Drug Side Effects Flashcards
Which 4 drugs can cause coronary vasospasm?
Amphetamines (alpha constriction)
Cocaine (alpha constriction)
Sumatriptan
Ergot alkaloids (like bromocriptine)
Which 6 drugs cause cutaneous flushing?
Vancomycin
Adenosine
Niacin
Nitrates
Ca channel blockers
Echinocandins
Which drugs can cause torsades?
ABCDE
A- anti Arrhythmia (Ia and III)
B - anti Biotics (macrolides)
C - anti Cychotics (haloperidol)
D - anti Depressants (TCAs)
E - anti Emetics (odansetron)
Lithium
DI (nephrogenic)
Hypothyroidism
Tremor
Ebstein anomaly in fetus
most reabsorbed in proximal tubule
Demeclocycline
DI (nephrogenic)
Photosensitivity and bone/teeth abnormalities (because part of tetracycline family)
it is an ADH antagonist for SIADH
Amiodarone
Hypothyroidism (iodine content)
Pulmonary fibrosis
Photosensitivity
Which 5 drugs cause hyperglycemia?
Tacrolimus
Protease inhibitors
Niacin
Hydrochlorothiazide
Corticosteroids
Carbamazepine
SIADH
Agranulocytosis
Aplastic anemia
Cyclophosphamide
SIADH
Hemorrhagic cystitis (give w/ mesna)
SSRIs
Sexual dysfunction (dec orgasms and libido)
Burproprion may alleviate sex dysfunction
SIADH
Diarrhea
Which drugs can cause hepatic necrosis? (4)
Halothane
Amanita phalloides (death cap mushroom)
Valproic acid
acetaminophen
“HAVAc”
When to check LFTs (7)
Rifampin, isoniazid, pyrazinamide
Statins, fibrates
Bosentan (pulm HTN drug)
Zileuton (anti-leukotriene)
Which drugs can cause pancreatitis? (6)
Didanosine
Corticosteroids
Alcohol
Valproic Acid
AZA
Diuretics
Chloramphenicol
Aplastic anemia
Gray baby syndrome (cannot metabolize in liver)
Methimazole and Propylthiouracil
Agranulocytosis, aplastic anemia
Methimazole is also teratogen so use PTU in first trimester
Hemolysis in G6PD Deficiency (7)
OXIDANTS
Isoniazid Sulfonamides Dapsone Primaquine Aspirin Ibuprofen Nitrofurantoin
Which drugs can cause megaloblastic anemia? (4)
Hydroxyurea
Phenytoin
Methotrexate
Sulfa drugs
Ganciclovir
Agranulocytosis
Clozapine
Agranulocytosis
Fluroquinolones
Tendonitis and tendon rupture
Protease Inhibitors
Hyperglycemia and fat redistribution
Which drugs cause gingival hyperplasia? (3)
Phenytoin
Ca channel blockers
Cyclosporine
Which drugs cause hyperuricemia? (4)
Furosemide and thiazides
Niacin
Cyclosporine
Pyrazinamide
Tetracyclines
Photo-sensitive
Discolored teeth
Which drugs cause SLE-like syndrome? (6)
Sulfa drugs
Hydralazine
Isoniazid
Procainamide
Phenytoin
Etanercept
Myopathy (9)
Statins, fibrates and niacin
Daptomycin
Colchicine
Hydroxychloroquinolone
Interferon alpha
Penicillamine
GCs
Tardive Dyskinesia
Antipsychotics (high potency - trifluoperazine, fluphenazine, haloperidol - “try to fly high”)
Metoclopramide (used for gastroparesis in DM)
Selegiline (MAO-B inhibitor if too much)
Seizures (5)
Isoniazid
Buproprion (if bullimia or anorexia)
Imipenem/cilastatin
Tramadol
Enflurane (inhaled anesthetic)
Tenofovir
Fanconi syndrome (proximal tubule problem)
Ifosfamide
CHEMO
Fanconi
Hemorrhagic cystitis (give w/ mesna whose thiol group binds toxic metabolites)
Pulmonary Fibrosis (6)
Methotrexate
Bleomycin & busulfan
Amiodarone
Nitrofurantoin
Carmustine (chemo)
Disulfiram-Like Reaction (5)
First generation sulfonylureas
Procarbazine
some Cephalosporins
Griseofulvin
Metro
Nephro and Ototoxicity (5)
Aminoglycosides
Vancomycin
Loop diuretics
Cisplatin
Amphotercin B
Which drugs are “sulfa drugs”?
Sulfonamide antibiotics
Sulfasalazine
Probenacid (uric acid reducer)
Furosemide
Acetazolamide
Thiazides
Sulfonylureas
Celecoxib
Fibrates
Myopathy
Cholesterol gallstones
Digoxin
Cholinergic - nausea, vomiting, diarrhea, arrhythmia, AV block
Blurry yellow vision
Hyperkalemia (no Na- K pump moving K+ in)
Clearance is dec if taken w/ verapamil, amiodarone or quinidine
Do not take w/ metoclopramide in DM
Beta Blockers
Impotence
Exacerbate COPD or asthma
Bradycardia / AV block
CNS - sedation or sleep alterations
DO NOT GIVE ALONE IN PHEO OR COCAINE BECAUSE UNOPPOSED ALPHA
Amiodarone
Hepatotoxic
Pulmonary fibrosis
Hypo or hyperthyroid (40% iodine by wt)
Corneal deposits or gray skin deposits in sun
PFTs / LFTs / TFTs
Metformin
Lactic acidosis
Glitazones / TZDs
Wt gain and edema
Inc risk fractures
Cimetidine
Anti-androgen effects - prolactin release, gynecomastia, impotence and dec libido
Crosses BBB (confusion, headaches, dizziness) and placenta
PPIs
Inc risk C diff and pneumonia
Deplete Mg in long term
Serotonin Syndrome
Ondansetron (5-HT3 antagonist)
Triptans (5-HT 1B/1D agonists)
Tramadol (weak opioid agonist and serotonin reuptake inhibitor)
MAOIs, SSRIs, SNRIs, TCAs
Atypical anti-dep like Vilazodone and Vortioxetine
Linezolid
MDMA
Dextromethorphan (NMDA antagonist for cough suppression)
3 A’s - agitated, hyper Activity, autonomic stim
Cytarabine
panCYTopenia
Myelosuppression w/ megaloblastic anemia
5-FU
Hand-foot syndrome
Palmar and planter erythrodysesthesia (skin reaction)
Nitrosureas
CHEMO
CNS (nitro for neuro - convulsions, ataxia, dizziness)
Etoposide / Teniposide
Alopecia
Rituximab
Inc risk progressive multifocal leukoencephalopathy (PML)
Bisphosphonates
Esophagitis (water and upright 30 min)
Osteonecrosis of jaw
Atypical stress fractures
Allopurinol
Inc conc of AZA and 6-MP b/c they are purine analogs normally metabolized by xanthine oxidase
Phenytoin
Nystagmus, diplopia, ataxia, sedation, peripheral neuropathy
Hirsutism, gingival hyperplasia, DRESS syndrome
SJS
Megaloblastic anemia, teratogen folate
P450 induction
Vigabatrin
BLACK BOX VISION LOSS
Levodopa / Carbidopa
Arrhythmia from peripheral conversion to catecholamines
On-off phenomenon (dyskinesia at dose and akinesia between doses)
Benzocaine
Methemoglobinemia
Depolarizing Nerve Block (succinylcholine)
Hypercalcemia
Hyperkalemia
Malignant hyperthermia
Bimatoprost / Latanoprost
Prostaglandins for eye
Darken iris and eyelash growth
Low Potency Typical Antipsychotics
Anti-cholinergic (dry)
Anti-histamine (sedation)
Alpha 1 blockade (orthostatic hypotension)
Include chlorpromazine, thioridazine
Typical Anti-psych in General
Extra-pyramidal symptoms
Inc prolactin - gynecomastia, galactorrhea, oligomenorrhea
Hyperglycemia, dyslipidemia, wt gain
QT prolongation
Chloro = corneal deposits Thio = reTinal deposits
Neuroleptic Malignant Syndrome - fever, encephalopathy, unstable vitals, inc enzymes, rigid, myolobinuria
Atypical Antipsychotics in General
Prolonged QT but fewer extra-pyramidal and fewer anticholinergic effects than typicals
“pines” = metabolic syndrome
Risperidone = hyper prolactin
TCAs
Sedation
Alpha block - postural hypotension
Anti-cholinergics - dry, tachy, urinary retention (amitriptyline tertiary»_space; secondary)
QT prolongation
Tri - C’s - coma, convulsions, cardiotoxic, confusion in elderly b/c anticholinergic
MAOIs
Hypertensive crises w/ ingestion tyramine (aged cheese and wine)
Tyramine displaces NE into cleft - inc symp stim
WAIT 2 WKS AFTER STOPPING TO START NEW SEROTONIN DRUG OR CHANGE DIET
Mirtazapine
Sedation
Inc appetite and wt gain
Dry mouth
Trazadone
Sedation (ZZZs)
Priapism in males (trazaBONE)
Postural hypotension
ACE Inhibitors
Brady cough
Angioedema (also due to inc bradykinin)
Inc creatinine
Hyperkalemia
Hypotension
USE WITH CAUTION IN RENAL STENOSIS
Interstitial Nephritis (5)
Sulfa drugs
PCNs
Furosemide
NSAIDs
PPIs
Copper IUD
Longer / heavier menses
PID on insertion
Danazol
Synthetic androgen / partial agonist
Hirsutism, wt gain, edema, acne, masculinization
Dec HDL
Hepatotoxic
Pseudotumor cerebri
PDE5 Inhibitors
Headache, flushing, blue-tinted vision (cyanopia), indigestion
DO NOT USE WITH NITRATE (life threatening hypotension)
First Generation Anti-Histamines
Also sedating, anti-muscarinic and anti-alpha-adrenergic
SECOND GENERATION FAR LESS SEDATING (end in -adine)
First Generation Anti-Histamines
Also sedating, anti-muscarinic and anti-alpha-adrenergic
SECOND GENERATION FAR LESS SEDATING (end in -adine)
Pseudoephedrine and Phenylephrine
HTN
Rebound congestion if used more than 4-6 days (body stops making endogenous NE)
CNS stim / anxiety
Epoprostenol and Iloprost
PGI2 prostacyclin analogs
Flushing and jaw pain