Side effects Flashcards
Penicillins
GI upset, C-diff due to broad action
10% have allergic reaction
Cephalosporins
GI upset, C-diff risk + risk of CNS toxicity and seizures
Trimethoprim
GI upset, rare hypersensitivity reactions
Can impair haematopoiesis - haematological disorders
Hyperkalaemia and raised plasma creatinine
Nitrofurantoin
GI upset, rare hypersensitivity reactions
Turns urine dark yellow/brown
Rare chronic pulmonary reactions, hepatitis and peripheral neuropathy
Neonates - haemolytic anaemia
Tetracyclines
GI upset, but amongst lowest risk for C-diff
Oesophageal irritation, ulceration, dysphagia, photosensitivity, tooth enamel discolouration
Aminoglycosides
Nephrotoxicity and Ototoxicity as they accumulate in renal tubular epithelial cells and cochlear/vestibular hari cells
Macrolides
GI upset when oral and thrombophlebitis when IV
Allergy, C-diff, QT prolongation and ototxicity
Quinolones
Generally well tolerated - GI upset and some delayed hypersensitivity reactions
Can have neurological effects, rupture muscle tendons, and prolong QT interval
Metronidazole
GI upset, hypersensitivity
At high doses - neuro effects, peripheral and optic neuropathy, seizures and encephalopathy
Glycopeptides
Thrombophlebitis, severe anaphylactoid reactions (Red man syndrome - due to non-specific degranulation of mast cells)
NSAIDs
GI toxicity, Renal Impairment, CV events, hypersensitivity and fluid retention
Codiene
Nausea, Constipation, dizziness, drowsiness, neurological and respiratory depression in overdose
Morphine
High dose = Resp and neuro depression, euphoria and detachment
Pupillary restriction, constipation,
Itching, urticaria, vasodilation and sweating - histamine release
Paracetamol
Generally very safe - lack of COX1 inhibition means no ulcers, RI or CV events
Xanthine Oxidase Inhibitors
Generally well tolerated but a skin rash could indicate a hypersensitivity reaction such as Stevens-Johnson syndrome
Alpha-Blockers
Postural Hypotension, dizziness and syncope
5-alpha-reductase Inhibitors
Anti-androgen effect can cause impotence, reduced libido, breast tenderness, hair growth - breast cancer reported
L-dopa
Any dopaminergic drug can cause drowsiness, nausea, confusion, hallucinations and hypotension
Phenytoin
Long term - skin coarsening, acne, hirsutism and gum hypertrophy
Dose related cerebellar toxicity and impaired cognition
Carbemazepine
GI upset, neurological effects, oedema and hyponatraemia
Antiepileptic hypersensitivity syndrome - Stevens Johnson syndrome
Sodium Valproate
GI upset, neurological/psychiatric effects, thrombocytopenia and increase in liver enzymes
Lamotrigine
Antiepileptic hypersensitivity syndrome
Levetiracetam
Nasopharyngitis, somnolence (Sleepiness), headache, fatigue and dizziness
Tricyclics
Dry mouth, constipation, urinary retention, blurred vision - muscarinic
Sedation and hypotension - H1 and a1 receptors
Arrythmias and ECG changes
SSRI’s
GI upset, appetite and weight disturbance, hypersensitivity and hyponatraemia
Can increase suicidal thoughts and behaviours
Serotonin syndrome - triad of autonomic hyperactivity, altered mental state and neuromuscular excitation
Benzodiazepines
Drowsiness, sedation and coma
Loss of airway reflexes
Withdrawal symptoms when stopped
Acetylcholinesterase inhibitors
Diarrhoea, muscle cramps, fatigue, nausea, vomiting and insomnia
Antacids
Diarrhoea + Constipation
H2 antagonists
Bowel disturbance, headaches and dizziness
PPI
GI disturbance and headaches, can reduce barrier against C-diff
Loperamide
Constipation
Laxatives
Abdo pain/cramps and diarrhoea
Aminosalicylates
GI upset and headache, can cause rare but serious blood disorders - leukopenia, thrombocytopenia and renal impairment
Antiemetics
Diarrhoea and can be extra-pyramidal symptoms
Loop diuretics
Dehydration, hypotension, loss of Na, K, Cl, Mg, Ca
Thiazide Diuretics
Hyponatraemia, hypokalaemia
Potassium Sparing Diuretics
Hyperkalaemia - muscle weakness, cardiac dysrhythmias
Gynaecomastia, liver impairent, jaundice and Stevens Johnson Syndrome
Beta-blockers
Fatigue, cold extremities, headache and GI disturbance
Bronchoconstriction
Calcium Blockers
Ankle swelling, flushing, headache, palpitations
ACE Inhibitors
Hypotension, cough, hyperkalaemia
AT1 Blockers
Hypotension, hyperkalaemia, renal failure
Nitrates
Flushing, headaches, light-headedness and hypotension
Cardiac Glycosides
Bradycardia, GI disturbance, rash, dizziness, visual disturbance
Low Therapeutic Range
Amiodarone
Few side effects acutely - hypotension during infusion
Chronically - Pneumonitis, bradycardia, AV block, hepatitis, photosensitivity and greying of skin
Aspirin
GI irritation, hypersensitivity reactions (bronchospasm), tinnitus
Clopidogrel
Bleeding, GI upset, rare = thrombocytopenia
Heparin
Bleeding and rarely thrombocytopenia
NOACs
Bleeding, back pain, dizziness, headache, menorrhagia,
Warfarin
Bleeding
Statins
Generally safe - headaches, GI upset or myopathy/ rhabdomyolosis
Beta-2-agonists
Tachycardia, palpitations, anxiety, tremor
Promote glycogenolysis - hyperglycaemia
Anticholinergics
Dry mouth
Corticosteroids
Increased catabolism can lead to proximal muscle wasting and skin thinning
Mood and behaivour changes, hypertension, hypokalaemia, oedema
Mucolytics
Anaphylaxis, allergic rashes and GI bleeding
Theophylline
Nausea, GI upset, Palpitations, Tachycardia, Arrythmias, Convulsions and headaches
Insulin
Hypoglycaemia - coma and death
Sulfonylureas
Weight gain due to anabolic nature of insulin which can lead to greater resistance
GI upset, hypoglycaemia, rare hypersensitivity reactions
Biguanides
Reduces weight gain
GI upset, lactic acidosis is rare,
Thyroxine
Similar effects to hyperthyroidism
Can precipitate cardiac ischaemia in those with coronary artery disease as increases HR and metabolism
Carbimazole
Nausea, headache arthralgia, GI upset, skin rashes, taste disturbance, fever, malaise
Bisphosphonates
Oesophagitis, hypophosphataemia, rare - osteonecrosis of the jaw
Calcium and Vit D
Oral calcium - dyspepsia and constipation
IV - Cardiovascular collapse if given too fast
Mineralicorticoids
Water retention, hypertension, hypokalaemia, weak bones, stomach ulcers, slow wound healing, thin skin, headaches and trouble sleeping
