Part 7 - Adverse drug reactions Flashcards

1
Q

what is the difference between a common and a dangerous adverse reaction of a drug using the examples of a statin

A

common - myalgia

dangerous - rhabdomyolysis

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1
Q

what is a type A reaction give examples

A

a common side effect such as renal impairement
hypokalaaemia
hepatic dysfunction
urinary retention

common predictable and dose related

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2
Q

type a reaction are easily adjusted how

A

adjusting dose

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3
Q

type b reaction also known as idiosyncratic are bizzarre and unexpected reactions related to gene, host and environmental interactions two examples of this are

A

anaphylaxis
skin rash with pencillin

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4
Q

SE of aminogylcosides such as gent and vanc

A

nephortoxic
ototoxic

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5
Q

SE of any abx especially broad spectrum abx such as cephalopsorins and ciprofloxacin

A

c diff colitis

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6
Q

SE ace i

A

low BP
AKI
dry cough
electrolyte imbalances

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7
Q

SE BB

A

low BP
bradycardia
not in asthmatics as wheze
worsen HF - helps chronic ( negaiv iontrophic repsonse and lower CO)

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8
Q

SE CCB

A

low BP
bradycardia
odedema
flushing

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9
Q

SE diuretics summary

A

low BP
electrolytes
AKI

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10
Q

SE heparin

A

haemorrhage especially in renal failure
heparin induced thrombocytopenia

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11
Q

when you prescribe warfarin for the first time what should be prescribed alongside and for how long

A

heparin until INR exceeds 2 as can take time

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12
Q

moa warfarin

A

vik k reductase inhibitor

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13
Q

se aspirin

A

haemorrhage
peptic ulcers
gastritis
tinnitus in large doses

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14
Q

SE digoxin

A

n and V
diarrhoea
blurred vision
confusion and drowsy
halo vision adn yellow green visual perception

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15
Q

moa of digoxin

A

competes with potassium at myocyte sodium potassium ATpase limiting sodium inlfux

since ca outflow relies on Na influx ca accumulates in cell lengthening action potential and slows HR

this is improtnat has high levels of potassium limit this effect and low levels auguments this effect

16
Q

SE amiodarone

A

PF
thyroid disease - related to iodine hence name amIODarone
skin greying
corneal depositis

17
Q

SE lithium

A

tremour - early
tiredness - intermediate
arrythmias, seizures, coma , renal failure and DI - late

18
Q

SE haloperidol

A

dyskinesias eg acute dystonia, drowsy

19
Q

clozapine

A

agrulocytosis - monitor FBC

20
Q

steriods

A

stomach ulcers
thin skin
edema
right and left heart fialure
osteoporosis
infection - candida included
diabetes - hyperglyceamia
cushing Syndrome

21
Q

fludrocortisone SE

A

high BP
sodium and water retention

22
Q

nsaid SE

A

No urine - RF
Systolic dysfunction - heart failure
asthma
inigestion - any cause
Dyscaria - clotting abnormality

23
Q

statins SE

A

myalgia
abdo pain
increased ALT and AST
rhabdomyolysis

24
Q

how do you manage statin induced myalgia

A

exclude rhabdo - CK and urine dip
ensure need of statin
reduce dose
switch to other atatin with lower myalgia risk - risk of myalgia - simvastatin > atorvastatin > pravastatin > fluvastatin or a fibrate

25
Q

common adverse effect of methotrexate

A

leucopenia

26
Q

common anaphylactic causing drugs

A

NSAIDs, b lactam abx, aspriin , chemo , vaccines

27
Q

benefical effect to montior for allopurinol

A

urate serum

28
Q

liraglutide side effect

A

vomiting

29
Q

how does rifampicin affect cocp

A

metabolises oestogens and progesterones quicker therefore leading to a reduced contraceptive effect with combined pills

30
Q

first line for drug induced parkinsons

A

procyclidine hydrochloride 2.5mg PO 8hrly

31
Q

hypoglycaemic in hosp - unconsouius

A

IV glucose 20% 100ml IV