Side Effects Flashcards by Naomi Cobbold

what should you not use in an asthmatic patient

adenosine (use verapamil as alternative)

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what anti hypertensive is a teratogen

ACEi

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side effect of ciclosporin

nephrotoxicity

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what can precipitate lithium toxicity

dehydration, renal failure, diuretics, ACEi, NSAIDs, metronidazole

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what can you get with tramadol

serotonin syndrome

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which anti seizure medication can cause erythema multiforme

carbamazepine

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which anti psychotic increases the risk of VTE

olanzapine

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SE beta blockers

bronchospasm, cold peripheries, fatigue, sleep disturbance

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what antibiotic should you not have with alcohol

metronidazole- causes a dilsurfiram type reaction- head and neck flushing, N&V, sweaty, headache etc

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what drugs can cause gingival hyperplasia

phenytoin, CCBs, ciclosporin, AML

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which cardio drug is associated with corneal opacities and optic neuritis

amiodarone

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which abx can cause a tendinopathy

cipro

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SE finasteride

gynaecomastia and sexual dysfunction

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what would the ABG show in aspirin OD

initial respiratory alkalosis due to stimulation respiratory centre then followed by metabolic acidosis leading to a mixed picture

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SE of bisphosphonates

oesophagitis, oesophageal ulcers, osteonecrosis of the jaw, increased risk fractures proximal femoral shaft

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what would you give in cellulitis if penicillin allergic

clarithro/clindamycin

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what antibiotics decrease the seizure threshold

quinolones- cipro, levofloxacin

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what is a side effect of ethambutol

optic neuritis

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what is the treatment of active TB

first phase 2 months- ethambutol, pyradimide, isoniazid, rifampicin. continuation phase (next 4 months)- rifampicin, isoniazid

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what is the treatment for eradication H pylori

PPI + amoxicillin + clarithromycin. or PPI + metronidazole +clarithromycin

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gentamicin, vancomycin

nephrotoxicity, ototoxicity

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any antibiotic

C dif colitis

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ACEi

hypotension, electrolyte abnormalities, AKI, dry cough

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B blockers

hypotension, bradycardia, wheeze, worsens acute heart failure

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CCB eg diltiazem

hypotension, bradycardia, peripheral oedema, flushing

diuretics

hypotension, electrolyte disturbances, AKI

heparin

haemorrhage (especially renal failure), heparin induced thrombocytopenia

aspirin

haemorrhage, peptic ulcers and gastritis, tinnitus

digoxin

N&V, blurred vision, confusion, drowsy, xanthopsia (disturbed yellow/green vision including halo)

amiodarone

ILD, thyroid dysfunction, skin greying, corneal deposits

lithium

early- tremor, intermed- tired, late- arrhytmia, seizures, coma, renal failure

haloperidol

dyskineasia

steroids side effects

stomach ulcers, thin skin, edema, right and left heart failure, osteoporosis, infection, diabetes, cushings syndrome

fludrocortisone

HTN, Na and H2O retention

NSAIDS

no urine (renal failure), systolic dysfunction (heart failure), asthma, indigestion, dyscrasia

statin

myalgia, abdominal pain, incr ALT/AST, rhabdomyolysis

side effects metformin

GI side effects, lactic acidosis

side effects sulfonylureas

hypoglycaemia, incr appetite and weight gain, SIADH, liver dysfunction

SE glitazones

weight gain, fluid retention, liver dysfunction (do LFTs), fractures

which NSAID is CI in cardio disease

diclofenac

what is the most common cause of drug induced angioedema

ACEi

what medication can cause a blue vision

viagra - sildenafil

which anti TB drug causes peripheral neuropathy

isoniazid

contraindications of sildenafil

patient taking nitrates, nicorandil, hypotension, recent stroke or MI

which anti diabetes drug is most likely to cause cholestasis

gliclazide

interactions amiodarone

decreases wafarin metabolism so incr conc and incr INR. increases digoxin levels

SE alpha blockers

postural hypotension, drowsy, SOB, cough

if tolerance develops to nitrates what should you do

give another dose isosorbide mononitrate after 8 hours instead of 12

SE ARBs

hypotension, hyperkalaemia. (candesartan, losartan)

side effects azathioprine

bone marrow depression, N&V, pancreatitis

when is metformin CI

when eGFR <30 and use with caution if <45

what anti diabetes can you use if CKD

gliclazide

what is the main CI for stimulant laxatives (senna, bisacodyl)

colitis/cramps

main CI for osmotic laxatives

bloating

what laxative can be used in bowel evacuation

sodium picosulfate

what can aminophylline cause at toxic levels

tachycardia and fatal tachyarrhthmyias

what do loop and thiazide diuretics do to K

lower it

when should diuretics be prescribed

not at nighttime`

when should ACEi be prescribed (lisinopril)

at night time to reduce the daytime postural hypotension

which anti emetic should be used with caution in Parkinsons patients

metoclopramide (dopamine antagonist). domperidone is a good choice as it does not cross the BBB

can simvastatin be taken in pregnancy

no- contraindicated

which antibiotic is used in C dif

metronidazole

when is gradual withdrawal of steroids necessary

received more than 40mg prednisolone daily for more than one week received more than 3 weeks treatment recently received repeated courses

which diuretic can cause gout

loop eg furosemide

what anti emetic can cause fluid retention and so shouldnt be used in heart failure

cyclizine

which anti emetic should be avoided in parkinsons

metoclopramide

what does hypokalaemia do to the effect of digoxin

augments it as it competes with K at Na/K ATPase and limits Ca in.

SE amiodarone

ILD, hyper and hypothyroidism, corneal deposits, skin greying

management INR > 8

vitamin K by slow IV injection

management INR 6-8 and no bleeding

withold 1-2 doses warfarin and restart at a lower dose

causes SIADH

malignancy (SCLC, prostate, pancreas), neuro (stroke, SAH, subdural, meningitis, abscess), drugs, infections (pneumonia, TB), porphyrias, PEEP

drugs causing SIADH

SSRIs, TCAs, cabamazepine, vincristine, cyclophosphamide, sulhponylureas

which types of antibiotics are associated with benign intracranial hypertension

tetracyclines/doxycycline

side effect pizotifen

weight gain

when is metformin CI

significant renal impairment or acutely unwell

what can cause urinary retention

morphine / opioids. anticholinergics (anti psychotics, anti depressants), anaesthetics, alpha agonists, benzos, NSAIDs, CCBs, anti histamines, alcohol

can metoclopramide cause confusion

yes

what can HRT do to BP

increase it- Na and water retention

drugs causing increase in BP

prednisolone, NSAIDs, venlafaxine

what is prochlorperazine

dopamine antagonist (anti psychotic)- can worsen parkinsons features

what drugs can cause constipation

codeine, ferrous sulfate

when is emergency contraception not required (if on regular medication and missed pills)

if taken 7 consecutive days worth of the pill then don't need emeregency contraception, but need to use alternative for the next7 days.

what CCBs should be avoided in heart failure patient

diltiazem, verapamil, nifedipine

what is the conversion of morphine PO to IM,SC,IV

10mg to 5mg

if miss one pill anywhere in the pack what should be done

just take the pill as soon as know and continue as normal. should be protected from pregnancy

what is eplerenone

K sparing diuretic

what anti depressant causes abnormal dreams

mirtazapine

oral abx for scarlet fever

phenoxymethylpenicillin

what should you give in oculogyric crisis

procyclidine

what dose is required for pred in exac COPD

30mg

what HRT can be used if don't want withdrawal bleeding

Evorel conti - contains estradiol and norethisterone, continuous so no withdrawal bleed

what is CI in PVD

B blockers as cause vasoconstriction

common triggers of psoriasis

b blockers, lithium, NSAIDs, ACEi

when should patient stop taking bisphosphonates

if start developing oesophageal reactions

drugs causing hyperprolactinaemia

phenothiazines eg prochloperazine, metoclopramide, domperidone

what can bendro do to Calcium

hypercalcaemia

what can contribute to lithium toxicity

NSAIDs causing renal impairment

side effects long term use of PPIs

osteoporosis, fractures and can mask gastric cancer

when are triptans CI

in cardiac disease- IHD

what illicit drugs can increase chance of VTE

opioids- heroin