical stress fractures of the proximal femoral shaft in pnts taking alendronate

Question 16

Which of the following drugs does not have dizziness as a side effect
phenytoin
carbamazepine
bisphosphonates
amantidine
nicorandil

Answer 16

bisphosphonates