List of adverse effects: part 1 Flashcards
What are the adverse effects of benzodiazepines?
- Dependence : withdrawal syndrome (less intense than barbs) .
Tolerance (less than barbs)
Potentiate other CNS depressants (alcohol, barbs) - Sedation, confusion, amnesia, ataxia
What are the adverse effects of barbiturates?
-Enzyme inducers ,Alter natural sleep (reduce REM) –> hangover, irritability , Depress respiration and O.d. is lethal(tf low safety margins) , Dependence (withdrawal syndrome) , Tolerance -,Potentiate effects of other CNS depressants (alcohol)w
Diiuretic side effects
Carbonic anhydrase inhibiitor, loop diuretics, Thiazide, cause metabolic alkalosis
K= sparing like amiadarone and spiranolactone(can cause testicular arophy, gynaecomastia and mentrual problems) can cause metabolic acidoss
Loop diurtics can cuase hypovolaemia and hypotension.
What are the side effects of levodopa?
Acute: - Nausea and vomiting (also converted to dopamine in periphery) - Hypotension - Psychological effects – schizophrenia like syndrome w/delusions and hallucinations - Confusion, disorientation - Insomnia, nightmares Chronic: - Dyskinesias – abnormal movements which affect face+limbs; start within 2y; disappear if dose reduced but clinical symptoms reappear - “On-Off” Effects – rapid fluctuations in clinical state, where hypokinesia and rigidity may suddenly worsen
NSAID side effects
What are the side effects of dopamine receptor agonists?
Ergot derivatives: - Cardiac fibrosis - Valvular disease Non-ergot derivatives do not have these effects
Side effects of chlopramazine and haloperidol
chlopramazine:
High incidence - anti-cholinergic, especially sedation
•Low incidence - extrapyramidal side-effects (EPS)
haloperidol:
•High incidence - EPS
SIde effects of different secon genearation anti-psychotics
Clozapine
Side effects
•Can cause potentially fatal neutropenia, agranulocytosis, myocarditis & weight gain(these set of side effects are why it is used as a last resort)
Risperidone
Side effects
•More EPS & hyperprolactinaemia than other atypical antipsychotics
Quetiapine
Side effects
•Lower incidence of EPS than other antipsychotics
Aripiprazole
Side effects
•Reduced incidences of hyperprolactinaemia & weight gain than other antipsychotics
What are the unwanted effects of cocaine overdose?
CNS - excitation, euphoria CVS - increased CO, hypertension, vasoconstriction (all sympathetic actions)
What are the unwanted effects of lidocaine overdose?
CNS - restlessness, confusion, tremor (paradoxical) CVS - myocardial depression, vasodilation, hypotension (caused by Na channel blockade)
What are the side effects of spinal anaesthesia?
Decreased BP Prolonged headache
what are the advers effects of CHD drugs
book 3 : 64-66
What are the unwanted effects of cocaine overdose?
CNS - excitation, euphoria CVS - increased CO, hypertension, vasoconstriction (all sympathetic actions)
What are the unwanted effects of lidocaine overdose?
CNS - restlessness, confusion, tremor (paradoxical) CVS - myocardial depression, vasodilation, hypotension (caused by Na channel blockade)
What are the side effects of spinal anaesthesia?
Decreased BP Prolonged headache
Suxamethonium side effects
Unwanted Effects
Post-operative muscle pains
This is due to the initial fasciculations
Bradycardia
This is due to the direct muscarinic action on the heart
But this effects tends to be prevented by the fact that suxamethonium is generally given after general anaesthetic when patients would have had atropine (competitive muscarinic antagonist) in their pre-med
Hyperkalaemia
Soft tissue injury or burns can lead to ventricular arrhythmias/cardiac arrest
If there is a burn or some soft tissue injury, you will lose some of the neurones innervating the muscle and so you get upregulation of the receptors in the skeletal muscle = deinnervation supersensitivity
So if you give suxamethonium you will get an exaggerated response
You get bigger influx of sodium and bigger efflux of potassium
Raised Intraocular Pressure
AVOID for eye injuries and glaucoma
Unwanted Effects of Tubocurarine
Ganglion block - it could block some of the nicotinic receptors in the ganglia
Histamine release from mast cells
Hypotension
Blood pressure can drop due to ganglion blockade
Histamine can act on the H1 receptors on the vasculature and cause vasodilation
Tachycardia
May lead to arrhythmias
This is a reflex in response to the hypotension
Could also be due to the blockade of vagal ganglia
Bronchospasm
Caused by the histamine release
Excessive secretions (bronchial and salivary)
Caused by the histamine release
Apnoea
This is why you always assist respiration in someone who’s taking tubocurarine
REMEMBER: the unwanted effects of tubocurarine are mainly due to ganglion blockade and histamine release from mast cells
Pilocarpine
The side effects are the general effects of parasympathetic discharge:
Blurred vision
Sweating
GI disturbance and pain
Hypotension
Respiratory distress
Bethanechol
Again the side-effects are that of parasympathetic discharge:
Sweating
Impaired vision
Nausea
Bradycardia
Hypotension
Respiratory difficulty
Ecothiopate side effects
Side-effects are that of parasympathetic discharge:
Sweating
Blurred vision
GI disturbance and pain
Bradycardia
Hypotension
Respiratory difficulty
side effects of beta antagonists and unwanted effects in certain conditions
Fatigue - due to reduced cardiac output and reduced muscle perfusion
Cold Extremities - loss of beta receptor mediated vasodilation of cutaneous vessels
Bad Dreams
Summary of conditions in which you wouldn’t give a non-selective beta blocker:
ASTHMA
COPD
CARDIAC FAILURE
DIABETES
Methyldopa adverse effects
Adverse effects: dry mouth, sedation, orthostatic hypotension, male sexual dysfunction
Salbutamol side effects
Side Effects:
Reflex tachycardia
Tremor
Blood sugar dysregulation
Isoprenaline, Dobutamine ,Salbutamol (Ventolin) common side effects
reflex tachycardia
