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