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Medicine > Drug Side Effects > Flashcards

Drug Side Effects Flashcards

0
Q

Sulphasalazine side effects

A

RASH
mouth ulcers
Oligospermia

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1
Q

Causes of gingival hyperplasia

A

Cyclosporin
Tacrolimus
Nifedipine (in bad oral hygiene)
Phenytoin

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2
Q

Methotrexate side effects

A

Pneumonitis and pulmonary fibrosis (lower zone)
Hepatotoxicity
Tetratogenic

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3
Q

Hydroxychloroquine side effects

A

Irreversible retinopathy (check visual acuity annually)

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4
Q

Azathioprine side effects

A

Diarrhoea and other GI problems

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5
Q

Leflunomide side effects

A

Teratogenic
Hypertension
Hepatotoxicity

Better to be used in elderly patients.

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6
Q

Side effects of VALPROATE

A 
"vALPROATE"
Appetite increase and weight gain
Liver failure (monitor LFTs during first 6/12)
Pancreatitis
Reversible hair loss
Oedema
Ataxia 
Teratogenicity (NTD); Tremor; Thrombocytopaenia
Encephalopathy (from hyperammonaemia)
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7
Q

Hydantoin syndrome

  1. Causes
  2. Clinical features
A
  1. Phenytoin, Carbamazepine

2. Hypoplastic digits, intellectual impairment, craniofacial abnormalities, growth retardation

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8
Q

Clozapine side effects

A

“TNM SS”

Temperature raised
Neutropenia (pts. need to be registered with a Clozapine monitoring service)
Myocarditis/cardiomyopathy
more associated with Metabolic Syndrome than other antipsychotics
Seizures particularly
Sialorrhoea (unknown mechanism, treat with Hyoscine)

NB. does NOT cause hyperprolactinaemia

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9
Q

Rispiridone

A

Atypical antipsychotic

Only antipsychotic available in a depot.

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10
Q

4 types of EPSEs associated with antipsychotics

A 
Dystonia reactions
- give procyclidine
Tardive dyskinesia
- refractory to treatment with anti-Ch
Akithesia (unpleasant subject feeling of motor restlessness)
- beta-blocker, antihistamines treat
Pseudo parkinsonian
- anticholinergics
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11
Q

General side effects associated with Antipsychotic drugs

A

Neuroleptic syndrome
Extrapyramidal side effects
Long QT
Hyperprolactinaemia (does not occur in clozapine, quetiapine, aripiprazole - the new antipsychotics)
Hyponatraemia
- increased water, SIADH, or pseudo- from raised lipids
Weight gain (esp. Clozapine and Olanzapine)
Reduced seizure threshold (esp. Clozapine)
Postural hypotension

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12
Q

Therapeutic dose of Clozapine

A

> 350u/l needed for therapeutic effect

Seizures >1000u/l

Usually do 600u/l with valproate cover for seizures

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13
Q

Carbamazepine side effects

A

“SAT”

Skin problems - toxic epidermal necrosis
Arrhythmias
Teratogenic it’s - fetal hydatoin syndrome

Also other CNS stuff, eg. Ataxia etc.

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14
Q

Indications for haemodialysis in drug poisonings

A

Pts with severe clinical features, and high plasma levels of:
“SMILEE” upside down

Salicylate
Methanol
Isopropanol
Lithium
Ethanol 
Ethylene glycol
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15
Q

Lithium side effects

A 
Leukocytosis
Insipid is (diabetes)
Teratogenic, tremor
Hypothyroidism; hypotonia
Increased weight 
Vomiting (RENAL toxicity)
M (=ECG changes)
16
Q

When NOT to use Charcoal in acute poisoning

  1. When is it mainly used for?
A

“COMA”

Corrosives & petroleum products
Organophosphates (eg. DDT & insecticides)
Metal salts (lithium and iron)
Alcohols (anti-freeze)

  1. Drugs, eg Paraquat, Antiepileptics, Digoxin, Ecstacy
17
Q

Organophosphate poisoning

  1. Clinical features
  2. Management
A
  1. “SLUD” - salivation, lacrimation, urination, diarrhoea (watery everywhere). Also other signs of high ACh, small pupils, muscle fasciculation, bradycardic
  2. Protect yourself with clothing
    Wash skin
    Atropine
    Pralidoxime

Diazepam if they develop seizures, but seems to help even without seizures.

18
Q

Beta-blocker overdose

  1. Clinical features
  2. Management
A
  1. Severe bradycardia and hypotension
  2. Atropine
    Glucagon + 5% dextroseAortic balloon pump (to maintain cardiac perfusion)
    (Can also try and pace)
19
Q

Phenothiazine toxicity

  1. Examples of phenothiazine drugs
  2. Clinical features
  3. Management
A
  1. Chlorpromazine (typical antipsychotic)
  2. Extrapyramidal symptoms (ie. tardive dyskinesia, dystonias, akithesia, pseudo-Parkinsonism etc)
    Neuroleptic malignant syndrome (fever, rigidity/EPSE, autonomic dysfunction)
  3. No real treatment
    Procyclidine could be tried
    Cool for NMS
20
Q

Things that grapefruit juice increases the levels of

A

Statins
Anti hypertensives
Immunosuppressives (tacrolimus, cyclosporin)

21
Q

Drugs tht cause GORD

A

CCB
Nitrates
Theophylline
Bisphosphanates

22
Q

Drugs that cause weight loss

A

“LaST MD”

Levodopa
SSRIs
Theophylline 
Metformin
Digoxin

Medicine (20 decks)

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