Side Effects Flashcards
Haloperidol (in the elderly - side effects and alternative drug)
Parkinsonian like symptoms
Long QT
Lorazepam is preferred
Why should you not be on an NSAID and anticoagulant?
High risk of GI bleed, even if pt is on a PPI
List some potential complications of IV therapy
Phlebitis - infection of the vein which can lead to infection
Cannula site infection
Infiltration - drug has gone into periphery and not the vein
Extravasation - certain drugs cannot be given IV or peripherally
Overload
Speed shock - systemic reaction when substances introduced rapidly into circulation
Anaphylaxis / allergy
Poor technique
Incorrect administration
Drug incompatibilities
Contamination
Bisphosphonates - treatment length, reasoning and alternative
5-8 years - any longer will cause brittle bones
Pt should be swapped to Denosumab (as long as there are adequate vitamin D levels)
Side effects of anti-muscarinic drugs
Retention Constipation Dry eyes Dry mouth Confusion
L-DOPA
Orange / dark urine
What class of anti hypertensive medications should be avoided in MG?
Beta blockers
What is an electrolyte abnormality caused by PPIs?
Hyponatraemia
What two drugs are commonly started in hospital that cause hyponatraemia
Furosemide
PPIs
What is are some contra indication to anti TNF? (Usually withhold the dose)
Infection
Orthopaedic procedures
Which drugs can cause AKI? (HINT: think CANDA)
Contrast Aminoglycosides (gentamicin) NSAIDS Diuretics ACEi
What are the major side effects of steroids? (HINT: think STEROIDS)
Stomach ulcers Thin skin oEdema Right (and L) heart failure Osteoporosis Infection Diabetes cushing Syndrome
What is a potential side effect for any antihypertensive?
Hypotension - esp postural
List some of the side effects of beta blockers?
Bradycardia
Wheeze (asthmatics)
Worsening acute heart failure
Which two classes of antihypertensives can cause bradycardia?
Beta blockers
CCB
Which two classes of antihypertensives can cause electrolyte imbalances?
ACEi
Diuretics
What is a common side effect of ACEi?
Dry cough
List two common side effects of CCBs?
Peripheral oedema
Flushing
Name a serious potential side effect of diuretics?
Renal failure
List a potential side effect of loop diuretics such as furosemide?
Gout
List a potential side effect of potassium sparing diuretics such as spironolactone
Gynaecomastia
Which antibiotic should never be prescribed for patients on metheotrexate? Why?
Trimethoprim - folate antagonist therefore can cause BM toxicity (pancytopenia and neutropenia sepsis)
Which two classes of antihypertensives should not be prescribed together? Why? Give an example
CCB and B blockers
High risk of bradycardia
Verapamil and bisoprolol
What is the most serious side effect of clozapine?
Neutropenia (agrnaulocytosis leading to neutropenia sepsis)
Which drugs can causes neutropenia,
Clozapine
Carbimazole
Which drugs can cause thrombocytopenia?
Heparin
Penicillamine
Which drugs can cause hypovolaemkc hyponatraemia?
Diuretics
Which drugs can cause hypokalaemia?
Loop and thiazide diuretics
Which drugs can cause hyperkalaemia?
K sparing diuretics
ACEi
Which drugs can causes hepatitis
Paracetamol overdose
Statins
Rifampicin
Which drugs can cause cholestasis?
Flucloxacillin Co-amoxiclav Nitrofurantoin Steroids Sulphonylureas
If there are high serum levels of gentamicin, what should you do?
Reduce dose fq by 12 hours (ie dose ever 24 hours should become every 36 hours)
What are the common signs of digoxin toxicity?
Confusion
Nausea
Visual halos
Arrhythmia
What are the common signs of lithium toxicity?
Tremor Tiredness Arrhythmia Seizures Coma Renal failure DI
What are the common signs of phenytoin toxicity?
Gum hypertrophy Ataxia Nystagmus Peripheral neuropathy Teratogenicity
What are the common signs of gentamicin toxicity?
Ototoxicity (deafness)
Nephrotoxicity (AKI)
What are the common signs of vancomycin toxicity?
Ototoxicity (deafness)
Nephrotoxicity (AKI)
What are the three main steps when treating drug toxicity?
Stop the drug
Supportive treatment
Give antidote (if available)
Why should you not prescribe hypertensive patients both a CCB and a b-blocker?
Risk of bradycardia
Why should you not prescribe hypertensive patients both a b-blocker and a thiazide-like diuretic?
Risk of DM
List some of the major side effects of b-blcokers
Bronchospasm Bradycardia Hypotension Peripheral vasconstriction Nightmares
List some of the major side effects of a-blockers
Postural hypotension Dizziness Headache Urinary incontinence Blurred vision
List some of the major side effects of dihydropiridine CCBs
Flushing Headache Ankle oedema Dizziness Hypotension Gingival hypertrophy
List some fo the major side effects of non-dihydropiridine CCBs
Flushing Headache Ankle oedema AV block HF Constipation Gynaecomastia
List a common side effect of anti-arrhythmic drugs
Negative inotropic effect - i.e. decrease force of contraction
Name a serious side effect of Class III anti-arrhythmic drugs (K channel blockers such as amiodarone)
Can cause worsening of arrhythmias or new onset, esp torsade de pointes
Why should you not give nitrates with sildenafil (and similar drugs)?
High risk of hypotension
What are some of the side effects of nitrates
Postural hypotension Hypotension Headache Syncope Dizziness Flushing Reflex tachycardia
List some of the side effects of digoxin
Toxicity
Nausea
Gynaecomastia
Reverse tick ECG
List some of the side effects of aspirin
Gastritis
Gastric ulceration
Bleeding
Bronchospasm
List some of the side effects of clopidogrel
Bleeding
GI upset
Dyspepsia
List some of the side effects of statins
Myositis
Derranged LFTs
GI upset
List some of the side effects of short-acting b-agonists
Tachycardia
Tremor
List some of the side effects of short-acting muscarinic antagonists
Dry mouth (i.e. antimuscarinic effects)
List some of the side effects of theophylline
Nausea
Arrhythmias
Seizures
Hypokalaemia
List some of the side effects of antihistamines (Eg: certirizine, chlorphenamine)
Hypotension
Long QT
Drowsiness
List some of the side effects of lamotrigine
Rash –> SJS
List some of the side effects of carbamazepine
Rash Dysarthria Ataxia Nystagmus Low Na
List some of the side effects of phenytoin
Ataxia
Peripheral neuropathy
Gum hyperplasia
Hepatotoxicity
List some of the side effects of sodium valproate
Tremor
Teratogenic
Weight gain
Which T2DM drug is associated with lactic acidosis?
Metformin
What are the two classical side effects of vancomycin?
Nephrotoxicity
Ototoxicity
List some of the side effects of steroids (HINT: think STEROIDS)
Stomach ulcers Thin skin Edema Right (and left) heart failure Osteoporosis Infection Diabetes Syndrome - cushing's
List some of the side effects of NSAIDs (HINT: think NSAID)
No urine (renal failure) Systolic (low) dysfunction (heart failure) Asthma Indigestion Dyscrasia (clotting abnormality)
List the anti-cholinergic side effects
Dilated pupils Dry mouth Dry skin / lack of sweatting Blurred vision Urinary retention Constipation
List the anti-histaminergic side effects
Sedation
Postural hypotension
List the anti-alpha adrenergic side effects
Postural hypotension
Sexual dysfunction
List the anti-dopaminergic side effects
Extrapyramidal SEs
List the side effects of TB drugs
Rifampicin = orange secretions + hepatitis Isoniazid = neuropathy + hepatitis Pyrazinamide = hepatitis Ethambutol = optic neuritis
List the side effects of L-DOPA (HINT: think DOPAMINE)
Dyskinesia On/off phenomenon (motor fluctuations) Psychosis (schizophrenia-like symptoms, i.e. hallucinations) ABP - hypotension Mouth dryness Insomnia Nausea and vomiting (most common) Excessive daytime sleepiness
