Pharm Adverse effects/Contraindications

Question 1

Barbiturates

Answer 1

A/E: Somnolence, Hypoventilation, Nausea, Bradycardia, agitation, confusion, nightmares, lethargy, vomiting, diarrhea, hypotension.

Contraindicated in patients with hepatic impairment, nephritic patients, dyspnea or airway obstruction, porphyria. Not recommended to be given SUBQ or intra-arterially.

Question 2

Antianxiety drugs (benzos/non-benzos)

Answer 2

A/E: Withdrawal syndrome after 4-6 weeks. Never discontinue abruptly. Decrease over 4-6 weeks.

Symptoms of withdrawal: Fatigue, metallic taste, HA, numbness in extremities, sweating, dry mouth.

Contraindications: Do not use in patients that are comatose or CNS depressed. Pregnancy Class D. Acute narrow-angle glaucoma.

Buspirone hydrochloride is pregnancy class B.

Question 3

TCAs

Answer 3

A/E: Dry mouth, blurred vision, postural hypotension, urinary retention, constipation, orthostatic hypotension.

Contraindication: Do not prescribe with MAOIs or within 14 days of MOAI use. Recovery phase after a myocardial infarction.

Question 4

MAOI

Answer 4

A/E: Food interactions, vertigo, nausea, constipation, dry mouth, headache, and over-activity.

Contraindications: CVA Disease, hypertension, CHF, and elderly.

Question 5

SSRI

Answer 5

A/E: Nausea, vomiting, sexual dysfunction, insomnia, and weight gain.

Contraindications: Fluoxetine is less effective in patients who smoke.

Question 6

Burpropion

Answer 6

Contraindicated in patients with a seizure disorder as it reduces the seizure threshold.

Question 7

Antipsychotic

Answer 7

Anticholinergic: Dry mouth, hypotension, sedation, photophobia, photosensitivity, headache

Extrapyramidal: Parkinson like symptoms; facial grimacing

Tardive dyskinesia: Irreversible, involuntary dyskinetic movements, rhythmic, movements of face mouth or jaw. Tongue may protrude.

Neuroleptic malignment syndrome: Immediately stop.

Contraindications: Not recommended in use of severely depressed patient or hypotensive.

Question 8

CNS Stimulants (Amphetamines/Anorexiants)

Answer 8

A/E: Headache, dizziness, apprehension. Can cause overstimulation of CNS. Insomnia, tachycardia, and blurred vision.

Contraindications: Hypertension, stroke, glaucoma.

Amphetamines has a risk of dependence.

Question 9

Anticonvulsants

Answer 9

A/E: Nausea, vomiting, constipation, bradycardia, hypoventilations, agitation, bleeding, fever, sore throat, and nystagmus. Steven-Johnson syndrome.

Contraindications: In patients with CNS depression. Pregnancy D. Psychoses, acute narrow-angle glaucoma.

Avoid Alcohol.