Drugs- By Side Effects

Question 1

Chronic use of this drug can lead to symptoms of iatrogenic Cushing’s Syndrome (Moon facies, truncal obesity, acne, insomnia, increased appetite, weight gain, muscle wasting, myopathy, thinning of skin and appearance of striae, hyperglycemia, diabetes, osteoporosis, impaired wound healing, and aseptic necrosis of the hips, among many others, including acute psychosis and hypomania and depression)

Answer 1

Dexamethasone.

Question 2

Over-expansion of ECF, electrolyte disturbances

Answer 2

Mannitol

Question 3

Rebound high intracranial pressure

Answer 3

Mannitol- with prolonged use and high doses, may pass BBB and cause rebound increased intracranial pressure.

Question 4

Photosensitivity, blurred near vision

Answer 4

Tropicamide

Question 5

Xerostomia, confusion

Answer 5

Tropicamide- a mAchR antagonist can cause systemic side effects

Question 6

Acute angle-closure glaucoma in susceptible patients

Answer 6

Tropicamide AND Phenylephrine

Question 7

Photosensitivity alone

Answer 7

Phenylephrine

Question 8

Increased BP

Answer 8

Phenylephrine- an alpha-1 agonist, can cause systemic side effects

Question 9

Danger of abuse with this local anesthetic drug

Answer 9

Cocaine

Question 10

Not recommended for corneal procedures, as risk may be higher because corneal damage can result

Answer 10

Cocaine

Question 11

Dangerous during pregnancy because of transient ischemia of the fetus

Answer 11

Cocaine

Question 12

This local anesthetic has some associated cardiotoxicity

Answer 12

Bupivicaine, since it is a slowly dissociating chemical. In general, the longer a drug takes to dissociate, the more cardiotoxic that drug will be.

Question 13

This drug can cause hematological side effects (methemoglobia), which can cause exercise intolerance, fatigue, cyanosis, dyspnea, etc.

Answer 13

Prilocaine- though the reaction can occur with benzocaine and lidocaine.

Question 14

This drug can cause local toxicity (local radiculopathies) after in perineural and spinal delivery

Answer 14

Lidocaine, though other anesthetics can also cause this reaction.

Question 15

These local anesthetics are more likely to cause hypersensitivity reactions

Answer 15

Ester local anesthetics

Question 16

This drug can cause seizures, and occasionally headache and insomnia.

Answer 16

Dalfampridine, due to the fact that prolongs NT release and increases membrane excitability.

Question 17

A drug that can be used to help treat severe cardiotoxicity secondary to local anesthetic overdose

Answer 17

intralipid fat emulsion

Question 18

Hypokalemia, metabolic acidosis

Answer 18

Acetazolamide

Question 19

Hypokalemia, metabolic alkalosis

Answer 19

Furosemide

Question 20

Three drugs that can cause sedation

Answer 20

Benzodiazepine, Cyclobenzaprine, Carisoprodol

Question 21

Produces less sedation than BDZs

Answer 21

Baclofen

Question 22

Three drugs that can cause skeletal muscle weakness, in order of increasing weakness

Answer 22

Tizanidine
Baclofen
Dantrolene

Question 23

Can cause drowsiness, dry mouth, hypotension, and low skeletal muscle weakness.

Answer 23

Tizanidine, alpha 2 agonist

Question 24

Hepatotoxic! especially in patients wit pre-existing liver abnormalities. Pt’s should be monitored for elevated hepatic enzymes, hyperbilirubinemia, and other hepatotoxic signs.

Answer 24

Dantrolene

Question 25

Metabolized to meprobamate, a CNS depressant that is related to BDZs that can prolong the effect of opioids

Answer 25

carisoprodol

Question 26

Limited efficacy over NSAIDs (5 drugs)

Answer 26

Muscle relaxants (Carisprodol, cyclobenzaprine, chlorzoxasone, methocarbamol, orphenadrine)

Question 27

Drug efficacy an be affected by eating high-protein diet

Answer 27

Levodopa

Question 28

Can cause effects due to systemic increased dopamine (nausea, dopamine dyskinesia, confusion)

Answer 28

Levodopa (3-4 years after initial use)

Entacapone

Question 29

Impulse control disorders

Answer 29

Levodopa, dopamine agonists (Ropinirole)

Question 30

Nausea, dizziness, confusion, hallucinations, insomnia, livedo reticularis

Answer 30

amantidine

Question 31

Hypotension, depression, sedation, parkinsonism

Answer 31

Tetrabenazine, because it depletes dopamine

Question 32

Dystonia, akathisia (extrapyramidal side effects), neuroleptic malignant syndrome, and with long term use: tardive dyskinesisa, chorea, choreoathetosis

Answer 32

Haloperidol and olanzapine

Question 33

Symptoms of hyperprolactinemia (mammary gland growth, menstrual irregularity, ED, infertility in men)

Answer 33

haloperidol, olanzapine

Question 34

Orthostatic hypotension, anticholinergic effects (dry mouth, blurred vision, constipation, urinary retention), sedation (usually goes away with time)

Answer 34

mACHr-antagonists

Question 35

decreased seizure threshold

Answer 35

antipsychotics (haloperidol, olanzapine, risperidone)- haloperidol is better tolerated, risperidone produces fewere WPS

Question 36

hypotension, sedation, constipation, contraindicated in depression

Answer 36

clonidine

Question 37

can produce more weakness than desired, resistance may develop, and rarely anti-cholinergic adverse effects

Answer 37

botulinum toxin

Question 38

can have some cross-reactivity in brain serotonin receptors, can increase airway resistance, esp in asthmatics, can block hypoglycemic response in diabetics, bradycarida, hypotension

Answer 38

propranolol

Question 39

Can cause sedation, depression, cognitive impairment, and osteoporosis (only w/prolonged use)

Answer 39

primidone

Question 40

Can cause sedation, cognitive slowing, paresthesia, fatigue, and dizziness, and kidney stones/weight loss (with chronic use)

Answer 40

Topiramate

Question 41

Sedation, ataxia, dizziness, weight GAIN,

Answer 41

Gabapentin

Question 42

Risk of psychological dependence and abuse, interactions with other CNS depressants

Answer 42

BDZs (alprazolam and clonazepam)

Question 43

Not recommended in elderly or demented patients

Answer 43

Trihexylphenidyl and Benztropine, mACHr antagonists