GYN/Final: drugs & Side effects Flashcards
1
Q
Amphotericin B
A
- Nephrotoxicity****
- dose dep
- decrs GFR, RTA, Mg and K wasting,
* **liposomal formulas are assoc with less nephrotoxicity - Anemia
- Fever/chills— long infusion times recc to avoid this
- Hypotension (severe) with hypokalemia
- Thrombophlebitis
2
Q
Nystatin
- oral suspension
- Cutaneous
A
Oral suspension
- diarrhea
- nausea
- stomach pain
- vomiting
- hypersensitivity
Topical
- contact dermatitis
- SJS
- hypersensitivity
3
Q
Fluconazole
A
- n/v
- HA
- skin rashes
- AST/ALT change
4
Q
Itraconazole
A
- n/v
- rash
- triad: hypoK, HTN and edema
- AVOID in ventricular dysfunction
5
Q
Voriconazole
A
- Vision changes
- visual and auditory hallucinations
- rash in 7%
- periostitis with prolonged use
- cardiac toxicity: tosades, QTc», sudden death)
- Alopecia
- nail changes
6
Q
Clotrimazole
A
Contact dermatitis
Burning sensation
Vaginal discharge
PO uses:
- Local discomfort of oral cavity
- nasea
- HA
- diarrhea
7
Q
Miconazole
A
Contact dermatitis
Burning sensation
Vaginal discharge
PO uses:
- Local discomfort of oral cavity
- nasea
- HA
- diarrhea
8
Q
Terbinafine
A
- GI
- taste disturbances
- elevated transaminases
9
Q
Caspofungin
A
as a class, the echoinocandins are very well tolerated + safe***
- nausea
- fever + rash
- phelbitis
- flushing (slow infusing rates decrs risk)
- asympto transaminitis
10
Q
5-FC
A
- Neutropenia (low WBC)
- Thrombocytopenia (low plats)
- Dose-related bone marrow suppression
* FIRST THREE ARE REVERSIBLE - hepatic dysfunction
- N/V/D
- Enterocolitis
11
Q
Metronidazole
*MC ones and the others
A
- MC=N/D, abd cramps and metallic taste
- others:
- dark urine
- stomatitis (painful swelling and sore throat)
- neuro: parasthesias, seizure, dizziness (with high doses but its rare)
- Disulfiram reaction with ETOH
- QTc»_space;> and torsades
- Renal inhibition of Lithium
12
Q
Tinidazole
A
- MC=N/D, abd cramps and metallic taste
- others:
- dark urine
- stomatitis (painful swelling and sore throat)
- neuro: parasthesias, seizure, dizziness (with high doses but its rare)
- Disulfiram reaction with ETOH
- QTc»_space;> and torsades
- Renal inhibition of Lithium
13
Q
Iodoquinol
A
- rash
- diarrhea
- dose-related peripheral neruopathy—such as optic neuritis
- avoid long term use**
14
Q
Paromycin
A
diarrhea
GI distress
15
Q
Chloroquine
A
SE: generally well tolerated and SE are minimal at low doses
- pruritis and rash
- GI distress
- Blurry vision and possible retinal toxicity–>do routine eye exam with prolong use
- HA
- QTc prolongation
16
Q
Primaquine
A
- gen well tolerated
- drug-induced hemolytic anemia in G6PD–have to test PT b4 initiating tx
- abdominal discomfort
- methemoglobinemia
17
Q
Atovaquone-proguanil
A
- GI s/s
* dizziness
18
Q
Mefloquine
A
- Neuropsychiatric–>why it is reserved for use when other agents cannot be used
- EKG changes and arrest when taken with Quinine or Quinidine
19
Q
quinine
A
SE are from cinchonism toxicity aka chinconism ALL FOUR S/S *nausea *vomiting *tinnitus *vertigo ----reversible
20
Q
Artemisinins
A
- N/V/D
* high doses can cause QTc»»
21
Q
Suramin
A
SE: pretty infrequent
- nauea/vom
- shock
- LOC
- acute urticaria
- blepharitis
- neuro–>paresthesias, photophobia, hyperesthesia of hands/feet
22
Q
Melarsoprol
A
- can cause CNS toxicity– encephalopathy***, periph neruopathy,
- HTN
- hepatoxicity
- albumineria
- hemolytic anemia can occur with G6PD PT
*vessel irritation with IV admin
23
Q
Benznidazole
A
SE:
- dermatitis
- peripher neuropathy
- insomina
- anorexia
24
Q
Nifurtimox
A
- hypersen rxn—anaphy to dermatitis
- GI problems that are severe enough to cause wt loss
- periph neruopathy
- HA
- dizziness
25
Pentamidine
SE:
* reversible renal dysfunction
* life threatening hypoglycemia
* hypoK
* hypotension
* pancreatitis
* cardiac arrhythmias
26
Oseltamivir
N/V
| **take wth food
27
Zanamivir
N/V
| ***irritation of resp tract
28
Ribavirin
* Dose dep. anemia
| * elevated bilirubin
29
Lamuvudine
* nausea
| * well tolerated
30
Tenofovir
SE
* Depression
* backache
* cough
* N/V/D
31
Entecavir
Nephrotoxicity
32
Peginterferon alfa-2
*Flu like s/s--->fever, chills, myalgias, GI
33
Acyclovir
INDS---"grandfather of antiherpetic tx agents"
* ***TOC in HSV encephalitis
* MC use is gential herpes
MOA
*causes premature DNA chain termination in viral DNA
Kinetics
* PO, IV, Topical
* well distributed into tissues and CNS + CSF
* Excr urine
* accumulates in renal failure PTs-->RENAL DOSING
SE
34
Cidofovir
* significant renal toxicity
* neutropenia
* metabolic acidosis***
35
Foscarnet
* nephrotoxicity
* anemia
* nausea
* fever
* HYPOmag and *HYPOcalcemia----can lead to arrhythmias
36
Ganciclovir
* Dose dep neutropenia
* carcinogenic
* teratogenic
37
NRTIs as a class
* peripheral neuropathy
* pancreatitis
* lipoatrophy
* *incr toxicity when NRTIs are combined together---ESP Abacavir
- ->hypersensitivity
- ->death
38
Protease Inhibitors
* hyperglycemia
* hypertriglyceridemia
* wt gain (taking with high fat meals)
* paraethesias
* MC= N/V/D
39
Enfuviride
(Entry inhibitor)
| *not given to TX for naive patients
40
Maraviroc
(Entry inhibitor)
| *severe hepatoxicity
41
Integrase Inhibitors (INSTIs)
* well tolerated
| * N/D MC
42
Estrogen
- nausea
- HA
- breast tenderness
- thromboembolic events
- MI
- incr risk of BCA
- incr risk of endo CA (estrogen unopposed)
43
Progestins
HA
Depression
Wt gain
Libido changes
44
Mifepristone
SE
* uterine cramps
* bleeding
* abd pain
* incomplete abortion
45
Tamoxifen
*flushing
*periphereal edema
*HTN
*N/V/D
*irreg menses
*endometrial hyperplasia
BBW******* stroke, thromboembolic events--PE, uterine malignancies
46
Clomiphene
* Hyperstimulation of ovary
* ovary enlargement
* HA
* ******Very high risk of multiple gestation
