High Risk Drugs 2: The Remix COPY Flashcards
What high risk drugs can cause hypo/hyperthyroidism? (2)
Ltihium (0.4-1.0, 0.8-1.0 manic)
Amiodarone (Pulmonary tox, Peripheral neuropathy, photophobia/skin reactions, eye deposits)
What high risk drugs can cause photophobia/phototoxic reactions? (3)
Amiodarone (Pulmonary tox, Peripheral neuropathy, photophobia/skin reactions, eye deposits)
Phenobarbital (10-40mg/L, hallucinations, memory problems/behavioural issues in children)
Tacrolimus (hyperglycaemia, renal and liver tox, rash, blood issues)
What high risk drugs are associated with drowsiness? (2)
Carbamazepine (4-12mg/L, hyponatraemia)
Ltihium (0.4-1.0, 0.8-1.0 manic)
What are the distinguishing side effects of amiodarone? (5)
Grey skin
Phototoxicity
Shortness of breath due to pulmonary toxicity - shared with methotrexate and some other cytotoxics
Peripheral neuropathy - see other cytotoxics as well
.
Reversible corneal deposits
What are the distinguishing side effects of carbamazepine? (3)
4-12mg/L
Hyponatraemia
Thrombocytopenia
Antiepileptic syndrome
What are the distinguishing side efects of digoxin? (4)
Mental confusion
Blurred yellow vision
Psychosis
Anorexia
In states of hypokalemia, or low potassium, digoxin toxicity is actually worsened because digoxin normally binds to the ATPase pump on the same site as potassium. When potassium levels are low, digoxin can more easily bind to the ATPase pump, exerting the inhibitory effects.
What are the distinguishing side effects of lithium? (3)
Fine tremor -> coarse tremor
Mucle weakness (also digoxin)
Intracranial hypertension - persistent headaches etc.
What is the distinguishing side effect for gentamicin?
peak 5-10mg/L, endo: 3-5mg/l
trough <2mg/L, endo: <1mg/L
- Hearing impairment/ototoxicity
What are the distinguishing side effects of vancomycin? (3)
10-15mg/L
15-20mg/L for endo/MRSA
- Vertigo/dizziness
- Flushing/Red man syndrome
- I guess phlebitis?
What are the distinguishing side effects of phenobarbital? (5)
- Halluncinations
- Impaired memory
- Megaloblastic anaemia (High MCV, low Hb)
- Osteomalacia
- Depression
What are the distinguishing side effects of phenytoin? (6)
10-20mg/L
1. Slurred speech
- Hyperglycaemia (also theophylline + tacrolimus)
- Suicidal thoughts? (Phenobarbital: depression)
- Low vitamin D –> rickets, osteoporosis, linked to anti-folate action? idk
- Rash/epidermal necrolysis (also with warfarin tho?)
- Non-linear kinetics
What are the distinguishin side effects of theophylline? (4)
10-20mg/L
Think caffeine overdose yo.
- Dilated pupils
- Restless (akasthasia)
- Intractable vomiting (maybe not so much with too many coffees..)
- Convulsions (less specific?)
What are the distinguishing side effects of tacrolimus? (3)
- Neurotoxic - tremor/headache
- Hyperglyceamia (theophylline and phenytoin)
- Cardiotoxicity
High risk drugs with therapeutic levels of 10-20mg/L (2)
Theophylline, 2 days SS, 4-6 hours post dose.
Phenytoin, 7-28 days SS, pre-dose.
High risk drugs with monitoring of renal function (6)
- Carbamazepine + Liver
- Digoxin
- Lithium
- Gentamicin
- Vancomycin
- Tacrolimus + Liver