Polypharmacy Flashcards
What are SE of fluoxetine overdose?
Fluoxetine is a selective serotonin re-uptake inhibitor (SSRI) used for depression.
Typically clinical features of toxicity include GI upset, tremor, sweating, dizziness and agitation.
Severe presentations can lead to convulsions and coma.
Serotonin syndrome can result and is more likely if taken with other neuro-active agents including amitriptyline. This presents with autonomic instability (including hyperpyrexia), CNS effects and neuromuscular excitability.
What are SE of amitriptyline overdose?
Amitriptyline is a tricyclic antidepressant and a dangerous drug in overdose, thereby restricting its use as an antidepressant - it is more commonly used now for neuropathic pain or insomnia.
Toxicity is due to a combination of anticholinergic (antimuscarinic, atropine-like) effects at autonomic nerve endings and in the brain and effects due to cardiac sodium channel blockade and alpha 1 adrenergic receptor blockade.
Presenting features include typical anticholinergic effects of tachycardia, drowsiness, dry mouth, dilated pupils, urinary retention and ileus. Severe toxicity results in arrhythmias, cardiovascular collapse, convulsions and coma.
What are SE of aspirin overdose?
Aspirin overdose is associated with dehydration, restlessness, tinnitus, warm extremities with bounding pulses, increased respiratory rate and hyperventilation. Respiratory alkalosis is often present at lower concentrations; metabolic acidosis may co-exist.
What are SE of digoxin overdose?
Digoxin toxicity can cause nausea, vomiting, diarrhoea and general malaise may develop within 1-2 hours of acute overdose, but cardiac features may take 6 hours or more to develop.
Onset of features in toxicity from chronic therapy can be very variable, but is often preceded by dehydration.
CNS features such as anorexia, headache, weakness and blurred vision or alteration in colour perception (classically xanthopsia – a yellowish tinge to the vision) may also occur.
What are signs of furosemide overdose?
Furosemide toxicity results primarily from the physiological effect of water and electrolyte loss from profound diuresis. Symptoms and signs of dehydration and hypotension may be evident.
What are signs of simvastatin overdose?
Simvastatin rarely causes severe toxicity. In therapeutic doses reversible myositis, myalgia, rhabdomyolysis, hyperkalaemia, myopathy, acute kidney injury and altered liver function tests have been reported.
