PSA: adverse drug reactions Flashcards
what medications are associated with haematemesis
nsaids
What drugs can cause gingival hyperplasia
phenytoin
ciclosporin
calcium channel blockers (nifedipine, verapamil, diltiazem).
main risk of hydroxycloriquine
bull’s eye retinopathy - may result in severe and permanent visual loss
Monitoring
baseline ophthalmological examination and annual screening is generally recommened
the BNF advises: ‘Ask patient about visual symptoms and monitor visual acuity annually using the standard reading chart’
side effects of typical antipsychotics other than EPSE
Extrapyramidal side effects (EPSEs): parkinsonism, akathisia, dystonia, dyskinesia
Hyperprolactinaemia: leads to sexual dysfunction, increased risk of osteoporosis, amenorrhoea in women, galactorrhoea, gynaecomastia and hypogonadism in men
Metabolic side effects: weight gain, increased risk of developing type 2 diabetes, hyperlipidaemia, increased risk of developing metabolic syndrome
Anticholinergic side effects: tachycardia, blurred vision, dry mouth, constipation, urinary retention
Neurological side effects: seizures, neuroleptic malignant syndrome (potentially life-threatening)
prolonged QT interval (particularly haloperidol)
Side effects of atypical antipsychotics
less likely to cause EPSE but still can
Hyperprolactinaemia risk varies between atypicals - common with amisulpride and risperidone
Metabolic side effects: weight gain, increased risk of developing type 2 diabetes, hyperlipidaemia, increased risk of developing metabolic syndrome
Anticholinergic side effects: tachycardia, blurred vision, dry mouth, constipation, urinary retention, dizziness
Neurological side effects: seizures, neuroleptic malignant syndrome (potentially life-threatening)
Elderly : increased risk of stroke
Elderly : increased risk of venous thromboembolism
clozapine is associated with agranulocytosis
what is the most important piece of information to give someone when prescribing benzodiazepines
may impair the ability to drive or perform skilled tasks is the most important advice to give patients starting a benzodiazepine
It is an offence to drive whilst unfit due to drug use and the law does not distinguish between prescribed or recreational medication. Patients should be advised not to drive until they know how the medication affects them
pt on clozapine with constipation
seek urgent medical assistance
This is due to the potentially fatal risk of intestinal obstruction, faecal impaction and paralytic ileus.
what are the initial features of lithium toxicity
agitation and restlessness, followed by vomiting, diarrhoea, tremor and muscle fasciculations.
what should you check before prescribing ondansetron
if prolonged QT or on drugs that prolong QT
as ondansetron can prolong the QT interval although usually only evident at high doses eg >16mg ondansetron. Avoid in pts with prolonged QT, if in doubt, ECG before prescribing
benzos in the eldery - adverse effect?
increased falls risk
Benzodiazepines are associated with decreased alertness, confusion, drowsiness and hypotension, all of which increase the risk of falls (particularly in the elderly)
adverse effects of steroids and CI
STEROIDS
Stomach ulcers
Thin skin
Edema
Right and left HF
Osteoporosis
Infection (inc candida)
Diabetes (hyperglycaemia)
cushing’s Syndrome
what headache drug is CI in coronary artery disease
triptans are contraindicated in CAD as it may cause vasospasm
side effect folic acid
flatulence
drugs contraindicated in breastfeeding
antibiotics: ciprofloxacin, tetracycline, chloramphenicol, sulphonamides
psychiatric drugs: lithium, benzodiazepines
aspirin
carbimazole
methotrexate
sulfonylureas
cytotoxic drugs
amiodarone
side effects carboplatin
ototoxicity
common drug causes gynacomastia
spironolactone (most common drug cause)
cimetidine
digoxin
cannabis
finasteride
GnRH agonists e.g. goserelin, buserelin
oestrogens, anabolic steroids
common drug causes hyperglycameia
steroids
antipsychotics
thiazides
beta blockers
tacrolimus
common causes diarrhoea
antibiotics (c.diff)
antacids containing magnesium
alendronic acid
colchicine
metformin
PPIs
common drug causes constipation
opioids
CCBs
antacids containing calcium
anticholinergics
common drug causes urianry retention
opioids
anticholinergics
common drug causes urinary incontinence
alpha blockers
diuretics
anticholinesterase inhibitors
clozapine (urinary incont but constipation!)
common drug causes gout
diuretics
common drug causes confusion
opioids
sedatives
anticholinergics
common drug causes falls
neuro:
benzos
antidepressants
antipsychotics
parkinsons meds
antiepileptics
hypotension:
antihypertensives
common drug causes osteoporosis
steorids
PPIs
LHRH agonists
common drug causes hypertension
NSAIDs
steroids
oral contraceptives
mirabegron
drug causes high cholesterol
steroids
thiazides
antipsychotics
drug causes hypokalaemia
loop diuretics
thiazides
steroids
salbuatmol
drug causes hyperkalaemia
ACEi
ARB
K sparing diuretics
heparin
blood transfusion
drug causes hypernautraemia
lithium
demeclocycline
