Section 6: Adverse drug reactions Flashcards
What are side effects of beta blockers?
Erectile dysfunction, bradycardia, fatigue, cold extremities, hyperkalemia
What are side effects of CCBs?
Ankle swelling (arterial vasodilation is unmatched by venous system), headache, flushing
What is the common electrolyte disturbance caused by diuretics?
Hypokalemia mostly, or hyperkalemia with K+ sparing diuretics e.g. spironolactone
What drugs cause gynaecomastia?
Ketoconazole, finasteride, spironolactone, dopamine antagonists, anti-retrovirals e.g. lamivudine (HBV), ritonavir (HIV), prednisolone, oestrogens, cimetidine
What drugs cause gum hypertrophy?
Phenytoin, ciclosporin, nifedipine, verapamil, diltiazem
What are the side effects from SSRIs?
S - sickness/ nausea
S - SIADH and hyponatremia
R - reduced libido
I - insomnia
What are the side effects of sulfalasazine?
Myelosuppression, hepatitis, rash, renal failure
What do you have to monitor in patients taking chloroquine and hydroxychloroquine?
Eye health. Patients have regular eye checks as retinopathy is a side effect.
What are the side effects of methotrexate?
Hepatotoxicity, pneumonitis, myelosuppression (MPH?)
What are some of the toxicities of chemotherapies?
Cisplatin = ototoxicity and nephrotoxicity Asparagine = neurotoxicity Bleomycin = hypersensitivity pneumonitis Vincristine = peripheral neuropathy Doxorubicin = cardiotoxicity Methotrexate = nephrotoxicity, myelosuppression Cyclophosphamide = bladder/ nephrotoxicity, SIADH
Which is the only TB drug that does not cause hepatitis and what are its side effects?
Ethambutol, optic neuritis
What antipsychotic causes QTc prolongation?
Haloperidol - halos for cuties
What are signs of digoxin toxicity?
Acute - nausea/ vomiting/ abdo pain, visual changes, tachycardia, confusion, irregular heartbeat/ VT/ VF/ SB/ PVCs, with ECG changes (reverse tick sign in ST segment) + hyperkalemia
Chronic - non specific symptoms
What is a common side effect of liraglutide?
This is a GLP1 analogue, and commonly causes GI symptoms e.g. nausea/ vomiting/ change in bowel habit/ anorexia.
What drugs reduce the contraceptive effect of oestrogens and progestogens?
These are metabolised by the liver, and accelerated by P450 inducers e.g. rifampicin
What is the first line treatment of antipsychotic-induced parkinsonism? e.g. haloperidol
Procyclidine hydrochloride 2.5mg PO 8 hourly/ TDS
Why do you monitor FBC for patients on methotrexate?
Risk of blood dyscrasias e.g. anaemia and leucopenia
What drugs can cause C. difficile colitis?
Most commonly broad spectrum antibiotics e.g. cephalosporins or ciprofloxacin
What are some early, intermediate and late effects of lithium toxicity?
Early: tremor
Intermediate: fatigue
Late: arrhythmias, seizures, renal failure, diabetes insipidus, coma
What drugs cause a disulfiram-like reaction to alcohol? i.e. nausea, vomiting, flushing, dizziness, headache, chest and abdominal discomfort
Metronidazole, cephalosporins, co-trimoxazole
Why do you avoid prescribing ACE inhibitors with NSAIDs, especially in elderly patients?
NSAIDs cause constriction of afferent renal vessels and can cause AKI, e.g AIN. ACE-is cause dilatation of efferent renal vessels and reduces GFR – exacerbates renal impairment, especialy in elderly.
What happens when methotrexate and trimethoprim are prescribed together?
Both are folate antagonists, and together may cause rapid BM suppression, pancytopenia, neutropenic sepsis. They are both nephrotoxic.
What asthma drug class most commonly causes dry mouth?
Muscarinic antagonists, short acting e.g. ipratropium or long acting e.g. tiotropium
What asthma drug can cause oral thrush?
Inhaled corticosteroids e.g. fluticasone, beclomethasone, budesonide
What drug classes cause falls?
Anticholinergics, antihypertensives, neuropathic painkillers, opioids, diuretics
What antibiotics are P450 inhibitors?
Macrolides e.g. erythromycin, clarithromycin
Fluoroquinolones e.g. ciprofloxacin
Sulfonamides
What are some symptoms of benzo withdrawal?
Tremor, anxiety, insomia
When do you lower dose of enoxaparin?
For patients <50kg and eGFR <30
