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PSA > PSA: Common Drug Effects > Flashcards

PSA: Common Drug Effects Flashcards

1
Q

What are the complications of amiodarone use?

A
  • thyrotoxicosis
  • pulmonary fibrosis
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2
Q

What are the complications of digoxin use?

A
  • drug induced gynaecomastia
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3
Q

What are the complications of carbimazole use?

A

Agranulocytosis (safety net for sore throat/fever)

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4
Q

What are the complications of lamotrigine use?

A

Rarely, Steven Johnson syndrome (safety net for viral prodrome, hypersensitivity rash which may spare scalp/hands/feet)

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5
Q

What drugs can cause gingival hyperplasia?

A
  • ciclosporin
  • phenytoin
  • CCBs
    (AML also associated…)
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6
Q

What are the complications of methotrexate use?

A
  • mucositis
  • folate deficiency
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7
Q

Which drugs can cause urinary retention?

A
  • anticholinergics e.g. oxybutynin
  • opioids
  • TCAs
  • NSAIDs
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8
Q

Statins are contraindicated in…

A

pregnancy

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9
Q

What are the side effects of corticosteroids?

A

a. STEROIDS:
i. Stomach ulcers
ii. Thin skin
iii. oEdema
iv. Right and left heart failure
v. Osteoporosis
vi. Infection (including Candida)
vii. Diabetes (mostly just hyperglycaemia alone)
viii. Cushing’s Syndrome

also: insomnia

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10
Q

What are the side effects of NSAIDs?

A

a. NSAID:
i. No urine (i.e. renal failure)
ii. Systolic dysfunction (i.e. heart failure)
iii. Asthma
iv. Indigestion (any cause)
v. Dyscrasia (clotting abnormality)

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11
Q

What are the side effects of anti-hypertensives generally and specifically?

A
  1. Anti-hypertensives
    a. Hypotension
    b. Bradycardia
    i. With beta blockers, some CCBs
    c. Electrolyte disturbance
    i. ACEi and diuretics
    d. Specifics
    i. ACEi = dry cough
    ii. Beta blockers = wheeze in asthmatics, can worsen ACUTE heart failure (improve in chronic!)
    iii. CCBs = peripheral oedema, flushing
    iv. Diuretics = renal failure, thiazide diuretics = gout, K+ sparing = gynaecomastia
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12
Q

RIPE side effects?

A

R: orange secretions, hepatotoxicity, P450 inducer e.g. can increase warfarin metabolism
I: peripheral neuropathy, drug induced lupus, B6 deficiency
P: GI symptoms (puke), gout
E: optic neuritis

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13
Q

You should never use verapamil with WHICH drug?

A

beta blockers

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14
Q

You should never use verapamil in which cardiac condition?

A

VT - blocks calcium current responsible for sinus and AV depolarisation - can cause haemodynamic deterioration in VT –> VF + cardiac arrest

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15
Q

Loop diuretics can cause…

A

ototoxicity

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16
Q

PDE5 inhibitors (e.g. sildenafil) and WHAT drug is contraindicated?

A

nitrates, due to risk of severe refractory hypotension

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17
Q

Name some immunomodulators safe for use in pregnancy

A

Azathioprine, hydroxychloroquine

18
Q

Mesalazine can cause…

A

drug induced pancreatitis

19
Q

Metaclopramide should be avoided in…

A

PD patients and young women (risk of dyskinesia)

20
Q

Cyclizine is first line except in…

A

heart failure (can cause fluid retention)

21
Q

Statins interact severely with….

A

macrolides!! (clarithromycin basically interacts with everything including warfarin)

22
Q

What drugs cause erythema multiforme?

A

(circular target lesions, rapid onset but self limiting after 1-2 weeks)
- aminopenicillins e.g. co-amoxiclav, sulphonamides, carbamazepine, allopurinol, NSAIDs and the oral contraceptive pill

23
Q

What drug is used for benzodiazepine toxicity + route?

A

IV flumazenil

24
Q

What drug reverses heparin?

A

protamine sulfate

25
Q

What is phytomenadione?

A

vitamin K used to reverse warfarin

26
Q

What reverses dabigatran?

A

Idarucizuamb

27
Q

A patient has minor bleeding and is on warfarin. Their INR is 7.0. What do you do?

A
  • stop warfarin
  • give IV vit K 1-3mg
  • restart when INR <5.0

(Mx if minor bleeding and INR 5-8)

28
Q

A patient has no bleeding and is on warfarin. Their INR is 7.0. What do you do?

A
  • Withhold 1 or 2 doses of warfarin
  • reduce subsequent maintenance dose

(no bleeding + INR 5-8 Mx)

29
Q

A patient has no bleeding and is on warfarin. Their INR is 9.0. What do you do?

A

(mx for no bleeding and INR >8)

  • stop warfarin
  • PO vit K 1-5mg (use IV prep orally)
  • repeat dose if INR still too high after 24 hours
  • restart when INR <5.0
30
Q

A patient has minor bleeding and is on warfarin. Their INR is 9.0. What do you do?

A

(mx when minor bleeding and INR >8)

  • stop warfarin
  • IV vit K 1-3mg
  • repeat dose if INR still too high after 24 hours
  • restart warfarin when INR <5.0
31
Q

A patient has a variceal haemorrhage on warfarin. What do you do?

A

major bleed = also intracranial etc

STOP warfarin
IV vit K 5mg
and prothrombin complex concentrate (2nd line FFP)

32
Q

Name drugs that can cause long QT syndrome:

A
  • amiodarone, sotalol, class 1a antiarrhythmic drugs
  • TCAs, SSRIs esp citalopram
  • methadone
  • chloroquine
  • terfenadine
  • erythromycin
  • haloperidol
  • ondansetron
33
Q

Non drug causes of long QT syndrome:

A
  • electrolytes e.g. hypocalcaemia, hypokalaemia, hypomagnesaemia
  • acute MI
  • acute myocarditis
  • hypothermia
  • SAH
  • congenital cases e.g. jervell-lange-nielsen syndrome (deafness), romano-ward syndrome (no deafness)
34
Q

What is a complication of long QT syndrome?

A

VT/TdP

normally QT <430ms in males, <450ms females

35
Q

Draw out toxicity bear!

A

Asparagine = neurotoxicity
Cisplatin = oto/nephrotoxic
Vincristine/vinblastine = peripheral neuropathy
Bleomycin = pulmonary fibrosis
Doxorubicin = cardiotoxic
Cyclophosphamide (psi symbol) = haemorrhagic cystitis
Methotrexate = nephrotoxic + myelosuppression (tx = filgrastim)

36
Q

A patient with previous MI and depression presents with erectile dysfunction. Which of his drugs is likely to have caused this?

A

bisoprolol, SSRIs

37
Q

Treatment of cluster headaches can involve both high flow oxygen and triptans, however, triptans are contraindicated in patients

A

with CAD as they have the potential to cause coronary vasospasm

38
Q

Name drugs associated with toxic epidermal necrolysis:

A

phenytoin, penicillins, sulphonamides, allopurinol, carbamazepine, NSAIDs

39
Q

Name some side effects of phenytoin

A
  • gingival hyperplasia + bleeding
  • peripheral neuropathy
  • lymphadenopathy
  • megaloblastic anaemia
40
Q
A

PSA (1 decks)

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