Side Effects Flashcards
What are anti-cholinergic side effects?
- Dilated pupils
- Blurred vision
- Dry mouth
- Flushed skin
- Urinary retention
- Constipation
Eg. TCAs, antihistamines, hyposcine, atropine, antipsychotics, incontinence meds
What are anti-histaminergic side effects?
- Weight gain
- Sedation
eg. TCAs, anti-psychotics, antihistamines
What are anti-alpha-adrenergic side effects?
- Postural hypotension
- Sexual dysfunction
- Nasal congestion
- Headache
Eg. TCAs, antipsychotics, a-blockers
What are anti-dopaminergic side effects?
- Extrapyramidal side → tardive dyskinesias, parkinsonism
- Hyperprolactinaemia → galactorrhoea, oligomenorrhoea, subfertility
- Neuroleptic malignant syndrome
- Oculogyric crisis
Eg. metoclopramide, anti-psychotics
Rifampicin
- Orange-red tears/urine
- Hepatitis
Isoniazid
- Neuropathy
- Hepatitis
Pyrazinamide
- Gout
- Hepatitis
Ethambutol
- Colour blindness
- Optic neuritis
Phenytoin
- Toxicity (→ cerebellar syndrome)
- Acne
- Coarse face
- Gum hypertrophy
- Hirsuitism
- Inhibits COCP
Carbamazepine
- Rash
- Dizziness
- Hyponatraemia
- Hair thinning
- Inhibits COCP
Sodium Valproate
- Tremor
- Weight gain
- Hair thinning
- Teratogenic (avoid if child-bearing age)
Lamotrigine
Rash (Stevens-Johnson syndrome)
SSRI
Eg. fluoxetine, citalopram, sertraline
- Nausea
- Low libido
- Withdrawal
- Insomnia
- Hyponatraemia
TCAs
eg. amitryptiline
- Anti-cholinergic effects
- Anti-histaminergic effects
- Anti-a-adrenergic effects
- Hyponatraemia (SIADH)
- Arrhythmias
MAOIs
eg. selegiline
- Hypertension
- Hepatocellular jaundice
- Hyperthermia
ACEi
- Dry cough
- Postural hypotension
- Renal failure in renal artery stenosis (check U+Es before + 2wks after)
- Angioedema of tongue
- Hyperkalaemia
- Profound hypotension when started
CCBs
- Ankle oedema
- Headache
- Flushing
- Dizziness
B-blockers
- Diabetes risk
- Impotence
- Bradycardia
- Fatigue
- Cold peripheries
- Sleep disturbance
Alpha-blockers
- Postural hypotension
- Sexual dysfunction
- Nasal congestion
- Headache
ALL diuretics
- Dehydration
- Hypotension
- Hyperuricaemia
- Hypokalaemia (except K+ sparing)
- Hyponatraemia
- Hypomagnesaemia
Apart from the all diuretic side effects, what is one specific loop diuretic side effect?
- Hypocalcaemia
Used in treatment of hypercalcaemia
Apart from all diuretic side effects, what is a thiazide specific side effect?
- Hypercalcaemia
Apart from all diuretic side effects, what are K+ sparing specific side-effects?
- Hyperkalaemia
- Gynaecomastia
Sulfasalazine
- Myelosuppression
- Oligospermia
- Hepatitis
- Rashes (SJS, erythema nodosum)
- Renal problems
- Discoloured urine
Choloroquine
- Retinopathy
- Tinnitus
- Myopathy
Methotrexate
- Hepatic toxicity
- Pulmonary toxicity
- Myelosuppression
- Mucositis
TNF inhibitors (-mabs)
- Infusion rxns (anaphylaxis)
- Infections (TB reactivation)
- Autoimmune rxns
- Blood disorders
Cyclophosphamide
- Haemorrhagic cystitis
- Myelosuppression
- Alopecia
Insulin
- Hypoglycaemia
- Fat-hypertrophy at injection site
- Hypokalaemia (used in Rx of hyperkalaemia)
- Weight gain
Metformin
- Weight loss
- Lactic acidosis
- Metallic taste
- GI disturbance
- B12 deficiency
Sulphonylureas (gliclazide)
- Hypoglycaemia
- Weight gain
Thiazolidinediones (glitazones eg. pioglitazone)
- Fluid retention → HF, oedema
- Hepatotoxicity
- Fractures
DPP4 inhibitors (gliptins)
Pancreatitis
SGLT2 inhibitors (flozins)
- UTIs/thrush
- Ketoacidosis
- Weight loss
- May increase risk of amputations
What are side-effects of ALL antipsychotics?
- Anti-dopaminergic
- Anti-cholinergic
- Anti-histaminergic
- Anti-alpha-adrenergic
Clozapine
Agranulocytosis
Chlorpomazine
Cholestatic jaundice
Haloperidol
- Prolonged QT interval
- Interference w/ temp regulation
Lithium
- Toxicity (tremor/ataxia/dysarthria) → coma, convulsions, hypotension
- Diarrhoea
- Hypothyroidism
- Diabetes insipidus
Steroids
- Diabetes risk + hyperglycaemia
- Cushingoid appearance
- Psychosis
- Osteoporosis
- Hypokalaemia
- Infections + Leukocytosis
- Risk of avascular necrosis
Azathioprine
Myelosuppression
Ciclosporin
- Tremor
- Chronic interstitial nephritis
- Hypertrichosis
- Gum hyperplasia
- Burning sensation in hands/feet
Levodopa
- Nausea
- Red urine + other body fluids
- Postural hypotension
- Dyskinesias
- “on-off” and “wearing off” effects
PPIs
- Tinnitus
- GI disturbance
- Headache
- Hyponatraemia
- Hypomagnesaemia
Amiodarone
- Thyroiditis
- Pulmonary fibrosis
- Peripheral neuropathy
- Myopathy
- Blue-grey skin pigmentation
- Skin photosensitivity
- Hepatitis
- Metallic taste
Digoxin
Signs of toxicity:
- Xanthopsia (yellow/orange tinge to vision)
- GI distress
- Any arrhythmia
Adenosine
- Flushing
- Sense of impending doom